Psoriasis Disease Perceptions Differ Between Patients, Dermatologists

A woman at a dermatology consultation
A woman at a dermatology consultation
Further communication between the patient and provider is needed to better understand the impact of disease severity and treatment.

Patients with psoriasis and their dermatologists differ in their perception of disease severity, the presence of symptoms, and satisfaction with control, according to a report published in the Journal of the European Academy for Dermatology and Venereology.

A retrospective study was conducted using data from the Growth from Knowledge Disease Atlas real-world evidence program, a multinational, cross-sectional survey of dermatologists and their patients with psoriasis across 9 different countries.

The sample included 524 dermatologists and 3821 systemic therapy-eligible patients with psoriasis. Concordance was defined as identical answers from patients and their dermatologists on the same survey questions.

Percentage agreement and Cohen’s kappa (k) statistic were used to evaluate concordance. The study defined 6 classifications of concordance: “none” (k≤ 0), “none to slight” (k=0.01-0.20), “fair” (k=0.21-0.40), “moderate” (k=0.41-0.60), “substantial” (k=0.61-0.80), and “almost perfect” (k>0.8). Analyses were performed across all participants as well as per country.

Results showed “fair” concordance between patients and their dermatologists in perception of disease severity (61% agreement, k=0.326 at diagnosis; 55% agreement, k=0.370 at time of survey), although patients with moderate to severe psoriasis evidenced higher levels of concordance with their dermatologists.

Patients and their dermatologists showed “fair” to “moderate” concordance (k=0.241-0.575) in perception of symptom presence. Concordance over satisfaction with disease control was “fair” as well (39% agreement, k=0.213). Different patterns of concordance were seen across participating countries. However, low concordance over satisfaction with disease control was observed in all countries.

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“The current analysis demonstrated that, overall and despite patients being treated for their disease at the time of the survey, patient-dermatologist concordance was low with regard to psoriasis severity, presence and extent of psoriasis-related symptoms, and satisfaction with the level of psoriasis control achieved,“ the researchers commented. Although these results need to be interpreted in the context of the varying healthcare systems and cultures represented in the sample, they still “reveal a need for further communication between the patient and the dermatologist when it concerns the impact of the disease and its treatment on psoriasis symptoms,according to the investigators.

Disclosures: Funding for the study was provided by Novartis Pharma AG. Several authors declare affiliations with the pharmaceutical industry. 


Griffiths CEM, Augustin M, Naldi L, et al. Patient-dermatologist agreement in psoriasis severity, symptoms and satisfaction: results from a real-world multinational survey.  [published online March 10, 2018].  J Eur Acad Dermatol Venereol.  doi:10.1111/jdv.14937