Vitamin D 2000 units daily, fish or flax oil 2 g (2 capsules) daily, sodium bicarb baths, and glucosamine/chondroitin with topical honey make up my recommended treatment for psoriasis with topical steroids when needed.  The steroids can be purchased over-the-counter.  Each has proven benefit.  Vegetarian diets have also been reports to help, especially avoiding beef and pork, i.e., mammal meat.

Expensive vitamin D3 calcipotriene ointment (Taclonex, Dovonex) seem unnecessary in most cases.  Much less expensive oral over-the-counter vitamin D appears to work just as well.  For reasons unknown, few physicians recommend the above medically proven inexpensive treatments.  Taclonex is a very expensive combination of a steroid plus calcipotriene.  If it is necessary to use topical vitamin D instead of oral, simply buy the steroid and vitamin D3 ointment separately for a $200 per month savings (roughly $300 vs. $100).  A number of other therapies are used by dermatologists for difficult cases including retinoids, and PUVA-light.

Vitamin D, Omega-3, and Vegetarian Diet Help: Fasting periods, vegetarian diets, and diets rich in omega-3 polyunsaturated fatty acids from fish oil have all been associated with improvement in some studies. However, only one of four controlled studies showed a benefit of omega-3 fatty acids compared to placebo. Some psoriasis patients are gluten-sensitive and may benefit from a gluten free diet. The active form of vitamin D exhibits anti-proliferative and immunoregulatory effects and has been shown to be useful in the treatment of psoriasis. The significance of diet and associated factors in psoriasis. Wolters M. Universitat Hannover, . Hautarzt 2006 Jun 7.

Chondroitin May Help Psoriasis, Too: Eleven adult patients with knee osteoarthritis and long-standing, moderate to severe psoriasis resistant to conventional therapy were treated with chondroitin sulfate 800 mg per day of chondroitin sulfate for 2 months. Skin biopsies were obtained before and after treatment. All patients but one presented a dramatic improvement of the condition of the skin, with a reduction of swelling, redness, flaking, and itching (clearance of psoriasis in one patient), increase in the hydration and softening of the skin, and amelioration of scaling. Histopathologically, there was a statistically significant decrease in epidermal thickness, a decrease in the thickness between the stratum basale and the stratum granulosum, a significant improvement of the degree of psoriasis activity, and a decrease in the number of keratinocytes stained with Ki-67. Clinical and histopathological improvement of psoriasis with oral chondroitin sulfate: a serendipitous finding. Verges J, et al. Barcelona, Spain. . Dermatol Online J. 2005 Mar 1;11(1):31.

Psoriasis: Based on a literature review of DB studies, the combination of steroids and vitamin D analogues or topical retinoids is perhaps the most promising current treatment. Can Fam Physician. 2005 Apr;51:519-25.

Sodium Bicarbonate Baths Help Psoriasis: For centuries, medicated baths have been one of the first lines of treatment for psoriasis. Even today, with sophisticated immunosuppressive treatments available, Dead Sea salts and spa waters are recognized to be beneficial in the management of psoriatic patients. In a 21-day DB PC study of 32 patients with mild-moderate psoriasis, sodium bicarbonate baths showed a statistically valuable improvement. NaHCO3 baths reduced itchiness and irritation; in general, the patients themselves recognized a beneficial impact on their psoriasis, so much so that they have continued to bathe in NaHCO3 even after the end of the study. Old fashioned sodium bicarbonate baths for the treatment of psoriasis in the era of futuristic biologics: an old ally to be rescued. Verdolini R, Bugatti L, et al. St Andrew's Hospital, London, UK. J Dermatolog Treat. 2005 Feb;16(1):26-30.

Honey-Beeswax-Olive Oil Seems to Help: In a small, hard-to-understand, randomized 2-week study of 39 patients with either atopic dermatitis (AD) or psoriasis vulgaris (PV), each used a mixture of honey, beeswax and olive oil (1:1:1). Mixtures A, B, and C contained honey mixture with the corticosteroids ointment in a ratio of 1:1, 2:1, and 3:1 respectively. These were compared by treating one-half the body with the honey mixture and the other half with Vaseline/paraffin or Vaseline/paraffin with a steroid. In honey mixture group, 8/10 patients with dermatitis showed significant improvement after 2 weeks. In psoriasis, 5/8 patients showed a significant response to honey mixture. Topical application of natural honey, beeswax and olive oil mixture for atopic dermatitis or psoriasis: partially controlled, single-blinded study. Al-Waili NS. Islamic Establishment for Education, Dubai, United Arab Emirates. Complement Ther Med. 2003 Dec;11(4):226-34. Ed: There are several larger well-done studies finding honey very useful for treating burn and other wounds. See Wound Healing.  

Remicade, Enbrel Help: 112 patients, injected twice a week for six months with either Enbrel or placebo, found that 56 percent of patients treated with Enbrel had at least a 75 percent improvement in their psoriasis at the six-month point compared with 5 percent of patients on placebo. Thirty percent of Enbrel patients achieved the trial's primary goal of a 75 percent improvement at three months. 29-patient trial of Johnson & Johnson's Remicade, which is given intravenously, found that about half the psoriasis patients given three infusions of the drug over six weeks maintained a 75 percent improvement in symptoms six months after treatment. The Remicade trial was an extension of an earlier study showing that 73 percent to 82 percent, depending on dose levels, of patients saw a 75 percent symptom improvement 10 weeks after they were given the three infusions.

Psoriasis: Etanercept, Efaluzimab Help:  Leonardi, New Engl J Med 11/18/03.Moderate-to-severe psoriasis in a total of 672 patients received either placebo or subcutaneous etanercept at a low dose (25 mg once weekly), a medium dose (25 mg twice weekly), or a high dose (50 mg twice weekly). At week 12, psoriasis had improved 75% or more from baseline in 4% of the patients in the placebo, 14% in the low-dose etanercept, 34% in the medium-dose etanercept, and 49% in the high-dose etanercept group. At week 24, 25% of the low-dose group, 44% of the medium-dose group, and 59% of patients in the high-dose group were 75% improved. Efaluzimab had similar results in another study. N Engl J Med. 2003;349:1987-1990, 2004-2013, 2014-2022. Etanercept is a recombinant human TNF-alpha receptor fusion protein that is approved for the treatment of rheumatoid arthritis. Efalizumab is a humanized monoclonal antibody that blocks LFA-1. Both are very expensive. Alefacept is the first memory T cell–specific biologic agent to be approved by the FDA for use in psoriasis

Psoriasis: Lymphoma Rates Tripled: Although the lymphoma rate is still only about 0.2% of psoriasis sufferers over age 65, it is still three times as high as that of individuals without psoriasis. Researchers don't know if the increase is due to the disease or the treatments. Arch Dermatology 11/03

Psoriasis: Purple Fleabane Seeds Help: A traditional treatment from Indian traditional medicine has found that the tropical plant Vernonia anthelmintica seeds are both anti-inflammatory and cytotoxic. BBC Health News 9/24/02

Mahonia (Oregon Grape) May Help Psoriasis: In a clinical trial of 32 patients with mild to moderate bilateral psoriasis treated up to 6 months, one side of the body received Mahonia and the other standard psoriatic treatment (eg, Dovonex cream). The primary outcomes were patient ratings of the Mahonia-treated side alone and the comparison between treatments received on each side of their body. Eighty-four percent of patients rated the Mahonia-treated psoriasis as good to excellent response. When compared with standard treatment, 63% of patients rated Mahonia aquifolium equal to or better than the standard psoriatic treatment. A second similar study found similar results. Authors conclude that Mahonia aquifolium is a safe and effective treatment of patients with mild to moderate psoriasis. A Report on Three Recent Clinical Trials Using Mahonia aquifolium 10% Topical Cream and a Review of the Worldwide Clinical Experience With Mahonia aquifolium for the Treatment of Plaque Psoriasis. Gulliver WP, et al. University of Rochester. Am J Ther. 2005 September/October;12(5):398-406. Ed: I couldn't find the cream, both a liquid tincture is available for $7 for a 1 ounces bottle from iherb.com. 

Vitamin D Orally Appears to Help: In 15 psoriatic patients receiving oral 1 alpha(OH)D3, clinical resolution occurred in 7 patients, three showed incomplete lesion resolution and the remaining 5 patients showed a complete lack of response during the 4-6 months of the study. Epidermal keratin levels during oral 1-alpha-hydroxyvitamin D3 treatment for psoriasis. Holland DB, et al. Leeds, UK. Skin Pharmacol 1989;2(2):68-76. Ed: There appears to be a lack of interest is using over-the-counter oral vitamin for psoriasis with the vast majority of the research on physician prescribed topical forms of vitamin D that were developed under patent.  In addition to cost, oral vitamin D may help many other parts of the body.

Vitamin D Orally Appears As Good As Expensive Vitamin D Analogue Creams: Ten of 14 patients with moderate to severe psoriasis who received oral 1,25-(OH)2-D3 showed significant clearing of their hyperkeratotic plaques. Three patients had complete clearing that was sustained with maintenance therapy, but four patients received little or no benefit. By the administration of 1,25-(OH)2-D3 as a single oral dose at bedtime, larger doses of the drug could be tolerated without evidence of hypercalciuria or hypercalcemia. Three patients who received topical 1,25-(OH)2-D3 showed a rapid response with complete clearing after 6 weeks of therapy. Therefore, these preliminary findings suggest that orally or topically administered 1,25-(OH)2-D3 may be a safe and effective alternative therapy for the treatment of psoriasis. A novel approach for the evaluation and treatment of psoriasis. Oral or topical use of 1,25-dihydroxyvitamin D3 can be a safe and effective therapy for psoriasis. Smith FL, et al. Boston City Hospital. J Am Acad Derm 1988 Sep;19(3):516-28.