<p>The Unmet Need for Clinical Guidelines on the Management of Patients with Plaque Psoriasis in Africa and the Middle East</p>

Abstract

Purpose: Dermatologists practicing in African and Middle Eastern countries face numerous challenges when managing patients with plaque psoriasis, especially those with disease in a difficult-to-treat anatomic area or those who are a pediatric, geriatric, or pregnant patient. The publication of comprehensive, up-to-date, region-specific clinical guidelines may help to address some of these challenges and improve outcomes. We conducted a literature review to identify recent guidelines and other publications describing patients with plaque psoriasis in Africa and the Middle East. Patients and Methods: An online literature search of the PubMed database was conducted to identify publications reporting clinical guidelines and research studies on plaque psoriasis. The search included all articles published from January 2008 to March 2020 inclusive. The titles and abstracts of all search results were screened by a reader to identify those that described patients in Africa or the Middle East. Results: A total of 145 publications were identified by the literature search and screened by a reader. There were 10 publications that described patients in Africa or the Middle East: 4 research articles, 3 reviews, 2 guidelines, and 1 case study. The 2010 guidelines from South Africa made recommendations for treating plaque psoriasis of varying severity, although without specific recommendations for difficult-to-treat anatomic areas or pediatric, geriatric, or pregnant patients. The 2014 guideline on biologics from Saudi Arabia included recommendations for the use of these agents in patients with plaque psoriasis, including difficult-to-treat anatomic areas and pediatric patients (TNF inhibitors only), but provided no recommendations for pregnant or geriatric patients. Conclusion: There is an urgent unmet need for comprehensive clinical guidelines on the management of patients with plaque psoriasis in Africa and the Middle East. Region-specific studies on the epidemiology, burden of disease, and the safety and effectiveness of newer pharmacotherapies are needed to support the development of such guidelines.

A Comparative Study of Psoriasis and Psoriasiform Dermatoses on Basis of Ki-67 Immunohistochemical Expression

“…Regarding moderate hyperkeratosis, parakeratosis, acanthosis & thickened rete ridges, they showed higher significant expression in psoriasis (31.8, 31.8, 36.4 and 31.8% versus 4.5, 0, 0 and 0 %) than in psoriasiform dermatoses respectively (P value <0 .5) as shown in table (2).…”

“…Psoriasis is clinically diagnosed with the presence of scaly, erythematous plaques on the skin surface with additional joint, and nail manifestations. Plaque psoriasis is the most common type, guttate, pustular, and erythrodermic are atypical forms (2) .…”

Beneficial Effects of Geological Materials: With Africa Case Descriptions

“…Phototherapy, i.e., treatment exclusively using light, is applied for moderate disease, whereas systemic therapy or biological agents are applied for more advanced form of the disease (WCD, 2023). However, there still remains an unmet need for clinical guidelines on managing patients with plaque psoriasis in Africa (Steinhoff et al, 2020).…”