3.1 Eczema and psoriasis
Ointments are recommended by Dermatology
As guided by ScriptSwitch in primary care for availability due to supply issues :
Mild corticosteroid:
Moderately potent corticosteroid:
Potent corticosteroid:
Very potent corticosteroid:
- Clobetasol propionate 0.05%. When available- ClobaDerm® is the preferred brand. Length of treatment as per dermatologist
Steroids with antimicrobials (for short term use e.g. 7 days in infected eczema or as per dermatologist until skin is clear and back to normal)
Preparations for psoriasis
- Emollient - See section 1
- Mild/moderate topical corticosteroids for face/flexures see above
- Silkis® (Calcitriol) Dovonex® 30g ointment (Calcipotriol)
- Dovobet® 60g gel/ointment (Betamethasone dipropionate 0.05%, Calcipotriol 50mcg)
- Enstilar® foam spray (Betamethasone dipropionate 0.05%, Calcipotriol 50mcg)
- Wynzora cream ®
- Exorex® lotion (coal tar solution 5%)
Scalp Preparations
- Betacap® Scalp Application (Betamethasone valerate 0.1%)
- Diprosalic® Scalp Application (Betamethasone 0.05%, Salicylic acid 2%)
- 2nd line Dovobet® gel (Betamethasone dipropionate 0.05%, Calcipotriol 50mcg).
- Enstilar foam spray
- Sebco® (Coal tar 12%, Salicylic acid 2%)
- Etrivex shampoo
- Synalar® gel
Specialist Use Drugs for Psoriasis
** Adalimumab – ✓ Specialist Use Only, prescribe by brand ** Amgevita® SC injection - preferred biosimilar
For treatment of chronic plaque psoriasis in adult patients who failed to respond to or have a contraindication to or are intolerant to other systemic therapy including ciclosporin methotrexate or PUVA.
** Ustekinumab - ✓ Specialist Use Only, prescribe by brand ** Uzpruvo® SC▼ injection - preferred biosimilar
For the treatment of moderate to severe plaque psoriasis in adults who failed to respond to, or who have a contraindication to, or are intolerant to other systemic therapies including ciclosporin, methotrexate and psoralen and UVA treatment (PUVA).
For the treatment of moderate to severe plaque psoriasis in adolescent patients from the age of 12 years and older, who are inadequately controlled by, or are intolerant to, other systemic therapies or phototherapies.
** Etanercept - ✓ Specialist Use Only, prescribe by brand ** Benepali® SC injection – preferred biosimilar
Treatment of adults with moderate to severe plaque psoriasis who failed to respond to, or who have a contraindication to, or are intolerant to other systemic therapy, including ciclosporin, methotrexate or psoralen and ultraviolet-A light (PUVA)
** Deucravacitinib (Sotyktu®) tablets – ✓ Specialist Use Only **
For the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. For use in patients who have failed to respond to standard systemic therapies (including ciclosporin, methotrexate and phototherapy), are intolerant to, or have a contraindication to these treatments.
** Tildrakizumab SC (Ilumetri®) injection - ✓ Specialist Use Only **
For the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. For use in patients who have failed to respond to conventional systemic therapies (including ciclosporin, methotrexate and phototherapy), are intolerant to, or have a contraindication to these treatments.
** Certolizumab pegol SC (Cimzia®) injection – ✓ Specialist Use Only **
For the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. For use in patients who have failed to respond to standard systemic therapies (including ciclosporin, methotrexate and phototherapy), are intolerant to, or have a contraindication to these treatments.
** Secukinumab SC (Cosentyx®) injection – ✓ Specialist Use Only **
For the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. For use in patients who have failed to respond to standard systemic therapies (including ciclosporin, methotrexate and phototherapy), are intolerant to, or have a contraindication to these treatments.
** Guselkumab SC (Tremfya®) injection – ✓ Specialist Use Only **
For the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. For use in patients who have failed to respond to conventional systemic therapies (including ciclosporin, methotrexate and phototherapy), are intolerant to, or have a contraindication to these treatments.
** Risankizumab SC (Skyrizi®) injection – ✓ Specialist Use Only **
For the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. For use in patients who have failed to respond to conventional systemic therapies (including ciclosporin, methotrexate and phototherapy), are intolerant to, or have a contraindication to these treatments.
** Bimekizumab SC (Bimzelx®) injection – ✓ Specialist Use Only **
For the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. For use in patients who have failed to respond to standard systemic therapies (including ciclosporin, methotrexate and phototherapy), are intolerant to, or have a contraindication to these treatments.
** Brodalumab SC (Kyntheum®) injection – ✓ Specialist Use Only **
For the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. For use in patients who have failed to respond to standard systemic therapies (including ciclosporin, methotrexate and phototherapy), are intolerant to, or have a contraindication to these treatments.
** Apremilast (Otezla®) tablets – ✓ Specialist Use Only **
For the treatment of moderate to severe chronic plaque psoriasis in adult patients who failed to respond to or who have a contraindication to, or are intolerant to other systemic therapy including ciclosporin, methotrexate or psoralen and ultraviolet-A light (PUVA).
** Dimethyl fumarate (Skilarence®) tablets – ✓ Specialist Use Only **
For the treatment of moderate to severe plaque psoriasis in adults in need of systemic medicinal therapy. For use in patients in whom other non-biologic systemic treatments (methotrexate, ciclosporin and acitretin) are not appropriate or have failed and who are considered unsuitable for biologic therapy given their current disease state or personal preference.
Specialist Use Drugs for Eczema Atopic Eczema
** Dupilumab SC (Dupixent®) injection – ✓ Specialist Use Only **
For the treatment of moderate-to-severe atopic dermatitis in adult patients who are candidates for systemic therapy. For use in patients who have had an inadequate response to existing systemic immunosuppressants such as ciclosporin, or in whom such treatment is considered unsuitable.
** Baricitinib (Olumiant®) tablets – ✓ Specialist Use Only **
For the treatment of moderate to severe atopic dermatitis in adult patients who are candidates for systemic therapy who have failed at least one current systemic immunosuppressant due to intolerance, contraindication or inadequate disease control.
** Upadacitinib (Rinvoq®) tablets – ✓ Specialist Use Only **
For the treatment of moderate to severe atopic dermatitis in adults and adolescents 12 years and older who are candidates for systemic therapy. For patients who have had an inadequate response to at least one conventional systemic immunosuppressant such as ciclosporin, or in whom such treatment is considered unsuitable.
** Abrocitinib (Cibinqo®) tablets – ✓ Specialist Use Only **
For the treatment of moderate-to-severe atopic dermatitis in adults and adolescents 12 years and older who are candidates for systemic therapy. For use in patients who have not responded to, or have lost response to, at least one systemic immunosuppressant therapy, or in whom these are contraindicated or not tolerated.
** Tralokinumab SC▼ (Adtralza®) injection – ✓ Specialist Use Only **
For the treatment of moderate-to-severe atopic dermatitis in adult patients who are candidates for systemic therapy. For use in patients who have had an inadequate response to an existing systemic immunosuppressant such as ciclosporin, or in whom such treatment is considered unsuitable.
** Lebrikizumab SC▼ (Ebglyss®) injection – ✓ Specialist Use Only **
For the treatment of moderate-to-severe atopic dermatitis in adults and adolescents 12 years and older with a body weight of at least 40 kg who are candidates for systemic therapy. For use in patients who have had an inadequate response to an existing systemic immunosuppressant such as ciclosporin, or in whom such treatment is considered unsuitable and where a biologic would otherwise be offered
DGRefHelp - NHS Dumfries & Galloway
