Severe plaque psoriasis

Chronic psoriasis involving more than 10% body surface area or affecting functionally important sites (face, palms, soles, genitals), refractory to topical therapy. Requires systemic immunosuppression, phototherapy or biologic agents.

ICD-10 L40.01 drug

Also known as: Extensive plaque psoriasis

Drugs used for this condition

ACiclosporinSecond line · Immunosuppressants. Calcineurin inhibitorsCyclosporine is used in severe psoriasis when topical therapy and phototherapy are insufficient. The effect develops in 4–8 weeks, achieving PASI 50 in 70–80% of patients. Course is limited to 1–2 years due to cumulative nephrotoxicity; after that, retinoids, methotrexate or biologics are used. NICE and the Russian Ministry of Health classify cyclosporine as a standard systemic option for severe psoriasis.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit