Knuckles Melissa L F, Levi Eugenia, Soung Jennifer
a Department of Dermatology , Richmond , KY , USA.
b Celgene Corporation , Summit , NJ , USA.
J Dermatolog Treat. 2018 Nov;29(7):658-663. doi: 10.1080/09546634.2018.1443200. Epub 2018 Mar 22.
Patients with moderate plaque psoriasis are often undertreated and may experience unsatisfactory clinical outcomes. Undertreatment may stem partly from a lack of consensus on the definition of moderate psoriasis and appropriate treatments for patients with moderate disease severity.
An online survey was conducted during October 2015 to determine how US dermatologists in the clinical setting define and treat moderate psoriasis.
A total of 150 dermatologists responded to the survey (mean time in practice: 13.5 years). On average, they saw 72 patients with psoriasis per month; 40% of these patients were considered to have moderate psoriasis. Most (95%) reported assessing disease severity based on the percentage of psoriasis-affected body surface area (BSA); 59% also considered location of the affected area. BSA cutoffs used to define moderate psoriasis varied widely (median low and high cutoffs: 5-10%; range: 1-70%). Similarly, wide variation in cutoff ranges was observed for the Psoriasis Area and Severity Index (PASI), Physician Global Assessment (PGA), and Dermatology Life Quality Index (DLQI). Primary therapy comprised biologics (47%), prescription topicals (28%), and oral systemics (18%).
The current findings indicate lack of consensus surrounding the definition of moderate psoriasis among US dermatologists.
中度斑块状银屑病患者常常治疗不足，临床结局可能不尽人意。治疗不足部分可能源于对中度银屑病的定义以及中度病情严重程度患者的适当治疗方法缺乏共识。
2015年10月进行了一项在线调查，以确定美国临床皮肤科医生如何定义和治疗中度银屑病。
共有150名皮肤科医生回复了调查（平均执业时间：13.5年）。他们每月平均诊治72例银屑病患者；其中40%的患者被认为患有中度银屑病。大多数（95%）报告根据银屑病累及的体表面积（BSA）百分比评估疾病严重程度；59%还考虑了受累区域的位置。用于定义中度银屑病的BSA临界值差异很大（低临界值和高临界值中位数：5 - 10%；范围：1 - 70%）。同样，银屑病面积和严重程度指数（PASI）、医生整体评估（PGA）和皮肤病生活质量指数（DLQI）的临界值范围也存在很大差异。主要治疗方法包括生物制剂（47%）、处方外用药物（28%）和口服系统药物（18%）。
目前的研究结果表明，美国皮肤科医生对中度银屑病的定义缺乏共识。
