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
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.
Psoriasis in VitaminDWiki
Some of the- Psoriasis is most strongly associated with low vitamin D (15 things were evaluated) – July 2022
- Long-term Psoriasis cured by 30,000 to 60,000 IU of Vitamin D daily (pictures and video) – early 2022
- Psoriasis paradigm shift – use topicals, like Vitamin D – Aug 2021
- Low Vitamin D plus psoriasis equals 8 times more likely to die – Dec 2020
- UV has treated psoriasis for over a century, guidelines finally agreed upon – Aug 2019
- Psoriasis severity associated with low vitamin D (10 studies) – meta-analysis Jan 2018
- Psoriasis reduced for those getting Vitamin D levels above 50 ng – RCT Feb 2018
- 35,000 IU vitamin D daily for 6 months helped ALL psoriasis suffers (106 ng) – Brazil March 2013
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