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Psoriasis Often Diagnosed By Non-Dermatologists, Undertreated According to Study

A study published in Journal of Psoriasis and Psoriatic Arthritis found that a majority of women in the Nurses' Health Study II (NHS II) with psoriasis had mild disease, and that a large proportion of these patients were diagnosed by providers other than dermatologists.

The findings were based on the answers of 2107 women who reported to have a diagnosis of psoriasis made by a clinician in the NHS II, a prospective study of female nurses. After study inclusion, the authors sent respondents the Psoriasis Screening Tool-2, a validated diagnostic tool consisting of inquiries about the women’s age at diagnosis, treatments, type of psoriasis lesions, body surface area involved, and the provider who made the diagnosis.

In total, 1382 women completed and returned the survey, of which 1243 were validated for having psoriasis. Of the patients with psoriasis, 30% were diagnosed by non-dermatologists, while 79%, 17%, and 4% reported having mild, moderate, and severe disease, respectively. Patients reported having plaque (41%), scalp (49%), inverse (27%), nail (22%) and palmoplantar (15%) psoriasis. Mild psoriasis was most often treated with topical therapy alone (58%), systemic therapy and/or phototherapy (16%), and no therapy (26%). Moderate to severe disease was treated with topicals only in 42% of patients vs systemic therapy and/or phototherapy in 47%, and 11% reported using no treatment for their flares.

The authors concluded that a majority of women in NHS II with psoriasis have mild disease and that a large proportion of these patients were diagnosed by non-dermatologists. They added that more than half of respondents with moderate to severe disease received no treatment or only topical medications, and that a considerable percentage of people with psoriasis reported phenotypes other than chronic plaque psoriasis.—Jessica Garlewicz

Reference
Tajalli M, Li T, Drucker AM, Qureshi AA, Cho E. A description of treatment patterns of psoriasis by medical providers and disease severity in US women. J Psoriasis Psoriatic Arthritis. 2021;6(1):45-51. doi:10.1177/2475530320970531

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