The Unmet Need for Clinical Guidelines on the Management of Patients with Plaque Psoriasis in Africa and the Middle East

Figures & data

Table 1 Research Articles Describing Patients with Plaque Psoriasis in Africa and the Middle East Published from January 2008 to March 2020

Publication	Country	Patient Population	Study Type
Al-Mutairi et al (2010)^Citation20	Kuwait	Adults (N=1835)	Non-interventional (case–control)
Al-Mutairi N and Al-Haddad A (2013)^Citation21	Kuwait	Adults with localized psoriasis of the scalp or palmoplantar areas (N=41)	Interventional (phototherapy)
Kassi et al (2016)^Citation22	Ivory Coast	Geriatric (≥60 years) (N=47)	Non-interventional (cross-sectional)
Bulur et al (2018)^Citation23	Turkey	Geriatric (≥65 years) (N=95)	Interventional (phototherapy)

Table 2 Review Articles Describing Patients with Plaque Psoriasis in Africa and the Middle East Published from January 2008 to March 2020

Publication	Focus of Review
Abdulghani et al (2011)^Citation24	Description of contemporary practice, unmet needs, and the challenges faced by dermatologists in Africa and the Middle East
Tavakolpour S and Rahimzadeh G (2016)^Citation25	Discussion of the potential for therapeutic immunomodulation in pregnant women with autoimmune disease
Al Hammadi et al (2017)^Citation8	Expert opinion on best practice regarding the use of biologics in patients with moderate-to-severe psoriasis in Africa and the Middle East

Table 3 Guidelines on the Management of Patients with Plaque Psoriasis in Africa and the Middle East Published from January 2008 to March 2020

Patient Population	2010 Guidelines from South Africa^Citation26	2014 Guidelines on Biologics from Saudi Arabia^Citation27
General	Mild-to-moderate disease (<5% body surface area): topical treatments (e.g., corticosteroids, coal tar, dithranol, tazarotene, vitamin D analogs) Moderate-to-severe disease (≥10% body surface area): systemic immunosuppressants (e.g., acitretin, cyclosporine, methotrexate) and phototherapy (e.g., UVB, PUVA, 308 nm excimer laser) Severe disease (PASI score ≥10): biologics (e.g., TNF inhibitors, IL-12/IL-23 inhibitors, alefacept)	Yes, but only in patients who have failed, cannot tolerate, or have a contraindication to topical therapy and ≥1 systemic treatment
Difficult-to-treat anatomic areas	Not specified	Yes (nails, scalp, palmoplantar areas, and genital or intertriginous areas)
Pregnant women	Not specified	Not specified
Pediatric	Not specified	Yes (TNF inhibitors only)
Geriatric	Not specified	Not specified

Note: Marketing of alefacept was discontinued in 2011.

Abbreviations: IL, interleukin; PASI, Psoriasis Area and Severity Index; PUVA, psoralen + ultraviolet light A; TNF, tumor necrosis factor; UVB, ultraviolet light B.

Al-Mutairi N, Al-Farag S, Al-Mutairi A, Al-Shiltawy M. Comorbidities associated with psoriasis: an experience from the Middle East. J Dermatol. 2010;37(2):146–155. doi:10.1111/j.1346-8138.2009.00777.x20175849

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Tavakolpour S, Rahimzadeh G. New insights into the management of patients with autoimmune diseases or inflammatory disorders during pregnancy. Scand J Immunol. 2016;84(3):146–149. doi:10.1111/sji.1245327300757

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Al Hammadi A, Al-Sheikh A, Ammoury A, et al. Experience and challenges for biologic use in the treatment of moderate-to-severe psoriasis in Africa and the Middle East region. J Dermatolog Treat. 2017;28(2):129–135.27196814

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Raboobee N, Aboobaker J, Jordaan HF, et al. Guideline on the management of psoriasis in South Africa. S Afr Med J. 2010;100(4 Pt 2):257–282. doi:10.7196/SAMJ.401520666218

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Hamadah IR, Al Raddadi AA, Bahamdan KA, et al. Saudi practical guidelines on biologic treatment of psoriasis. J Dermatolog Treat. 2015;26(3):223–229. doi:10.3109/09546634.2014.94688225075955

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