Adherencia y satisfacción del paciente y características organolépticas y de uso de los tratamientos tópicos utilizados para la psoriasis: Consenso Delphi del panel de expertos y miembros del Grupo de Psoriasis de la Academia Española de Dermatología y Venereología / Adherence and Patient Satisfaction With Topical Treatment in Psoriasis, and the Use, and Organoleptic Properties of Such Treatments: A Delphi Study With an Expert Panel and Members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology

Antecedentes: El tratamiento tópico es fundamental en el manejo de la psoriasis y la adherencia al mismo contribuye a su eficacia en el tratamiento prolongado. Objetivos: Establecer un consenso sobre la adherencia al tratamiento tópico en la psoriasis y recomendaciones para mejorarla, así como evaluar las características de los diferentes vehículos. Método: Se elaboró un cuestionario sobre adherencia al tratamiento tópico de la psoriasis que se sometió a Consenso Delphi por un panel de expertos, al igual que un cuestionario sobre las características de los principales vehículos utilizados, que también fue sometido a consenso por los miembros del Grupo de Psoriasis de la Academia Española de Dermatología y Venereología. Resultados: Se alcanzó consenso en que: a) la adherencia al tratamiento tópico aumenta su eficacia en la psoriasis; b) para aumentar la adherencia es necesario mejorar la comunicación con el personal sanitario, proporcionar instrucciones escritas, simplificar el tratamiento, con preparados de aplicación cómoda, preferiblemente diaria, y agradables; y c) la satisfacción con el tratamiento aumenta la adherencia y tiende a mejorar la calidad de vida relacionada con la salud de los pacientes. La pomada fue el vehículo peor valorado, mientras que los mejor considerados fueron las espumas y las soluciones. Las cremas y el gel lipofílico tuvieron valoraciones superiores a la pomada en diversos parámetros. Conclusión: Para aumentar la adherencia al tratamiento tópico y la eficacia del mismo en la psoriasis hay que proporcionar más información, simplificar el tratamiento y prescribir preparados cómodos de aplicar y que aseguren la satisfacción del paciente (AU)

Background: Topical therapy is key to the successful management of psoriasis, and patient adherence to treatment contributes to its effectiveness in the long-term. Objectives: To establish consensus on adherence to topical treatment in psoriasis, draw up recommendations on how adherence could be improved, and evaluate the properties of the main vehicles used. Method: We designed a questionnaire on adherence to topical treatments in psoriasis and another on the properties of the main vehicles used; the 2 questionnaires were evaluated using the Delphi method by a panel of experts and members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology, respectively. Results: Consensus was reached on the following statements: a) treatment adherence increases the effectiveness of topical treatments in psoriasis; b) to improve adherence, it is necessary to improve communication between patients and health care staff, provide written instructions, and simplify treatment with easy-to-use, pleasant products that are preferably applied only once a day; c) treatment satisfaction increases adherence and tends to improve the health related quality of life of the patient. Ointment was rated the worst vehicle, while foams and solutions were rated the best. Creams and lipophilic gels were considered to be better than ointment in several respects. Conclusion: To improve adherence to topical regimens in psoriasis and the effectiveness of such therapy, we need to give patients more information, simplify treatment regimens, and prescribe easy-to-use products that will ensure satisfaction (AU)

Adherence and patient satisfaction with topical treatment in psoriasis, and the use, and organoleptic properties of such treatments: a Delphi study with an expert panel and members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology.

BACKGROUND: Topical therapy is key to the successful management of psoriasis, and patient adherence to treatment contributes to its effectiveness in the long-term. OBJECTIVES: To establish consensus on adherence to topical treatment in psoriasis, draw up recommendations on how adherence could be improved, and evaluate the properties of the main vehicles used. METHOD: We designed a questionnaire on adherence to topical treatments in psoriasis and another on the properties of the main vehicles used; the 2 questionnaires were evaluated using the Delphi method by a panel of experts and members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology, respectively. RESULTS: Consensus was reached on the following statements: a) treatment adherence increases the effectiveness of topical treatments in psoriasis; b) to improve adherence, it is necessary to improve communication between patients and health care staff, provide written instructions, and simplify treatment with easy-to-use, pleasant products that are preferably applied only once a day; c) treatment satisfaction increases adherence and tends to improve the health-related quality of life of the patient. Ointment was rated the worst vehicle, while foams and solutions were rated the best. Creams and lipophilic gels were considered to be better than ointment in several respects. CONCLUSION: To improve adherence to topical regimens in psoriasis and the effectiveness of such therapy, we need to give patients more information, simplify treatment regimens, and prescribe easy-to-use products that will ensure satisfaction.

[Etanercept in childhood psoriasis]. / Etanercept en psoriasis infantil.

We present the case of a 10-year old male child with severe incapacitating psoriasis resistant to multiple treatments. He was treated with etanercept successfully in our Dermatology Department. The use of etanercept in children and adolescents with severe psoriasis has been recently approved by the European Medicines Agency. Thus, it has become the first and only biological drug authorized for its use in the child population.

[Bacillary (epithelioid) angiomatosis with a nodular presentation and self-limited evolution]. / Angiomatosis bacilar (epitelioide) de presentación nodular y evolución autolimitada.

Bacillary angiomatosis (epithelioid) is a recently described clinicopathologic syndrome, principally associated to infection by the human immunodeficiency virus. The case of a patient who was seen for fever and the appearance of four painful, erythematous and indurated subcutaneous nodules on the anteroexternal face of the right lower extremity 15 days previously is presented. No microorganisms were observed by microbiologic and histologic techniques however the latter showed a vascular proliferation with prominent endothelium of epithelioid morphology and notable interstitial inflammatory reaction according to the pattern described as characteristic of epithelioid angiomatosis. The fever and the nodules disappeared spontaneously. The clinical and histopathologic characteristics of this disease as well as the recent contributions with respect to the identification of the possible causative bacillus are discussed.