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Topical Therapies for Psoriasis: Improving Management Strategies and Patient Adherence

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CME/CE-Certified Supplement:
Earn up to 2.5 AMA PRA Category 1 Credits
3.0 Nursing Contact Hours

Activity Information

Original Release Date: March 2016
Most Recent Review Date: March 2016
Expiration Date: February 28, 2018
Estimated Time to Complete Activity: 2.5 hours

Jointly provided by:


This activity is supported by an educational grant from:
LEO Pharma Inc.

Method of Participation

Participants should read the activity information, review the activity in its entirety, and complete the online post-test and evaluation. Upon completing this activity as designed and achieving a passing score on the post-test, you will be directed to a Web page that will allow you to receive your certificate of credit via e-mail or you may print it out at that time. Scroll down to the bottom of this page and “Begin the Activity”. You will be able to claim your credit upon completion of the activity.

Inquiries about CME/CE accreditation may be directed to the University of Louisville Office of CME & PD at or (502)852-5329 or to Global Academy for Medical Education at

Target Audience

This journal supplement is intended for dermatologists, family practitioners, internists, nurse practitioners, physician assistants, and other clinicians who treat patients with psoriasis.

Educational Needs

Psoriasis is a distressing, chronic inflammatory disease characterized by thickened, scaly, erythematous plaques on the body and scalp. It is estimated that 7 million Americans—about 2% of the population—are affected with psoriasis. Most patients with psoriasis have localized disease that is manageable by topical therapy alone.

Despite a range of effective therapies being available, many patients are not receiving appropriate treatment. A National Psoriasis Foundation survey showed that a large proportion of patients with mild to moderate psoriasis were dissatisfied with the treatments they had received, and one-third of patients did not use psoriasis medications as directed.

Currently approved topical treatments for psoriasis include prescription medications such as corticosteroids (most commonly used), vitamin D derivatives, vitamin A derivatives (tazarotene), anthralin, tacrolimus, and pimecrolimus, and over-the-counter (OTC) topicals such as salicylic acid and tar. To be effective, topical treatments must be prescribed in sufficient quantities calculated according to the patient’s body surface area (BSA) and used consistently, and consideration must be given to the choice of vehicle (ointment, cream, lotion, gel, or foam). All of these factors are important in patient adherence and, therefore, drug efficacy.

The availability of new topical drugs for mild to moderate psoriasis and newer vehicles has broadened the landscape of psoriasis management, offering additional treatment options for patients. These advances, however, complicate treatment decision making and present a variety of challenges for health care professionals. Clinicians must be able to effectively and safely use topical therapies. They must be able to evaluate and analyze recent clinical data on new and emerging molecules, and new formulations and vehicles that may improve patient adherence. In addition, they must be knowledgeable about how best to integrate these therapies into their practice to optimize clinical outcomes while improving patient adherence.

This supplement focuses on current and emerging topical treatment options for mild to moderate psoriasis with discussions on efficacy, safety, and strategies to minimize side effects. An overview of the effect of drug vehicles on treatment efficacy, medication safety, and patient preferences is presented, and practical approaches for optimizing patient outcomes are offered. In particular, strategies for improving patient adherence to medications are addressed.

Learning Objectives

After reading and studying this journal supplement, participants should be better able to:

  • Interpret and evaluate emerging clinical trial data related to the use of new molecules and new formulations of topical treatments used in mild to moderate psoriasis.
  • Discuss topical treatments for psoriasis, including corticosteroids and nonsteroidal topical agents (such as those containing vitamin D, topical immunomodulators, and tar).
  • Explain the role of the vehicle in topical drug delivery and patient adherence.
  • Discuss four key issues—quantity of medication prescribed, vehicle type, adverse events, and allergic reactions—that can affect patients’ acceptance and use of topical therapies.

Accreditation Statements

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The University of Louisville and Global Academy for Medical Education, LLC. The University of Louisville is accredited by the ACCME to provide continuing medical education for physicians.

The University of Louisville Office of Continuing Medical Education & Professional Development designates this enduring material for a maximum of 2.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This program has been approved by the Kentucky Board of Nursing for 3.0 contact hours through the University of Louisville Hospital, provider number 4-0068-7-16-820. The Kentucky Board of Nursing approval of an individual nursing education provider does not constitute endorsement of program content. Participants must complete the entire session, provide their license number, and complete the evaluation to receive contact hours.

Guest Editor

Linda F. Stein Gold, MD
Director of Dermatology Research
Henry Ford Health System
Detroit, Michigan

Disclosure Declarations

As a provider accredited by the ACCME, the Office of CME & PD, School of Medicine, University of Louisville must ensure balance, independence, objectivity, and scientific rigor in all its sponsored educational activities. All planners, faculty, reviewers, and other persons that affected the content of this CME activity were required to submit a financial disclosure form from which relevant conflicts of interest were determined. The persons below disclosed the following:

Linda F. Stein Gold, MD, Consultant: Anacor Pharmaceuticals, Eli Lilly and Company, Galderma Laboratories, L.P., LEO Pharma Inc., Novartis Pharmaceuticals Corporation, Pfizer Inc., Sandoz, Taro Pharmaceutical Industries Ltd., and Valeant Pharmaceuticals North America LLC. Speaker: Galderma, LEO, Novartis, and Valeant. Grant Research/Support: Anacor, Galderma, GlaxoSmithKline, LEO, Novartis, Pfizer, Sandoz, Taro, and Valeant.

CME Content Peer Reviewer: Timothy S. Brown, MD, University of Louisville, has no relevant financial relationships to disclose.

The CME & PD Staff and Advisory Board have nothing to disclose with the exception of Douglas Coldwell, MD, Speaker: Sirtex, Inc.; Consultant: DFINE, Inc. Global Academy for Medical Education Staff: Sylvia H. Reitman, MBA, DipEd; Shirley V. Jones, MBA; Jenny Campano; and Jayashree Gokhale, PhD, have no relevant financial relationships to disclose.

Off-Label/Investigational Use Disclosure

This activity discusses the off-label use of the immunomodulators tacrolimus and pimecrolimus for psoriasis, which are US Food and Drug Administration (FDA) approved for atopic dermatitis. In 2005, the FDA issued an alert about a possible link between these agents and lymphoma and skin cancer in children, and placed a black box warning in the prescribing information in 2006.

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Seminars in Cutaneous Medicine and Surgery
Supplement to Dermatology News

Contact Information for Technical Questions

Please technical questions or concerns to Global Academy for Medical Education at 973-290-8225 or email


Publication copyright © 2016 by Global Academy for Medical Education, LLC. And Frontline Medical Communications Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the Publisher. Printed in the United States of America.

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