Treatment of psoriasis is aimed at symptom relief and minimizing Koebner's phenomenon. After PUVA—psoralen (P) and long-wave ultraviolet radiation (UVA)—treatment for extensive, generalized disease, psoriatic vulvar plaques may remain due to inadequate phototherapy in this region (18). Thus, vulvar psoriasis may require separate treatment. This disorder often requires more aggressive and prolonged treatment than dermatitis.
For cases of limited disease, clinicians can attempt initial treatment with a low-potency topical corticosteroid, such as 1% hydrocortisone cream. However, when used as monotherapy, such drugs are seldom effective for disease control. Many cases can be treated successfully with a 14-day course of mid- to high-potency topical corticosteroid. Intralesional corticosteroids may be an alternative (13). Systemic steroids often produce a rebound flare-up of the disease and should be avoided.
Randomized, placebo-controlled studies have proven both topical tacroli-mus and pimecrolimus successful for treating generalized disease but not for vulvar psoriasis. Clinically, tacrolimus has been effective in treating psoriasis of the vulva.
Tazarotene, a retinoid, and calcipotreine, a topical vitamin D3 analog, are used to treat generalized psoriasis without the adverse effects of steroid treatment. These have not been studied specifically for use in vulvar disease.
Weak tar preparations, such as 3% liquor picis carbonis in aqueous cream, are possible alternatives. Generally, however, tar preparations are irritating to the vulvar skin and should be avoided.
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Do You Suffer From the Itching and Scaling of Psoriasis? Or the Chronic Agony of Psoriatic Arthritis? If so you are not ALONE! A whopping three percent of the world’s populations suffer from either condition! An incredible 56 million working hours are lost every year by psoriasis sufferers according to the National Psoriasis Foundation.