Treatment of Scalp Psoriasis: Review of the Evidence and Delphi Consensus of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology

Puig, Luís; Ribera, M.; Hernanz, J.M.; Belinchón, Isabel; Santos‐Juanes, Jorge; Linares, M.; Querol, I.; Colomé, E.; Caballé, G.

doi:10.1016/s1578-2190(10)70730-7

Cited by 9 publications

(10 citation statements)

References 87 publications

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“…Issues within themes and emerging critical issues were prioritized using Likert scales, as used in previous consensus studies in dermatology. 20,21,23,24 Our experts ranked issues using a six-point Likert scale (1 = least important, 6 = most important). For issues where it was more appropriate to assess the level of agreement, a seven-point Likert scale was used to evaluate expert opinions (1 = strongly disagree, 7 = strongly agree).…”

Section: Methodsmentioning

confidence: 99%

“…To our knowledge, this is the first attempt to use expert consensus to propose recommendations for improving the real world efficacy of topical AK field therapy. The effectiveness of the Delphi approach for producing recommendations for new therapeutic directions has already been shown for psoriasis [21][22][23] and epidermolysis bullosa. 24 This research provides a balanced consensus that encompasses both physician and patient perspectives, providing a sound basis on which to argue for new directions in topical AK treatment.…”

Section: Ae Sdmentioning

confidence: 99%

“…Consensus studies with experts have been acknowledged as an appropriate way to inform clinical decision making and develop supporting strategies. 19 The Delphi approach unites experts to discuss and make progress on complex issues based on consensus opinion 20 and has previously been applied successfully to produce therapeutic recommendations in dermatology in the areas of psoriasis [21][22][23] and epidermolysis bullosa. 24 This study convened a modified Delphi approach to generate consensus on factors constraining the real-world efficacy of topical AK therapy and make recommendations for the future development of AK care strategies.…”

Section: Introductionmentioning

confidence: 99%

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A consensus approach to improving patient adherence and persistence with topical treatment for actinic keratosis

et al. 2015

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BackgroundTopical therapy is important in the treatment of actinic keratosis, but guidance for improving adherence/persistence during topical therapy is still lacking.ObjectivesTo utilize expert consensus to generate a list of recommendations to improve real-world efficacy when prescribing topical therapy for actinic keratosis.MethodsAn expert panel of eight dermatologists was convened to generate recommendations based on facilitated discussion and consensus generation using a modified Delphi session. The recommendations were ratified with the expert panel.ResultsFacilitated discussion generated 31 issues within five themes, which were prioritized using expert voting. Consensus was achieved on the importance of short and simple treatment regimens for maximizing patient compliance, physician awareness of the progression of actinic keratosis to squamous cell carcinoma, provision of appropriate patient information, and the use of effective communication strategies to educate physicians about actinic keratosis. Based on these key findings, eight recommendations were generated.ConclusionsThe recommendations will assist physicians when prescribing topical actinic keratosis therapy. Further research should focus on the types of patient outcomes that are influenced by the characteristics of topical field therapy.

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Section: Methodsmentioning

confidence: 99%

Section: Ae Sdmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A consensus approach to improving patient adherence and persistence with topical treatment for actinic keratosis

et al. 2015

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“…However, there is no unanimous consensus on the concept of agreement or disagreement, and a review of the literature shows considerable variability in the criteria applied. In some reports, a Likert scale from 0 to 5 is used, while in others the scale runs from 0 to 7 or 9 to 10 . Other formats have included questions with a simple yes/no response, questions in which participants were asked to rank a series of options in the order of preference, and questions where the participants provide free‐text answers.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 Sometimes, an overall definition of agreement is sought, agreement is graded (e.g. strong agreement), strong consensus on a specific item requires the vote of at least 90% of the participants (regarded as 'agreement'), [12][13][14][15] or consensus is defined when ≥70% of participants 4,7,10 or ≥75% of participants 5 score within the 6-7 4 or 7-9 range 5,7,10 on the scale. Consensus may also be considered to have been reached for a text when at least a simple consensus on a certain item has been reached (i.e.…”

Section: Introductionmentioning

confidence: 99%

Consensus document on the evaluation and treatment of moderate‐to‐severe psoriasis: Psoriasis Group of the Spanish Academy of Dermatology and Venereology

Daudén

Puig

Ferrándiz

et al. 2016

Acad Dermatol Venereol

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106

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Psoriasis is a highly prevalent disease with a major impact on quality of life; therefore, appropriate patient management is mandatory. Given that many issues in psoriasis are controversial and not clearly defined by evidence-based medicine, management of psoriasis is very variable. Expert consensus can generate practical guidelines for optimization of patient care. Much has changed since 2009, when the Consensus Document on the Evaluation and Treatment of Moderate to Severe Psoriasis was published by the Spanish Psoriasis Group (GEP) of the Spanish Academy of Dermatology and Venereology (AEDV). The objective of the present consensus document is to provide the dermatologist with updated recommendations for the evaluation and treatment of patients with moderate-to-severe plaque psoriasis. All active members of the GEP of the AEDV were invited to participate in the survey. The final group comprised 46 members from various areas of Spain and with substantial experience in managing psoriasis. A 3-round Delphi process was used to reach consensus. Consistent agreement and consistent disagreement (consensus) required the achievement of at least two of the following three criteria: Criterion 1, which was based on the position occupied by the mean on a scale of 1-9 and an SD <2; Criterion 2, which was based on the median and interquartile range (IQR) on a scale of 1-9; Criterion 3, which considered the percentage of the voting experts on a scale of 1-9. The items studied were definition of severity, therapeutic objectives, indications for systemic treatment and biologic therapy, induction and maintenance periods, therapeutic failure, loss of response, relapse and rebound, continuous and intermittent therapy, screening of patients before treatment, adherence to therapy, follow-up of treatment outcome, combination of drugs, transitioning and associated comorbidities. Consistent agreement or disagreement (consensus) was achieved for 198 items (agreement, 3 criteria 146 items, 2 criteria 43 items; disagreement, 3 criteria 9 items, 2 criteria 0 items) based on the criteria described above. Completion of the Delphi consensus process enabled a broad and experienced group of Spanish psoriasis experts to provide useful and practical guidelines for the management and treatment of patients with moderate-to-severe psoriasis, particularly in areas where evidence is lacking.

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Prolonged skin retention of clobetasol propionate by bio-based microemulsions: a potential tool for scalp psoriasis treatment

Langasco

Tanrıverdi

Özer

et al. 2017

Drug Development and Industrial Pharmacy

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Novel effective and cosmetically acceptable formulations are needed for the treatment of scalp psoriasis, due to the poor efficacy of the current products. The challenge in developing safe, efficient, and convenient delivery systems for this drug was addressed in the present work by formulating clobetasol propionate-loaded W/O microemulsions (MEs). Pseudo-ternary phase diagrams were constructed by using a combination of biocompatible and biodegradable excipients. Characterization studies demonstrated that selected MEs had suitable technological features such as being Newtonian fluids, possessing low viscosity, and high thermodynamic stability. Photomicrographs showed a significant alteration of the skin structure after treatment with MEs, and a preferential concentration of these in the stratum corneum and epidermis. These data, together with ex vivo permeation results, suggested an enhanced topical targeted effect due to an increased drug retention efficacy in the upper skin layers, as desired. Moreover, the bio-based excipients selected could contribute to the healing of the psoriatic scalp. In this way, the improvement of clobetasol efficacy is combined with the useful properties of the microemulsion components and with environmental safety.

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Treatment of Scalp Psoriasis: Review of the Evidence and Delphi Consensus of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology

Cited by 9 publications

References 87 publications

A consensus approach to improving patient adherence and persistence with topical treatment for actinic keratosis

A consensus approach to improving patient adherence and persistence with topical treatment for actinic keratosis

Consensus document on the evaluation and treatment of moderate‐to‐severe psoriasis: Psoriasis Group of the Spanish Academy of Dermatology and Venereology

Prolonged skin retention of clobetasol propionate by bio-based microemulsions: a potential tool for scalp psoriasis treatment

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