KENNETH GORDON, MD: I think the goal of treatment for psoriasis really has to be determined by the patient. Each patient has different goals and different things they're looking for. Clearance, really, complete clearance of psoriasis is really not the ultimate goal, because very few patients become completely clear and free of their disease. What you want to do is control it to the point where the patient can be satisfied and go out and do their activities of daily living in a way that's satisfactory to the patient. For each patient, that level is going to be different.
MABEL JONG: Let's talk a little bit now about the treatments. A lot of topical medications are available, Dr. Lebwohl?
MARK LEBWOHL, MD: There are dozens, if not actually hundreds of topical medications, but they fall into a small number of categories. Until recently, certainly, the most commonly prescribed treatment for psoriasis was topical corticosteroids, and there are probably several hundred, or at least 100 of those available worldwide. And they range in strength from very weak to very strong. They come in lotions, solutions, creams, emollient creams, ointments. As a rough rule, the messier they are, the more effective they are, so that ointments are more effective than creams.
There are some old-fashioned treatments that are derived from tar. Tars themselves that are used are anthralin, which is a rather messy treatment that is available for psoriasis.
MABEL JONG: For the topical medications, do you need prescriptions for all of these?
