Pustular Psoriasis: Recognizing and Treating A Rare But Serious Disease
Pustular psoriasis is a clinically heterogenous group of rare psoriasis subtypes characterized by aseptic, neutrophil-rich pustules. The three most common types are generalized pustular psoriasis, palmoplantar pustular psoriasis, and acrodermatitis continua of Hallopeau. The diagnosis of pustular psoriasis relies mainly on clinical features and is challenging. Recent guidelines on diagnosis, classification, and assessment of severity have been published by ERASPEN and by the Japanese Dermatological Association.
Current systemic treatment has involved cyclosporine, methotrexate or acitretin. The Japanese Dermatological Association has also published guidelines that include a treatment algorithm. However, it has been recognized that IL-36 cytokines are likely the key driver of the autoimmune response in pustular psoriasis. There are two novel, investigational monoclonal antibodies that target the IL-36 receptor. In addition, agents that target other molecules have also been investigated.
Pustular Psoriasis: Recognizing and Treating A Rare But Serious Disease will review the most recent guidelines for diagnosing, classifying, and assessing the severity of pustular psoriasis and provide information on current treatment guidelines and agents in development to manage this rare group of disorders.
Welcome and Introductions
Diagnosing and Assessing Severity of Pustular Psoriasis
Managing Pustular Psoriasis
Q & A Session and Activity Roundup
The intended audience for this educational initiative is dermatologists, the clinicians who manage patients with pustular psoriasis.
At the conclusion of this activity, participants should be able to:
- Discuss how the pathophysiology of pustular psoriasis differs from that of plaque psoriasis
- Employ the most recent consensus recommendations to diagnose and classify pustular psoriasis
- Apply the most recent guidelines when managing patients with pustular psoriasis
- Assess the mechanism of action, efficacy, and safety of agents in development for managing pustular psoriasis
Alice B. Gottlieb, MD, PhD
Clinical Professor of Dermatology, Department of Dermatology
Division of Rheumatology
Icahn School of Medicine at Mount Sinai
Medical Director, Department of Dermatology
Mount Sinai at Union Square
New York, NY
Alice B. Gottlieb, MD, PhD is an internationally recognized expert in the field of psoriasis and psoriatic arthritis. Her research uses targeted immunobiologics as pathogenic probes, providing new understanding of the pathogenesis of psoriasis and providing the foundation for biologic drug development in these two debilitating diseases. Through a study she had published in Lancet in 2001, Dr. Gottlieb was the first to show the efficacy of TNF blockers as monotherapy for moderate to severe psoriasis. Her research led to multiple TNF blockers being FDA-approved for psoriasis which revolutionized the care of psoriasis and psoriatic arthritis patients. In addition, Dr. Gottlieb was one of the first scientists to demonstrate that psoriasis is a T cell mediated disease. She showed that treatment with a T cell-specific immunotoxin cleared psoriasis clinically and histologically. With her published studies and public presentations she has been able to convince pharmaceutical companies to use psoriasis as their proof-of-concept disease when testing new immunomodulators that may decrease T cell and dendritic cell cytokine production. So far, her research has affected drug development in psoriasis, psoriatic arthritis, rheumatoid arthritis, inflammatory bowel disease and transplantation.
Abby S. Van Voorhees, MD
Professor and Chair, Department of Dermatology
Eastern Virginia Medical School
Abby S. Van Voorhees, MD is a professor, chair and residency director of the department of dermatology at the Eastern Virginia Medical School. She obtained her B.A. from Brown University in 1979 in biology and received her M.D. from Yale University in 1983. She completed her dermatology residency at the Yale-New Haven Hospital in 1988, serving as the chief resident from July 1987 to 1988. In addition to her current position, Dr. Van Voorhees has also worked in the University of Pennsylvania Department of Dermatology and the University of Connecticut Department of Medicine. She has been active in clinical research issues in dermatology, particularly those related to the treatment of psoriasis. Dr. Van Voorhees is the chair of the Medical Board of the National Psoriasis Foundation and is also on the Board of Directors of the American Academy of Dermatology. She previously was the Medical Editor of Dermatology World. Additionally, she has served on several of the American Academy of Dermatology’s committees and task forces, including serving as the chairman for the Guidelines of Care task force. She is the author of over 90 publications.
The Potomac Center for Medical Education (PCME) adheres to the policies and guidelines, including the Standards for Commercial Support, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous.
All persons in a position to control the content of a continuing medical education program provided by PCME are required to disclose any relevant financial relationships with any commercial interest to PCME as well as to learners. All conflicts of interest are identified and resolved by PCME in accordance with the Standards for Commercial Support in advance of delivery of the activity to learners.
The faculty, authors and content developers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
Alice B. Gottlieb, MD, PhD: Honoraria for Advisory Board Member and Consultant: Anaptyps Bio, Avotres Therapeutics, Beiersdorf, Boehringer Ingelheim, Bristol-Myers Suibb Co., Eli Lilly, Janssen, LEO Pharma, Novartis, Sun Pharmaceutical Industries, Inc., UCB; Stock Options: Xbiotech; Grant/Research Support: Boehringer Ingelheim, Janssen, Novartis, Sun Pharmaceutical Industries, Inc., UCB, Xbiotech
Abby S. Van Voorhees, MD: Grant/Research Support: AbbVie, Celgene, Lilly; Honoraria: Amgen, Boehringer Ingelheim, Bristol Myers Squibb, UCB
Planners and Managers
The planners and mangers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
Terry Ann Glauser, MD, MPH: Nothing to disclose
The content reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
Katie Propst, PhD: Nothing to disclose
The contents of some CME activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses
PHYSICIAN ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Potomac Center for Medical Education and Rockpointe. The Potomac Center for Medical Education is accredited by the ACCME to provide continuing medical education for physicians.
PHYSICIAN CREDIT DESIGNATION STATEMENT
The Potomac Center for Medical Education designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
For questions regarding CME/MOC credit or the evaluation, please email [email protected].
ABIM MOC RECOGNITION STATEMENT
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
To receive CME credit and/or MOC points, you MUST pass the post-test and complete the evaluation. For ABIM MOC points, your information will be shared with the ABIM through PCME's ACCME Program and Activity Reporting System (PARS). Please allow 6-8 weeks for your MOC points to appear on your ABIM records.
AMERICAN BOARD OF DERMATOLOGY MOC INFORMATION
Dermatologists certified by the American Board of Dermatology (ABD) must earn a minimum of 25 hours of AMA PRA Category 1 Credits™ annually. Half of these credits must be Dermatology practice-specific CME credits from accredited organizations in order to fulfill the lifelong learning component of MOC. Participation in this activity will support board certified dermatologists in contributing towards this MOC requirement set forth by the ABD.
INSTRUCTIONS FOR PARTICIPANTS AND OBTAINING CME CREDIT AND MOC POINTS
There is no fee for this activity. To receive credit, participants must take the pre-test, view this CME/MOC activity in its entirety, and then complete the post-test, with a score of 75% or better, and evaluation. The estimated time for completion of this activity is 1 hour. To receive their certificates, participants must demonstrate mastery of the presented material via the post-test. Participant is allowed to take the post-test multiple times.
- 1.00 ABMS MOC
- 1.00 AMA PRA Category 1 Credit™
This course is offered through Rockpointe.
To take this course you will be redirected to Rockpointe's website. You must login or create an account with Rockpointe in order to complete this activity.
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