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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Psoriasis is not uncommon in childhood&#44; but only scant information is available on the epidemiology of the condition and its management with systemic therapy in the pediatric population&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Studies on pediatric psoriasis report that around 8&#37; of these patients have moderate to severe disease requiring treatment with phototherapy or systemic drugs&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> Given the chronic nature of psoriasis and the need for prolonged treatment&#44; it is important to carefully select the best treatment option based on both its effectiveness and the safety profile&#44; especially in very young children&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Our principal objective was to describe the systemic treatments used in clinical practice to treat moderate to severe psoriasis in children&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Our second aim was to describe the effectiveness and safety of these treatments&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This was a descriptive&#44; cross-sectional&#44; multicenter study carried out in the dermatology units managed by the 7 health districts &#40;Estructuras de Gesti&#243;n Integrada&#41; that make up the Galician Public Health network &#40;SERGAS&#41;&#46; We included patients with moderate to severe psoriasis aged under 18 years who were currently receiving or had been treated with systemic drugs &#40;classic or biologic&#41; or phototherapy between January 2005 and August 2017&#46; The decision to include patients aged up to 17 years &#40;and not just pediatric patients up to 12 or 14 years of age&#41; was taken because 18 is the age at which a patient is considered to be an adult&#46; It is also the lowest age at which most systemic treatments &#40;with the exception of etanercept<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> and more recently adalimumab<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> and ustekinumab<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a>&#41; are approved for use in this setting &#40;the prescription of other systemic treatments to children aged under 18 years is deemed to be &#8220;off-label&#8221; use&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The following data was collected for each patient&#58; clinical and demographic information&#44; the results of a basic laboratory workup&#44; the characteristics and severity of psoriasis &#40;assessed using the Psoriasis Area and Severity Index &#91;PASI&#93; or the Body Surface Area &#91;BSA&#93;&#41;&#44; and the presence of comorbidities&#46; Psoriasis was considered to be moderate to severe when the PASI was at least 10 or when the PASI was under 10 but the condition failed to respond to appropriate treatment&#46; With the BSA&#44; the cut-off point for moderate to severe psoriasis was 10&#37;&#46; We also collected data on the duration and dosage of and response to systemic treatments&#44; as well as on adverse events&#44; tolerance&#44; and the reasons for withdrawal of treatment&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Treatment response was assessed at weeks 12 and&#47;or 24 for all the treatments except phototherapy&#44; which was only assessed at week 12&#46; The reason for this difference is that opposed to systemic therapies&#44; in routine clinical practice in our units&#44; we do not perform a standardized assessment at week 24 after finishing phototherapy&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Taking into account the PASI&#44; the BSA&#44; and the descriptive information recorded by the dermatologist in the patients&#8217; clinical record&#44; definitions were established for classifying patients as good responders&#44; partial responders&#44; and non-responders&#46; A good response was defined as an improvement in the PASI score of at least 75&#37; over baseline &#40;PASI 75&#41; at week 12 or week 24&#46; Also included in this group were patients whose clinical history indicated&#58; &#8220;Very good or excellent outcome&#8221;&#44; &#8220;almost complete clearing&#8221; of psoriasis&#44; &#8220;total or almost total remission&#8221;&#44; or &#8220;withdrawal of treatment owing to a good response&#8221;&#46; When no PASI value was available&#44; a BSA of 0&#37; or 1&#37; was also considered as a good response&#46; Partial response was defined as an improvement of more than 50&#37; but less than 75&#37; in the PASI score or an indication in the clinical record describing the outcome as &#8220;partial improvement&#8221;&#44; &#8220;partial clearance&#8221;&#44; or &#8220;partial remission&#8221;&#46; Patients who did not achieve a PASI 50 response or whose medical record included the terms &#8220;little improvement&#8221;&#44; &#8220;minimal effect&#8221;&#44; &#8220;no improvement&#8221;&#44; &#8220;lesions unchanged with respect to start of treatment&#8221;&#44; or &#8220;withdrawal of treatment due to lack of response&#8221; were classified as non-responders&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">We distinguished between &#8220;adverse events&#8221; &#40;treatment-related clinical signs or abnormalities in test results observed by the physician and recorded in the medical record&#44; whether or not they resulted in withdrawal of treatment&#41; and &#8220;intolerance&#8221; &#40;subjective symptoms or discomfort reported by the patient or their parents thought to be related to the treatment&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The motives for withdrawal of treatment were as follows&#58; good response&#44; poor response&#44; lack of response&#44; loss of response &#40;secondary treatment failure&#41;&#44; use of an intermittent treatment regimen&#44; express wish of the patient or the parents&#44; poor adherence to therapy&#44; therapy limited by a clinical trial&#44; interruption of therapy for medical reasons &#40;surgery&#44; active infection&#44; or the need for other treatments that might interact or were contraindicated with the treatment in question&#41;&#44; intolerance&#44; and adverse effects&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The protocol of this study was reviewed and approved by the Clinical Research Ethics Committee of Galicia&#46; It was also classified by the Spanish Agency for Medicines and Health Products &#40;AEMPS&#41; as a post-authorization study with a design other than prospective follow-up &#40;EPA-OD&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistic Analysis</span><p id="par0060" class="elsevierStylePara elsevierViewall">All the data collected were recorded on an Excel spreadsheet and analyzed with the R Statistics program &#40;version R i386 3&#46;4&#46;2&#41;&#46; We calculated the frequency distribution for qualitative variables and the mean and standard deviation for quantitative variables&#46; The Chi square test &#40;or Fisher&#39;s exact test if appropriate depending on the number of observations&#41; was used to determine the relationships between qualitative variables&#46; Student&#39;s T test was use to compare quantitative variables by treatment group&#46; Statistical significance was set at <span class="elsevierStyleItalic">P</span> less than &#46;05&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">The final analysis included 40 patients &#40;60&#37; female&#44; mean age at the start of the first treatment 13 years&#44; 65&#37; with plaque psoriasis&#41; who underwent a total of 63 treatment cycles&#46; The characteristics of the study population are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">In the case of the first treatment administered &#40;n &#61; 40&#41;&#44; phototherapy was the option most frequently chosen &#40;68&#37;&#41;&#44; followed by acitretin &#40;15&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; In the analysis of the outcomes recorded at week 12 &#40;which includes phototherapy&#41;&#44; 66&#37; &#40;25&#47;38&#41; of the patients were classified as good responders and 24&#37; &#40;9&#47;38&#41; as partial responders&#46; At week 24 &#40;assessment of classic systemic drugs and biologic agents only&#41;&#44; 25&#37; of the patients &#40;3&#47;12&#41; were classified as good responders and 50&#37; as partial responders&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">In the analysis of all of the treatment cycles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41;&#44; the most frequent treatment was phototherapy&#44; which accounted for 57&#37; of cycles&#44; followed by methotrexate&#44; accounting for 16&#37; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; At week 12&#44; 66&#37; &#40;38&#47;58&#41; were classified as good responders and 22&#37; &#40;13&#47;58&#41; as partial responders&#46; At week 24 &#40;analysis of classic systemic and biologic therapies only&#41;&#44; 36&#37; of patients &#40;8&#47;22&#41; continued to have a good response and 32&#37; &#40;7&#47;22&#41; had a partial response&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a> shows the data on response for the different treatments at weeks 12 and 24 with respect to the first treatment administered &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>40&#41; and for all the treatment cycles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41;&#46; Phototherapy&#44; ciclosporin&#44; and biologic drugs achieved the best results in the short term &#40;week 12&#41;&#46; At week 24&#44; biologic drugs obtained the best response and the next most effective treatment was methotrexate&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">The regimens used and the data on tolerance and adverse effects for all the treatment cycles are included in the supplementary material &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41;&#46; Etanercept and acitretin were the most prolonged treatments with mean durations of 26 and 23 months&#44; respectively&#46; In the case of phototherapy &#40;94&#37; narrow-band UV-B therapy&#41;&#44; the average duration of a treatment cycle was 2 months&#46; No relationship was observed between duration of treatment or number of treatment cycles and the type of psoriasis &#40;plaque versus guttate&#41; &#40;<span class="elsevierStyleItalic">P</span> &#62; &#46;05&#41;&#46; The treatments were well tolerated &#40;97&#37;&#41;&#46; Adverse events were rare &#40;11&#37;&#41; and in no case led to withdrawal of treatment&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a> shows the distribution of the motives for treatment withdrawal&#46; The most common reason for withdrawal was a good response &#40;47&#37;&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">Studies evaluating therapies used in children and adolescents to treat moderate to severe psoriasis have used differing methodologies and have reported diverse results &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">One group of descriptive studies analyzed clinical variables and epidemiological data from children with psoriasis of all levels of severity and&#8212;although this was not their main objective&#8212;also reported the treatments used&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">7&#8211;9</span></a> Kwon et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> studied 358 children and adolescents&#44; 26&#37; of whom received systemic treatment&#46; Phototherapy and acitretin were the treatments most often prescribed&#44; followed by ciclosporin&#46; While the proportion of patients who received systemic treatment was similar in a study of 280 cases by Tovar-Garza et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> the treatments prescribed in that study were not those recommended in the consensus statements followed in our medical setting&#46; Dapsone was the drug most frequently prescribed&#44; followed by antibiotics&#44; which were prescribed for guttate psoriasis&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> The largest of these studies analyzed data from 842 children and adolescents &#40;average age 7 years&#44; 2&#37; with BSA<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>10&#41;&#44; of whom only 3 received systemic treatment &#40;2 ciclosporin and 1 methotrexate in combination with etanercept&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Other studies&#44; which used a methodology more similar to that of our study&#44; analyzed only pediatric patients with psoriasis treated with systemic drugs&#46; Of particular interest are 5 studies with populations ranging from 27 to 390 patients &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10&#8211;14</span></a> Three included phototherapy among the treatment options assessed&#44; as we did&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10&#8211;12</span></a> Methotrexate followed by etanercept&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10&#44;13</span></a> etanercept followed by methotrexate&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> acitretin&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> and ciclosporin<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> were the drugs most often prescribed&#44; depending on the study&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The dosages of each treatment were similar across the different studies&#58; phototherapy &#40;narrowband UV&#8211;B and PUVA&#41; 2 to 3 times a week&#59; acitretin at a dose of 0&#46;2-1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#59; methotrexate at a dose of 0&#46;2-0&#46;7<span class="elsevierStyleHsp" style=""></span>mg&#47;wk&#59; ciclosporin at a dose of 2&#46;5-5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#59; and etanercept prescribed according to the Summary of Product Characteristics &#40;0&#46;8<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;wk up to a maximum of 50<span class="elsevierStyleHsp" style=""></span>mg&#47;wk&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;12&#44;15&#44;16</span></a> These data are in line with the guidelines followed in our study&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In the descriptive studies cited above&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10&#8211;12&#44;14</span></a> notwithstanding differences in study design and the way the results are expressed&#44; the authors generally report satisfactory responses for all treatment groups&#46; With respect to efficacy&#44; Garber et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> observed better responses with biologic drugs than with classic systemic therapy and phototherapy&#44; while Charbit et al&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> reported a higher response rate for the combination of phototherapy and acitretin&#44; although this regimen accounted for only 10 of the 261 treatment cycles they analyzed &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; In our study population&#44; the percentage of good responders was 66&#37; at week 12&#44; falling to 32 at week 24&#46; The percentages for good and partial responses combined are higher &#40;88&#37; at week 12 and 68&#37; at week 24&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">In most of these case series&#44; side effects were mild and rare&#46; The percentage of adverse events leading to withdrawal of treatment ranged from 4&#37; to 11&#37; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10&#8211;14</span></a> In a recent retrospective study of 390 children aged under 18 years&#44; Bronckers et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> observed a lower percentage of adverse effects overall with biologic agents than with methotrexate&#44; although the percentage of infections was higher in the group of patients on biologic therapy&#46; The most significant adverse events were injection site reactions in patients on biologic drugs &#40;20&#47;106&#41; and gastrointestinal symptoms in patients on methotrexate &#40;67&#47;270&#41;&#46; Six patients &#40;2&#37;&#41; developed a serious adverse event&#58; 3 associated with methotrexate&#44; 2 with fumaric acid esters&#44; and 1 with adalimumab&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Other studies provide data on effectiveness and adverse effects for a single treatment or a few different drugs &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15&#44;17&#44;18</span></a> The number of patients included&#44; the timing of response assessment&#44; and the scales used to measure effectiveness vary&#44; but the percentage of good responders was around 40&#37; for methotrexate&#44; acitretin&#44; and ciclosporin in all these studies&#46; Earlier studies reported better responses with methotrexate&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">19&#44;20</span></a> Response rates of 62&#37; have been reported for ciclosporin<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a>&#59; but this result should be evaluated with caution&#44; since the study enrolled only 10 patients and the effectiveness of ciclosporin was evaluated at week 4&#46; Di Lernia et al&#46;&#44; <a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> who analyzed the effectiveness of etanercept in clinical practice in a group of patients under 18 years of age&#44; reported a PASI 75 response at week 24 in 65&#37;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Once again&#44; all of these authors report very few adverse effects&#44; and these led to withdrawal of treatment in fewer than 4&#37; of cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15&#8211;21</span></a>In the case of phototherapy&#44; total clearing or an improvement of more than 70&#37; has been documented in over 60&#37; of cases&#44; and only minor side effects have been reported &#40;erythema&#44; itching or burning sensation&#44; blisters&#44; and reactivation of the herpes simplex virus&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">22&#8211;30</span></a> In our study population&#44; phototherapy achieved a good response in over 80&#37; of treatment cycles&#44; with minimal adverse effects&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Our study is affected by certain limitations&#46; The study population was small and the data was analyzed retrospectively&#46; Consequently&#44; the results depend on the information recorded in medical records&#46; Further research is needed to confirm our findings and provide more data&#44; preferably prospective studies analyzing larger groups of patients&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusion</span><p id="par0140" class="elsevierStylePara elsevierViewall">In our setting&#44; in the population under 18 years of age with psoriasis&#44; phototherapy was the treatment most often prescribed&#44; followed by methotrexate&#46; The treatments studied had a good safety profile and achieved a good response in 66&#37; of the patients assessed at week 12 &#40;including phototherapy&#41; and 32&#37; at week 24 &#40;systemic drugs without phototherapy&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicts of Interest</span><p id="par0145" class="elsevierStylePara elsevierViewall">Ana Batalla has received honoraria for training activities from Abbvie&#44; Leo-Pharma&#44; Novartis and Pierre-Fabre and has participated in clinical trials from Lilly and Novartis&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Rosa Fern&#225;ndez-Torres has received honoraria for training activities from Abbvie&#44; Leo-Pharma&#44; Janssen&#44; Novartis and Pfizer and has participated in clinical trials from Janssen and Novartis&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Laura Rodr&#237;guez-Pazos has participated in clinical trials from Novartis&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Romina Rodr&#237;guez Lojo has received honoraria for training activities from Abbvie&#44; Bristol-Myers&#44; and Roche&#44; and has participated in clinical trials from Janssen and Novartis&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Ander Zulaica has received honoraria for training activities&#44; clinical trials&#44; and consultancy work from Abbvie&#44; Almirall&#44; Celgene&#44; Janssen&#44; Leo-Pharma&#44; MSD&#44; Novartis&#44; and Pfizer&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Miguel Cabanillas has received honoraria for training activities from Abbvie&#44; Janssen&#44; Leo-Pharma&#44; and Pfizer&#44; and has participated in clinical trials from Abbvie and Novartis&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Eduardo Fonseca Capdevila has received honoraria for training activities and clinical trials from Abbvie&#44; Almirall&#44; Celgene&#44; Janssen&#44; Novartis&#44; and Pfizer&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">&#193;lvaro Le&#243;n has received honoraria for training activities from Leo-Pharma&#44; Novartis&#44; and Pierre-Fabre&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Luisa Fern&#225;ndez-D&#237;az has received honoraria for training activities&#44; research&#44; and consultancy from Abbvie&#44; Celgene&#44; Gebro-Pharma&#44; Janssen&#44; Leo-Pharma&#44; Lilly&#44; MSD&#44; Novartis&#44; and Pfizer&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Mar&#237;a Jos&#233; Seoane-Pose has participated in clinical trials from Abbvie and Novartis&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Hugo V&#225;zquez-Veiga has received honoraria for his participation in research projects&#44; training and consulting activities from Almirall&#44; Celgene&#44; Leo-Pharma&#44; Lilly&#44; Janssen&#44; MSD&#44; and Novartis&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Teresa Abalde has received honoraria for training activities from Celgene&#44; LeoPharma&#44; Janssen&#44; MSD&#44; Novartis&#44; and Pfizer and has participated in clinical trials from Janssen and Novartis&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Laura Salgado-Boquete has received honoraria for training activities and scientific consultancy from Abbvie&#44; Celgene&#44; Janssen&#44; Lilly&#44; Medea&#44; MSD&#59; Novartis&#44; and Pfizer&#44; and has participated in clinical trials from Janssen and Novartis&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Ignacio Su&#225;rez-Conde has participated in clinical trials from Novartis&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">&#193;ngeles Fl&#243;rez has received honoraria for participation in research projects&#44; training and consulting activities from Almirall&#44; Celgene&#44; Leo-Pharma&#44; Lilly&#44; Janssen&#44; MSD&#44; and Novartis&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">The other authors report no conflicts of interest&#46;</p></span></span>"
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          "titulo" => "Abstract"
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              "identificador" => "abst0005"
              "titulo" => "Background and objective"
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              "titulo" => "Antecedentes y objetivo"
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    "fechaRecibido" => "2018-02-07"
    "fechaAceptado" => "2018-05-23"
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            0 => "Effectiveness"
            1 => "Adverse effects"
            2 => "Pediatrics"
            3 => "Psoriasis"
            4 => "Treatment"
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          "palabras" => array:5 [
            0 => "Efectividad"
            1 => "Efectos indeseables"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Studies on the use of systemic therapy for psoriasis in pediatric patients are scarce&#46; The main aim of this study was to describe the systemic treatments used for moderate to severe psoriasis in pediatric clinical settings&#46; The second aim was to describe the effectiveness and safety of these treatments&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Descriptive&#44; cross-sectional&#44; multicenter study of patients under 18 years of age with moderate to severe psoriasis who were being treated or had been treated with a systemic drug &#40;conventional or biologic&#41; or phototherapy&#46; We recorded demographic and clinical information&#44; treatments received&#44; tolerance&#44; adverse effects&#44; and response to treatment&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Data were collected for 40 patients &#40;60&#37; female&#59; mean age&#44; 13 years&#41; who had received 63 treatments in total&#46; The most common first treatment &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>40&#41; was phototherapy &#40;administered to 68&#37; of patients&#41;&#44; followed by acitretin &#40;15&#37;&#41;&#46; The most common treatments overall &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41; were phototherapy &#40;57&#37;&#41; and methotrexate &#40;16&#37;&#41;&#46; At week 12 &#40;evaluation of systemic treatment and phototherapy&#41;&#44; 66&#37; of the patients were classified as good responders and 22&#37; as partial responders&#46; The respective rates for week 24 &#40;evaluation of systemic treatment only&#41; were 36&#37; and 32&#37;&#46; The treatments were well tolerated &#40;97&#37;&#41; and adverse effects were reported in just 11&#37; of cases&#46; There were no treatment discontinuations because of adverse effects&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Phototherapy&#44; followed by methotrexate&#44; were the most common treatment for moderate to severe psoriasis in this series of patients under 18 years&#46; The treatments showed a favorable safety profile and were associated with a good response rate of 66&#37; at week 12 &#40;systemic treatment and phototherapy&#41; and 36&#37; at week 24 &#40;systemic treatment only&#41;&#46;</p></span>"
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          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background and objective"
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            "titulo" => "Material and methods"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes y objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los trabajos sobre el tratamiento sist&#233;mico de la psoriasis en edad pedi&#225;trica son escasos&#46; El objetivo principal de este trabajo consisti&#243; en describir qu&#233; tratamientos sist&#233;micos se emplean en pr&#225;ctica cl&#237;nica en psoriasis moderada-grave en edad pedi&#225;trica&#46; Secundariamente se describi&#243; la efectividad y perfil de seguridad de dichos tratamientos&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo transversal multic&#233;ntrico&#44; de los pacientes con psoriasis moderada-grave&#44; que siendo menores de 18 a&#241;os estuviesen recibiendo o hubieran recibido tratamiento sist&#233;mico &#40;cl&#225;sico o biol&#243;gico&#41; o fototerapia&#46; Se recogieron datos cl&#237;nico-demogr&#225;ficos&#44; tipo de tratamiento recibido&#44; y tolerancia&#44; efectos indeseables y respuesta al mismo&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se obtuvieron datos de 40 pacientes &#40;60&#37; sexo femenino&#44; edad media 13 a&#241;os&#41;&#44; que realizaron 63 ciclos de tratamiento&#46; Teniendo en cuenta el primer tratamiento &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>40&#41;&#44; la fototerapia fue la opci&#243;n m&#225;s frecuente &#40;68&#37;&#41;&#44; seguida de acitretino &#40;15&#37;&#41;&#46; Considerando el total de ciclos de tratamiento &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41;&#44; el tratamiento m&#225;s frecuentemente empleado fue la fototerapia &#40;57&#37;&#41;&#44; seguida de metotrexato &#40;16&#37;&#41;&#46; En la semana 12 &#40;incluye evaluaci&#243;n de fototerapia&#41;&#44; el 66&#37; y el 22&#37; fueron buenos respondedores o respondedores parciales&#44; respectivamente&#46; En la semana 24 &#40;datos exclusivos sobre f&#225;rmacos sist&#233;micos&#41;&#44; el 36&#37; y el 32&#37; continuaron con respuestas buenas y parciales&#46; Los tratamientos fueron bien tolerados &#40;97&#37;&#41; y los efectos indeseables escasos &#40;11&#37;&#41;&#44; sin que en ning&#250;n caso motivasen la suspensi&#243;n del f&#225;rmaco&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En la poblaci&#243;n menor de 18 a&#241;os con psoriasis moderada-grave evaluada la fototerapia fue el tratamiento m&#225;s utilizado&#44; seguida de metotrexato&#46; Los tratamientos consiguieron porcentajes de buenos respondedores del 66&#37; en la semana 12 &#40;incluida fototerapia&#41;&#44; y del 36&#37; en la semana 24 &#40;f&#225;rmacos sist&#233;micos sin fototerapia&#41;&#44; presentando un buen perfil de seguridad&#46;</p></span>"
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            "identificador" => "abst0035"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Batalla A&#44; Fern&#225;ndez-Torres R&#44; Rodr&#237;guez-Pazos L&#44; Monteagudo B&#44; Pardavila-Riveiro R&#44; Rodr&#237;guez-Lojo R&#44; et al&#46; Tratamiento sist&#233;mico de la psoriasis moderada-grave en edad pedi&#225;trica en Galicia&#58; estudio descriptivo&#46; Actas Dermosifiliogr&#46; 2018&#59;109&#58;722&#8211;732&#46;</p>"
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            "apendice" => "<p id="par0230" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0045"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribution of treatments in patients aged under 18 years with moderate to severe psoriasis&#46; A&#44; Considering the first treatment carried out &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>40&#41;&#46; B&#44; Considering all treatment cycles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41;&#46; The number of patients receiving each treatment is indicated to the left of each bar&#46;</p>"
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Distribution of good responders&#44; partial responders&#44; and non-responders for each treatment&#46; A&#44; Considering the first treatment carried out &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>40&#41;&#46; B&#44; Considering all treatment cycles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41;&#46; The number of patients in each response group is indicated at the top of each bar&#46;</p>"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Distribution of the causes for withdrawal of treatment &#40;all treatment cycles&#41;&#46;</p>"
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; BMI&#44; Body Mass Index&#59; BSA&#44; Body Surface Area&#59; F&#44; female&#59; M&#44; male&#59; PASIP&#44; soriasis Area and Severity Index&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sex&#44; F&#58; M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;60&#37;&#41;&#58; 16 &#40;40&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age &#40;SD&#41; when first treated&#44; y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;4 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age &#40;SD&#41; at onset of psoriasis&#44; y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;2 &#40;4&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Duration of disease &#40;SD&#41;&#44; y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;8 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Type&#58; plaque&#47;guttate&#47;flexural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;65&#37;&#41;&#47;12 &#40;30&#37;&#41;&#47;2 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Family history of psoriasis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#47;39 &#40;51&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Highest PASI score &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#46;5 &#40;6&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Highest BSA&#44; &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#46;7&#37; &#40;17&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">PASI score before treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#46;0 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BSA score before treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;0 &#40;14&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Onychopathy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#47;32 &#40;15&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Psoriatic arthritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#47;39 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Uveitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#47;40 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Other inflammatory diseases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#47;40 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#47;40 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#47;40 &#40;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dyslipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#47;40 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#47;40 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI &#40;SD&#41;&#44; kg&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19 &#40;21&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Metabolic syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#47;40 &#40;2&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Characteristics of Patients Under 18 Years of Age With Moderate to Severe Psoriasis on Systemic Treatment &#40;Including Phototherapy&#41; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>40&#41;&#46;</p>"
        ]
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        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; &#9792;&#44; female&#59; Acitret&#44; acitretin&#59; Ada&#44; adalimumab&#59; BSA&#44; Body Surface Area&#59; CsP&#44; ciclosporin&#59; Etan&#44; etanercept&#59; FAE&#44; fumaric acid esters&#59; Inf&#44; infliximab&#59; Mtx&#44; methotrexate NB&#8211;UV-B&#44; narrow-band UV-B&#59; n&#44; number of patients&#59; PASI&#44; Psoriasis Area and Severity Index&#59; PGA&#44; Physician Global Assessment&#59; PUVA&#44; UV-A<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>psoralen&#59; Ust&#44; ustekinumab&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">References&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Population&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kwon et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>358 &#40;&#8804;&#160;18 y&#41;<br>49&#37; &#9792;&#46; Mean age 14 y<br>Mean PASI score&#58; 17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26&#37; systemic treatment<br>&#8226; NB&#8211;UV-B &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>26&#59; 7&#46;3&#37;&#41;&#44; PUVA &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#59; 4&#46;2&#37;&#41;<br>&#8226; Acitretin &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>40&#59; 11&#46;2&#37;&#41;<br>&#8226; Ciclosporin &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#59; 4&#46;2&#37;&#41;<br>&#8226; Oral corticosteroids &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#59; 3&#46;6&#37;&#41;<br>&#8226; Methotrexate &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#59; 2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Moustouet al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>842 &#40;&#60;&#160;18&#160;y&#41;<br>52&#37; &#9792;&#46; Mean age 7 y<br>BSA&#160;&#8805;&#160;10&#58; 1&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#46;4&#37;&#41; systemic treatment<br>&#8226; Ciclosporin &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;<br>&#8226; Methotrexate<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>etanercept &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tovar-Garza et al&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>280 &#40;&#8804;&#160;18 y&#41;<br>60&#37; &#9792;&#46; Mean age 11 y<br>PASI<span class="elsevierStyleHsp" style=""></span>&#62;&#160;10&#58; 31&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 &#40;25&#37;&#41; systemic treatment<br>&#8226; Dapsone &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>35&#59; 12&#46;5&#37;&#41;<br>&#8226; Antibiotics &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>31&#59; 11&#37;&#41;<br>&#8226; Psoralens &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>5&#59; 2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Garber et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27 &#40;56 cycles&#41;<br>&#40;&#8804;&#160;18 y&#41;<br>70&#37; &#9792;&#59; 96&#37; plaque psoriasis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><elsevierMultimedia ident="201810020632510481"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Klufas et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a><br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>51 &#40;80 cycles&#41;<br>&#40;&#8804;&#160;18 y&#41;<br>63&#37; &#9792;&#59; mean age<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> 14 y&#59; 80&#37; plaque psoriasis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><elsevierMultimedia ident="201810020632510482"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Charbit et al&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a><br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>154 &#40;261 cycles&#41;<br>&#40;&#60;&#160;18 y&#41;<br>50&#37; &#9792;&#59; mean age<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> 10&#59; 56&#37; plaque psoriasis&#59;<br>PGA<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>4&#58; 50&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><elsevierMultimedia ident="201810020632510483"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DI Lernia et al&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>58 &#40;92 cycles&#41;<br>&#40;&#60;&#160;18 y&#41;<br>53&#37; &#9792;&#59; mean age<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> 12&#59; 100&#37; plaque psoriasis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><elsevierMultimedia ident="201810020632510484"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bronckers et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>390 &#40;482 cycles&#41;<br>&#40;&#60;&#160;18 y&#41;<br>52&#37; &#9792;&#46; Mean age<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> 11&#46; Mean PASI&#58; 14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><elsevierMultimedia ident="201810020632510485"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Systemic Treatments for Moderate to Severe Psoriasis in Children and Adolescents&#58; Data From Descriptive Studies<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">7&#8211;14</span></a></p>"
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        "etiqueta" => "Table 3"
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          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; Ada&#44; adalimumab&#59; BSA&#44; Body Surface Area&#59; Cr&#44; creatinine&#59; CsP&#44; ciclosporin&#59; FAE&#44; fumaric acid esters&#59; Etan&#44; etanercept&#59; GI&#44; gastrointestinal&#59; HSV&#58; herpes simplex virus&#59; LFT&#44; liver function tests&#59; Mtx&#44; methotrexate&#59; NB-UV-B&#58; narrow-band UV-B&#59; n&#44; number of patients&#59; PASI&#44; Psoriasis Area and Severity Index&#59; PGA&#44; Physician Global Assessment&#59; PUVA&#44; UV-A and psoralen&#59; S&#8211;MAPA&#44; Simple Measure for Assessing Psoriasis Activity&#58; a product of the PGA times the &#37; BSA&#59; Tg&#44; triglycerides&#59; TNF&#44; tumor necrosis factor&#59; Ust&#44; ustekinumab&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">a</span> As treated&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">b</span> Last observation carried forward</p><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">c</span> 2&#47;18 &#40;11&#46;1&#37;&#41; taking into account all the treatment cycles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41;&#46;</p><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">d&#44;e&#44;f</span> Studies including patients with psoriasis and other skin conditions &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113<span class="elsevierStyleSup">d</span>&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>77<span class="elsevierStyleSup">e</span>&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>116<span class="elsevierStyleSup">f</span>&#41;&#59; adverse effects corresponding to all the patients in those studies &#40;and not the subgroup of patients with psoriasis&#41;&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Population&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Effectiveness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Adverse Events&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Garber et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27<br>&#40;56 cycles&#41;<br>&#40;&#8804;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Clearing&#58;<br>- Ada &#40;4&#47;6&#41; and Etan &#40;6&#47;9&#41;&#58; 66&#46;7&#37;<br>- Ust &#40;1&#47;3&#41;&#58; 33&#46;3&#37;<br>- Conventional systemic drugs&#58; 0&#47;28 &#40;0&#37;&#41;<br>S-MAPA 50&#37;&#58;<br>- NB&#8211;UV-B 3&#47;3 &#40;100&#37;&#41;&#44; Mtx 4&#47;11 &#40;36&#46;4&#37;&#41;&#44; CsP 2&#47;3 &#40;66&#46;7&#37;&#41;&#44; Ada 6&#47;6 &#40;100&#37;&#41;&#44; Etan 7&#47;9 &#40;77&#46;8&#37;&#41;&#44; Ust 2&#47;3 &#40;66&#46;7&#37;&#41;&#44; combinations &#40;biologic<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Mtx or CsP&#41;&#58; 4&#47;4 &#40;100&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Most common&#58;<br>- Mtx&#58; minor infections 16&#37;&#44; GI 16&#37;&#44; LFT alterations 11&#37;<br>- Ada&#58; minor infections 25&#37;<br>- Etan&#58; minor infections 33&#37;<br>Leading to withdrawal of treatment&#58; 2&#47;56 &#40;3&#46;6&#37;&#41;<br>- Mtx 1&#47;19 &#40;5&#37;&#41;<br>- Ust 1&#47;3 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Klufas et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>51<br>&#40;80 cycles&#41;<br>&#40;&#8804;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PGA&#44; 5-7 months and 12 months<br>- All the treatment groups achieved positive responses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#47;80 &#40;36&#37;&#41;&#44; minor and subjective<br>Most frequent adverse effect fatigue &#40;7&#46;5&#37;&#41;<br>&#8220;Few treatments discontinued due to adverse effects&#8221; &#40;no exact percentages provided&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Charbit et al&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>154<br>&#40;261 cycles&#41;<br>&#40;&#60;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PASI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>50&#58; 59&#37; for systemic drugs<br>- Phototherapy<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>acitretin achieved the best response rates&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#47;261 &#40;33&#46;7&#37;&#41;<br>- Most frequent&#58; acitretin &#40;52&#47;116&#44; 45&#37;&#41;<br>Leading to withdrawal of treatment&#58; 15&#47;261 &#40;5&#46;7&#37;&#41;<br>- CsP&#58; 5&#47;25 &#40;20&#37;&#41;<br>- Mtx&#58; 4&#47;48 &#40;8&#46;3&#37;&#41;<br>- Acitretin&#58; 6&#47;142 &#40;4&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Di Lernia et al&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>58<br>&#40;92 cycles&#41;<br>&#40;&#60;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Not clearly specified<br>Data on withdrawal due to complete remission is given&#44; but effectiveness was not measured directly&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Leading to withdrawal of treatment&#58; 19&#47;92 &#40;10&#46;9&#37;&#41;<br>- PUVA&#58; none<br>- Mtx&#58; 1&#47;13 &#40;7&#46;7&#37;&#41;&#58; elevated transaminases<br>- CsP&#58; 8&#47;38 &#40;21&#46;1&#37;&#41;&#58; GI&#44; headache&#44; elevation of Cr or Tg&#44; pyodermitis&#44; hypertrichosis<br>- Acitretin&#58; 1&#47;18 &#40;5&#46;6&#37;&#41;&#58; joint pains<br>- Etan&#58; none&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bronckers et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>390<br>&#40;482 cycles&#41;<br>&#40;&#60;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Assessing effectiveness was not an objective of this study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Less frequent with TNF inhibitors than with Mtx<br>- Mtx&#58; 130&#47;270 &#40;48&#46;1&#37;&#41;&#58; &#8805;1 &#40;GI&#58; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>67&#41;<br>- Biologic agents&#58; 41&#47;106 &#40;38&#46;7&#37;&#41;&#58; 20&#47;106 &#40;18&#46;9&#37;&#41;&#58; local reactions<br>- Acitretin 38&#47;57 &#40;66&#46;7&#37;&#41;<br>- Fumarates 13&#47;19 &#40;68&#46;4&#37;&#41;<br>- CsP 11&#47;30 &#40;36&#46;7&#37;&#41;<br>Severe&#58;<br>- Mtx&#58; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#59; FAE&#58; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#59; Ada&#58; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1<br>Leading to withdrawal of treatment&#58; 47&#47;390 &#40;9&#46;75&#37;&#41;&#58;<br>- Mtx&#58; 33&#47;270 &#40;12&#46;2&#37;&#41;<br>- CsP&#58; 3&#47;30 &#40;10&#37;&#41;<br>- Acitretin&#58; 6&#47;57 &#40;10&#46;5&#37;&#41;<br>- Biologic agents&#58; 3&#47;106 &#40;2&#46;8&#37;&#41;<br>- Fumarates&#58; 2&#47;19 &#40;10&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Van Geel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25<br>Mtx<br>&#40;&#60;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PASI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>75&#58;<br>- Week 12&#58; 4&#46;3&#37;<span class="elsevierStyleSup">a</span>&#47;4&#37;<span class="elsevierStyleSup">b</span><br>- Week 24&#58; 33&#46;3&#37;<span class="elsevierStyleSup">a</span>&#47;32&#37;<span class="elsevierStyleSup">b</span><br>- Week 36&#58; 40&#37;<span class="elsevierStyleSup">a</span>&#47;40&#37;<span class="elsevierStyleSup">b</span><br>- Week 48&#58; 28&#46;6&#37;<span class="elsevierStyleSup">a</span>&#47;28&#46;6&#37;<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Most common&#58; severe nausea &#40;5&#47;25&#44; 20&#37;&#41;&#44; infections &#40;5&#47;25&#44; 20&#37;&#41;&#44; and asthenia &#40;4&#47;25&#44; 16&#37;&#41;<br>Withdrawal&#58; 6&#47;25 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kaur et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24<br>Mtx<br>&#40;&#60;&#160;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PASI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>75&#58;<br>- 22&#47;24 &#40;91&#46;7&#37;&#41;<br>PASI 50-75<br>- 2&#47;24 &#40;8&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9&#47;24 &#40;37&#46;5&#37;&#41; mild adverse effects&#58; nausea&#44; vomiting&#44; loss of appetite&#46;<br>None required withdrawal of treatment&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Collin et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13<br>Mtx<br>&#40;3-15 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Good response &#40;defined as clearing with minimal residual disease&#41;<br>- 11&#47;13 &#40;84&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Most common GI&#58; 6&#47;13 &#40;46&#46;2&#37;&#41;<br>Withdrawal&#58; 1&#47;13 &#40;7&#46;7&#37;&#41;<span class="elsevierStyleSup">c</span>&#58; LFT abnormalities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Di Lernia et al&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18<br>Acitretin<br>&#40;&#60;17 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PASI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>75&#58;<br>- 8&#47;18 &#40;44&#46;4&#37;&#41; week 16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Most frequent muco-cutaneous side effects&#58; 18&#47;18 &#40;100&#37;&#41;&#58; managed by dose adjustment&#46;<br>Withdrawal&#58; 1&#47;18 &#40;5&#46;5&#37;&#41;&#58; joint pains&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dogra et al&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10<br>CsP<br>&#40;&#60;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PASI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>75&#58;<br>- 5&#47;8 &#40;62&#46;5&#37;&#41; week 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#47;8 &#40;25&#37;&#41;&#58; abdominal pain&#44; elevated Cr&#46;<br>No withdrawals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ergun et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>226<br>Acitretin &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>61&#41;<br>Mtx &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>85&#41;<br>CsP &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>80&#41;<br>&#40;&#60;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PASI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>75&#58;<br>- 29&#47;61 &#40;47&#46;5&#37;&#41; acitretin<br>- 29&#47;85 &#40;34&#46;1&#37;&#41; Mtx<br>- 32&#47;80 &#40;40&#37;&#41; CsP<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mild adverse effects&#58;<br>- Acitretin&#58; 29&#46;3&#37;&#58; mucocutaneous &#40;25&#46;9&#37;&#41;&#44; hyperlipidemia &#40;1&#46;7&#37;&#41;&#44; nausea &#40;1&#46;7&#37;&#41;<br>- Mtx&#58; 9&#46;2&#37;&#58; nausea&#44; vomiting &#40;8&#37;&#41;&#44; LFT abnormalities &#40;1&#46;1&#37;&#41;<br>- CsP&#58; 22&#46;5&#37;&#58; hyperlipidemia &#40;3&#46;8&#37;&#41;&#44; elevated Cr &#40;1&#46;3&#37;&#41;&#44; GI &#40;1&#46;3&#37;&#41;&#44; and cytopenia &#40;1&#46;3&#37;&#41;<br>Withdrawal&#58;<br>- 1&#47;61 &#40;1&#46;7&#37;&#41; acitretin<br>- 1&#47;85 &#40;1&#46;1&#37;&#41; Mtx<br>- 2&#47;80 &#40;2&#46;5&#37;&#41; CsP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Di Lernia et al&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>23<br>Etan<br>&#40;&#60;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PASI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>75&#58;<br>- 56&#46;5&#37; week 12<br>- 65&#46;2&#37; week 24<br>- 52&#46;1&#37; week 52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Most common<br>- 2&#47;23 &#40;8&#46;7&#37;&#41;&#58; injection site reaction<br>- 8&#47;23 &#40;34&#46;7&#37;&#41;&#58; mild pain at the injection site<br>No withdrawal of treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ersoy-Evans et al&#46;<span class="elsevierStyleSup">d&#44;</span><a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28<br>NB&#8211;UV-B<br>&#40;&#60;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Improvement<span class="elsevierStyleHsp" style=""></span>&#62; 75&#37;&#58; 26&#47;28 &#40;92&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Erythema 51&#46;6&#37;<span class="elsevierStyleSup">d</span><br>Itching 18&#37;<span class="elsevierStyleSup">d</span><br>Burning 9&#37;<span class="elsevierStyleSup">d</span><br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ersoy-Evans et al&#46;<span class="elsevierStyleSup">d&#44;</span><a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30<br>UV-B<br>&#40;&#60;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Improvement<span class="elsevierStyleHsp" style=""></span>&#62; 75&#37;&#58; 28&#47;30 &#40;93&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ersoy-Evans et al&#46;<span class="elsevierStyleSup">d&#44;</span><a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7<br>PUVA<br>&#40;&#60;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Improvement<span class="elsevierStyleHsp" style=""></span>&#62; 75&#37;&#58; 5&#47;7 &#40;71&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jain et al&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20<br>NB&#8211;UV-B<br>&#40;6-14 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Week 12&#58;<br>- PASI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>90&#58; 12&#47;20 &#40;60&#37;&#41;<br>- PASI 70-90&#58; 3&#47;20 &#40;15&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mild erythema&#58; 2&#47;20 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pasi&#263; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20<br>NB&#8211;UV-B<br>&#40;6-14 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PASI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>90&#58; 9&#47;20 &#40;45&#37;&#41;<br>PASI 70-90&#58; 4&#47;20 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">None&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Zamberk et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20<br>NB&#8211;UV-B<br>&#40;5-17 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PASI 90&#58; 52&#46;2&#37;<br>PASI 75-90&#58; 17&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#37;&#58; mostly erythema &#40;exact value not given&#41;<br>No treatment withdrawals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pavlovsky et al&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>79<br>NB&#8211;UV-B<br>&#40;&#8804;&#160;18 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Clearance&#58; 40&#47;79 &#40;50&#46;6&#37;&#41;<br>Improvement &#8805; 75&#37;&#58; 33&#47;79 &#40;41&#46;8&#37;&#41;<br>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#47;79 &#40;22&#46;8&#37;&#41;&#58;<br>- Mild erythema &#40;13&#47;18&#44; 72&#46;2&#37;&#41;&#44; pruritus &#40;2&#47;18&#44; 11&#46;1&#37;&#41;&#44; first-degree burn &#40;3&#47;18&#44; 16&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Jury et al&#46;<span class="elsevierStyleSup">e&#44;</span><a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>35<br>NB&#8211;UV-B<br>&#40;&#8804;16 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Clearance or minimal residual disease&#58; 22&#47;35 &#40;62&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Erythema &#40;23&#47;77&#44; 28&#46;6&#37;&#41;&#44; blisters &#40;5&#47;77&#44; 6&#46;5&#37;&#41;&#44; herpes zoster &#40;1&#47;77&#44; 1&#46;3&#37;&#41;&#44; anxiety &#40;5&#47;77&#44; 6&#46;5&#37;&#41;<span class="elsevierStyleSup">e</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tan et al&#46;<span class="elsevierStyleSup">f&#44;</span><a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38<br>NB&#8211;UV-B<br>&#40;&#60;16 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">75&#37; improvement or clearance&#58; 90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mild erythema &#40;36&#37;&#41;<span class="elsevierStyleSup">f</span><br>No withdrawal of treatments&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Eustace et al&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21<br>NB&#8211;UV-B<br>&#40;&#8804;17 y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Clearance &#40;PASI 90 or PGA 0-1&#41;&#58; 86&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Erythema &#40;5&#47;21&#44; 23&#46;8&#37;&#41;&#44; HSV &#40;2&#47;21&#44; 9&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Wong et al&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12<br>NB&#8211;UV-B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Improvement in BSA<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>90&#37;&#58; 5&#47;10 &#40;50&#37;&#41;<br>Improvement in BSA 70&#37;-90&#37;&#58; 4&#47;10 &#40;40&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mild burn &#40;1&#47;12&#44; 8&#46;3&#37;&#41;&#44; burn &#40;1&#47;12&#44; 8&#46;3&#37;&#41;&#44; pruritus &#40;2&#47;12&#44; 16&#46;7&#37;&#41;&#44; pain &#40;2&#47;12&#44; 16&#46;7&#37;&#41;&#44; erythema 2&#47;12&#59; 16&#46;7&#37;&#41;&#46;<br>Withdrawal&#58; 1&#47;12 &#40;8&#46;3&#37;&#41; due to progressive increase in erythema&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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