What is the appropriate treatment course for a patient with ineffective topical therapy for psoriasis?

For a patient experiencing ineffective topical therapy for psoriasis, considering systemic therapies such as methotrexate or ciclosporin is an appropriate treatment course. Topical treatments, while effective for many patients, can be insufficient for those with moderate to severe psoriasis or for those who do not respond adequately to these therapies.

Systemic therapies like methotrexate or ciclosporin work on a broader scale, targeting the underlying immune response that contributes to psoriasis flares. Methotrexate is a conventional systemic agent that reduces skin cell turnover and inflammation, making it a suitable choice for long-term management. Ciclosporin, on the other hand, is an immunosuppressant that provides rapid relief from symptoms and is particularly useful for severe cases.

The need for systemic treatment arises when a patient's psoriasis is not manageable through topical options alone. This approach not only helps control the symptoms more effectively but also improves the overall quality of life for the patient.

In contrast, immediate hospitalization is not a standard requirement for patients with ineffective topical therapy unless there are severe complications or comorbidities that warrant it. Switching to biologic agents, while also an option, is generally considered after trying conventional systemic therapies, as biologics are often used for refractory cases or specific