Topical Nonsteroidal Agents for Psoriasis: Practical Integration with and without Topical Steroids

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, is joined by Omar Noor, MD, co-owner of Rao Dermatology in New York, NY, who shares his expertise on integrating nonsteroidal topical therapies into psoriasis treatment. As systemic therapies continue to advance, Dr Noor emphasizes the enduring importance of topical treatments with a focus on the aryl hydrocarbon receptor agonist, tapinarof.

They begin by discussing the role of newer nonsteroidal options for psoriasis like roflumilast and tapinarof, highlighting their benefits in contrast to corticosteroids, which, despite their effectiveness, can carry significant adverse effects. Dr Noor describes how he incorporates these treatments into his practice, starting with topical steroids in some cases and transitioning to nonsteroidal options as needed. Dr Noor’s approach allows for flexible treatment plans tailored to each patient’s response.

Dr Noor goes on to note that his experience with tapinarof aligns with emerging clinical data, showing effectiveness in challenging areas like the scalp with minimal adverse effects. He highlights that while contact dermatitis was observed in trials, it is rare in his practice, and proper patient education helps mitigate risks.

They then discuss the remittive effect that some patients achieve with tapinarof, thanks to its mechanism of action as an aryl hydrocarbon receptor agonist. This contrasts with corticosteroids, which are often seen as temporary solutions. He encourages health care providers to take the time to engage thoughtfully with patients, recognizing their investment in their care and the value of personalized attention and education.

Tune in to this episode for valuable insights on optimizing psoriasis treatment and improving patient care through effective use of nonsteroidal therapies and enhanced communication strategies.