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Background: Although long-term management of psoriasis is paramount, this approach is challenging in clinical practice. In the recent PSO-LONG trial, a fixed-dose combination of betamethasone dipropionate (BD) and calcipotriol (Cal) foam applied twice a week on non-consecutive days for 52 weeks (proactive treatment) reduced the risk of relapse. However, the role of Cal/BD foam in the long-term management of psoriasis needs further clarifications. The ProActive Management (PAM) program, a nationwide Italian project, aims at reaching a consensus on the role of proactive management of psoriasis., Methods: A steering committee generated some statements through the nominal group technique (NGT). The statements were voted by an expert panel in an adapted Delphi voting process., Results: Eighteen statements were proposed, and the majority of them (14/18) reached a consensus during the Delphi voting. The need to provide long-term proactive topical treatment to reduce the risk of relapse for the treatment of challenging diseases sites or in patients where phototherapy or systemic therapies are contraindicated/ineffective was widely recognized. A consensus was reached about the possibility to associate the proactive treatment with systemic and biological therapies, without the need for dose intensification, thus favoring a prolonged remission. Moreover, the proactive treatment was recognized as more effective than weekend therapy in increasing time free from relapses. Approaches to improve adherence, on the other hand, need further investigation., Conclusions: The inclusion in guidelines of a proactive strategy among the effective treatment options will be a fundamental step in the evolution of a mild-moderate psoriasis therapeutic approach., (© 2022 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)

Topical treatments are frequently used for the therapy of psoriasis. However, they may be associated with poor adherence in clinical practice. Therapeutic adherence is affected by patient's characteristics, as well as disease- and treatment-related factors; moreover, satisfaction with therapy, cosmetic acceptability, and complexity of the treatment regimen do also play a role. Since low adherence could lead to treatment failure, it is crucial to elaborate effective strategies aimed at improving patient adherence and thus clinical outcomes in psoriasis. To this purpose, here we have addressed several aspects of dermatological treatment that impact on adherence such as selection of therapy, selection of vehicle, and physician-patient communication. In addition, possible practical measures to improve adherence have also been discussed. In this light, we report that the use of calcipotriol and betamethasone dipropionate (Cal/BD) fixed-combination gel may be associated with improved patients' preference and better outcomes compared to similar formulations.

Koebner phenomenon regards the formation of a psoriatic lesion after a trauma, including tattoo, insect bite or other injuries. Although this manifestation is not specific for psoriasis, physicians should be aware because early recognition may be helpful in making the diagnosis when present. [ABSTRACT FROM AUTHOR]

Postcast hypertrichosis is a common transient occurrence in orthopedic patients and generally resolves within a few months. Until now, two cases of localized hypertrichosis occurring on more than one pre-existing psoriatic lesions are reported in the literature. We describe the case of a patient who simultaneously developed a single psoriatic plaque and overlying localized hypertrichosis after plaster application. This concurrence is exceptional and may be explained by the expression of several growth factors and cytokines influencing both the hair cycle and the psoriatic inflammatory working. [ABSTRACT FROM AUTHOR]