SNAP Benefit Cycles and Antiretroviral Therapy Adherence Among Adults With HIV.

Psoriasis is a chronic inflammatory skin disease characterized by erythematous plaques with silvery scales, affecting 60 million people worldwide. Psoriasis has a high prevalence and is associated with various comorbidities, including obesity, metabolic syndromes, cardiovascular diseases, and mental health disorders. Considering the prevalence, comorbidities, and the emergence of expensive new treatments, such as biologics and small molecule drugs, psoriasis imposes a substantial economic burden on both individuals and society compared to other skin diseases. This economic burden has driven significant research and development efforts, leading to substantial advancements in psoriasis treatment, particularly with the introduction of biologics in the 2000s and 2010s. Before the widespread use of biologics, treatment goals for psoriasis were often focused on reducing symptoms and improving quality of life. However, with the advent of these highly effective therapies, treatment targets have been progressively elevated, with 75% reduction in Psoriasis Area and Severity Index (PASI 75), PASI 90, and even complete clearance becoming achievable goals. Despite these advances, complete clearance (PASI 100) remains difficult to achieve in routine clinical practice, particularly in patients with involvement of high impact areas. Consequently, recent guidelines emphasize the need for intensive treatment of psoriasis affecting special areas, such as the scalp, palmoplantar areas, inverse areas (intertriginous areas like the axillae, groin, and inframammary folds), genital psoriasis, and nail psoriasis, as these locations often present significant challenges in achieving complete remission. In parallel with these developments, recent guidelines and expert consensus statements demonstrate a growing trend towards including 'special areas' in the assessment and definition of psoriasis severity. However, the current Korean definitions rely predominantly on PASI and Body Surface Area (BSA) thresholds, with limited consideration of disease burden in special areas. Consequently, we undertook this study to develop a revised Korean expert consensus on psoriasis severity and treatment targets using a modified Delphi method.