In this HCPLive RX Review Special Report, Mona Shahriari, MD, Associate Clinical Professor of Dermatology at Yale University, sits down with David Hartigan, a biologic coordinator with Biologic Coordinators of Dermatology, to explore integrating topical roflumilast into the treatment regimens of patients on biologics, particularly for managing residual or scalp psoriasis.
In this clip, Shahriari emphasizes that even among patients with moderate-to-severe disease on systemic therapy, topicals remain essential to maintaining long-term disease control. She outlines 3 key roles for roflumilast in biologic workflows. First, it serves as a therapeutic bridge while patients await biologic approval or navigate insurance delays. Second, for patients hesitant to initiate systemic therapy, it provides a non-steroidal, well-tolerated alternative that can manage symptoms while allowing time for decision-making. Finally, among patients already receiving biologics, tapinarof functions as a reliable adjunct for addressing breakthrough lesions—what she refers to as “touch-up paint”—helping maintain clearance and potentially delaying or avoiding unnecessary treatment switches.
She highlights the importance of minimizing disruptions in effective biologic regimens and notes that roflumilast can be safely used in combination with systemic agents, with no FDA contraindications. This flexibility allows for seamless integration into existing care plans while reducing the administrative burden on biologic coordinators and preserving therapeutic continuity.
Editor's note: The FDA approved Arcutis Biotherapeutics's roflumilast under the name Zoryve as the first foam option available for scalp psoriasis in May 2025.
Our Panelists:
Mona Shahriari, MD, is Assistant Clinical Professor of Dermatology at Yale University School of Medicine, the Associate Director of Clinical Trials at CCD Research and a senior editor for the Journal of Psoriasis and Psoriatic arthritis. She also hosts HCPLive's podcast, The Medical Sisterhood.
David Hartigan, is a biologic coordinator for Optima Dermatology and the Education Chair for Biologic Coordinators of Dermatology.
Relevant disclosures for Shahriari include AbbVie, Dermira, Cara, Dermavant, Novartis, Union, BMS, Leo, Eli Lilly, Sanofi, Regeneron, UCB, and others. Hartigan reports no relevant disclosures.
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