Evidence-based guidelines of the spanish psoriasis group on the use of biologic therapy in patients with psoriasis in difficult-to-treat sites (nails, scalp, palms, and soles).
Actas Dermosifiliogr
; 105(10): 923-34, 2014 Dec.
Article
en En, Es
| MEDLINE
| ID: mdl-24852726
ABSTRACT
Psoriatic lesions affecting the scalp, nails, palms, and the soles of the feet are described as difficult-to-treat psoriasis and require specific management. Involvement of these sites often has a significant physical and emotional impact on the patient and the lesions are difficult to control with topical treatments owing to inadequate penetration of active ingredients and the poor cosmetic characteristics of the vehicles used. Consequently, when difficult-to-treat sites are involved, psoriasis can be considered severe even though the lesions are not extensive. Scant information is available about the use of biologic therapy in this setting, and published data generally comes from clinical trials of patients who also had moderate to severe extensive lesions or from small case series and isolated case reports. In this article we review the quality of the scientific evidence for the 4 biologic agents currently available in Spain (infliximab, etanercept, adalimumab, and ustekinumab) and report level i evidence for the use of biologics to treat nail psoriasis (level of recommendation A) and a somewhat lower level of evidence in the case of scalp involvement and palmoplantar psoriasis.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Psoriasis
/
Dermatosis del Cuero Cabelludo
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Factores Biológicos
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Dermatosis del Pie
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Dermatosis de la Mano
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Enfermedades de la Uña
Tipo de estudio:
Guideline
Límite:
Humans
Idioma:
En
/
Es
Revista:
Actas Dermosifiliogr
Año:
2014
Tipo del documento:
Article