Clinical practice guideline for psoriasis management in Latin America
Abstract
Background Psoriasis care in Latin America is heterogeneous, and access to systemic agents, biologics, phototherapy, and monitoring resources varies widely across countries. Objective To develop a regional, evidence-based clinical practice guideline for psoriasis management using GRADE methodology. Methods The Latin American Psoriasis Society (SOLAPSO) convened a guideline development group, an extended expert panel, patients, and an independent methodological team. We framed clinical questions using PICO, conducted systematic literature reviews, rated certainty of evidence with GRADE, and formulated recommendations through structured Evidence-to-Decision deliberations incorporating benefits and harms, patient values, feasibility, equity, and resource use. Independent external reviewers assessed clarity and methodological quality. Results The guideline provides measurable therapeutic targets for plaque psoriasis and key phenotypes, including nail psoriasis, generalized pustular psoriasis, and other special forms. It recommends first-line conventional systemic options (methotrexate, cyclosporine, acitretin) and phototherapy, and it defines indications for escalation to biologic agents or small molecules after inadequate response, intolerance, or contraindications to conventional therapy. It addresses selection across biologic classes, use of biosimilars, and strategies for primary and secondary therapeutic failure. Additional recommendations cover high-impact areas (scalp, nails, palmoplantar, inverse, genital) and special situations (pregnancy, cancer, chronic viral infections, HIV, latent tuberculosis, pediatric psoriasis), plus nonpharmacologic interventions (weight reduction and structured psychological support). Study limitations Limitations include heterogeneity in the availability of regional evidence, indirect evidence for some special populations, and variability in access to therapies across Latin American health systems. Conclusions This guideline offers an actionable framework for comprehensive psoriasis care in Latin America, balancing best available evidence with regional constraints to support equitable, patient-centered implementation in routine clinical practice.
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BibTeX
@article{valenzuela2026clinical,
title = {{Clinical practice guideline for psoriasis management in Latin America}},
author = {Fernando Valenzuela and Juan Raúl Castro Ayarza and Débora Kaplan and Angela María Londoño-García and Karla del Rocío Macías García and Gabriel Magariños and Enrique Salvador Rivas Záldivar and Manuel Franco and Sara Cano and Carolina Cortés and Paola Jimena Cárdenas and Carla Castro and Renata Ferreira and Susan Martínez and Linda Ibatá Bernal and Julieth Carolina Castillo and Jorge Ospina},
journal = {Anais Brasileiros de Dermatologia},
year = {2026},
month = nov,
doi = {10.1016/j.abd.2026.501449},
url = {https://doi.org/10.1016/j.abd.2026.501449},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical practice guideline for psoriasis management in Latin America
AU - Fernando Valenzuela
AU - Juan Raúl Castro Ayarza
AU - Débora Kaplan
AU - Angela María Londoño-García
AU - Karla del Rocío Macías García
AU - Gabriel Magariños
AU - Enrique Salvador Rivas Záldivar
AU - Manuel Franco
AU - Sara Cano
AU - Carolina Cortés
AU - Paola Jimena Cárdenas
AU - Carla Castro
AU - Renata Ferreira
AU - Susan Martínez
AU - Linda Ibatá Bernal
AU - Julieth Carolina Castillo
AU - Jorge Ospina
PY - 2026
DA - 2026/11/03
JO - Anais Brasileiros de Dermatologia
DO - 10.1016/j.abd.2026.501449
UR - https://doi.org/10.1016/j.abd.2026.501449
AB - Background Psoriasis care in Latin America is heterogeneous, and access to systemic agents, biologics, phototherapy, and monitoring resources varies widely across countries. Objective To develop a regional, evidence-based clinical practice guideline for psoriasis management using GRADE methodology. Methods The Latin American Psoriasis Society (SOLAPSO) convened a guideline development group, an extended expert panel, patients, and an independent methodological team. We framed clinical questions using PICO, conducted systematic literature reviews, rated certainty of evidence with GRADE, and formulated recommendations through structured Evidence-to-Decision deliberations incorporating benefits and harms, patient values, feasibility, equity, and resource use. Independent external reviewers assessed clarity and methodological quality. Results The guideline provides measurable therapeutic targets for plaque psoriasis and key phenotypes, including nail psoriasis, generalized pustular psoriasis, and other special forms. It recommends first-line conventional systemic options (methotrexate, cyclosporine, acitretin) and phototherapy, and it defines indications for escalation to biologic agents or small molecules after inadequate response, intolerance, or contraindications to conventional therapy. It addresses selection across biologic classes, use of biosimilars, and strategies for primary and secondary therapeutic failure. Additional recommendations cover high-impact areas (scalp, nails, palmoplantar, inverse, genital) and special situations (pregnancy, cancer, chronic viral infections, HIV, latent tuberculosis, pediatric psoriasis), plus nonpharmacologic interventions (weight reduction and structured psychological support). Study limitations Limitations include heterogeneity in the availability of regional evidence, indirect evidence for some special populations, and variability in access to therapies across Latin American health systems. Conclusions This guideline offers an actionable framework for comprehensive psoriasis care in Latin America, balancing best available evidence with regional constraints to support equitable, patient-centered implementation in routine clinical practice.
SN - 0365-0596
ER -