A Medline literature review was undertaken by the National Psoriasis Foundation to evaluate treatment options regarding severe scalp psoriasis. Levels of evidence were graded. The recommended short-term or intermittent therapy was topical corticosteroids for severe scalp psoriasis. Alternative treatments included calcipotriol/calcipotriene therapy, tazarotene, salicylic acid, coal tar and anthralin. Combination therapies (e.g., calcipotriol/betamethasone) and second line therapies comprised UVB, excimer laser and biological therapies such as adalimumab or etanercept (Chan, C.S. et al. J Am Acad Dermatol 2009, 60: 962).