Mild to moderate psoriasis is associated with indicators of suboptimal treatment and disease control, according to recent research. The study, presented at the 2024 American Academy of Dermatology (AAD) Annual Meeting, highlighted a correlation between the severity of psoriasis and various factors suggesting inadequate management of the condition.

Researchers analyzed data from over 18,000 patients with psoriasis, focusing on those with mild to moderate disease severity. They identified several key indicators linked to suboptimal treatment and disease control, including:

* Higher levels of patient-reported itch: Patients experiencing more intense itching reported less satisfaction with their current treatment.
* Increased use of systemic therapies: A greater reliance on systemic medications, rather than topical treatments, suggested a need for more effective disease management.
* Lower rates of achieving PASI 75: PASI 75, a measure of psoriasis improvement, was achieved less frequently in patients with indicators of suboptimal control.
* Greater impact on quality of life: Patients with less controlled psoriasis experienced a more notable negative impact on their daily lives.

“These findings underscore the importance of proactive and comprehensive psoriasis management,” explained Alexander Litvintchouk, PharmD, MS, lead author of the study. “Even in mild to moderate cases, identifying and addressing these indicators can significantly improve patient outcomes and quality of life.”

The study emphasizes the need for dermatologists to regularly assess not only the physical manifestations of psoriasis but also the patient’s subjective experience, treatment satisfaction, and overall well-being. Early intervention and personalized treatment plans are crucial for achieving optimal disease control and preventing the progression of psoriasis.

!Mild to Moderate Psoriasis Linked with Indicators of suboptimal Treatment, Disease Control

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Mild Psoriasis May Be Underestimated, Study Suggests

A recent study highlights that a significant proportion of patients initially diagnosed with mild psoriasis may actually have more extensive disease, perhaps leading to underestimation of disease severity and therapeutic needs.

The research indicated that 64.7% of individuals diagnosed with moderate psoriasis had a Body Surface area (BSA) greater than 10%.Notably, patients initially categorized as having mild disease experienced a significantly larger increase in relative BSA compared to those diagnosed as moderate (mean change 113.2% versus 17.7%; P* < .001).

At the time of diagnosis, topical agents and phototherapy where the most common initial treatments. Their use was more prevalent among those with mild disease (94.9%) compared to those with moderate disease (85.5%; *P < .001). Conversely, patients classified as moderate were significantly more likely to start treatment with systemic agents ( P* < .001), and to receive biologics both at diagnosis (p = 0.029) and during the study survey (P* < .001).

Quality of life measures further demonstrated a greater burden for the moderate group, as reflected in Dermatology Life Quality Index scores (P* = .006) and Work Productivity and Activity Impairment scores (P* = .002 and *P* =.006).

The study authors conclude that many patients labeled with mild psoriasis exhibit clinical indicators of more extensive disease at presentation. This suggests a need for improved classification of psoriasis severity, which could expand access to advanced treatments, including biologics, in line with European guidelines.

“A better understanding of the reasons disease severity is underestimated and improved classification of PsO severity would likely increase access to more efficacious and novel advanced treatments and contribute to enhancing patient care,” the authors suggest.