Patient Survey Reveals Significant Physical Burden of Psoriatic Disease

Increasing patients’ participation in their care may result in better treatment adherence and patient outcomes.

Approximately one-third of patients with psoriasis are not aware that it is part of a systemic disease, and almost one-half reported that their disease has a very large to extremely large effect on their quality of life, according to study results published in Dermatology.

Researchers reported results from a cross-sectional online survey of patients with psoriatic disease (PsD) in 20 countries. Participants with plaque psoriasis with or without concomitant psoriatic arthritis (PsA) were recruited through online panels. Data were collected from November 12, 2020, to June 13, 2021.

The participants were aged 18 years and older and reported having a physician-given diagnosis of psoriasis or psoriasis with PsA before or at the time of data collection. They also had a self-assessed body surface area (BSA) score of between 5 and 10 affecting sensitive and/or prominent body parts or a BSA score of at least 10 when their psoriasis was at its worst. A 25-minute Internet-based survey was conducted without any follow-up.

A total of 4978 respondents were included (51.0% women [mean age, 44.0 years]; 49.0% men [mean age, 42.5 years]). Of the total cohort, 69% of participants had heard that their disease was part of a systemic disease, 60% had previously heard of “psoriatic disease,” and among those with psoriasis only, 29% were aware that PsA was related to their psoriasis. Also, less than one-third of participants were aware of the relationship between psoriasis or PsA and common comorbidities such depression, anxiety, cardiovascular disease, and diabetes. Patient awareness was generally highest in Asia-Pacific countries.

The results of this study demonstrate that many patients do not yet fully understand that psoriasis and PsA are part of a systemic disease and therefore require further education.

A BSA score was known by 82% of participants, of whom 63% reported a moderate (BSA, ≥5 to <10) disease activity and 37% reported severe (BSA, ≥10) disease activity when their psoriasis was at its worst.

Approximately 30% of participants also reported a diagnosis of PsA, of whom 14%, 47%, and 25% reported low, moderate, and highly active PsA, respectively, and 8% stated that their health care professional (HCP) had never told them about their PsA activity.

The participants who had not previously been diagnosed with PsA were screened for PsA signs and symptoms with use of the Psoriasis Epidemiology Screening Tool. Of the participants with psoriasis only (n=3490), 38% screened positive, which indicated potential PsA.

A total of 48% of participants reported that their disease had a very large to extremely large impact on their quality of life based on Dermatology Life Quality Index scores, and 13% reported no effect of the disease on quality of life. The effect was greater in participants with moderate and severe psoriasis.

Among all treated participants, 58% (n=4757) were satisfied with their current treatment, as were 64% of treated participants with psoriasis plus PsA (n=1409). The main reasons for dissatisfaction were that the treatment provided only partial or no relief of symptoms and did not improve quality of life.

In other findings, 40% of participants reported that their HCP decided on treatment goals, 41% decided on treatment goals along with their HCP, and 19% reported no discussion occurring with the HCP on treatment goals.

Limitations include the use of self-reported data, and diagnosis and any treatment-related aspects were self-reported by the respondents. Also, survey answers were based on patients’ perceptions and attitudes, which makes recall bias possible.

“The results of this study demonstrate that many patients do not yet fully understand that psoriasis and PsA are part of a systemic disease and therefore require further education,” conclude the researchers.

Disclosure: This study was funded by Novartis Pharma AG, Basel, Switzerland. Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Armstrong AW, Bohannan B, Mburu S, et al. Patient perspectives on psoriatic disease burden: results from the Global Psoriasis and Beyond Survey. Dermatology. Published online April 19, 2023. doi:10.1159/000528945