title: A series of critically challenging case scenarios in moderate to severe psoriasis: a Delphi consensus approach.
abstract: Clinical trials for systemic psoriasis therapy typically enroll healthy patients and exclude patients with cardiovascular disease, latent tuberculosis, liver disease, histories of malignancies, viral infections, children, and pregnant or breast-feeding women. Physicians often require guidance for optimum management of severe psoriasis in patients that have a combination of underlying disease states. To provide treatment recommendations for complex psoriasis scenarios, a consensus panel comprising 15 experts in psoriatic disease convened to review and discuss available evidence-based data and to arrive at a consensus for treatment options of difficult cases. An application of the Delphi Method was used to select case scenarios, provide medical treatment options, present the case study with existing medical evidence, and anonymously vote on treatment options. The top 10 treatment options were ranked and statistically analyzed to compare the differences between treatments. The final rankings and analysis provide guidance for practical, safe, and efficacious treatment options in a number of complex psoriasis scenarios.
authors.affiliation: Department of Dermatology, New York University Medical Center, New York, NY, USA. b_strober@hotmail.com
authors.forename: Bruce
authors.initials: B
authors.lastname: Strober
authors.forename: Emily
authors.initials: E
authors.lastname: Berger
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cather
authors.forename: David
authors.initials: D
authors.lastname: Cohen
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Crowley
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Gordon
authors.forename: Alice
authors.initials: A
authors.lastname: Gottlieb
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Horn
authors.forename: Arthur F
authors.initials: AF
authors.lastname: Kavanaugh
authors.forename: Neal J
authors.initials: NJ
authors.lastname: Korman
authors.forename: Gerald G
authors.initials: GG
authors.lastname: Krueger
authors.forename: Craig L
authors.initials: CL
authors.lastname: Leonardi
authors.forename: Alan
authors.initials: A
authors.lastname: Menter
authors.forename: Sergio
authors.initials: S
authors.lastname: Schwartzman
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Sobell
authors.forename: Melodie
authors.initials: M
authors.lastname: Young
mesh_terms: D002648:Child; D015897:Comorbidity; D003697:Delphi Technique; D015658:HIV Infections / Q000150:complications; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy / Q000628:therapy*