{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:59:35Z","timestamp":1790794775465,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Our objective was to establish consensus on (1) which patients with plaque psoriasis and limited skin involvement (body surface area [BSA] &lt;10%) are suitable for systemic treatment, and (2) a definition of \u2018topical therapy failure\u2019. A steering committee refined 13 statements drawn from literature related to the study objectives. An independent panel of 45 clinical experts from Japan indicated their agreement to each statement using a 10\u2010point Likert scale (Round 1; strong consensus, \u226570% of responses\u2009=\u20097\u201310 and median value \u22658). The steering committee reviewed Round 1 results and refined the statements for Round 2, as necessary. In Round 2, the panel indicated their agreement to each statement using a 3\u2010point scale (strong consensus, \u226570% of responses and median value\u2009of\u20093) and were shown Round 1 responses before voting. Forty\u2010five clinicians participated in Round 1 and 41 of those (91%) participated in Round 2. Consensus was achieved on the criteria of eligibility for systemic treatment among patients with limited skin involvement as disease involvement at special or difficult to treat areas, psoriasis\u2010induced psychological distress, uncontrolled symptoms (e.g., scaling, bleeding, pruritus, insomnia) affecting their social life, psoriatic arthritis, or failure of topical therapy. Consensus on criteria for topical failure were persistent symptoms (e.g., itchiness, pain) and plaques, poor patient satisfaction with treatment, a need to increase medication quantity or application time after treatment with two topicals for 4\u2009weeks; or if the Psoriasis Area Severity Index score of &gt;3 or Physician Global Assessment Score of \u22652 after 8\u2009weeks treatment. Our Delphi panel proposes criteria to help physicians identify patients with psoriasis and limited skin involvement who would benefit from systemic therapy and suggests a definition for topical therapy \u2018failure\u2019 which could indicate a move to systemic treatment is warranted.<\/jats:p>","DOI":"10.1111\/1346-8138.17444","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T04:45:32Z","timestamp":1725425132000},"page":"56-66","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Expert consensus on systemic therapy for plaque psoriasis with limited skin involvement in JAPAN: Results from a DELPHI study"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8372-3754","authenticated-orcid":false,"given":"Akimichi","family":"Morita","sequence":"first","affiliation":[{"name":"Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9526-1259","authenticated-orcid":false,"given":"Yukari","family":"Okubo","sequence":"additional","affiliation":[{"name":"Department of Dermatology Tokyo Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8568-4349","authenticated-orcid":false,"given":"Shinichi","family":"Imafuku","sequence":"additional","affiliation":[{"name":"Department of Dermatology Fukuoka University Faculty of Medicine  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yayoi","family":"Tada","sequence":"additional","affiliation":[{"name":"Department of Dermatology Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8863-9428","authenticated-orcid":false,"given":"Masatoshi","family":"Abe","sequence":"additional","affiliation":[{"name":"Kojinkai Sapporo Skin Clinic  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2755-6968","authenticated-orcid":false,"given":"A. 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