All of the following are used in systemic therapy of psoriasis except

Oral glucocoicoids should not be used for the treatment of psoriasis due to the potential for development of life-threatening pustular psoriasis when therapy is discontinued. Methotrexate is an effective agent, especially in patients with psoriatic ahritis. The synthetic retinoid acitretin is useful, especially when immunosuppression must be avoided; however, teratogenicity limits its use. The evidence implicating psoriasis as a T cell-mediated disorder has directed therapeutic effos to immunoregulation. Cyclosporine and other immunosuppressive agents can be very effective in the treatment of psoriasis . Methotrexate typically is only used to treat severe cases of psoriasis, when the symptoms are debilitating. Methotrexate doesn't just work on your skin rash like some other psoriasis treatments do. Rather, it suppresses the cells of your immune system that cause the psoriasis rash. Ref: Harrison 19e pg: 348