Background: Psoriasis vulgaris is a chronic, immune-mediated inflammatory skin disease characterized by a relapsing-remitting course. Frequent recurrences significantly impair patients' quality of life and impose a heavy economic burden. This study aims to optimize preventive strategies by evaluating the efficacy of a proactive maintenance therapy protocol compared to standard reactive treatment. Methods: A randomized controlled clinical trial was conducted involving 120 patients with vulgar psoriasis who achieved clinical remission. Patients were divided into two groups: Group I (n=60) received standard reactive therapy (treatment only upon relapse), and Group II (n=60) followed an optimized proactive protocol (weekend maintenance with topical calcipotriol/betamethasone and lifestyle modification). Recurrence rates, duration of remission, and Dermatology Life Quality Index (DLQI) were assessed over a 12-month period. Results: The optimized proactive protocol significantly reduced the recurrence rate. At 12 months, only 23.3% of patients in Group II experienced a relapse compared to 58.3% in Group I (p < 0.001). The mean duration of remission was extended by 4.5 months in the optimized group. Conclusion: Implementing a proactive maintenance strategy combined with lifestyle modifications is superior to on-demand therapy for preventing psoriasis recurrence. This approach stabilizes the epidermal barrier and suppresses subclinical inflammation.

Vulgar psoriasis, recurrence prevention, proactive therapy, maintenance treatment, dermatology, quality of life, calcipotriol.

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