Modified Delphi Consensus Recommendations for the Management of Psoriasis in Asia-Pacific

Psoriasis imposes a substantial clinical and quality-of-life burden across the Asia-Pacific (APAC) region. Despite advances in systemic therapies, variability in disease severity classification, assessment tools, and treatment escalation criteria continues to contribute to undertreatment and delayed access to effective care.

A modified Delphi panel was conducted to develop APAC-contextualised consensus recommendations for psoriasis management. Statements were generated from a literature review and refined through Steering Committee interviews and review. The steering committee (n = 6) and Delphi panellists (n = 12) was comprised of dermatology experts from six APAC markets (Australia, China, Japan, South Korea, Malaysia, Taiwan). Consensus was generated through two structured online voting rounds involving all panellists, followed by a moderated consensus meeting, involving only the steering committee, to deliberate on any remaining non-consensus items. Consensus was defined a priori as ≥ 75% agreement among panellists.

In rounds 1 and 2, 92/130 (71%) and 17/24 (71%) statements achieved consensus, respectively. Eight statements were discussed during the steering committee meeting, during which consensus was reached on all eight. In total, 121 statements achieved formal consensus, which includes an additional 4 non-consensus statements from round 1 that were retained in the final recommendations based on steering committee determination of clinical relevance. Recommendations focused on severity classification and assessment thresholds, treatment goals and response criteria, and systemic therapy eligibility and escalation.

These Delphi-derived recommendations provide a practical, patient-centred framework to standardise psoriasis assessment and guide timely treatment escalation in APAC. Adoption may reduce variability in care, support equitable access to appropriate systemic therapies, and improve outcomes across diverse APAC health systems.