ABSTRACT
INTRODUCTION: In numerous clinical practice guidelines, emphasis is placed on the need for coordinated care of psoriatic arthritis (PsA) between rheumatologists and the objective was to develop experience-based points to consider facilitating the implementation of multidisciplinary units (Dermatology/Rheumatology) for the management of patients with PsA. METHODS: A scientific committee of rheumatology and dermatology experts in the management of PsA, and with experience in joint care, discussed the critical aspects of multidisciplinary PsA Units. The discussion became the basis for a Delphi survey in two rounds submitted to a panel of 24 specialists in rheumatology and dermatology not involved in PsA units. The statements and practices that reached a consensus were summarized and further elaborated. RESULTS: After two Delphi rounds, agreement was reached for 49 of the 50 proposed statements. These included a justification of the units, objectives, and utilities, as well as operational aspects of the units, such as the minimal and ideal premises, referral criteria, and necessary resources. The statements were compiled in 11 points to consider. CONCLUSIONS: This consensus offers some points to consider, including premises and recommendations, for the development of specialized Units in the management of PsA based on expert opinion. We trust these guidelines may facilitate their implementation in the future. FUNDING: Pfizer.
Subject(s)
Arthritis, Psoriatic/diagnosis , Arthritis, Psoriatic/therapy , Dermatology/methods , Interprofessional Relations , Patient Care Team/standards , Practice Guidelines as Topic , Rheumatology/methods , Adult , Aged , Aged, 80 and over , Delphi Technique , Female , Humans , Male , Middle Aged , Patient Care Team/organization & administration , Surveys and QuestionnairesABSTRACT
BACKGROUND: For years, phototherapy has been used in a wide range of skin diseases, which is unsurprising as skin is the anatomical feature most directly exposed to light, especially in psoriasis. Although the role of light therapy has been replaced by different therapeutic modalities in recent years, this treatment is now an established option for many skin diseases. OBJECTIVES: The aim was to characterize the patient population that had received the aforementioned treatment in the Virgen Macarena Health Area in Seville (Spain) between June 1985 and October 2011. METHODS: We have designed a descriptive study with a univariate analysis covering 443 treatments with light therapy, all administered to the same number of patients suffering from psoriasis. RESULTS: 79.15% of patients were discharged due to improvement or healing, while the 20.85% were discharged due to other reasons. The average total accumulative dose was 131.53 J/cm2. We do not detected an increase in proportion in patients for develop NMSK after light therapy treatment. CONCLUSIONS: We consider that phototherapy is still an effective and efficient treatment that will have to be reconsidered in the current macroeconomic context.
Subject(s)
Psoriasis/radiotherapy , Ultraviolet Therapy/methods , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Female , Hospitals, Teaching , Humans , Male , Middle Aged , Radiation Dosage , Sex Distribution , Spain , Statistics, Nonparametric , Time Factors , Treatment Outcome , Young AdultABSTRACT
AbstractBACKGROUND:For years, phototherapy has been used in a wide range of skin diseases, which is unsurprising as skin is the anatomical feature most directly exposed to light, especially in psoriasis. Although the role of light therapy has been replaced by different therapeutic modalities in recent years, this treatment is now an established option for many skin diseases.OBJECTIVES:The aim was to characterize the patient population thathad received the aforementioned treatment in the Virgen Macarena Health Area in Seville (Spain) between June 1985 and October 2011.METHODS:We have designed a descriptive study with a univariate analysis covering 443 treatments with light therapy, all administered to the same number of patients suffering from psoriasis.RESULTS:79.15% of patients were discharged due to improvement or healing, while the 20.85% were discharged due to other reasons. The average total accumulative dose was 131.53 J/cm2. We do not detected an increase in proportion in patients for develop NMSK after light therapy treatment.CONCLUSIONS:We consider that phototherapy is still an effective and efficient treatment that will have to be reconsidered in the current macroeconomic context.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Psoriasis/radiotherapy , Ultraviolet Therapy/methods , Age Distribution , Hospitals, Teaching , Radiation Dosage , Sex Distribution , Spain , Statistics, Nonparametric , Time Factors , Treatment OutcomeABSTRACT
El prúrigo nodular de Hyde es una dermatosis de curso crónico que cursa con elementos papulosos y nodulares muy pruriginosos. En su tratamiento se han empleado numerosos fármacos tópicos, intralesionales, sistémicos, crioterapia y fototerapia, habitualmente de forma combinada. A pesar de las numerosas opciones, muchos tratamientos resultan ineficaces y no existen protocolos estandarizados. La terapia ultravioleta B (UVB) de banda estrecha constituye una alternativa bien tolerada y moderadamente eficaz en esta patología
Prurigo nodularis is an uncommon chronic skin condition characterized by multiple intensely itchy papules and nodules. Both the pruritus and the skin lesions are difficult to treat and are often refractory to many treatments. Local, intralesional and sistemic drugs, criosurgery and phototherapy have been employed, even in combination. Therapy of nodular prurigo with narrow band UVB phototherapy is a safe and well-tolerated treatment that could be useful in these patients
