Treatment of a patient with psoriasis in the family doctor’s office

Psoriasis is a chronic, recurrent, inflammatory skin disease affecting approximately 1–3% of the world population. It is estimated that in about 80% of patients, psoriatic skin lesions are mild, and 20% are moderate to severe. According to estimates, approximately 5–30% of patients with psoriasis develop psoriatic arthritis. The method of treatment is mainly determined by the type and history of psoriasis and additional tests. Patients with psoriatic lesions of mild intensity can be treated only with topical medications, eventually combined with phototherapy. The most commonly used topical drugs include glucocorticosteroids, calcipotriol in combination with betamethasone, dithranol, tars and vitamin A derivates (tazarotene), calcineurin inhibitors. According to diagnostic and therapeutic recommendations of the Polish Dermatological Society, in topical therapy the most commonly used drug is the combination of calcipotriol and betamethasone. This combination is available in gel base, ointment and recently also foam, the latter galenic form is reimbursement in Poland from the 30 of September 2019. Patients with moderate to severe psoriasis should be treated with phototherapy, classic anti-psoriatic drugs (methotrexate, cyclosporine, acitretin), or biologics substances. The final decision regarding the use of a particular therapy is always made by the physician.