Background Although long-term management of psoriasis is paramount, this approach is challenging in clinical practice. In the recent PSO-LONG trial, a fixed-dose combination of betamethasone dipropionate (BD) and calcipotriol (Cal) foam applied twice a week on nonconsecutive days for 52 weeks (proactive treatment) reduced the risk of relapse. However, the role of Cal/BD foam in the long-term management of psoriasis needs further clarifications. The ProActive Management (PAM) program, a nationwide Italian project, aims at reaching a consensus on the role of proactive management of psoriasis.Methods A steering committee generated some statements through the nominal group technique (NGT). The statements were voted by an expert panel in an adapted Delphi voting process.Results Eighteen statements were proposed, and the majority of them (14/18) reached a consensus during the Delphi voting. The need to provide long-term proactive topical treatment to reduce the risk of relapse for the treatment of challenging diseases sites or in patients where phototherapy or systemic therapies are contraindicated/ineffective was widely recognized. A consensus was reached about the possibility to associate the proactive treatment with systemic and biological therapies, without the need for dose intensification, thus favoring a prolonged remission. Moreover, the proactive treatment was recognized as more effective than weekend therapy in increasing time free from relapses.Approaches to improve adherence, on the other hand, need further investigation. ConclusionsThe inclusion in guidelines of a proactive strategy among the effective treatment options will be a fundamental step in the evolution of a mild-moderate psoriasis therapeutic approach.

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Introduzione: il ricovero di un proprio caro in terapia intensiva provoca un profondo cambiamento nella gestione della vita quotidiana della famiglia. Questa situazione fa emerge la necessità di svolgere ricerche che analizzino i bisogni dei familiari per comprenderne i problemi che sorgono durante la degenza in Terapia Intensiva (TI).Obiettivo: rilevare i bisogni dei familiari dei pazienti ricoverati in terapia intensiva confrontando le differenze emerse tra TI aperte e TI chiuse.