ABBREVIATIONS USED:AAD ( American Academy of Dermatology), AM ( Alternative medicine), AV ( Aloe Vera), BSA ( body surface area), CYA ( Cyclosporine), DLQI ( Dermatology Life Quality Index), EPA ( Eicosapentaenoic acid), FDA ( the Food and Drug Administration), GFD ( Gluten-free diet), HM ( Herbal medicine), HPA ( hypothalamic-pituitary-adrenal), LCD ( Liquor carbonis detergens), NB-UVB ( narrow band ultraviolet B), NPF ( National Psoriasis Foundation), NAPSI ( Nail Psoriasis Severity Index), PASI ( Psoriasis Area Severity Index), PCB ( Polychlorinated biphenyls), PGA ( Physician's Global Assessment), PsA ( Psoriatic arthritis), PSI ( Psoriasis symptom inventory), QOL ( Quality of life), RCT ( Randomized controlled trial), SORT ( Strength of Recommendation Taxonomy), UVA ( ultraviolet A), UVB ( ultraviolet B), WG ( Work group)
Publication stageIn Press Journal Pre-Proof
Publishable Conflict of Interest Statement
The American Academy of Dermatology (AAD) strives to produce clinical guidelines that reflect the best available evidence supplemented with the judgment of expert clinicians. Significant efforts are taken to minimize the potential for conflicts of interest to influence guideline content. The management of conflict of interest for this guideline complies with the Council of Medical Specialty Societies’ Code of Interactions with Companies. Funding of guideline production by medical or pharmaceutical entities is prohibited, full disclosure is obtained and evaluated for all guideline contributors throughout the guideline development process, and recusal is used to manage identified relationships. The AAD conflict of interest policy summary may be viewed at www.aad.org.
The information below represents the authors disclosed a relationship with industry during guideline development. Authors (listed alphabetically) with relevant conflicts with respect to this guideline are noted with an asterisk*. In accordance with the AAD policy, fewer than 51% of workgroup members had any relevant conflicts of interest.
Participation in one or more of the below-listed activities constitutes a relevant conflict:
• service as a member of a speaker bureau, consultant, advisory board, for pharmaceutical companies on the psoriasis disease state or psoriasis drugs in development or FDA-approved.
• sponsored research funding or investigator-initiated studies with partial/full funding from pharmaceutical companies on the psoriasis disease state or psoriasis drugs in development or FDA-approved.
Draft guideline recommendations were developed through a collaborative approach between conflicted and non-conflicted section leaders. Initial recommendations were presented to the full workgroup for finalization.
Adherence to these guidelines will not ensure successful treatment in every situation. Furthermore, these guidelines should not be interpreted as setting a standard of care, nor should they be deemed either inclusive of all proper methods of care, or exclusive of other methods of care reasonably directed toward obtaining the same results. The ultimate judgment regarding the propriety of any specific therapy must be made by the physician and the patient in light of circumstances presented by the individual patient and the known variability and biological behavior of the disease. Furthermore, the treatment dosages used in clinical trials may not be effective in certain cases, and some patients may require shorter intervals between doses and/or higher treatment doses of a particular treatment methodology. This guideline reflects the best available data at the time the guideline was prepared. The results of future studies may require revisions to the recommendations in this guideline to reflect new data.
∗∗∗∗∗∗∗∗ Reprinted from Dermatology: 2-Volume Set, 4th Edition, Jean Bolognia, Julie Schafer, and Lorenzo Cerroni, Glucocorticosteroids, Page No. 2190, Copyright 2018, with permission from Elsevier.
§§§§§§§§§ Scalp solution application, in some classifications class 2
†††††††††† Shampoo 0.05%
§§§§§§§§§§ Lotion, Depending upon classification, class 3 or 5
∗∗∗∗∗∗∗∗∗∗∗ Foam, Depending upon classification, class 3 or 4
††††††††††† Kenalog® Ointment (Manufactured by APOTHECON, A Bristol-Myers Squibb Company; Princeton, NJ)
∗∗∗∗∗∗∗∗∗∗∗∗ Supporting suggestions are not evidence based