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If psoriasis is resistant to one treatment, a combina-tion of treatments used together may be the answer. Combination treatments can even prevent side-effects by allowing less of each drug to be used. Common combinations include topical vitamin D analogues with either local steroids or UVB, dithranol following a tar bath and UVB (Ingram regimen) and coal tar fol-lowing a tar bath and UVB (Goeckerman regimen).
Rotational therapy may also minimize the toxicity of some treatmentsaan example would be PUVA, metho-trexate, acitretin and cyclosporin, each used separately for 1–2 years before moving on to the next treatment.
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