RESUMEN
Psoriasis is a chronic, inflammatory, multisystem disease that affects up to 3.2% of the United States population. This guideline addresses important clinical questions that arise in psoriasis management and care and provides recommendations based on the available evidence. The treatment of psoriasis with topical agents and with alternative medicine will be reviewed, emphasizing treatment recommendations and the role of dermatologists in monitoring and educating patients regarding benefits as well as risks that may be associated. This guideline will also address the severity assessment methods of psoriasis in adults.
Asunto(s)
Terapias Complementarias/métodos , Fármacos Dermatológicos/administración & dosificación , Dermatología/métodos , Psoriasis/terapia , Academias e Institutos/normas , Administración Cutánea , Terapia Combinada/métodos , Terapia Combinada/normas , Terapias Complementarias/normas , Dermatología/normas , Medicina Basada en la Evidencia/métodos , Medicina Basada en la Evidencia/normas , Fundaciones/normas , Humanos , Educación del Paciente como Asunto/normas , Psoriasis/diagnóstico , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Estados UnidosRESUMEN
Psoriasis is a chronic, multisystem, inflammatory disease that affects approximately 1% of children, with onset most common during adolescence. This guideline addresses important clinical questions that arise in psoriasis management and provides evidence-based recommendations. Attention will be given to pediatric patients with psoriasis, recognizing the unique physiology, pharmacokinetics, and patient-parent-provider interactions of patients younger than 18 years old. The topics reviewed here mirror those discussed in the adult guideline sections, excluding those topics that are irrelevant to, or lack sufficient information for, pediatric patients.
Asunto(s)
Productos Biológicos/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Metotrexato/uso terapéutico , Fotoquimioterapia , Psoriasis/tratamiento farmacológico , Psoriasis/epidemiología , Adolescente , Corticoesteroides/uso terapéutico , Antralina/uso terapéutico , Inhibidores de la Calcineurina/uso terapéutico , Enfermedades Cardiovasculares/epidemiología , Niño , Preescolar , Alquitrán/uso terapéutico , Comorbilidad , Ciclosporina/uso terapéutico , Dislipidemias/epidemiología , Medicina Basada en la Evidencia , Humanos , Lactante , Recién Nacido , Enfermedades Inflamatorias del Intestino/epidemiología , Resistencia a la Insulina , Salud Mental , Síndrome Metabólico/epidemiología , Ácidos Nicotínicos/uso terapéutico , Obesidad/epidemiología , Psoriasis/psicología , Retinoides/uso terapéuticoRESUMEN
Psoriasis is a chronic inflammatory disease involving multiple organ systems and affecting approximately 2% of the world's population. In this guideline, we focus the discussion on systemic, nonbiologic medications for the treatment of this disease. We provide detailed discussion of efficacy and safety for the most commonly used medications, including methotrexate, cyclosporine, and acitretin, and provide recommendations to assist prescribers in initiating and managing patients on these treatments. Additionally, we discuss newer therapies, including tofacitinib and apremilast, and briefly touch on a number of other medications, including fumaric acid esters (used outside the United States) and therapies that are no longer widely used for the treatment of psoriasis (ie, hydroxyurea, leflunomide, mycophenolate mofetil, thioguanine, and tacrolimus).
Asunto(s)
Psoriasis/tratamiento farmacológico , Acitretina/uso terapéutico , Ciclosporina/uso terapéutico , Monitoreo de Drogas , Humanos , Metotrexato/uso terapéutico , Piperidinas/uso terapéutico , Pirimidinas/uso terapéutico , Talidomida/análogos & derivados , Talidomida/uso terapéuticoRESUMEN
Psoriasis is a chronic inflammatory disease involving multiple organ systems and affecting approximately 3.2% of the world's population. In this section of the guidelines of care for psoriasis, we will focus the discussion on ultraviolet (UV) light-based therapies, which include narrowband and broadband UVB, UVA in conjunction with photosensitizing agents, targeted UVB treatments such as with an excimer laser, and several other modalities and variations of these core phototherapies, including newer applications of pulsed dye lasers, intense pulse light, and light-emitting electrodes. We will provide an in-depth, evidence-based discussion of efficacy and safety for each treatment modality and provide recommendations and guidance for the use of these therapies alone or in conjunction with other topical and/or systemic psoriasis treatments.
Asunto(s)
Dermatología/normas , Fototerapia/normas , Guías de Práctica Clínica como Asunto , Psoriasis/terapia , Academias e Institutos/normas , Fundaciones/normas , Humanos , Metaanálisis como Asunto , Fototerapia/instrumentación , Fototerapia/métodos , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento , Estados UnidosRESUMEN
Psoriasis is a chronic, inflammatory, multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations on the basis of available evidence.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Salud Mental , Síndrome Metabólico/epidemiología , Obesidad/epidemiología , Rol del Médico , Psoriasis/epidemiología , Psoriasis/psicología , Calidad de Vida , Artritis Psoriásica/diagnóstico , Artritis Psoriásica/epidemiología , Comorbilidad , Dislipidemias/epidemiología , Medicina Basada en la Evidencia , Humanos , Hipertensión/epidemiología , Enfermedades Inflamatorias del Intestino/epidemiología , Enfermedades Renales/epidemiología , Estilo de Vida , Hepatopatías/epidemiología , Enfermedades Pulmonares Obstructivas/epidemiología , Neoplasias/epidemiología , Educación del Paciente como Asunto , Psoriasis/terapia , Síndromes de la Apnea del Sueño/epidemiologíaRESUMEN
Psoriasis is a chronic, inflammatory multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations based on the available evidence. The treatment of psoriasis with biologic agents will be reviewed, emphasizing treatment recommendations and the role of the dermatologist in monitoring and educating patients regarding benefits as well as associated risks.
Asunto(s)
Productos Biológicos/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Psoriasis/tratamiento farmacológico , Adalimumab/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados , Biosimilares Farmacéuticos/uso terapéutico , Certolizumab Pegol/uso terapéutico , Quimioterapia Combinada , Etanercept/uso terapéutico , Medicina Basada en la Evidencia , Humanos , Infliximab/uso terapéutico , Piperidinas/uso terapéutico , Pirimidinas/uso terapéutico , Pirroles/uso terapéutico , Ustekinumab/uso terapéuticoRESUMEN
The National Psoriasis Foundation (NPF) is developing an agenda for patient-centered research to help patients and their caregivers make more informed health care decisions by engaging psoriasis patients in prioritizing comparative effectiveness research (CER) topics. The NPF has created a novel patient-centered research platform known as Citizen Pscientist (CP), allowing patients with psoriasis and psoriatic arthritis to register and contribute their health data. The CP Governance Council administered an online 23-question CER survey to the CP community and held a structured meeting on December 3, 2016, with patients and researchers to review CER survey results and discuss patient-centered research priorities. Of the 2,945 patients surveyed, 792 patients responded. Three CER topics were deemed to be of high priority for the research agenda: 1) Treat-to-target therapy for psoriasis, 2) Psoriatic arthritis screening questionnaires for early detection and treatment of psoriatic arthritis, and 3) Comparative effectiveness of home-based phototherapy for psoriasis.