Treatment of Mild to Moderate Psoriasis

Introduction to Treatment

The American Academy of Dermatology recommends applying mometasone 0,1% cream once daily for 2 to 4 weeks, then switching to a maintenance treatment with a vitamin D analogue or a fixed combination calcipotriene/corticosteroid to avoid long-term side effects of corticosteroids 1, 2, 3

Apply a thin layer of mometasone 0,1% once daily to affected areas for 2 to 4 weeks, as recommended by the American Academy of Dermatology 1

In clinical studies, 58 to 92% of patients achieved excellent or good improvement after 2 to 4 weeks, according to Praxis Medical Insights 3

After the initial 2-4 week phase, it is imperative to modify the treatment to avoid side effects, as recommended by the American Academy of Dermatology and Praxis Medical Insights 1, 2, 3

Weeks 1-2: Mometasone 0,1% once daily, as recommended by the American Academy of Dermatology and Praxis Medical Insights 1, 3
Weeks 3-12: Calcipotriene alone or in fixed combination calcipotriene/betamethasone once daily, according to Praxis Medical Insights 2, 3
This approach reduces corticosteroid exposure while maintaining efficacy, as recommended by Praxis Medical Insights 2

Never use mometasone with calcipotriene simultaneously, as the acidic pH inactivates calcipotriene and reduces its efficacy, according to Praxis Medical Insights 2, 4

Skin atrophy, striae, telangiectasias (especially after 4 weeks of continuous use), as reported by the American Academy of Dermatology and Praxis Medical Insights 1, 3
Suppression of the hypothalamic-pituitary-adrenal axis possible with prolonged use, according to Praxis Medical Insights 3
Tachyphylaxis (loss of efficacy) may occur with continuous use, as reported by the American Academy of Dermatology 1

Use tacrolimus 0,1% ointment instead, applied twice daily for 8 weeks (81% complete clearance), as recommended by the American Academy of Dermatology 5
If using mometasone, limit to 2 weeks maximum and use a lower potency, according to Praxis Medical Insights 3

Prefer calcipotriene foam or gel calcipotriene/betamethasone for 4-12 weeks, as recommended by Praxis Medical Insights 2, 3

Mometasone alone has limited efficacy due to poor penetration, according to Praxis Medical Insights 4
Prefer combination calcipotriene/betamethasone or tazarotene 0,1% under occlusion, as recommended by the American Academy of Dermatology and Praxis Medical Insights 6, 4

If no improvement after 2 weeks, re-evaluate the diagnosis, as recommended by Praxis Medical Insights 2
If the affected area exceeds 10% of the body surface area, consider systemic treatment, according to Praxis Medical Insights 2
After disease control, gradually reduce the application frequency before stopping, as recommended by the American Academy of Dermatology 1
Average duration of remission after stopping: 2 months, as reported by the American Academy of Dermatology 1

Apply emollients after mometasone to avoid diluting the active medication, as recommended by Praxis Medical Insights 2
Emollients reduce itching, scaling, and extent of involvement for 4-8 weeks, according to Praxis Medical Insights 2
Can be applied 1 to 3 times daily, as recommended by the American Academy of Dermatology 7