{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:14:06Z","timestamp":1788286446975,"version":"build-2803163510"},"reference-count":56,"publisher":"Ordem dos Medicos","issue":"9","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>Generalized pustular psoriasis (GPP) is a rare, severe, and potentially life-threatening inflammatory skin disease associated with high morbidity and significant healthcare burden. Acute flares require rapid and effective treatment to prevent severe complications, including hospitalization and death. This work aimed to gather insights from a Portuguese expert panel on the management of GPP, focusing on the patient journey, diagnostic approaches, treatment goals, and healthcare resource utilization. This qualitative study collected in-depth insights from seven dermatologists geographically distributed across Portugal during a virtual expert panel meeting in June 2025. Several critical challenges in GPP management were identified, including diagnostic delays, lack of disease awareness among non-dermatologists, limited access to novel therapies, and inconsistent referral pathways. The expert panel emphasized the need for urgent treatment of flares, improved diagnostic protocols, and systematic referral of GPP patients to existing specialized centers, better coordination between healthcare levels, and faster access to treatments with proven efficacy. Spesolimab was highlighted for its potential to reduce long-term healthcare expenditure by shortening hospital stays, lowering the need for intensive care, and decreasing the risk of complications, factors that collectively support more efficient resource use and overall cost reduction. This expert insight highlights actionable strategies to optimize GPP care in Portugal, emphasizing early diagnosis, timely initiation of effective treatment, improved multidisciplinary collaboration, and healthcare system reforms as key priorities to improve clinical outcomes, enhance resource efficiency, and reduce the overall burden of GPP.<\/jats:p>","DOI":"10.20344\/amp.24535","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T16:06:55Z","timestamp":1779293215000},"page":"565-575","source":"Crossref","is-referenced-by-count":0,"title":["Generalized Pustular Psoriasis in Portugal: Expert Perspectives on Patient Journey, Diagnosis, Therapeutic Goals, and Healthcare Optimization"],"prefix":"10.20344","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0404-0870","authenticated-orcid":false,"given":"Tiago","family":"Torres","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6302-338X","authenticated-orcid":false,"given":"\u00c2ngela","family":"Roda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3986-6253","authenticated-orcid":false,"given":"C\u00e9sar","family":"Magalh\u00e3es","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5471-7889","authenticated-orcid":false,"given":"Joana","family":"Frade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7735-944X","authenticated-orcid":false,"given":"Maria Jo\u00e3o","family":"Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3247-2470","authenticated-orcid":false,"given":"Maria Jos\u00e9","family":"Guimar\u00e3es","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6842-1360","authenticated-orcid":false,"given":"Margarida","family":"Gon\u00e7alo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"8464","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"12869","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.14294"},{"key":"12870","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14386"},{"key":"12871","doi-asserted-by":"publisher","DOI":"10.1111\/exd.14765"},{"key":"12872","doi-asserted-by":"publisher","DOI":"10.1016\/j.abd.2021.05.011"},{"key":"12873","doi-asserted-by":"publisher","DOI":"10.20344\/amp.22672"},{"key":"12874","doi-asserted-by":"publisher","DOI":"10.2147\/PTT.S98954"},{"key":"12875","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-021-00655-y"},{"key":"12876","doi-asserted-by":"publisher","DOI":"10.12788\/cutis.0579"},{"key":"12877","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18851"},{"key":"12878","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2019.1648209"},{"key":"12879","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18720"},{"key":"12880","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-021-00664-x"},{"key":"12881","doi-asserted-by":"publisher","DOI":"10.2165\/11586900-000000000-00000"},{"key":"12882","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-022-00881-0"},{"key":"12883","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2024.2345728"},{"key":"12884","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2024.0915"},{"key":"12885","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-021-00654-z"},{"key":"12886","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2023.09.080"},{"key":"12887","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-021-00652-1"},{"key":"12888","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2016.08.056"},{"key":"12889","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1013068"},{"key":"12890","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-021-00658-9"},{"key":"12891","unstructured":"European Medicines Agency. Spevigo (spesolimab): EPAR - product information. London: EMA; 2022."},{"key":"12892","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2111563"},{"key":"12893","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-022-01801-4"},{"key":"12894","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01378-8"},{"key":"12895","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2025.01.089"},{"key":"12896","unstructured":"European Medicines Agency. Spevigo (spesolimab): extension of indication for prevention of flares in generalized pustular psoriasis (GPP). London: EMA; 2024."},{"key":"12897","unstructured":"U.S. Food and Drug Administration. BLA approval package for spevigo (spesolimab). Silver Spring (MD): U.S. FDA; 2022."},{"key":"12898","unstructured":"U.S. Food and Drug Administration. FDA approves Spevigo for reduction of flares in generalized pustular psoriasis (GPP). Silver Spring (MD): U.S. FDA; 2024."},{"key":"12899","doi-asserted-by":"publisher","DOI":"10.1159\/000538072"},{"key":"12900","doi-asserted-by":"publisher","DOI":"10.1177\/24755303251318976"},{"key":"12901","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdin.2023.03.012"},{"key":"12902","unstructured":"Elder DE, Elenitsas R, Murphy GF, Rosenbach M, Rubin AI, Seykora JT, et al. Lever\u2019s Dermatopathology: Histopathology of the Skin. 12th ed. 2023. [cited 2026 May 04]. Available from: https:\/\/www.wolterskluwer.com\/en\/solutions\/ovid\/levers-dermatopathology-histopathology-of-the-skin-2571."},{"key":"12903","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.14523"},{"key":"12904","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljad071"},{"key":"12905","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18999"},{"key":"12906","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2023.09.078"},{"key":"12907","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljae491"},{"key":"12908","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12070"},{"key":"12909","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2007.10.024"},{"key":"12910","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2023.04.066"},{"key":"12911","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19901"},{"key":"12912","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2021.1894108"},{"key":"12913","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2021.1951192"},{"key":"12914","doi-asserted-by":"publisher","DOI":"10.1177\/24755303211021786"},{"key":"12915","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2023.02.040"},{"key":"12916","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-024-00906-8"},{"key":"12917","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.17795"},{"key":"12918","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1359481"},{"key":"12919","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18820"},{"key":"12920","unstructured":"National Institute for Health and Care Excellence Spesolimab for treating generalised pustular psoriasis flares. London; NICE: 2025."},{"key":"12921","unstructured":"British Association of Dermatologists. Spesolimab for treating generalised pustular psoriasis flares. 2024. [cited 2025 Sep 12]. Available from: https:\/\/cdn.bad.org.uk\/uploads\/2024\/08\/27095403\/BAD-response-to-NICE-STA-spesolimab-for-GPP-ID3963-8-Aug-2024.pdf."},{"key":"12922","doi-asserted-by":"publisher","DOI":"10.5826\/dpc.1301a31"},{"key":"12923","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.07.043"},{"key":"12924","doi-asserted-by":"publisher","DOI":"10.25251\/skin.10.supp.542"}],"container-title":["Acta M\u00e9dica Portuguesa"],"original-title":[],"link":[{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/24535\/15960","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/24535\/15960","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:29:15Z","timestamp":1788283755000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/view\/24535"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":56,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.20344\/amp.24535","relation":{},"ISSN":["1646-0758","0870-399X"],"issn-type":[{"value":"1646-0758","type":"electronic"},{"value":"0870-399X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5,20]]}}}