Asian consensus on assessment and management of mild to moderate plaque psoriasis with topical therapy.
Asian consensus on assessment and management of mild to moderate plaque psoriasis with topical therapy.
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DOI：
10.1111/1346-8138.14338
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发表时间：
2018-07
期刊：
影响因子：
--
通讯作者：
Song HJ
中科院分区：
文献类型：
--
作者：
Imafuku S;Zheng M;Tada Y;Zhang X;Theng C;Thevarajah S;Zhao Y;Song HJ
亚洲国家的皮肤科医生工作组评估了该地区银屑病治疗的现状，以准备一份关于轻度至中度斑块状银屑病局部治疗的共识报告。尽管人们越来越认识到银屑病与全身性合并症的联系，但银屑病在该地区的医疗保健优先顺序中仍然较低。牛皮癣的心理社会影响可能在亚洲国家更大，由于文化规范和社会歧视。不依从治疗在亚洲人中也很常见。目前给予轻度至中度银屑病患者的护理需要简化，加强和组织以患者为中心的护理方法，以实现更好的结果。在开始治疗之前，需要对疾病的严重程度及其对患者生活的影响进行全面评估。教育和患者积极参与治疗计划是银屑病管理的重要组成部分。建议根据疾病的严重程度、心理社会影响、患者的期望以及更重要的是患者主动遵循治疗程序的意愿和能力，个性化局部治疗以满足患者的需求。皮质类固醇和维生素D类似物的固定剂量组合是治疗初始和维持阶段的首选外用药物。疾病的快速遏制是4-8周初始阶段的目标，它需要有效的快速作用的局部治疗。在维持阶段，每周两次或周末应用，应达到令人满意的疾病控制和复发预防。
A working group of dermatologists in Asian countries assessed the current status of psoriatic management in the region to prepare a consensus report on topical treatment in mild to moderate plaque psoriasis. Even though the association of psoriasis with systemic comorbidities is increasingly acknowledged, psoriasis is still lower in health‐care priority lists in the region. The psychosocial impact of psoriasis may be greater in Asian countries due to cultural norms and social discrimination. Non‐adherence to treatment is also common among Asians. The current care given to patients with mild to moderate psoriasis needs to be streamlined, enhanced and organized with a patient‐centered care approach to achieve better outcomes. A comprehensive assessment of the disease severity and its impact on a patient's life is required before initiating treatment. Education and active involvement of the patient in the treatment plan is an important part of psoriatic management. It is recommended to personalize topical treatment to meet the needs of the patient, depending on disease severity, psychosocial impact, the patient's expectations and, more importantly, the patient's willingness and ability to actively follow the treatment procedure. Fixed‐dose combination of corticosteroid and vitamin D analogs is the preferred topical medication for both initial and maintenance phases of treatment. The fast containment of the disease is the goal of the initial phase of 4–8 weeks and it demands a potent fast‐acting topical therapy. Satisfactory control of the disease and prevention of relapses should be achieved during the maintenance phase with twice a week or weekend applications.
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