Joint American Academy of Dermatology–National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy

Elmets, Craig A.; Lim, Henry W.; Stoff, Benjamin K.; Connor, Cody; Cordoro, Kelly M.; Lebwohl, Mark; Armstrong, April W.; Davis, Dawn M.; Elewski, Boni E.; Gelfand, Joel M.; Gordon, Kenneth B.; Gottlieb, Alice B.; Kaplan, Daniel H.; Kavanaugh, Arthur; Kiselica, Matthew; Kivelevitch, Darío; Korman, Neil J.; Kroshinsky, Daniela; Leonardi, Craig L.; Lichten, Jason; Mehta, Nehal N.; Paller, Amy S.; Parra, Sylvia L.; Pathy, Arun L.; Prater, Elizabeth A. Farley; Rupani, Reena; Siegel, Michael; Strober, Bruce; Wong, Emily; Wu, Jashin J.; Hariharan, Vidhya; Menter, Alan

doi:10.1016/j.jaad.2019.04.042

Cited by 117 publications

(100 citation statements)

References 148 publications

(185 reference statements)

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“…It is better to keep the amount used for mild potent <100 g/week, for midpotent and potent <50 g/week and for super potent 30 g/week (Koh, Tian, & Oon, ; A. Nast et al, ; Rademaker et al, ). **Folic acid supplement is essential since UVB lowers folic acid levels and might cause neural tube defects in the fetus (Elmets, Lim et al, ). It can worsen melasma (Amatore et al, ; Gisondi et al, ).…”

Section: Treatment Strategies In Special Populationsmentioning

confidence: 99%

“…It can be used for patients with local disease interfering with daily activity such as scalp or flexural psoriasis (National Institute for Health and Care Excellence, ). It is indicated for guttate psoriasis in American and British guidelines irrespective of age (Elmets, Lim et al, ; National Institute for Health and Care Excellence, , ; van de Kerkhof & Nestlé, ; Vassantachart, Soleymani, & Wu, ). Phototherapy is also indicated for moderate–severe psoriasis as a first line therapy before systemic therapy (S. Hsu, ; van de Kerkhof & Nestlé, ; Vassantachart et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…PUVA refers to the usage of psoralens followed by UVA (320–400 nm) mediated photoactivation. Available psoralens are 8‐methoxypsoralen (8‐MOP)—the available type of oral psoralen in United States, 5‐methoxypsoralen (5‐MOP)—the available oral psoralen in Europe and 4,5,8‐trimethylpsoralen (TMP) usually used for topical PUVA (Burden & Kirby, ; Elmets, Lim et al, ; Hönigsmann & Schwarz, ). In Box , the different methods of psoralen application and exposure of UVA is illustrated.…”

Section: Introductionmentioning

confidence: 99%

“…Typically, two to three sessions weekly are applied. The starting dose takes into consideration plaque thickness/induration and skin phototype, or MED (Elmets, Lim et al, ). The side effects are localized to the irradiated skin including erythema, hyperpigmentation, burning and blistering (Elmets, Lim et al, ; Menter et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…BOX 10 NBUVB (Amatore et al, 2019;Elmets, Lim et al, 2019;Menter et al, 2010;Vassantachart et al, 2016) Frequency: 2-3 times/week $…”

mentioning

confidence: 99%

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Practical compendium for psoriasis management

Ibrahim

Amer

Nofal

et al. 2020

Dermatologic Therapy

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Psoriasis management is complex and challenging. It should be tailored for each patient. Treatment strategy differs according to patient's age, sex, disease type, disease severity, burden on patient's quality of life, comorbidities, involvement of specific sites, and pregnancy. The choice of the appropriate therapeutic must take into consideration the availability, the price, and the patient's preferences. It is very important that the chosen treatment is not more unpleasant, intolerable, or dangerous than the disease itself. According to the disease type, severity, and effect on patient's quality of life, dermatologist chooses whether to start with topical therapy, phototherapy or systemic therapy, or a combination of two or more of them. Under each category, there are different types of therapies that can be the first line therapeutics, second line, or even contraindicated. In this compendium, we provide dermatologists with different treatment plans considering all the mentioned variables so that a dermatologist can choose the optimum plan for the patient.

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Section: Treatment Strategies In Special Populationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…BOX 10 NBUVB (Amatore et al, 2019;Elmets, Lim et al, 2019;Menter et al, 2010;Vassantachart et al, 2016) Frequency: 2-3 times/week $…”

mentioning

confidence: 99%

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Practical compendium for psoriasis management

Ibrahim

Amer

Nofal

et al. 2020

Dermatologic Therapy

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Pathophysiology, Clinical Presentation, and Treatment of Psoriasis

Armstrong

Read

2020

JAMA

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1,070

929

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ImportanceApproximately 125 million people worldwide have psoriasis. Patients with psoriasis experience substantial morbidity and increased rates of inflammatory arthritis, cardiometabolic diseases, and mental health disorders.ObservationsPlaque psoriasis is the most common variant of psoriasis. The most rapid advancements addressing plaque psoriasis have been in its pathogenesis, genetics, comorbidities, and biologic treatments. Plaque psoriasis is associated with a number of comorbidities including psoriatic arthritis, cardiometabolic diseases, and depression. For patients with mild psoriasis, topical agents remain the mainstay of treatment, and they include topical corticosteroids, vitamin D analogues, calcineurin inhibitors, and keratolytics. The American Academy of Dermatology-National Psoriasis Foundation guidelines recommend biologics as an option for first-line treatment of moderate to severe plaque psoriasis because of their efficacy in treating it and acceptable safety profiles. Specifically, inhibitors to tumor necrosis factor α (TNF-α) include etanercept, adalimumab, certolizumab, and infliximab. Other biologics inhibit cytokines such as the p40 subunit of the cytokines IL-12 and IL-13 (ustekinumab), IL-17 (secukinumab, ixekizumab, bimekizumab, and brodalumab), and the p19 subunit of IL-23 (guselkumab, tildrakizumab, risankizumab, and mirikizumab). Biologics that inhibit TNF-α, p40IL-12/23, and IL-17 are also approved for the treatment of psoriatic arthritis. Oral treatments include traditional agents such as methotrexate, acitretin, cyclosporine, and the advanced small molecule apremilast, which is a phosphodiesterase 4 inhibitor. The most commonly prescribed light therapy used to treat plaque psoriasis is narrowband UV-B phototherapy.Conclusions and RelevancePsoriasis is an inflammatory skin disease that is associated with multiple comorbidities and substantially diminishes patients’ quality of life. Topical therapies remain the cornerstone for treating mild psoriasis. Therapeutic advancements for moderate to severe plaque psoriasis include biologics that inhibit TNF-α, p40IL-12/23, IL-17, and p19IL-23, as well as an oral phosphodiesterase 4 inhibitor.

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