What Is the First-Line Treatment for Plaque Psoriasis?

This protocol addresses the initial treatment of plaque psoriasis. First-line management targets improvement and clearance of plaques, with clinical response expected at 2 to 4 weeks.

Clinical Goal

Improvement and clearance of plaque psoriasis at 2 to 4 weeks.

Treatment Approach

Initial management centers on topical corticosteroids, with potency selection guided by the nature of the affected plaques. The complete selection criteria, site-specific guidance, and full treatment schedule are contained in the structured protocol.

References

DOI: 10.1016/j.jaad.2020.07.087

  • In adults, corticosteroids in classes 2 through 5 (moderate to high potency; Table II) are generally recommended as initial therapy.
  • Areas with thick, chronic plaques often require treatment with class 1 (ultrahigh-potency) corticosteroids.
  • The use of class 1, class 2, and class 3-5 topical corticosteroids for up to 4 weeks is recommended for the treatment of plaque psoriasis not involving intertriginous areas.
  • In numerous randomized controlled trials (RCTs), different potency topical corticosteroids were effective and safe at 2 to 4 weeks in the treatment of mild to severe plaque psoriasis.
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