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The clinical, humanistic, and economic burden of generalized pustular psoriasis: a structured review.
Expert Review of Clinical Immunology ( IF 4.4 ) Pub Date : 2020-02-19 , DOI: 10.1080/1744666x.2019.1708193
Saifuddin Kharawala 1 , Amanda K Golembesky 2 , Rhonda L Bohn 3 , Dirk Esser 4
Affiliation  

Introduction: Generalized pustular psoriasis (GPP) is characterized by widespread erythema and edema, superficial sterile coalescing pustules, and lakes of pus. Although the impact of GPP is thought to be substantial, emerging literature on its clinical, humanistic, and economic burden has not previously been described in a structured way.Areas covered: A structured search focused on the identification of studies in GPP using specific search terms in PubMed and EMBASE® from 2005 onwards, with additional back-referencing and pragmatic searches. Outcomes of interest included clinical, humanistic, and economic burden.Expert opinion: Despite its significant clinical, humanistic, and economic burden, GPP is poorly classified and inadequately studied. A recent European (ERASPEN) consensus classifies GPP into relapsing and persistent disease and classifies patients on the presence or absence of psoriasis vulgaris. Classification of GPP lesions involving >30% body surface area or use of hospitalization as a surrogate may be a way to identify significant flares. Given the frequency of flares, the impaired quality of life during the post-flare period, and safety/tolerability issues, it is clear that current treatment options are not sufficient. Long-term studies utilizing the European consensus statement with subclassifiers are required to supplement our current understanding of the burden of GPP.

中文翻译:

广义脓疱型牛皮癣的临床,人文和经济负担:结构性综述。

简介:广义脓疱型牛皮癣(GPP)的特征是广泛的红斑和浮肿,浅表的无菌聚结脓疱和脓液。尽管GPP的影响被认为是巨大的,但有关其临床,人文和经济负担的新兴文献以前并未以结构化的方式进行描述。研究范围:结构化搜索侧重于使用特定搜索词在GPP中识别研究从2005年起开始在PubMed和EMBASE®中使用,并进行了附加的反向引用和实用搜索。感兴趣的结果包括临床,人文和经济负担。专家意见:尽管GPP具有巨大的临床,人文和经济负担,但是GPP的分类很差且研究不足。最近的欧洲人(ERASPEN)共识将GPP分为复发性和持续性疾病,并根据寻常性牛皮癣的存在或不存在将患者分类。GPP病变的分类涉及> 30%的体表面积或使用住院治疗作为替代手段,可能是识别明显耀斑的方法。考虑到耀斑的发生频率,耀斑后时期生活质量的下降以及安全性/耐受性问题,很明显,目前的治疗方案还不够。需要使用带有子分类器的欧洲共识声明进行长期研究,以补充我们目前对GPP负担的理解。30%的体表面积或使用住院替代治疗可能是识别明显耀斑的方法。考虑到耀斑的发生频率,耀斑后时期生活质量的下降以及安全性/耐受性问题,很明显,目前的治疗方案还不够。需要使用带有子分类器的欧洲共识声明进行长期研究,以补充我们目前对GPP负担的理解。30%的体表面积或使用住院替代治疗可能是识别明显耀斑的方法。考虑到耀斑的发生频率,耀斑后时期生活质量的下降以及安全性/耐受性问题,很明显,目前的治疗方案还不够。需要使用带有子分类器的欧洲共识声明进行长期研究,以补充我们目前对GPP负担的理解。
更新日期:2020-04-20
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