Why One Foam Works for Scalp and Body Psoriasis

In this segment, Dr. Tina Bhutani-Jacques expands on the rationale for selecting roflumilast 0.3% foam for a patient with plaque psoriasis affecting both the scalp and body. She explains that one of the patient's greatest challenges was managing multiple topical therapies for different body sites, resulting in confusion, inconsistent adherence, and ongoing disease burden. Dr. Bhutani-Jacques emphasizes that the availability of a single, once-daily foam approved for use on both the scalp and body simplifies treatment, improves convenience, and addresses many of the practical barriers that commonly limit adherence in clinical practice.

Dr. Bhutani-Jacques also discusses the importance of identifying the underlying reasons for poor adherence before changing therapy. She encourages clinicians to explore whether patients struggled because of cosmetic concerns, difficulty remembering multiple medications, dissatisfaction with treatment efficacy, or challenges related to vehicle formulation. By understanding these barriers, clinicians can better individualize treatment and select therapies that align with each patient's preferences and lifestyle. She notes that simplifying the treatment regimen can significantly improve adherence and ultimately lead to better long-term disease control.

The discussion concludes with practical guidance on monitoring patients after initiating a nonsteroidal topical therapy. Dr. Bhutani-Jacques recommends close follow-up at approximately three and six months to assess treatment response, adherence, and any ongoing concerns before extending visit intervals for patients with well-controlled disease. She also emphasizes that patients who continue to have inadequate disease control, poor adherence despite optimized topical therapy, or extensive disease involving high-impact areas should be reevaluated for escalation to systemic therapy. This patient-centered approach highlights the importance of ongoing assessment and individualized treatment planning to optimize outcomes in plaque psoriasis.

In the next episode, "Case 3: Redefining How We Classify Psoriasis Severity," Dr. Bhutani-Jacques turns to Case 3, a patient with limited but stubborn psoriasis who's determined to avoid topical steroids altogether - prompting a look at how severity itself gets defined.