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

Abstract

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. To describe treatment patterns of psoriasis among US women. 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. 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%. 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.