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Non-biologic therapies are useful in psoriasis for intermittent, rotational or combination treatment and in managing "difficult to treat" psoriasis, patients with minimal lesions, or who have achieved recommended cumulative dose or developed side effects/intolerance to conventional drugs, or where co-morbidities pose unusual challenges. Methotrexate, cyclosporine, acitretin, tar, anthralin, corticosteroids or calcipotriol ointments, and phototherapy are well established in psoriasis treatment. Hydroxycarbamide, azathioprine, leflunomide, mycophenolate mofetil, isotretinoin, fumarates, calcineurin inhibitors, peroxisome proliferator-activated receptor agonists, statins, pentoxifylline, sulfasalazine, colchicine, or various physical modalities often mentioned as non-standard therapies. They will remain important until an affordable, safe, effective, and remittiv therapy becomes available.
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