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J Eur Acad Dermatol Venereol. 2017 Jul;31(7):1188-1195. doi: 10.1111/jdv.14250. Epub 2017 Apr 19.

Topical treatment of psoriasis: questionnaire results on topical therapy accessibility and influence of body surface area on usage.

Author information

1
Department of Dermatology, Aarhus University Hospital, Aarhus C, Denmark.
2
Innovaderm Research, Montreal, QC, Canada.
3
Santa Casa de Misericórdia de Porto Alegre Hospital, Porto Alegre, Brazil.
4
Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
5
St. Vincents Hospital, Dublin, Ireland.
6
The Dermatology Centre, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK.
7
Department of Medicine, University of Toronto, Toronto, ON, Canada.
8
International Psoriasis Council, St. Louis, MO, USA.
9
Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.

Abstract

BACKGROUND:

Topical treatment of mild to moderate psoriasis is first-line treatment and exhibits varying degrees of success across patient groups. Key factors influencing treatment success are physician topical treatment choice (high efficacy, low adverse events) and strict patient adherence. Currently, no formalized, international consensus guidelines exist to direct optimal topical treatment, although many countries have national guidelines.

OBJECTIVE:

To describe and analyse cross-regional variations in the use and access of psoriasis topical therapies.

METHODS:

The study was conducted as an observational cross-sectional study. A survey was distributed to dermatologists from the International Psoriasis Council (IPC) to assess topical therapy accessibility in 26 countries and to understand how body surface area (BSA) categories guide clinical decisions on topical use.

RESULTS:

Variation in the availability of tars, topical retinoids, dithranol and balneotherapy was reported. The vast majority of respondents (100% and 88.4%) used topical therapy as first-line monotherapy in situations with BSA < 3% and BSA between 3% and 10%, respectively. However, with disease severity increasing to BSA > 10%, the number of respondents who prescribe topical therapy decreased considerably. In addition, combination therapy of a topical drug and a systemic drug was frequently reported when BSA measured >10%.

CONCLUSION:

This physician survey provides new evidence on topical access and the influence of disease severity on topical usage in an effort to improve treatment strategies on a global level.

PMID:
28370534
DOI:
10.1111/jdv.14250
[Indexed for MEDLINE]

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