Brief Answer: Methotrexate is a good option Detailed Answer: Hello and welcome to healthcaremagic I am Dr. Kakkar. I have gone through your query and I have uinderstood it. Psoriasis is an inflammatory skin disease characterised by well defined erythematous scaly plaques with silvery white or candle wax type of scaling. Chronic plaque psoriasis is the most common type. It can affect sites like scalp, arms, and legs (specifically elbows and knees), palms and soles etc Other types of psoriasis are: Erythrodermic psoriasis, Pustular psoriasis (generalised and localised), Nail psoriasis and Localized scalp psoriasis. The disease has a chronic course and there are topical creams/ointments/gels/lotions etc as well as oral and injectable medicines which can treat psoriasis but there is no permanent cure for psoriasis. Topical treatment: Moisturizers specially those which contain hygroscopic (attract water from the atmosphere and lock it into the skin) and keratoloytic agents like Ammonium lactate, Urea, Lactic acid etc are especially useful in dry scaly conditions like psoriasis. For the patches you could use a steroid+salicylic acid ointment, twice daily (clobetasol+3% OR 6% salicylic acid in an ointment base) over and above the moisturizer for 4 weeks. Other treatment modalities which can be used for localized plaque psoriasis are: Vit D analogues like calcipotriol, calcipotriene alone or in combination with steroid. Calcipotriol is available in both lotion form (for scalp psoriasis) as well as ointment form. Oral treatment: -Once weekly oral methotrexate is another option in case of plaque psoriasis but it should always be taken under the supervision of a dermatologist since it can rarely cause serious side effects like bone marrow suppression, therefore requires monitoring. Methotrexate is a good option and is very effective in all forms of psoriasis. It takes about 4-6 weeks for methotrexate to show noticeable improvement and can be given in weekly doses from as low as 7.5mg/week to 25mg/week. -Oral cyclosporine is given for extensive psoriasis involving more than 20% of the body surface area. It is rapidly effective but it requires monitoring of kidney functions and BP. Other commonly used oral treatment modalities are: -Oral Psoralens e.g 8-methoxypsoralen and UV A phototherapy (PUVA) -Narrow-Band phototharapy(NB-UVB) -Biologics response modifiers (BRMs) Topical treatment is an essential part of therapy along with oral treatment with methotrexate. I hope you will find this information useful. I am here to answer if you have any more questions/clarifications regards

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