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7.3 Screening, monitoring, and stepped-care management To avoid over-pathologizing, a stepped-care approach is recommended

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Management: Generally safe

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The 2024 European Dermatology Forum Guidelines (51a) recommend medium-to-high dose phototherapy with UVA1 or PUVA as first-line therapy, methotrexate as second-line therapy, and other treatments including immunosuppressants, corticosteroids, intravenous immunoglobulin, and electron-beam therapy as advanced therapies (52)