It is essential to improve the clinical results of efalizumab and to assure that it is used under safety criteria in order to obtain a systemic management of the treatment. Prior to proposing and prescribing the treatment, the dermatologist should make sure that the patient fulfills pills the requirements to be able to initiate it and that, on the other hand, there is no serious contraindication that may affect its short-to-long term safety. During the course of the treatment, some follow-up guidelines should be established that will make it possible to compare the evolution of the patient with the general perspectives of efalizumab as well as to monitor and manage the most common adverse effects associated to its use. Finally, it would be convenient to become familiar with the natural course of the disease once the treatment is discontinued in those cases in which this action is decided or should be carried out.