ABSTRACT
Psoriasis is one of the most common inflammatory human skin disorders, covering a broad range of clinical manifestations. These are influenced by individual factors, comorbidities, and comedication, which make therapeutic decisions complex and demanding. Local therapy may suffice in mild disease. As this makes up about two-thirds of the spectrum, topical agents are still important, even with the availability of efficient and well-tolerated systemic therapeutic modalities. Ample moisturizing of psoriatic skin is of upmost importance to support any specific treatment. Whereas tar products are still widely used, they are only reluctantly recommended by current therapy guidelines. Anthralin is an efficient and, with respect to disease-free interval, the most effective topical agent. Due to its unwanted effects, it is mainly used in a hospital setting. Corticosteroids and vitamin D analogues represent the main topical treatment and may efficiently be combined with each other and ultraviolet therapy. Although not licensed for psoriasis, topical calcineurin inhibitors are an alternative for corticosteroids, especially at sensitive sites like the face and skinfolds, as well as for sensitive populations like children, pregnant women, and the elderly. After years of standstill, novel topical agents like Janus kinase inhibitors are approaching the market and are currently examined in clinical studies.
