Psoriasis is a chronic inflammatory
skin disease that affects millions of people in the United States as well as worldwide. While there is currently no cure for
psoriasis, many treatment options are available. Topical
therapies are the mainstay for the majority of patients who have limited or mild
psoriasis. Among these medications, topical
vitamin D analogs (eg,
calcipotriene) and
corticosteroids (eg,
betamethasone), and these drugs in combination, are the most widely prescribed
psoriasis drugs and are the cornerstone of topical
therapies. For patients with more severe disease,
phototherapy, conventional systemic agents, and biologics are often indicated. Currently, the goal of treatment is to control the clinical symptoms of the skin, reduce systemic disease potential, and improve the patient's quality of life. Despite the availability of various therapeutic options for
psoriasis, many patients go untreated, and even among those who are treated, many do not achieve complete resolution of the disease. The new consensus is to treat to a target of 1% or less of body surface area involvement. Innovative treatment strategies are needed to meet this goal and patients' desire to achieve clear skin. Combination
therapies are widely used by physicians, and adjunctive topical
therapies used with other antipsoriatic regimens have been demonstrated to provide many clinical benefits. This article reviews the most recently published clinical evidence of adjunctive use of topical agents with biologics, conventional systemic agents, and
phototherapy, to better establish the role of topical agents in combination
therapy for the treatment of
psoriasis.