Treatment practices for psoriasis and how they are changing

Abstract

ongoing and evolving regulations and practice adaptations, 15.7 million patient visits and $3.5 billion in practice revenue could be lost through 2020.Practices most frequently identified patient social distancing (67.1%; 95% CI, 63.8%-70.3%), patient COVID-19 concerns (67.2%; 95% CI, 63.9%-70.4%), and office workflow and personal protective equipment requirements (56.3%; 95% CI, 52.9%-59.7%) as significant challenges to recovery. Among those who responded, 1% specifically noted they retired from dermatology due to COVID-19 implications.Limitations include estimations could have led to recall bias, and methodology could have introduced sampling and nonresponse bias. Those with lower work volumes potentially could have had more time to respond, but this bias was minimized by weekend-only data collection. A consistent large sample magnitude, crowdsourced responses, 4 representative demographic distribution, and CIs further mitigate biases and demonstrated significance. Our predictive model also does not account for the impact of a potential second wave or earlier than anticipated vaccine availability.Our findings demonstrate the significant impact COVID-19 had on US dermatologic care and provide a better understanding of national trends. From an estimated pre-COVID baseline of 50 million annual US dermatology office visits, 5 a 30% decrease may lead to material adverse patient morbidity and practice economics. Telemedicine had mitigating effects, but the implications and magnitude of future integration are unclear. Further analyses will be required to assess the longer-term implications of COVID-19 on dermatology practice, identifying key factors influencing success in the ''new normal.''

Trends in psoriasis treatments may differ for new and established patients

“…In addition, Muddasani et al found a stable trend in acitretin and apremilast use, while we showed an increase in apremilast use and a decrease in acitretin use. 1,2 Differences in these results are likely due to the study designs. Muddasani et al included both new and continued therapies, while we only counted therapies prescribed in newly diagnosed psoriasis patients.…”

“…Despite these differences in the study populations, both analyses found increasing biologics use in the treatment of patients with psoriasis, supporting the impact of biologics for psoriasis treatment. 1,2 The reasons for the upward trend in biologics use are likely multifactorial, including excellent efficacy and convenient dosing schedules. 3 There were several key differences in our findings compared to those of Muddasani et al 1 First, Muddasani et al found a stable trend in the phototherapy use in all patients with psoriasis while we observed a decline in phototherapy use in newly diagnosed patients.…”

“…1,2 The reasons for the upward trend in biologics use are likely multifactorial, including excellent efficacy and convenient dosing schedules. 3 There were several key differences in our findings compared to those of Muddasani et al 1 First, Muddasani et al found a stable trend in the phototherapy use in all patients with psoriasis while we observed a decline in phototherapy use in newly diagnosed patients. In addition, Muddasani et al found a stable trend in acitretin and apremilast use, while we showed an increase in apremilast use and a decrease in acitretin use.…”

“…Trends in phototherapy, acitretin, and apremilast use may be different for new and established psoriasis patients. [1][2][3]5 In light of the rapidly changing landscape of psoriasis treatment, it is essential for physicians to consider disease severity, joint involvement, comorbidities, and quality of life when selecting the most appropriate treatment.…”

Effect of cognitive behavioral therapy on anxiety and depression in patients with psoriasis

“…[1][2][3] The main symptoms include red papules, erythema, and silver-white scales. [4][5][6] So far, the cause of psoriasis is not clear. [7] According to related research, there are many inducing factors, including heredity, infection, abnormal immune function, abnormal metabolic function, abnormal endocrine function, and so on.…”