头皮银屑病的管理：来自AEDV银屑病工作组53位皮肤科医生德尔菲共识的更新治疗建议。
完整摘要 · 中文译文
背景：头皮银屑病影响约80%的银屑病患者，并在治疗依从性、剂型选择和生活质量方面带来治疗挑战。需要更新管理建议。 方法：开展了一项德尔菲共识研究，涉及西班牙皮肤病与性病学会（AEDV）银屑病工作组中的53名皮肤科医生。在文献回顾之后，专家们使用7分李克特量表评估了47条建议，共识定义为至少75%的同意或不同意。还评估了对局部用载体和系统性治疗的偏好。 结果：对34条建议达成了共识。局部用皮质类固醇，尤其是高效价制剂，被推荐为一线治疗。维生素D类似物的联合用药被支持用于初始和维持治疗，而角质溶解剂与皮质类固醇的联合用药被认为适用于严重鳞屑。头皮相容性剂型，包括使用聚丙烯酰胺分散体（PAD）技术的洗剂、溶液、洗发水、凝胶和乳膏，受到青睐。系统性治疗被认为适用于严重症状或生活质量受损的情况，其中IL-17和IL-23抑制剂获得最高偏好评分（分别为8.84和8.32）。 结论：本德尔菲共识为头皮银屑病的管理提供了更新的、临床适用的建议，强调有效的局部治疗、合适的剂型、治疗依从性以及个体化的系统性治疗选择。 tion。
完整摘要 · 英文原文
BACKGROUND: Scalp psoriasis affects approximately 80% of patients with psoriasis and presents therapeutic challenges related to treatment adherence, formulation selection, and quality of life. Updated management recommendations are needed. METHODS: A Delphi consensus study involving 53 dermatologists from the Psoriasis Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) was conducted. Following a literature review, experts evaluated 47 recommendations using a 7-point Likert scale, with consensus defined as at least 75% agreement or disagreement. Preferences for topical vehicles and systemic treatments were also assessed. RESULTS: Consensus was reached on 34 recommendations. Topical corticosteroids, particularly high-potency agents, were recommended as first-line treatment. Combinations with vitamin D analogues were supported for initial and maintenance therapy, while keratolytic agents combined with corticosteroids were considered appropriate for severe scaling. Scalp-compatible formulations, including lotions, solutions, shampoos, gels, and creams using Polyaphron Dispersion (PAD) technology, were favored. Systemic treatment was considered appropriate for severe symptoms or impaired quality of life, with IL-17 and IL-23 inhibitors receiving the highest preference scores (8.84 and 8.32, respectively). CONCLUSIONS: This Delphi consensus provides updated, clinically applicable recommendations for scalp psoriasis management, emphasizing effective topical therapies, appropriate formulations, treatment adherence, and individualized systemic treatment selection.