TY - JOUR
T1 - Asia-Pacific consensus recommendations on the management of generalized pustular psoriasis
AU - Choon, Siew Eng
AU - Foley, Peter Anthony
AU - Asawanonda, Pravit
AU - Fujita, Hideki
AU - Jo, Seong Jin
AU - Shi, Yu ling
AU - Theng, Colin
AU - Affandi, Azura Mohd
AU - Bang, Chul Hwan
AU - Frez, Maria Lorna
AU - Huei, Huang Yu
AU - Le Huu, Doanh
AU - Kim, Tae Gyun
AU - Morita, Akimichi
AU - Oon, Hazel H.
AU - Fernández-Peñas, Pablo
AU - Rajatanavin, Natta
AU - Robinson, Suganthy
AU - Selvarajah, Latha
AU - Tsai, Tsen Fang
N1 - Publisher Copyright:
© 2024 The Author(s). The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.
PY - 2024/12
Y1 - 2024/12
N2 - Generalized pustular psoriasis (GPP) is a rare, chronic, heterogeneous, and potentially life-threatening disease characterized by primary, sterile, and macroscopically visible pustules with or without systemic symptoms. There are ethnic differences in the genetic mutations associated with GPP that might affect the clinical manifestations and treatment responses. Currently, there is limited evidence from the patient population in the Asia-Pacific (APAC) region, resulting in a general paucity of information on the effective management of patients with GPP in this region. This modified Delphi panel study aimed to identify current evidence and gain advanced insights to facilitate the development of a regionally tailored APAC consensus on the management of GPP. A systematic literature review (SLR) was conducted to identify published literature and develop consensus statements on (i) definition and clinical course, (ii) diagnosis of GPP, (iii) treatment outcomes, goals, and monitoring measures, and (iv) optimal management strategies and clinical practices. Statements were rated by a panel of dermatologists in two rounds, with the threshold for consensus at ≥80% agreement. Twenty experts from the APAC region reached consensus on 106 statements that were developed based on the SLR and experts' collective expertise. The experts agreed that GPP is a rare, severe, and potentially life-threatening condition that is distinct from plaque psoriasis. This consensus emphasized the importance of a tailored treatment strategy taking into account the GPP flare severity and each patient's unique clinical circumstances. The experts reached consensus on the severity classification of GPP flares and recommended first-line and maintenance treatment options for adult GPP, childhood GPP, and GPP in pregnancy. These consensus outcomes have been synthesized into treatment algorithms to guide dermatologists in the APAC region in their clinical decision-making processes.
AB - Generalized pustular psoriasis (GPP) is a rare, chronic, heterogeneous, and potentially life-threatening disease characterized by primary, sterile, and macroscopically visible pustules with or without systemic symptoms. There are ethnic differences in the genetic mutations associated with GPP that might affect the clinical manifestations and treatment responses. Currently, there is limited evidence from the patient population in the Asia-Pacific (APAC) region, resulting in a general paucity of information on the effective management of patients with GPP in this region. This modified Delphi panel study aimed to identify current evidence and gain advanced insights to facilitate the development of a regionally tailored APAC consensus on the management of GPP. A systematic literature review (SLR) was conducted to identify published literature and develop consensus statements on (i) definition and clinical course, (ii) diagnosis of GPP, (iii) treatment outcomes, goals, and monitoring measures, and (iv) optimal management strategies and clinical practices. Statements were rated by a panel of dermatologists in two rounds, with the threshold for consensus at ≥80% agreement. Twenty experts from the APAC region reached consensus on 106 statements that were developed based on the SLR and experts' collective expertise. The experts agreed that GPP is a rare, severe, and potentially life-threatening condition that is distinct from plaque psoriasis. This consensus emphasized the importance of a tailored treatment strategy taking into account the GPP flare severity and each patient's unique clinical circumstances. The experts reached consensus on the severity classification of GPP flares and recommended first-line and maintenance treatment options for adult GPP, childhood GPP, and GPP in pregnancy. These consensus outcomes have been synthesized into treatment algorithms to guide dermatologists in the APAC region in their clinical decision-making processes.
KW - Asia-Pacific
KW - consensus
KW - Delphi panel
KW - generalized pustular psoriasis
KW - management
UR - https://www.scopus.com/pages/publications/85205850455
U2 - 10.1111/1346-8138.17471
DO - 10.1111/1346-8138.17471
M3 - Article
AN - SCOPUS:85205850455
SN - 0385-2407
VL - 51
SP - 1579
EP - 1595
JO - The Journal of Dermatology
JF - The Journal of Dermatology
IS - 12
ER -