Combined topical calcipotriene ointment 0.005% and various systemic therapies in the treatment of plaque-type psoriasis vulgaris : Review of the literature and results of a survey sent to 100 dermatologists

Plaque-type psoriasis may at times require systemic therapy. There are limited data as to whether topical calcipotriene ointment 0.005% can be used to increase the efficacy and improve the risk/benefit ratio of concurrent systemic antipsoriatic therapy. We attempt to answer this question by means of a literature review and results of a written survey that was sent to 100 international psoriasis treatment experts. The survey was sent to academic and psoriasis treatment center-based dermatologists who treat approximately 3000 to 4000 patients with psoriasis per month. The survey requested that dermatologists relate their experience regarding the safety and efficacy of topical, systemic, and combined topical/systemic agents in psoriasis after 8 weeks of therapy. The results of the survey support the experience in the literature regarding the favorable use of calcipotriene ointment combined with systemic therapy for the treatment of psoriasis. Combination therapy with calcipotriene ointment and acitretin/etretinate, cyclosporine, methotrexate, or phototherapy usually enhances efficacy while improving the risk/benefit ratio by decreasing exposure to the potentially hazardous systemic agent.