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Observational Study
. 2021 Jun;20(6):1573-1579.
doi: 10.1111/jocd.14104. Epub 2021 Apr 3.

How does COVID-19 impact psoriasis practice, prescription patterns, and healthcare delivery for psoriasis patients? A cross-sectional survey study

Mohamed H M El-Komy  1   2 , Asmaa Abdelnaby  3 , Mona El-Kalioby  1   2
Affiliations
Observational Study

How does COVID-19 impact psoriasis practice, prescription patterns, and healthcare delivery for psoriasis patients? A cross-sectional survey study

Mohamed H M El-Komy et al. J Cosmet Dermatol. 2021 Jun.

Abstract

Background: Psoriasis is a chronic skin disease that needs continuous medical care. During COVID-19, delivering medical service was negatively affected.

Aims: To describe the impact of COVID-19 on psoriasis healthcare delivery, management, and practice.

Methods: This observational cross-sectional study was conducted on 197 dermatologists using a validated online questionnaire. The survey evaluated the effect of COVID-19 on the decisions, prescription patterns, appointments rescheduling, and healthcare delivery for psoriasis patients by dermatologists. The questionnaire was developed and validated with a reliability score >0.7.

Results: During the pandemic, most dermatologists delayed initiating biological/immunosuppressive therapy for psoriasis unless urgently needed by the patient. For patients already receiving biologics or immunosuppressive treatment, most dermatologists favored continuation of therapy. Almost half (44.2%) of participants do not perform SARS-CoV-2 PCR screening before initiating biologics/immunosuppressive therapy. Dermatologists also reported an increased prescription of topical medications (79.2%), natural sunlight (28.4%), acitretin (26.9%), and home UVB (21.3%). Opinions regarding the use of hydroxychloroquine for COVID-19 treatment/prophylaxis for psoriasis patients were controversial. Intervals between face-to-face follow-up visits were prolonged by 71.6% of dermatologists. More than half of participants reported that their patients discontinued treatment without medical consultation. More than three fourth of responders either agreed or strongly agreed that COVID-19 negatively affected psoriasis patients.

Conclusions: The COVID-19 pandemic has a negative impact on psoriasis management and healthcare delivery. Dermatologists are cautious about using biologics and immunosuppressive drugs during the pandemic, making case-by-case decisions. Psoriasis patients need compliance monitoring, and psychological support during the pandemic, which can be facilitated by teledermatology.

Keywords: PCR; SARS-CoV-2; biologics; coronavirus; immunosuppressive; psoriasis.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
SARS‐CoV2 PCR workup by dermatologists before biological or immunosuppressive therapy initiation during the pandemic
FIGURE 2
FIGURE 2
Percentage of dermatologists reporting an increased prescription of topical medications, natural sunlight, acitretin, and home UVB during the pandemic
FIGURE 3
FIGURE 3
Percentage of dermatologists reporting the use of teledermatology during COVID‐19
FIGURE 4
FIGURE 4
Treatment received by psoriasis patients who tested positive for COVID‐19 as reported by participating dermatologists
See this image and copyright information in PMC

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