Tapinarof

How it works

By activating the aryl hydrocarbon receptor in skin cells, it downregulates pro-inflammatory cytokines, normalises keratinocyte differentiation and reduces oxidative stress in psoriatic plaques.

Prescribing in practice

• Folliculitis and contact dermatitis are common local reactions and are the main reason for treatment discontinuation.
• Apply to affected skin only and avoid the eyes, mouth and other mucous membranes.
• It is a non-steroidal topical option suitable for intertriginous and other sensitive sites where prolonged steroid use is undesirable.

Monitoring

No laboratory monitoring is required; review local tolerability and treatment response clinically.

Counselling the patient

• Apply a thin layer once daily to the affected areas.
• Local folliculitis, itching or a headache may occur and usually settle.
• Wash hands after application unless the hands are being treated.

Evidence & guidelines

Efficacy in plaque psoriasis was demonstrated in the PSOARING phase 3 trial programme.