Etanercept With Tacrolimus for Psoriasis

Inclusion Criteria

Adults 18 years or older with moderate to severe psoriasis, who are candidates for systemic or phototherapy, with a baseline score of 6 or higher on the target lesion score, and a baseline score of 3 or higher on the Physician's Global Assessment, on each side of the body
Patients who are already on a stable dose of etanercept for at least 2 months and have the above criteria
Subjects must have target lesions on each side of the body that are at least 1.5 cm in diameter and roughly symmetrical in appearance and location

Exclusion Criteria

Inability to understand consent or comply with study requirements
Pregnancy or unwillingness to use adequate birth control method
Lactation
Psoriasis plus ultraviolet A (PUVA) or systemic therapy within the past 4 weeks (other than a stable dose of Enbrel for at least 2 months)
Ultraviolet B (UVB) or topical therapy (other than over-the-counter moisturizers) within the past 2 weeks
Active tuberculosis or other opportunistic infection
Demyelinating disease
Uncontrolled congestive heart failure
Known allergy to or any contraindications to using topical tacrolimus or etanercept
Lack of insurance coverage or inability/refusal to pay out of pocket for etanercept and standard of care laboratory tests and PPD/CXR