背景:银屑病严重程度类别已成为临床医生用于治疗决策以及确定临床研究合格标准的重要工具。然而,由于严重程度分类的异质性,以及他们缺乏对特殊地区或既往治疗史的银屑病受累的影响的考虑,患者可能被错误分类,这可能导致牛皮癣治疗不足。
目的:就银屑病严重程度的分类达成共识。
方法:国际银屑病委员会开发了一种改进的德尔菲法,以确定银屑病的严重程度。
结果:完成练习后,7个严重性定义优先排序。这个最喜欢的声明拒绝温和的,中度,和支持二分法定义的严重类别:牛皮癣患者应分为局部治疗或全身治疗的候选人;后者是至少符合以下标准之一的患者:(1)体表面积>10%,(2)涉及特殊地区的疾病,(3)局部治疗失败。
结论:这项努力可能受到所有相关利益相关者缺乏代表性的影响,包括患者。
结论:共识声明描述了2类银屑病严重程度,同时考虑患者可能需要全身治疗的特殊情况。
BACKGROUND: Psoriasis severity categories have been important tools for clinicians to use in treatment decisions as well as to determine eligibility criteria for clinical studies. However, owing to the heterogeneity of severity classifications and their lack of consideration for the impact of psoriasis involvement of special areas or past treatment history, patients may be miscategorized, which can lead to undertreatment of psoriasis.
OBJECTIVE: To develop a
consensus statement on the classification of psoriasis severity.
METHODS: A modified Delphi approach was developed by the International Psoriasis Council to define psoriasis severity.
RESULTS: After completion of the exercise, 7 severity definitions were preferentially ranked. This most preferred statement rejects the mild, moderate, and severe categories in favor of a dichotomous definition: Psoriasis patients should be classified as either candidates for topical therapy or candidates for systemic therapy; the latter are patients who meet at least one of the following criteria: (1) body surface area >10%, (2) disease involving special areas, and (3) failure of topical therapy.
CONCLUSIONS: This effort might have suffered from a lack of representation by all relevant stakeholders, including patients.
CONCLUSIONS: The
consensus statement describes 2 categories of psoriasis severity, while accounting for special circumstances where patients may require systemic therapy.