What orals or biologics do you reach for in a child with recalcitrant inverse psoriasis in the groin who has tried and failed topical including steroids, pimecrolimus, zoryve, ketoconazole, and tacrolimus?

I would first ensure that we couldn't get it under control with even higher potency topical corticosteroids for a short period of time and then maintenance with lower potency topical corticosteroids and steroid-sparing agents or sometimes along with the higher potency topical corticosteroids twice p...