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Psoriasis paradigm shift – use topicals, like Vitamin D – Aug 2021


Emerging paradigm shift towards proactive topical treatment of psoriasis: A narrative review

Dermatol Ther. 2021 Aug 21;e15104. doi: 10.1111/dth.15104 publisher rents the PDF for $16
Kim A Papp 1, Gurbir Dhadwal 2, Melinda Gooderham 3, Lyn Guenther 4, Irina Turchin 5, Marni Wiseman 6, Jensen Yeung 7

VitaminDWiki

Note by Founder of VitaminDWiki:
Topical Vitamin D works great for many skin problems, not just psoriasis. Vitamin D oil or nanoemulsion (2,000 IU per drop), and Vitamin D Aloe Cream (10,000 IU per pump) both work within days


Psoriasis (PsO) requires safe and effective long-term management to reduce the risk of recurrence and decrease the frequency of relapse. Topical PsO therapies are a cornerstone in the management of PsO though safety concerns limit the chronic, continuous use of topical corticosteroids and/or vitamin D3 analogues.

Evidence-based guidelines on optimal treatment targets and maintenance therapy regimens are currently lacking. This review explores the evidence supporting approaches to maintenance topical therapy for PsO including

  • continuous long-term therapy,
  • chronic intermittent use,
  • step-down therapy,
  • sequential or pulse therapy regimens, and
  • proactive maintenance therapy.

Several unaddressed questions are discussed including how and when to transition from acute to maintenance therapy, strategies for monitoring long-term treatment, the role of topical maintenance therapy in the context of systemic and biologic therapies, risks of maintenance therapy, prescribing a topical preparation suitable for patients' preferences and skin type, and key concepts for patient education to maximize long-term outcomes.
Overall, emerging evidence supports a paradigm shift towards proactive treatment once skin is completely clear as a strategy to enhance disease control without compromising safety.


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