Nijsten Tamar, Lambert Julien
Department of Dermatology, University Hospital Antwerp, Edegem, Belgium.
Dermatology. 2006;213(2):123-33. doi: 10.1159/000093851.
Experts' opinions about old and new psoriasis therapies are well documented.
To document the views and opinions of a large, diverse group of dermatologists about psoriasis treatment.
PARTICIPANTS/METHODS: A survey was conducted among Belgian dermatologists. In addition to demographic and professional characteristics, the questionnaire assessed the self-rated level of experience, frequency of use, preference and considerations regarding UVB, PUVA, methotrexate (MTX), cyclosporin (CsA) and acitretin. Multivariate logistic regression analyses were performed to investigate predictors of these dermatologist-based outcomes.
Of the 628 contacted dermatologists, 310 responded (response rate of 49.3%). The dermatologists were significantly more experienced with photo(chemo)therapy than with systemic agents (p < or = 0.02); about half reported none or little experience with MTX and CsA. Also, photo(chemo)therapies were significantly more frequently used than systemic drugs (p < or = 0.01). In the last year, almost 40% had not used and less than 10% had used MTX or CsA more than 10 times. Despite the limitations of PUVA, it was preferred to UVB, followed by acitretin (+/- phototherapy), and MTX and CsA were considered final options by most dermatologists. After adjusting for confounding variables, age, years in practice, seeing and treating more patients, residency programme and/or access to UV therapy were significantly associated with limited experience, regular use and/or preference of studied therapies.
Either a substantial proportion of the dermatologists does not need or wish to use conventional systemic psoriasis therapies or they may need better and more uniform training during and after their residency. This may improve patient care and patient selection for other treatments.
关于银屑病新旧疗法的专家意见已有充分记录。
记录一大群不同的皮肤科医生对银屑病治疗的看法和意见。
参与者/方法：对比利时皮肤科医生进行了一项调查。除人口统计学和专业特征外，问卷评估了自我评定的经验水平、使用频率、对紫外线B（UVB）、补骨脂素加紫外线A（PUVA）、甲氨蝶呤（MTX）、环孢素（CsA）和阿维A的偏好及考虑因素。进行多变量逻辑回归分析以研究这些基于皮肤科医生的结果的预测因素。
在联系的628名皮肤科医生中，310名做出了回应（回应率为49.3%）。皮肤科医生对光（化学）疗法的经验明显多于对全身用药的经验（p≤0.02）；约一半的人表示对MTX和CsA没有或几乎没有经验。此外，光（化学）疗法的使用频率明显高于全身用药（p≤0.01）。在过去一年中，近40%的人未使用过MTX或CsA，不到10%的人使用MTX或CsA超过10次。尽管PUVA有局限性，但它比UVB更受青睐，其次是阿维A（±光疗），大多数皮肤科医生将MTX和CsA视为最终选择。在对混杂变量进行调整后，年龄、从业年限、诊治更多患者、住院医师培训项目和/或获得紫外线治疗与所研究疗法的经验有限、经常使用和/或偏好显著相关。
要么相当一部分皮肤科医生不需要或不想使用传统的系统性银屑病疗法，要么他们在住院期间及之后可能需要更好、更统一的培训。这可能会改善患者护理以及为其他治疗进行患者选择。
