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The following is a summary of “Global Delphi consensus on treatment goals for generalised pustular psoriasis,” published in the January 2025 issue of Dermatology by Barker et al. 

Generalized pustular psoriasis (GPP) is a chronic, systemic neutrophilic inflammatory disease, with previous consensus on treatment goals lacking patient perspectives.  

Researchers conducted a retrospective study to identify and reach consensus on specific treatment goals for GPP with patient participation.  

They generated statements through a systematic literature review, which was revised by a Steering Committee. The statements were categorized into overarching principles, short-term, and long-term treatment goals. A global panel of 30 dermatologists and 3 patient representatives voted on each statement, with consensus defined as ≥80% approval from panellists.  

The results showed consensus was achieved in the first voting round, with ≥90% agreement for 23 out of 26 statements, GPP management requires a timely, personalized treatment plan developed collaboratively by individuals and physicians, involving a multidisciplinary approach to address the disease’s complexity, variability, and chronic nature. Short-term goals include clearing pustules within 7 days, preventing recurrence, reducing cutaneous symptoms (≥ −4 points on the Itch and Skin Pain Numeric Rating Scale), resolving systemic symptoms (e.g., fever resolution within 3 days and reduced fatigue), preventing severe complications, and improving inflammatory biomarkers. For individuals with comorbid psoriatic diseases, treatment should prioritize GPP, while the long-term goals involve reducing disease activity through flare prevention and symptom control, maintaining sustained disease control, managing comorbidities, and improving QoL. Differences in treatment priorities, such as avoiding hair or nail loss to enhance QoL, highlight the need for a person-centered approach. 

Investigators concluded the first global Delphi panel in GPP, incorporating patient perspectives, achieved consensus with dermatologists on key treatment principles and short-term and long-term goals, providing valuable insights for developing patient-centered GPP treatment guidelines. 

Source: academic.oup.com/bjd/advance-article/doi/10.1093/bjd/ljae491/7973903