Psoriasis: utilising the treatment options.

Psoriasis varies so much in severity and clinical pattern that there is no 'best' treatment. Topical treatment with dithranol, tar or wisely used corticosteroids is preferable to systemic treatment, except in severe forms of psoriasis where systemic corticosteroids or antimitotic drugs, especially methotrexate, may be necessary. Photochemotherapy with PUVA has come to stay and can certainly be used as first-line treatment in those with extensive plaque psoriasis who are over 60 years of age. Its role in treating younger patients is still being asssssed, particularly with regard to possible long term side effects, but it is likely that eventually its use will be extended.