Calcipotriene is reported to be effective as a steroid sparing medication. Minimal alterations in calcium metabolism occur when no more than 100 g per week are used by the patient. Systemic Modalities Used in the Treatment of Psoriasis Systemic modalities are available for the treatment of more extensive disease. These agents may be used on a rotational basis or in combination with one another. These treatments should be administered by knowledgeable physicians to avoid unnecessary UV exposure, which could result in burns and skin carcinogenesis.
Dermatologic literature continues to recommend a liver biopsy at various intervals.
The typical dose is 10 to 30 mg weekly. Etretinate is an oral retinoid of use in patients with erythrodermic, pustular, and acral psoriasis. Etretinate is not as useful in the treatment of extensive chronic plaque type psoriasis. Side effects include cheilitis, conjunctivitis, thinning hair, lipid elevation, hepatotoxicity, and teratogenicity. However, cyclosporine has been used as first-line treatment in those patients with widespread inflammatory lesions or erythrodermic psoriasis.