Treatment of Facial Psoriasis, Genital Psoriasis, and Psoriasis of the Body Folds
Psoriasis involving the face, genitalia, or intertriginous (body fold) skin requires a distinctly different therapeutic approach from psoriasis on other body surfaces. The permeability and sensitivity of these sites mean that standard topical regimens used elsewhere are not appropriate here.
Clinical Scenario
This protocol is indicated for patients with psoriasis localised to one or more sensitive anatomical sites: the face (facial psoriasis), the genitalia, or the body folds (intertriginous skin). These locations share characteristics that preclude the use of the same agents recommended for plaque psoriasis on the trunk or limbs.
First-Line Treatment Approach
For these sensitive sites, topical calcineurin inhibitors are the recommended first-line class of therapy. The use of ultra-high-potency topical corticosteroids in the face, genitalia, and body folds is specifically avoided in this protocol.
The complete regimen — agent selection, alternatives, and the full clinical algorithm — is available in the structured protocol below.
References
DOI: 10.1016/j.jaad.2019.08.049
- Tacrolimus 0.1% ointment is recommended for off-label use as monotherapy for pediatric psoriasis of the face and genital region.
- The systematic review of pediatric psoriasis treatment by de Jager et al recommends TCIs as the preferred first-line therapy for psoriasis of the face, genitalia, and body folds and includes pimecrolimus, tacrolimus, and cyclosporine.
- It is advisable to avoid the use of ultra-high-potency topical corticosteroids in the face, fold, and genitalia of infants and children.
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