Comparative Analysis of Topical versus Systemic Treatments in Managing Psoriasis — A Dermatologist’s Perspective

Abstract

Introduction: Psoriasis is a chronic inflammatory skin condition that significantly affects patients' quality of life due to its physical and psychological impact. Managing psoriasis requires a careful balance between efficacy and safety, as treatments range from topical applications for mild cases to systemic therapies for more severe presentations. This study aimed to compare topical vs. systemic treatments in managing psoriasis. Methods & Materials: The retrospective cross-sectional study was conducted in the Department of Dermatology in 250 Bedded District Sadar Hospital, Gopalganj, Bangladesh, from January 2023 to January 2024. The data was collected from the patient records of the hospital. Data analysis was performed using SPSS (version 26). Results: The study included mostly individuals aged 18–49 (75%) and showed no significant gender-based differences. Comorbidities, especially hypertension, were common (30%). Treatment was split evenly between topical and systemic approaches; topical treatments led to skin irritation (15%), while systemic ones were linked to gastrointestinal issues (10%) and liver enzyme elevations (7%). Moderate PASI improvement was achieved by 30%, with notable QoL gains of 25%. Treatment discontinuation (38%) was mainly due to a lack of efficacy and adverse effects. Conclusion: This study concludes that systemic treatments may provide better efficacy, especially for severe cases, while topical therapies are more prone to causing skin irritation. The findings highlight the importance of personalized treatment plans to balance efficacy, side effects, and quality of life for optimal psoriasis management.