Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;6(1):45-51.
doi: 10.1177/2475530320970531. Epub 2020 Nov 3.

A description of treatment patterns of psoriasis by medical providers and disease severity in US women

Mahroo Tajalli  1 , Tricia Li  1 , Aaron M Drucker  1   2 , Abrar A Qureshi  1   3   4 , Eunyoung Cho  1   3   4
Affiliations

A description of treatment patterns of psoriasis by medical providers and disease severity in US women

Mahroo Tajalli et al. J Psoriasis Psoriatic Arthritis. 2021 Jan.

Abstract

Background: Studies on treatment patterns of psoriasis are valuable to evaluate how efficiently individuals with psoriasis are treated and may facilitate improved outcomes for these patients.

Objective: To describe treatment patterns of psoriasis among US women.

Methods: In the Nurses' Health Study II (NHS II), a prospective study of female nurses, 2107 women reported to have a diagnosis of psoriasis made by a clinician. We sent them the Psoriasis Screening Tool-2, a validated diagnostic tool for psoriasis, which queries age at diagnosis, treatments, type of psoriasis lesions, body surface area involved, and the provider who made the diagnosis.

Results: A total of 1382 women completed and returned the survey, with 1243 of them validated for having psoriasis. 30% of the patients were diagnosed by non-dermatologists. 79% of the patients reported mild, 17% moderate and 4% severe disease. Psoriasis phenotypes were as follows: plaque 41%, scalp 49%, inverse 27%, nail 22% and palmoplantar 15%. Treatment patterns for mild psoriasis were as follows: only topical treatment 58%, systemic therapy and/or phototherapy 16% and no treatment 26%. Treatment patterns for moderate-to-severe disease were as follows: only topical treatment 42%, systemic therapy and/or phototherapy 47% and no treatment 11%.

Conclusion: The majority of women in NHS II with psoriasis have mild disease. A large proportion of psoriasis patients were diagnosed by non-dermatologists. More than half of people with moderate-to-severe disease received no treatment or only topical medications. A considerable percentage of people with psoriasis reported phenotypes other than chronic plaque psoriasis.

Keywords: biologic; phototherapy; psoriasis; severity; systemic; topical; treatment; treatment pattern.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: In the last three years, Dr. Drucker has served as an investigator and has received research funding from Sanofi and Regeneron and has been a consultant for Sanofi, RTI Health Solutions, Eczema Society of Canada and Canadian Agency for Drugs and Technology in Health. He has received honoraria from Prime Inc, Spire Learning, CME Outfitters, Eczema Society of Canada and the Canadian Dermatology Association. His institution has received educational grants from Sanofi and Abbvie. The other authors do not report any recent or relevant disclosures.

Figures

Figure. 1.
Figure. 1.
Treatment patterns of psoriasis by medical provider in Nurses’ Health Study II A. diagnosed by a dermatologist B. diagnosed by a non-dermatologist provider.
Figure. 2.
Figure. 2.
Treatment patterns of psoriasis by severity in Nurses’ Health Study II A. mild psoriasis, B. moderate-to-severe psoriasis.
Figure. 3.
Figure. 3.
Systemic treatment of psoriasis in Nurses’ Health Study II A. mild psoriasis B. moderate-to-severe psoriasis
See this image and copyright information in PMC

References

    1. Augustin M, Reich K, Glaeske G, et al. Co-morbidity and age-related prevalence of psoriasis: Analysis of health insurance data in Germany. Acta Derm Venereol. 2010; 90:147–51. - PubMed
    1. Kurd SK, Gelfand JM. The prevalence of previously diagnosed and undiagnosed psoriasis in US adults: results from NHANES 2003–2004. J Am Acad Dermatol. 2009; 60:218–24. - PMC - PubMed
    1. Ferr_andiz C, Bordas X, Garc_ıa-Patos V, et al. Prevalence of psoriasis in Spain (Epiderma Project: phase I). J Eur Acad Dermatol Venereol. 2001; 15:20–3. - PubMed
    1. Stern RS, Nijsten T, Feldman SR, et al. Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction. J Investig Dermatol Symp Proc. 2004; 9:136–9. - PubMed
    1. Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008; 58:826–50. - PubMed

LinkOut - more resources