Factors impacting the combination of topical corticosteroid therapies for psoriasis: perspectives from the international psoriasis council

Corticosteroids are the mainstay of topical therapies for the treatment of mild to moderate psoriasis. Selection of vehicle, concentrations of corticosteroid and coadministered medications, and frequency of administration are critical factors that enhance bioavailability of topical corticosteroids. Topical corticosteroids are commonly used as polytherapy and combination therapy with other agents, such as salicylic acid, vitamin D analogues and tazarotene. Combinations are selected for the ability to enhance efficacy while minimizing corticosteroid-related side-effects, such as cutaneous atrophy. New, innovative products such as sprays, foams and nail lacquers provide opportunities to tailor treatment for individuals, which promotes patient adherence to medications. This review covers features of topical corticosteroid formulations that affect bioavailability, efficacy and safety when used as monotherapy and in combination with other agents for the treatment of mild to moderate psoriasis. Received: 13 December 2010; Accepted: 21 April 2011