Addressing Steroid Fear with Non-Steroidal Treatment Options in Psoriasis

In the concluding segment, Dr. Tina Bhutani-Jacques discusses the rationale for initiating tapinarof 1% cream in a patient with localized plaque psoriasis who is unwilling to use topical corticosteroids because of concerns about long-term adverse effects. She explains that tapinarof represents a newer generation of nonsteroidal topical therapies with improved tolerability, patient-friendly formulations, and demonstrated efficacy, making it an appropriate option for patients seeking steroid-sparing treatment. Dr. Bhutani-Jacques emphasizes the importance of helping patients feel optimistic about advances in psoriasis care and encouraging confidence in newer therapeutic options.

The discussion then focuses on practical strategies to support long-term treatment adherence in patients with intermittent disease and previous inconsistent treatment responses. Dr. Bhutani-Jacques recommends encouraging patients to apply tapinarof consistently once daily during active flares to achieve rapid disease control. She also explains that, once lesions have cleared, patients may either temporarily discontinue therapy or transition to a proactive management strategy by applying the medication a few days each week. This approach may help prolong periods of disease remission, reduce the frequency of future flares, and make long-term treatment feel more manageable for patients who may otherwise struggle with daily therapy indefinitely.

Finally, Dr. Bhutani-Jacques reviews her monitoring approach for patients receiving tapinarof. She recommends follow-up approximately every three months while disease remains active to assess treatment response, reinforce adherence, and provide guidance on long-term disease management. As patients achieve sustained disease control, follow-up intervals can be gradually extended to every six months or annually. The episode concludes by reinforcing the importance of individualized treatment plans, proactive maintenance strategies, and ongoing patient engagement to optimize long-term outcomes in plaque psoriasis.

In the next episode, "Why Patient-Reported Outcomes Matter in Psoriasis Care," Dr. Bhutani-Jacques closes the series by explaining what physicians should be asking patients beyond plaque counts - and her message to primary care colleagues about psoriasis care today.