Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr 8;4(4):CD011541.
doi: 10.1002/14651858.CD011541.pub2.

Non-antistreptococcal interventions for acute guttate psoriasis or an acute guttate flare of chronic psoriasis

Annabel Maruani  1 , Mahtab Samimi, Natasha Stembridge, Rania Abdel Hay, Elsa Tavernier, Carolyn Hughes, Laurence Le Cleach
Affiliations

Non-antistreptococcal interventions for acute guttate psoriasis or an acute guttate flare of chronic psoriasis

Annabel Maruani et al. Cochrane Database Syst Rev. .

Abstract

Background: Guttate psoriasis displays distinctive epidemiological and clinical features, making it a separate entity within the heterogeneous group of cutaneous psoriasis types. It is associated with genetic, immune, and environmental factors (such as stress and infections) and usually arises in younger age groups (including children, teenagers, and young adults). There is currently no cure for psoriasis, but various treatments can help to relieve the symptoms and signs. The objectives of treatment when managing an acute flare of guttate psoriasis are to reduce time to clearance and induction of long-term remission after resolution. This is an update of a Cochrane Review first published in 2000; since then, new treatments have expanded the therapeutic spectrum of systemic treatments used for psoriasis.

Objectives: To assess the effects of non-antistreptococcal interventions for acute guttate psoriasis or an acute guttate flare of chronic psoriasis.

Search methods: We searched the following databases up to June 2018: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We searched five trials registers and checked the reference lists of included studies for further references to relevant randomised controlled trials. We checked the proceedings of key dermatology conferences from 2004 to 2018, and also searched for trials in the US Food and Drug Administration (FDA) database for drug registration.

Selection criteria: All randomised controlled trials assessing the effects of treatments for acute guttate psoriasis or an acute guttate flare of chronic psoriasis clinically diagnosed in children and adults. This included all topical and systemic drugs, biological therapy, phototherapy (all forms: topical and systemic), and complementary and alternative therapies. We compared these treatments against placebo or against another treatment. We did not include studies on drugs that aim to eradicate streptococcal infection. We did not include studies when separate results for guttate psoriasis participants were not available.

Data collection and analysis: Two review authors independently assessed study eligibility and methodological quality and extracted data. We used standard methodological procedures expected by Cochrane. Our primary outcomes were 'percentage of participants clear or almost clear (i.e. obtaining Psoriasis Area Severity Index (PASI) 100/90 and/or Physician's Global Assessment (PGA) of 0 or 1)' and 'percentage of participants with adverse effects and severe adverse effects'. Our secondary outcomes were 'number of relapses of guttate psoriasis or flares within a period of six months after the treatment has finished', 'percentage of participants achieving a PASI 75 or PGA of 1 or 2', and 'improvement in participant satisfaction measures and quality of life assessment measures'. We used GRADE to assess the quality of the evidence for each outcome.

Main results: This review included only one trial (21 participants), which compared fish oil-derived (n-3) fatty acid-based lipid emulsion (50 mL per infusion (1.05 g eicosapentaenoic and 10.5 g docosahexaenoic acid)) (10 participants) to soya oil-derived (n-6) fatty acid-based lipid emulsion (50 mL per infusion (1.05 g eicosapentaenoic and 10.5 g docosahexaenoic acid)) (11 participants) administered intravenously twice daily for 10 days, with a total follow-up of 40 days. The study was conducted in a single centre in Germany in 18 men and three women, aged between 21 and 65 years, who were in hospital with acute guttate psoriasis and had mean total body surface involvement of 25.7% ± 20.4% (range 10 to 90). The study was funded by a company that produces the oil emulsions. We found no other evidence regarding non-antistreptococcal interventions used in clinical practice for guttate psoriasis, such as topical treatments (corticosteroids, vitamin D₃ analogues), systemic drugs, biological therapy, and phototherapy.The primary outcomes of the review were not measured, and only one of our secondary outcomes was measured: improvement in participant satisfaction measures and quality of life assessment measures. However, the study authors did report that there was rare skin irritation at the site of peripheral intravenous route, but the number of affected participants was not provided.Improvement between baseline and day 10, using a non-validated score assessed by participants themselves daily based on five items (appearance of lesions, impairment of daily life, pruritus, burning, and pain), was greater in the group that received the fish oil-derived (n-3) fatty acid-based lipid emulsion (75%) than in the group receiving the soya oil-derived (n-6) fatty acid-based lipid emulsion (18%) (one trial, 21 participants). However, these results are uncertain as they are based on very low-quality evidence.

Authors' conclusions: There is no evidence regarding topical and systemic drugs, biotherapy, or phototherapy in guttate psoriasis (we did not consider drugs that aimed to eradicate streptococcal infection because these are assessed in another Cochrane Review). We are uncertain of the effect of intravenously administered lipid emulsion on guttate psoriasis because the quality of the evidence is very low, due to risk of bias (unclear risk of bias for all domains), indirectness (the trial only included adults, and the follow-up from baseline was only 10 days), and imprecision (small number of participants).This review highlights the need for trials assessing the efficacy and safety of phototherapy and topical and systemic drugs for guttate psoriasis. There is also a need for studies that clearly distinguish the specific population with guttate psoriasis from the larger group of people with chronic plaque psoriasis, and children and young adults should be assessed as a distinct group.

PubMed Disclaimer

Conflict of interest statement

Annabel Maruani: Nothing to declare. Mahtab Samimi: received fees for speaking at educational programs (BMS) and travel, accommodation and meeting expenses (Novartis, Galderma International, Janssen‐Cilag, Cosmetique Active France, NAOS, MSD‐France, Shire) that are unrelated to this review. Natasha Stembridge: Nothing to declare. Rania Abdel Hay: Nothing to declare. Elsa Tavernier: Nothing to declare. Carolyn Hughes: Nothing to declare. Laurence Le Cleach: Nothing to declare.

Key Editor, Gloria Sanclemente: I do not have current or past affiliations or other involvement in any organisation or entity with an interest in the outcome of this review. I have not been involved in any study included in this review, but in the last three years, I have received sponsoring for attending scientific meetings or congresses by Janssen‐Cilag, Novartis, and AbbVie. I also declare that I am currently co‐ordinating a Diploma in Evidence‐Based Dermatology in which attendees have been sponsored by Pfizer, AbbVie, and Novartis laboratories.

Figures

1
1
Guttate psoriasis.
2
2
Guttate psoriasis.
3
3
Study flow diagram.
4
4
Risk of bias graph: review authors' judgments about each risk of bias item presented as percentages across all included studies.
5
5
Risk of bias summary: review authors' judgments about each risk of bias item for each included study.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Grimminger 1993 {published data only}
    1. Grimminger F, Mayser P, Papavassilis C, Thomas M, Schlotzer E, Heuer KU, et al. A double‐blind, randomized, placebo‐controlled trial of n‐3 fatty acid based lipid infusion in acute, extended guttate psoriasis. Rapid improvement of clinical manifestations and changes in neutrophil leukotriene profile. Clinical Investigator 1993;71(8):634‐43. [CENTRAL: CN‐00096708; PUBMED: 8219661] - PubMed

References to studies excluded from this review

Bittiner 1988 {published data only}
    1. Bittiner SB, Tucker WF, Cartwright I, Bleehen SS. A double‐blind, randomised, placebo‐controlled trial of fish oil in psoriasis. Lancet 1988;1(8582):378‐80. [CENTRAL: CN‐00052032; PUBMED: 2893189] - PubMed
Boztepe 2006 {published data only}
    1. Boztepe G, Karaduman A, Sahin S, Hayran M, Kolemen F. The effect of maintenance narrow‐band ultraviolet B therapy on the duration of remission for psoriasis: a prospective randomized clinical trial. International Journal of Dermatology 2006;45(3):245‐50. [CENTRAL: CN‐00563262; PUBMED: 16533223] - PubMed
Caca‐Biljanovska 2002 {published data only}
    1. Caca‐Biljanovska NG, V'lckova‐Laskoska MT. Management of guttate and generalized psoriasis vulgaris: prospective randomized study. Croatian Medical Journal 2002;43(6):707‐12. [CENTRAL: CN‐00412128; PUBMED: 12476481] - PubMed
Gokdemir 2005 {published data only}
    1. Gokdemir G, Kivanc‐Altunay I, Koslu A. Narrow‐band ultraviolet B phototherapy in patients with psoriasis: for which types of psoriasis is it more effective?. Journal of Dermatology 2005;32(6):436‐41. [PUBMED: 16043915] - PubMed
Gomez 1996 {published data only}
    1. Gomez MI, Perez B, Harto A, Misa RF, Ledo A. 8‐MOP bath PUVA in the treatment of psoriasis: clinical results in 42 patients. Journal of Dermatological Treatment 1996;7:11‐2.
Green 1992 {published data only}
    1. Green C, Lakshmipathi T, Johnson BE, Ferguson J. A comparison of the efficacy and relapse rates of narrowband UVB (TL‐01) monotherapy vs. etretinate (re‐TL‐01) vs. etretinate‐PUVA (re‐PUVA) in the treatment of psoriasis patients. British Journal of Dermatology 1992;127(1):5‐9. [CENTRAL: CN‐00561843; PUBMED: 1637696] - PubMed
Gupta 1989 {published data only}
    1. Gupta AK, Ellis CN, Tellner DC, Anderson TF, Voorhees JJ. Double‐blind, placebo‐controlled study to evaluate the efficacy of fish oil and low‐dose UVB in the treatment of psoriasis. British Journal of Dermatology 1989;120(6):801‐7. [CENTRAL: CN‐00061539; PUBMED: 2667615] - PubMed
Hofmann 1980 {published data only}
    1. Hofmann C, Neiss A, Plewig G, Braun‐Falco O. Oral 8‐methoxypsoralen‐UVA (PUVA) therapy in psoriasis: comparison of 3 treatment protocols [Orale 8‐methoxypsoralen‐UVA‐(PUVA‐)therapie bei psoriasis: vergleich dreier behandlungsprotokolle]. Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und Verwandte Gebiete 1980;31(6):315‐23. [CENTRAL: CN‐00509657; PUBMED: 6893320] - PubMed
Leviav 2004 {published data only}
    1. Leviav A, Wolf R, Vilan A. Treatment of psoriasis with light and heat energy (LHE): a preliminary study. Dermatology Online Journal 2004;10(2):4. [CENTRAL: CN‐00602271; PUBMED: 15530294] - PubMed
Melski 1977 {published data only}
    1. Melski JW, Tanenbaum L, Parrish JA, Fitzpatrick TB, Bleich HL. Oral methoxsalen photochemotherapy for the treatment of psoriasis: a cooperative clinical trial. Journal of Investigative Dermatology 1977;68(6):328‐35. [CENTRAL: CN‐00303675; PUBMED: 864273] - PubMed
O'Daly 2009 {published data only}
    1. O'Daly JA, Lezama R, Rodriguez PJ, Silva E, Indriago NR, Pena G, et al. Antigens from Leishmania amastigotes induced clinical remission of psoriasis. Archives of Dermatological Research 2009;301(1):1‐13. [CENTRAL: CN‐00665503; PUBMED: 18777031] - PubMed
Tas 2004 {published data only}
    1. Tas S, Avci O. Rapid clearance of psoriatic skin lesions induced by topical cyclopamine. A preliminary proof of concept study. Dermatology (Basel, Switzerland) 2004;209(2):126‐31. [PUBMED: 15316166] - PubMed

Additional references

Asumalahti 2003
    1. Asumalahti K, Ameen M, Suomela S, Hagforsen E, Michaelsson G, Evans J, et al. Genetic analysis of PSORS1 distinguishes guttate psoriasis and palmoplantar pustulosis. Journal of Investigative Dermatology 2003;120(4):627‐32. [PUBMED: 12648227] - PubMed
Cai 2012
    1. Cai Y, Fleming C, Yan J. New insights of T cells in the pathogenesis of psoriasis. Cellular & Molecular Immunology 2012;9(4):302‐9. [PUBMED: 22705915] - PMC - PubMed
Chalmers 2001
    1. Chalmers RJ, O'Sullivan T, Owen CM, Griffiths CE. A systematic review of treatments for guttate psoriasis. British Journal of Dermatology 2001;145(6):891‐4. [PUBMED: 11899141] - PubMed
Chaudhari 2001
    1. Chaudhari U, Romano P, Mulcahy LD, Dooley LT, Baker DG, Gottlieb AB. Efficacy and safety of infliximab monotherapy for plaque‐type psoriasis: a randomised trial. Lancet 2001;357(9271):1842‐7. [PUBMED: 11410193] - PubMed
Chen 2013
    1. Chen X, Yang M, Cheng Y, Liu GJ, Zhang M. Narrow‐band ultraviolet B phototherapy versus broad‐band ultraviolet B or psoralen‐ultraviolet A photochemotherapy for psoriasis. Cochrane Database of Systematic Reviews 2013, Issue 10. [DOI: 10.1002/14651858.CD009481] - DOI - PMC - PubMed
Christophers 1992
    1. Christophers E, Mrowietz U, Henneicke HH, Farber L, Welzel D. Cyclosporine in psoriasis: a multicenter dose‐finding study in severe plaque psoriasis. The German Multicenter Study. Journal of the American Academy of Dermatology 1992;26(1):86‐90. [PUBMED: 1732342] - PubMed
Collamer 2010
    1. Collamer AN, Battafarano DF. Psoriatic skin lesions induced by tumor necrosis factor antagonist therapy: clinical features and possible immunopathogenesis. Seminars in Arthritis & Rheumatism 2010;40(3):233‐40. [PUBMED: 20580412] - PubMed
Deeks 2011
    1. Deeks JJ, Higgins JP, Altman DG. Chapter 9: Analysing data and undertaking meta‐analyses. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Dubertret 1992
    1. Dubertret L, Wallach D, Souteyrand P, Perussel M, Kalis B, Meynadier J, et al. Efficacy and safety of calcipotriol (MC 903) ointment in psoriasis vulgaris. A randomized, double‐blind, right/left comparative, vehicle‐controlled study. Journal of the American Academy of Dermatology 1992;27(6 Pt 1):983‐8. [PUBMED: 1479106] - PubMed
Dupire 2019
    1. Dupire G, Droitcourt C, Ferneiny M, Hughes C, Katsahian S, Cleach L. Antistreptococcal interventions for guttate and chronic plaque psoriasis. Cochrane Database of Systematic Reviews 2019, Issue 3. [DOI: 10.1002/14651858.CD011571.pub2] - DOI - PMC - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315(7109):629‐34. [PUBMED: 9310563] - PMC - PubMed
Goldfarb 1988
    1. Goldfarb MT, Ellis CN, Gupta AK, Tincoff T, Hamilton TA, Voorhees JJ. Acitretin improves psoriasis in a dose‐dependent fashion. Journal of the American Academy of Dermatology 1988;18(4 Pt 1):655‐62. [PUBMED: 2967310] - PubMed
GRADEpro GDT [Computer program]
    1. McMaster University (developed by Evidence Prime). GRADEpro GDT. Version accessed prior to 21 June 2018. Hamilton (ON): McMaster University (developed by Evidence Prime), 2015.
Higgins 2011a
    1. Higgins JP, Altman DG, Sterne JA. Chapter 8: Assessing risk of bias in included studies. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Higgins 2011b
    1. Higgins JP, Deeks JJ, Altman DG. Chapter 16: Special topics in statistics. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Highton 1995
    1. Highton A, Quell J. Calcipotriene ointment 0.005% for psoriasis: a safety and efficacy study. Calcipotriene Study Group. Journal of the American Academy of Dermatology 1995;32(1):67‐72. [PUBMED: 7822519] - PubMed
Ho 1996
    1. Ho S, Clipstone N, Timmermann L, Northrop J, Graef I, Fiorentino D, et al. The mechanism of action of cyclosporin A and FK506. Clinical Immunology & Immunopathology 1996;80(3 Pt 2):S40‐5. [PUBMED: 8811062] - PubMed
Ho 2001
    1. Ho VC, Griffiths CE, Berth‐Jones J, Papp KA, Vanaclocha F, Dauden E, et al. Intermittent short courses of cyclosporine microemulsion for the long‐term management of psoriasis: a 2‐year cohort study. Journal of the American Academy of Dermatology 2001;44(4):643‐51. [PUBMED: 11260540] - PubMed
Hone 1996
    1. Hone SW, Donnelly MJ, Powell F, Blayney AW. Clearance of recalcitrant psoriasis after tonsillectomy. Clinical Otolaryngology and Allied Sciences 1996;21(6):546‐7. [PUBMED: 9118579] - PubMed
Ko 2010
    1. Ko HC, Jwa SW, Song M, Kim MB, Kwon KS. Clinical course of guttate psoriasis: long‐term follow‐up study. Journal of Dermatology 2010;37(10):894‐9. [PUBMED: 20860740] - PubMed
Koo 1998
    1. Koo J. A randomized, double‐blind study comparing the efficacy, safety and optimal dose of two formulations of cyclosporin, Neoral and Sandimmun, in patients with severe psoriasis. OLP302 Study Group. British Journal of Dermatology 1998;139(1):88‐95. [PUBMED: 9764154] - PubMed
Krueger 2002
    1. Krueger GG, Papp KA, Stough DB, Loven KH, Gulliver WP, Ellis CN. A randomized, double‐blind, placebo‐controlled phase III study evaluating efficacy and tolerability of 2 courses of alefacept in patients with chronic plaque psoriasis. Journal of the American Academy of Dermatology 2002;47(6):821‐33. [PUBMED: 12451365] - PubMed
Kwon 2012
    1. Kwon HH, Na SJ, Jo SJ, Youn JI. Epidemiology and clinical features of pediatric psoriasis in tertiary referral psoriasis clinic. Journal of Dermatology 2012;39(3):260‐4. [PUBMED: 22211370] - PubMed
Lebwohl 2003
    1. Lebwohl M, Christophers E, Langley R, Ortonne JP, Roberts J, Griffiths CE. An international, randomized, double‐blind, placebo‐controlled phase 3 trial of intramuscular alefacept in patients with chronic plaque psoriasis. Archives of Dermatology 2003;139(6):719‐27. [PUBMED: 12810502] - PubMed
Lebwohl 2010
    1. Lebwohl M, Papp K, Han C, Schenkel B, Yeilding N, Wang Y, et al. Ustekinumab improves health‐related quality of life in patients with moderate‐to‐severe psoriasis: results from the PHOENIX 1 trial. British Journal of Dermatology 2010;162(1):137‐46. [PUBMED: 19903183] - PubMed
Leonardi 2003
    1. Leonardi CL, Powers JL, Matheson RT, Goffe BS, Zitnik R, Wang A, et al. Etanercept as monotherapy in patients with psoriasis. New England Journal of Medicine 2003;349(21):2014‐22. [PUBMED: 14627786] - PubMed
Leung 1993
    1. Leung DY, Walsh P, Giorno R, Norris DA. A potential role for superantigens in the pathogenesis of psoriasis. Journal of Investigative Dermatology 1993;100(3):225‐8. [PUBMED: 8440891] - PubMed
Mallbris 2005
    1. Mallbris L, Larsson P, Bergqvist S, Vingard E, Granath F, Stahle M. Psoriasis phenotype at disease onset: clinical characterization of 400 adult cases. Journal of Investigative Dermatology 2005;124(3):499‐504. [PUBMED: 15737189] - PubMed
Martin 1996
    1. Martin BA, Chalmers RJ, Telfer NR. How great is the risk of further psoriasis following a single episode of acute guttate psoriasis?. Archives of Dermatology 1996; Vol. 132, issue 6:717‐8. [PUBMED: 8651734] - PubMed
Menter 2008
    1. Menter A, Tyring SK, Gordon K, Kimball AB, Leonardi CL, Langley RG, et al. Adalimumab therapy for moderate to severe psoriasis: a randomized, controlled phase III trial. Journal of the American Academy of Dermatology 2008;58(1):106‐15. [PUBMED: 17936411] - PubMed
Menter 2010
    1. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy. Journal of the American Academy of Dermatology 2010;62(1):114‐35. [PUBMED: 19811850] - PubMed
Mrowietz 2011
    1. Mrowietz U, Kragballe K, Reich K, Spuls P, Griffiths CE, Nast A, et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Archives of Dermatological Research 2011;303(1):1‐10. [PUBMED: 20857129] - PMC - PubMed
Naldi 2001
    1. Naldi L, Peli L, Parazzini F, Carrel CF, Psoriasis Study Group of the Italian Group for Epidemiological Research in Dermatology. Family history of psoriasis, stressful life events, and recent infectious disease are risk factors for a first episode of acute guttate psoriasis: results of a case‐control study. Journal of the American Academy of Dermatology 2001;44(3):433‐8. [PUBMED: 11209111] - PubMed
Owen 2000
    1. Owen CM, Chalmers R, O'Sullivan T, Griffiths CEM. Antistreptococcal interventions for guttate and chronic plaque psoriasis. Cochrane Database of Systematic Reviews 2000, Issue 2. [DOI: 10.1002/14651858.CD001976] - DOI - PubMed
Perez‐Lorenzo 1998
    1. Perez‐Lorenzo R, Zambrano‐Zaragoza JF, Saul A, Jimenez‐Zamudio L, Reyes‐Maldonado E, Garcia‐Latorre E. Autoantibodies to autologous skin in guttate and plaque forms of psoriasis and cross‐reaction of skin antigens with streptococcal antigens. International Journal of Dermatology 1998;37(7):524‐31. [PUBMED: 9679694] - PubMed
Pettit 1979
    1. Pettit JH. Oral retinoid for psoriasis. A report of a double blind study. Acta Dermato‐Venereologica. Supplementum 1979;59(85):133‐6. [PUBMED: 393035] - PubMed
Rachakonda 2015
    1. Rachakonda TD, Dhillon JS, Florek AG, Armstrong AW. Effect of tonsillectomy on psoriasis: a systematic review. Journal of the American Academy of Dermatology 2015;72(2):261‐75. [PUBMED: 25455609] - PubMed
RevMan 2014 [Computer program]
    1. Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Samarasekera 2013
    1. Samarasekera EJ, Sawyer L, Wonderling D, Tucker R, Smith CH. Topical therapies for the treatment of plaque psoriasis: systematic review and network meta‐analyses. British Journal of Dermatology 2013;168(5):954‐67. [PUBMED: 23413913] - PubMed
Saurat 2008
    1. Saurat JH, Stingl G, Dubertret L, Papp K, Langley RG, Ortonne JP, et al. Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. methotrexate vs. placebo in patients with psoriasis (CHAMPION). British Journal of Dermatology 2008;158(3):558‐66. [PUBMED: 18047523] - PubMed
Schmitt 2016
    1. Schmitt J, Deckert S, Alam M, Apfelbacher C, Barbaric J, Bauer A, et al. Report from the kick‐off meeting of the Cochrane Skin Group Core Outcome Set Initiative (CSG‐COUSIN). British Journal of Dermatology 2016;174(2):287‐95. [PUBMED: 26779929] - PubMed
Schulz 2010
    1. Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. Journal of Clinical Epidemiology 2010;63(8):834‐40. [PUBMED: 20346629] - PubMed
Schünemann 2011
    1. Schünemann HJ, Oxman AD, Vist GE, Higgins JP, Deeks JJ, Glasziou P, et al. Chapter 12: Interpreting results and drawing conclusions. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from handbook.cochrane.org.
Spuls 2010
    1. Spuls PI, Lecluse LL, Poulsen ML, Bos JD, Stern RS, Nijsten T. How good are clinical severity and outcome measures for psoriasis?: quantitative evaluation in a systematic review. Journal of Investigative Dermatology 2010;130(4):933‐43. [PUBMED: 20043014] - PubMed
Telfer 1992
    1. Telfer NR, Chalmers RJ, Whale K, Colman G. The role of streptococcal infection in the initiation of guttate psoriasis. Archives of Dermatology 1992;128(1):39‐42. [PUBMED: 1739285] - PubMed
WebPlotDigitizer [Computer program]
    1. Ankit Rohatgi. WebPlotDigitizer. Version 4.1. Austin, Texas, USA: Ankit Rohatgi, January 2018.
Weinstein 1997
    1. Weinstein GD, Krueger GG, Lowe NJ, Duvic M, Friedman DJ, Jegasothy BV, et al. Tazarotene gel, a new retinoid, for topical therapy of psoriasis: vehicle‐controlled study of safety, efficacy, and duration of therapeutic effect. Journal of the American Academy of Dermatology 1997;37(1):85‐92. [PUBMED: 9216528] - PubMed
Weinstein 2003
    1. Weinstein GD, Koo JY, Krueger GG, Lebwohl MG, Lowe NJ, Menter MA, et al. Tazarotene cream in the treatment of psoriasis: two multicenter, double‐blind, randomized, vehicle‐controlled studies of the safety and efficacy of tazarotene creams 0.05% and 0.1% applied once daily for 12 weeks. Journal of the American Academy of Dermatology 2003;48(5):760‐7. [PUBMED: 12734506] - PubMed
Williams 1976
    1. Williams RC, McKenzie AW, Roger JH, Joysey VC. HL‐A antigens in patients with guttate psoriasis. British Journal of Dermatology 1976;95(2):163‐7. [PUBMED: 952752] - PubMed
Yan 2010
    1. Yan KX, Fang X, Han L, Zhang ZH, Kang KF, Zheng ZZ, et al. Foxp3+ regulatory T cells and related cytokines differentially expressed in plaque vs. guttate psoriasis vulgaris. British Journal of Dermatology 2010;163(1):48‐56. [PUBMED: 20222932] - PubMed
Zhao 2005
    1. Zhao G, Feng X, Na A, Yongqiang J, Cai Q, Kong J, et al. Acute guttate psoriasis patients have positive streptococcus hemolyticus throat cultures and elevated antistreptococcal M6 protein titers. Journal of Dermatology 2005;32(2):91‐6. [PUBMED: 15906537] - PubMed

References to other published versions of this review

Chalmers 2000
    1. Chalmers R, O'Sullivan T, Owen CM, Griffiths CEM. Interventions for guttate psoriasis. Cochrane Database of Systematic Reviews 2000, Issue 2. [DOI: 10.1002/14651858.CD001213] - DOI - PubMed
Maruani 2015
    1. Maruani A, Samimi M, Stembridge N, Abdel Hay R, Tavernier E, Hughes C, et al. Interventions for guttate psoriasis. Cochrane Database of Systematic Reviews 2015, Issue 2. [DOI: 10.1002/14651858.CD011541] - DOI - PMC - PubMed

Publication types

Substances