Treatments

Goals of therapy for psoriasis include the following:

Pursue clearance of skin symptoms.
- PASI 75 has been the gold standard, but with some of the newer biologics, PASI 90/100 is possible
Enhance quality of life and minimize day-to-day psoriasis burden.
Minimize adverse events through individualization of therapy.
Minimize comorbid disease burden.
Maintain patient involvement.

Psoriasis Treatments

Psoriasis treatments include:

Biologics
- TNF-alpha blockers
  - Certolizumab pegol (psoriatic arthritis)
  - Etanercept
  - Adalimumab
  - Infliximab
  - Golimumab (psoriatic arthritis)
- IL 12/23 blocker
  - Ustekinumab
- IL-17A blockers
  - Ixekizumab
  - Secukinumab
- IL-17 receptor blockers
  - Brodalumab
- Systemics
- Acitretin
- Apremilast
- Cyclosporine
- Methotrexate
Phototherapy
- Ultraviolet light B (UVB)
- Sunlight
- Psoralen + UVA (PUVA)
- Laser treatments
- Tanning beds
Topicals (for mild psoriasis)
- Over-the-counter agents
- Topical steroids
- Calcipotriene with or without betamethasone
- Tazarotene
- Calcitriol
- Anthralin
Complementary and alternative therapies
- Diet and nutrition
- Herbal remedies
- Mind/body therapies
- Alternative therapies
- Exercise/yoga/tai chi

Biologic agents are typically targeted to moderate-to-severe psoriasis and are given by injection or intravenous (IV) infusion. These agents are protein-based molecules derived from cell culture and in contract to systemic agents, target specific parts of the immune system such as tumor necrosis factor-alpha (TNF-alpha), IL-17A, or IL-12/IL-23. Each of these cytokines plays a significant role in developing psoriasis and psoriatic arthritis.