The Role of Antimalarials in the Exacerbation of Psoriasis

Objective: To critically review the body of literature that refutes or supports the role of antimalarials in the exacerbation of psoriasis.Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were reviewed to identify English-language publications from 1966–2005 examining the role of antimalarials in the exacerbation of psoriasis. A total of 374 articles were identified, of which 32 studies met the inclusion criteria. All available clinical trials or reported cases of the use of antimalarials for patients with psoriasis were included. Data from clinical studies were summarized according to the level of evidence and the outcome of the study. Data were entered into a standardized data extraction form by two independent reviewers.Results and conclusion: No randomized trial evidence was found. Only one cohort study was available for review. A total of 31 case series and case reports were obtained. There is no strong evidence to refute or support the role of antimalarials in the exacerbation of psoriasis. Controlled trials of antimalarial therapy and its effect on psoriasis are warranted.