INTRODUCTION
Therapeutic use of various systemic and topical modalities for psoriasis have been well studied and practiced by dermatologists worldwide.1 However, there is always a need for newer effective and convenient modes of therapies as the disease is relapsing and remitting, often recalcitrant to topical treatment and adversely affects the patient’s quality of life. Moreover, with increasing reports suggesting association of psoriasis with multiple co-morbidities, newer intralesional mode of drug administration is gaining popularity. We need a detailed discussion on these intralesional drugs with respect to their regimens and specific indications to ensure a patientcentric approach with minimum systemic adverse effects. In this article we review the various intralesional (IL) drugs which have been tried in psoriasis or are in the pipeline, along with their mechanism of action, dose and possible adverse effects.
MATERIALS AND METHODS
We undertook a comprehensive English literature search across multiple databases such as PubMed, SCOPUS, EMBASE, MEDLINE, and Cochrane using keywords (alone and in combination) and MeSH items such as “psoriasis†AND “intralesional†OR “treatment†OR “drugs†OR “administration†OR “therapy†to obtain several relevant articles, priority being given to prospective randomized controlled trials. We scanned all the relevant articles in English literature and summarized them to obtain the latest information about this molecule to prepare the current review article. The references of selected articles were scanned for more relevant articles. Articles in other languages were excluded from our search (Table 1).
Corticosteroids
Corticosteroids are potent anti-inflammatory agents used in topical or systemic form in various inflammatory disorders. The general rebound or flare up of the psoriatic lesions post systemic corticosteroids limits its usage in psoriasis. Topical corticosteroids have poor percutaneous absorption especially in the thick scaly plaques of scalp psoriasis and palmoplantar areas, they are therefore often used with keratolytic agents and occlusive dressings.2,4 Due to these drawbacks of systemic and topical corticosteroid therapy, intralesional therapy offers a new avenue of hope.
Corticosteroids
Corticosteroids are potent anti-inflammatory agents used in topical or systemic form in various inflammatory disorders. The general rebound or flare up of the psoriatic lesions post systemic corticosteroids limits its usage in psoriasis. Topical corticosteroids have poor percutaneous absorption especially in the thick scaly plaques of scalp psoriasis and palmoplantar areas, they are therefore often used with keratolytic agents and occlusive dressings.2,4 Due to these drawbacks of systemic and topical corticosteroid therapy, intralesional therapy offers a new avenue of hope.
