Overview of psoriasis therapy used by dermatologists

If psoriasis therapy available in primary care is not effective, refer to a dermatologist for consideration of specialist treatments. General practitioners who suspect a patient will need biological therapy (eg significant psychological distress, severe or extensive disease, disease on face, disease on hands or feet) should refer early for dermatologist advice.

Specialist treatments used by dermatologists include:

• narrowband ultraviolet B phototherapy
• methotrexate
• acitretin
• apremilast
• ciclosporin
• biological therapy.

Biological therapy may be subsidised by the Pharmaceutical Benefits Scheme (PBS) if specific criteria are met¹.

Topical dithranol has an antiproliferative effect on psoriatic skin, but is rarely used because it can burn unaffected skin, and stain clothes and skin.