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One of these statements about the treatment of psoriasis is false – which is it?
- Treatment is often selected on the basis of disease severity, patient preference, relevant comorbidities and efficacy
- Mild-to-moderate psoriasis is often managed by topical therapy
- More than half of patients find their treatment highly satisfactory
- Psoriasis affecting the hands, feet and face warrants more aggressive treatment
Which of these statements about topical therapy is false?
- The adverse effects of topical steroids on skin thickness are less of a concern on areas such as the scalp, palms and soles
- The standard dithranol regimen is to apply progressively reducing concentrations, from 2% to 0.5%, on a daily basis
- Topical steroids may be associated with tachyphylaxis
- Dithranol is not recommended for the treatment of acute psoriasis
Which of these statements about topical vitamin D analogues is false?
- They may cause hypercalcaemia
- Calcipotriol has been shown to be more effective than topical fluocinonide in the treatment of plaque psoriasis
- Calcitriol is thought to be less irritant than tacalcitol when applied to the face
- Vitamin D analogues should not be combined with phototherapy
One of these statements about narrowband UVB (nUVB) is false – which is it?
- It is the phototherapy of choice for psoriasis
- The spectrum of nUVB is 350nm
- Patients do not have to wear eye protection during treatment
- It can be used during pregnancy
One of these statements about phototherapy is false – which is it?
- Prolonged PUVA therapy is associated with an increased risk of nonmelanoma skin cancer
- nUVB is administered three times a week
- Laser with a wavelength of 308nm can be targeted at affected skin, reducing the risk to uninvolved skin
- Most patients achieve remission after treatment with nUVB so one course of treatment is usually sufficient
Regarding the treatment of psoriasis with methotrexate, which one of these statements is false?
- It must be given by iv infusion
- It is indicated for recalcitrant disease unresponsive to topical or phototherapy
- Folic acid supplementation reduces nausea
- Regular liver function tests are required during treatment
Regarding the treatment of psoriasis with oral retinoids, which one of these statements is false?
- They are more effective for chronic plaque psoriasis than pustular or erythrodermic psoriasis
- Combination with PUVA or UVB allows dose reduction to reduce the incidence of adverse effects
- They are teratogenic
- They may cause mucocutaneous dryness and alopecia
Regarding the treatment of psoriasis with immunosuppressants, which one of these statements is false?
- Loss of renal function associated with ciclosporin can be prevented by treatment with a calcium channel blocker
- Ciclosporin is an inappropriate choice for short-term control because its onset of action is too slow
- Mycophenolate mofetil is not licensed for the treatment of severe psoriasis
- Fumaric acid derivatives may cause flushing
Which one of these statements about treating psoriasis with biological agents is false?
- Adalimumab, infliximab and etanercept target tumour necrosis factor
- Ustekinumab is a monoclonal antibody that targets IL-12 and IL-23
- Etanercept acts more quickly than infliximab and adalimumab
- Treatment with biological agents should be continued only when an adequate response has been demonstrated after a period of 10-16 weeks (depending on the agent)
One of these statements about biological agents in the treatment of psoriasis is false – which is it?
- A history of psoriatic arthritis predicts a poorer response to ustekinumab
- Anti-TNF agents may reactivate latent tuberculosis
- Patients who do not respond to one biological agent will rarely benefit from a second
- 19 per cent of patients develop antibodies to infliximab during treatment and this impairs its efficacy

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