Treatment of pustular psoriasis: From the Medical Board of the National Psoriasis Foundation - 13/07/12
Correspondence to: Robert E. Kalb, MD, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 295 Essjay Rd, Buffalo, NY 14221.Abstract |
Background |
A task force of the National Psoriasis Foundation Medical Board was convened to evaluate treatment options for pustular psoriasis. Meetings were held by teleconference. Consensus on treatment of pustular psoriasis was achieved. Pustular psoriasis has been classified into localized and generalized forms. There are a number of treatment modalities, but there is little evidence-based information to guide the management of this type of psoriasis.
Objectives |
The purpose of this article was to present treatment recommendations to aid in the treatment of patients with pustular psoriasis.
Methods |
A literature review was conducted to examine treatment options for pustular psoriasis and assess the strength of the literature for each option.
Results |
Overall the quality of the literature about the treatment of pustular psoriasis is weak. Treatment should be governed by the extent of involvement and severity of disease. Acitretin, cyclosporine, methotrexate, and infliximab are considered to be first-line therapies for those with generalized pustular psoriasis. Adalimumab, etanercept, and psoralen plus ultraviolet A are second-line modalities in this setting. Pustular psoriasis in children, in pregnant women, and in localized forms alter which agents are first-line modalities as concerns such as teratogenicity need to be factored into the decisionmaking for the individual patient.
Limitations |
There are few high-quality studies examining treatment options for pustular psoriasis.
Conclusions |
Treatment of patients with pustular psoriasis depends on the severity of presentation and patient’s underlying risk factors. The data are extremely limited for this type of psoriasis and we encourage further exploration.
Le texte complet de cet article est disponible en PDF.Key words : drug therapy, psoriasis
Abbreviations used : GPP, PPPP, PUVA, TNF, UV
Plan
| Funding sources: None. |
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| Disclosure: Dr Van Voorhees has served as a consultant/speaker/advisor for Amgen, Abbott, Centocor, Genentech, Warner Chilcott, and Leo. She has been an investigator for Amgen and Genentech. She has served on a drug safety monitoring board for Synta. Dr Hsu has been a consultant for Abbott, Amgen, Biogen Idec, Centocor, and Genentech. She has been a clinical investigator for Amgen and Centocor. Dr Korman has been a consultant for Abbott, Astellas, Centocor, and Genentech; he has also been a speaker for Abbott, Amgen, Astellas, Centocor, and Genentech. Dr Lebwohl has been a consultant for Abbott, Amgen, Astellas, Centocor, Genentech, Galderma, Leo Pharma, and Novartis. Dr Bebo is employed by the National Psoriasis Foundation. The foundation receives unrestricted financial support from Abbott, Centocor, Amgen, Wyeth, Genentech, Astellas, Stiefel, Galderma, Warner Chilcott, and Photomedix. Dr Kalb has been an investigator and consultant for Abbott, Amgen, Centocor, Astellas, Warner Chilcott, and Stiefel. Dr Robinson has no conflicts of interest to declare. |
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| Reprints not available from the authors. |
Vol 67 - N° 2
P. 279-288 - août 2012 Retour au numéro
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