Clearance is not a realistic expectation of psoriasis treatment

Background: Psoriasis is a disease with many manifestations for which numerous treatments are available. Objective: The purpose of this article is to assess whether complete clearance is a realistic expectation given the currently available treatments for psoriasis. Methods: Clinical trials of the treatment of psoriasis were identified from the medical literature, and the reported rates of clearance were compared. Results: The percentage of patients who experienced complete clearing of their psoriasis varied with the different monotherapy treatments from 2% with tazarotene gel to a maximum of 86% with narrow-band UVB. Combinations of systemic retinoids (etretinate, acitretin) and photochemotherapy (PUVA) attained the maximum reported clearance rate as combination therapy. Conclusion: The new treatments available for psoriasis give physicians new opportunity to control the severity of psoriasis. Despite the availability of novel treatments for psoriasis, complete clearing of psoriasis is obviously not a realistic expectation of topical treatment. Phototherapy and systemic therapy provide greater improvement, but studies rarely report complete clearing of the disease as an endpoint. At this time, optimal therapy consists of using combinations of different treatments to obtain short-term improvement and long-term control of the disease.