| Scalp | Hair-bearing areas are not receptive to ointment vehicles. | A topical corticosteroid and/or topical calcipotriene (Dovonex) in a solution vehicle are recommended, along with daily use of a tar shampoo. |
| Nails | The thick keratin of the nail blocks absorption of topical agents. | For onycholysis, a topical corticosteroid in a solution vehicle may be used under the nail. Systemic therapy may be required to improve severe disease. |
| Genitalia | The thin skin of the genitalia is highly sensitive to the adverse effects (atrophy) of topical corticosteroids. | A low-potency topical corticosteroid ointment is recommended. Topical calcipotriene, which is not associated with a risk of atrophy, may be used. |
| Palms and soles | The thick stratum corneum of palms and soles is a barrier to penetration of topical agents. | A highest-potency topical corticosteroid is recommended. Methotrexate (Rheumatrex) or acitretin (Soriatane; a systemic retinoic acid analog) may be needed. |