Recommendations for a patient-centered approach to the assessment and treatment of scalp psoriasis: A consensus statement from the Asia Scalp Psoriasis Study Group
Journal
Journal of Dermatological Treatment
Journal Volume
25
Journal Issue
1
Pages
38-45
Date Issued
2014
Author(s)
Abstract
Background: International consensus statements on the management of scalp psoriasis are available, but no such recommendations exist for Asia. Methods: The Asia Scalp Psoriasis Study Group (ASPSG) met in May 2011 to review the epidemiologic pattern of scalp psoriasis in Southeast Asia and to develop Asia-specific recommendations for its management. Results: The overall prevalence of psoriasis in Asia is <0.3%, but 75-90% have scalp involvement, whether isolated or with lesions elsewhere, which can negatively impact quality of life (QoL). Treatment decisions should be based primarily on objective disease severity, but should also take account of patient QoL. Psychosocial support and more aggressive treatment should be offered to all patients with moderate to severe QoL impairment. Topical therapy is indicated first-line in all patients, with combination therapy (corticosteroid + calcipotriol), more occlusive formulations, keratolytics, and very potent corticosteroids for patients needing greater or faster efficacy. Systemic therapies, light or laser treatments should be reserved for patients with severe and recalcitrant disease. Conclusions: The ASPSG recommends a patient-centered approach to scalp psoriasis management, consistent with the international consensus statements. Asian physicians should also consider patient QoL, prior treatment response, formulation preferences, likely adherence, cost, time available for self-management, and potential adverse events. ? 2014 Informa Healthcare USA on behalf of Informa UK Ltd.
SDGs
Other Subjects
antifungal agent; betamethasone; betamethasone dipropionate; betamethasone valerate; biological product; calcipotriol; calcitriol; calcium; clobetasol propionate; coal tar; colecalciferol derivative; corticosteroid; cyclosporin; dithranol; etretin; fluocinolone acetonide; hydrocortisone; keratolytic agent; ketoconazole; methotrexate; mometasone furoate; placebo; salicylic acid; selenium sulfide; shampoo; steroid; tacalcitol; tazarotene; triamcinolone acetonide; Asia; clinical assessment; clinical decision making; clinical protocol; consensus; corticosteroid therapy; disease severity; drug absorption; drug formulation; drug metabolism; epidemiological data; erythema; foam; fungal strain; gel; Hospital Anxiety and Depression Scale; human; lotion; low drug dose; low level laser therapy; Malassezia; meta analysis; monotherapy; patient care; phototherapy; prevalence; priority journal; pruritus; psoriasis; Psoriasis Area and Severity Index; Psoriasis Scalp Severity Index; psychosocial care; quality of life; rating scale; review; scalp; scalp psoriasis; sebaceous gland; seborrheic dermatitis; skin defect; Southeast Asia; topical treatment; Administration, Cutaneous; Adrenal Cortex Hormones; Adult; Age of Onset; Asia; Consensus; Dermatologic Agents; Female; Humans; Malassezia; Male; Patient-Centered Care; Phototherapy; Psoriasis; Quality of Life; Scalp Dermatoses; Severity of Illness Index
Type
review