Table 74Possible sequences of first, second and third line treatment

First lineSecond lineThird line
Vitamin D or vitamin D analogue ODVitamin D or vitamin D analogue ODCombined product containing calcipotriol monohydrate and betamethasone dipropionate OD
Vitamin D or vitamin D analogue BDVitamin D or vitamin D analogue BDVery potent corticosteroid OD
Potent corticosteroid ODPotent corticosteroid ODVery potent corticosteroid BD
Potent corticosteroid BDPotent corticosteroid BDCoal tar polytherapy (Capasal)
TCF ODTCF ODReferral to specialist
Very potent corticosteroid ODVery potent corticosteroid OD
Very potent corticosteroid BDVery potent corticosteroid BD

From: 8, Topical therapy

Cover of Psoriasis
Psoriasis: Assessment and Management of Psoriasis.
NICE Clinical Guidelines, No. 153.
National Clinical Guideline Centre (UK).
Copyright © National Clinical Guideline Centre - October 2012.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

The rights of National Clinical Guideline Centre to be identified as Author of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.