Robby is a 53-year-old male who suffers from chronic plaque psoriasis (L40.0). His symptoms include dry, itchy, red, flaking plaques located on his arms, elbows, legs and knees. Robby has tried and failed clobetasol treatment which gave him little to no relief. Robby is not a candidate for systemic treatments such as Methotrexate due to the adverse side effects (which can be fatal) of these treatments. As stated in the package insert from the manufacture “Methotrexate should be used only in life threatening neoplastic disease or in patients with psoriasis or rheumatoid arthritis with severe recalcitrant, disabling disease which is not adequately responsive to other forms of therapy.” Requiring patients to cycle through two or more “steps”
