Medical Advisory Board: Dr. Ram Dandillaya, Clinical Chief, Cardiology, Cedars-Sinai; Dr. Antonio J. Forte, Faculty, Mayo Clinic; Dr. John J. Lee, Faculty, Harvard Medical School; Dr. Daniel Kahneman, Nobel Prize Laureate. OpenEvidence is a Mayo Clinic Platform Accelerate Company.

Answered on June 5, 2023

The most effective treatments for psoriasis depend on the type, severity, and extent of the disease, as well as patient preferences and comorbidities. Current treatment options include topical agents, phototherapy, systemic therapies, biologic agents, and small molecule inhibitors.[1-4]
Topical treatments, such as vitamin D analogues and corticosteroids, are commonly used for mild psoriasis.[1] Phototherapy, including narrowband ultraviolet B radiation (NB-UVB) and psoralen and ultraviolet A radiation (PUVA), is another option for moderate to severe cases.[1] Systemic therapies, such as methotrexate, ciclosporin, and acitretin, can be used for more severe or extensive disease.[1]
Biologic agents, including tumor necrosis factor (TNF), interleukin (IL)-17, and IL-23 inhibitors, have revolutionized the treatment of moderate to severe psoriasis and psoriatic arthritis.[1][3] Small molecule inhibitors, such as dimethyl fumarate and apremilast, are also available for treating psoriasis.[1]
Nutritional supplementation and lifestyle modifications can also play a role in psoriasis management. Randomized controlled trials have shown the effectiveness of topical vitamin A and D derivatives, intravenous ω-3 fatty acids, oral inositol, and various combined therapies.[5] Additionally, reducing alcohol consumption, smoking, and stress, as well as maintaining a healthy weight, may help improve psoriasis symptoms.[2]
In summary, the most effective treatments for psoriasis depend on individual patient factors and may include a combination of topical agents, phototherapy, systemic therapies, biologic agents, small molecule inhibitors, and lifestyle modifications.

References

1.Raharja A, Mahil SK, Barker JN. Psoriasis: A Brief Overview. Clinical Medicine (London, England). 2021;21(3):170-173. doi:10.7861/clinmed.2021-0257.
2.Albaghdadi A. Current and Under Development Treatment Modalities of Psoriasis: A Review. Endocrine, Metabolic & Immune Disorders Drug Targets. 2017;17(3):189-199. doi:10.2174/1871530317666170804153751.
3.Lebwohl M. Psoriasis. Annals of Internal Medicine. 2018;168(7):ITC49-ITC64. doi:10.7326/AITC201804030.
4.Ramanunny AK, Wadhwa S, Singh SK, et al. Treatment Strategies Against Psoriasis: Principle, Perspectives and Practices. Current Drug Delivery. 2020;17(1):52-73. doi:10.2174/1567201816666191120120551.
5.Ricketts JR, Rothe MJ, Grant-Kels JM. Nutrition and Psoriasis. Clinics in Dermatology. 2010 Nov-Dec;28(6):615-26. doi:10.1016/j.clindermatol.2010.03.027.

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