The impact of complete clearance and almost complete clearance of psoriasis on quality of life: a literature review

Boswell, Nicole; Cook, Madison K; Balogh, Esther A.; Feldman, Steven R.

doi:10.1007/s00403-022-02420-5

Cited by 11 publications

(11 citation statements)

References 27 publications

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“…Patient‐reported outcomes that provide a measure of HR‐QOL are not integrated into the reimbursement criteria. The residual minimal disease can still substantially impact HR‐QOL 38 . The extent of this psychological distress is often under‐recognised 39 and far‐reaching 40 .…”

Section: Discussionmentioning

confidence: 99%

“…The new biological and targeted therapies have improved treatment outcomes to the extent that, in the clinical trial setting, the traditional gold standard of PASI 75 has been replaced by more rigorous outcome measures (PASI 90, PASI 100 and clear/almost clear skin). From the patient's perspective, complete clearance of psoriasis lesions represents a meaningful end goal of treatment and is associated with improvements in HR‐QOL 36,38,42 and treatment satisfaction 38 . However, in the context of setting treatment targets, these should be patient‐centred by taking into account patient‐expressed wishes and carefully balanced to ensure that the target is not beyond the reach of the majority of patients 24,43 .…”

Section: Discussionmentioning

confidence: 99%

“…The residual minimal disease can still substantially impact HR-QOL. 38 The extent of this psychological distress is often under-recognised 39 and far-reaching. 40 Relying only on PASI could therefore result in misalignment between physician-reported and patient-reported severity.…”

Section: Consideration Of Other Assessment Metricsmentioning

confidence: 99%

“…From the patient's perspective, complete clearance of psoriasis lesions represents a meaningful end goal of treatment and is associated with improvements in HR-QOL 36,38,42 and treatment satisfaction. 38 However, in the context of setting treatment targets, these should be patient-centred by taking into account patient-expressed wishes and carefully balanced to ensure that the target is not beyond the reach of the majority of patients. 24,43 Analysis of clinical trial data shows that not all patients achieve PASI 100 (response rates at 1 year: TNF inhibitors, 21.8-34.8%; IL-17 inhibitors, 41.4-67.5%; IL-12/23 inhibitors, 41.8-56.3%), suggesting that its utility be restricted to the research setting.…”

Section: Pasi 90 As a Realistic Treatment Goalmentioning

confidence: 99%

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Australian consensus: Treatment goals for moderate to severe psoriasis in the era of targeted therapies – Adult patients

Foley,

Gebauer,

Sullivan

et al. 2023

Aust J Dermatology

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BackgroundOver the last decade, the treatment landscape for moderate–severe psoriasis has rapidly evolved. The Australasian College of Dermatologists sought to review and update previously published treatment goals for moderate–severe psoriasis.MethodsA modified Delphi approach was used. Comprehensive literature review and guideline evaluation resulted in the development of statements and other questions to establish current clinical practices. Two rounds of anonymous voting were undertaken, with a collaborative meeting held in between to discuss areas of discordance. Overall, consensus was defined as achievement of ≥75% agreement in the range 7–9 on a 9‐point scale (1 strongly disagree; 9 strongly agree).ResultsConsensus was achieved on 26/29 statements in round 1 and a further 20 statements in round 2. There was strong agreement to expanding the classification/definition of psoriasis severity by including a choice of metrics, incorporating quality of life measures, and widening the scope of high‐impact sites. Consensus was also reached on revised treatment response criteria, which were then incorporated into a new treatment algorithm. There was discordance with the current requirement to undertake a trial with established systemic agents before accessing targeted therapy.ConclusionThe ability of new targeted treatment options to change the narrative in psoriasis patient care can only be properly realised if challenges to timely and equitable access are addressed. The proposed framework for the assessment, classification and management of moderate–severe psoriasis aligns with international recommendations. Its adoption into Australian clinical practice is hoped to improve treatment outcomes and patients' satisfaction with their care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Consideration Of Other Assessment Metricsmentioning

confidence: 99%

Section: Pasi 90 As a Realistic Treatment Goalmentioning

confidence: 99%

See 2 more Smart Citations

Australian consensus: Treatment goals for moderate to severe psoriasis in the era of targeted therapies – Adult patients

Foley,

Gebauer,

Sullivan

et al. 2023

Aust J Dermatology

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“…As shown in figure (4). Psoriasis is an immune mediated skin disease (21) that causes itchy, scaly patches, most commonly on the knees, elbows, trunk and scalp (22) . The present study aimed at investigating the effects of topical and oral use of aescin on psoriasis through its anti-inflammatory, antioxidant, anti-edematous and venotonic effect and compare these effects to the effects of clobetasol.…”

Section: Histopathologymentioning

confidence: 99%

Effect of Aescin in Psoriatic-Induced Animal Model: Immunohistochemical and Pathological Study

Wadhah,

Talib,

Ali

et al. 2024

AJPS

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Background: Aescin is a mixture of the triterpene saponins extracted from the seeds of the horse chestnut tree Aesculus hippocastanum. Aescin has a venotonic, anti-inflammatory, antioxidant and anti-edematous characteristics that are mostly connected to the agent molecular mechanism. Objective: The present study aim to investigate the potential effects of Aescin on psoriasis induced by Imiquimod in male rats, ncluding its effect on the level of tumor necrosis factor alpha, Ki-67 and the histopathologic features of the psoriatic skin. Methods: Thirty-six albino male rats were divided into six groups each group containing 6 animals, psoriasis was induced by Imiquimod to five of the groups, while for the last group vasaline was applied and the group served as a control group. The animals were then treated with topical Aescin, topical clobetasol, combination of topical Aescin and clobetasol and oral Aescin, finally all animals were sacrificed and the dorsal back skin was taken to perform histopathological and immunohistochemical analysis. Results: regarding the level of Ki-67, Strong expression of Ki-67 was seen in the group who received Imiquimod only, where the scoring of Ki-67 was notably lowered among the other groups. However, the lowest expression was noticed in the group that were treated with the combination of topical Aescin and clobetasol. While the number of TNF-α positive cells and the intensity of immunostaining were higher in the induction group who received Imiquimod only and the lowest among the group who received the combination of topical Aescin and Clobetasol. Lastly the histopathologic analysis shows that the histopathologic features of psoriasis was markedly affected by the anti-inflammatory effect of Aescin and clobetasol, which was noticed through inhibition of proinflammatory markers, and the decrease in capillary permeability. Conclusion: Topical Aescin alone or in combination with clobetasol reduced Ki-67 expression successfully; furthermore, the combination of topical Aescin and Clobetasol decreased TNF- score and had the strongest anti-inflammatory activity more than the other groups. Lastly Aescin was able to alter the histopathologic features of the psoriatic skin through its anti-inflammatory, venotonic and anti-edematous activity.

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Evaluation and Comparison of the Efficacy and Safety of Cryotherapy and Electrosurgery in the Treatment of Sebaceous Hyperplasia, Seborrheic Keratosis, Cherry Angioma, and Skin Tag: A Blinded Randomized Clinical Trial Study

Sadeghzadeh‐Bazargan,

Shafiei,

Atefi

et al. 2024

Health Science Reports

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BackgroundCryotherapy and electrosurgery are two commonly used methods to remove sebaceous hyperplasia, seborrheic keratosis, cherry angioma, and skin tags, which can be bothersome and uncomfortable. We compare the effectiveness and adverse effects of cryotherapy and electrosurgery in treating these skin conditions.MethodThe study was conducted as an assessor‐blind trial. The 32 lesions in each lesion group were divided into two treatment groups, cryotherapy and electrosurgery, using sealed envelopes. We collected baseline information, which included age, gender, lesion location, and consent, from the patients. Follow‐up visits were scheduled at 2 weeks, 1 month, and 3 months after the initial treatment session to evaluate the response rate of the lesions. Based on before‐after clinical images, this evaluation encompassed patient and physician satisfaction (no change, little, somewhat, good, and excellent), and any potential complications.ResultsThe mean age of cryotherapy group was 52.04 ± 11.59 years, while the mean age in the electrosurgery group was 50.48 ± 10.70 years (p > 0.05). Regarding gender, 15 (23.4%) in the cryotherapy and 24 (37.5%) in the electrosurgery were female (p > 0.05). Physician and patient satisfaction increased significantly over time in the cryotherapy and electrosurgery groups (p < 0.001). For sebaceous hyperplasia, cherry angioma and skin tags, the degree of satisfaction of patients and physicians was significantly higher for electrosurgery than cryotherapy during follow‐up (p < 0.05). However, seborrheic keratosis responded better to cryotherapy. Hypopigmentation and depigmentation occurred in 2 (3.1%) and 4 (6.3%) of the cryotherapy cases, respectively. Hypopigmentation and atrophic scars also occurred in 4 (6.3%) and 2 (3.1%) of the cases in the electrosurgical group in different sessions.ConclusionIt appears that electrosurgery is more effective in the treatment of sebaceous hyperplasia, cherry angioma and skin tags, while cryotherapy is more effective in the treatment of seborrheic keratosis.

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The impact of complete clearance and almost complete clearance of psoriasis on quality of life: a literature review

Cited by 11 publications

References 27 publications

Australian consensus: Treatment goals for moderate to severe psoriasis in the era of targeted therapies – Adult patients

Australian consensus: Treatment goals for moderate to severe psoriasis in the era of targeted therapies – Adult patients

Effect of Aescin in Psoriatic-Induced Animal Model: Immunohistochemical and Pathological Study

Evaluation and Comparison of the Efficacy and Safety of Cryotherapy and Electrosurgery in the Treatment of Sebaceous Hyperplasia, Seborrheic Keratosis, Cherry Angioma, and Skin Tag: A Blinded Randomized Clinical Trial Study

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