How does COVID‐19 impact psoriasis practice, prescription patterns, and healthcare delivery for psoriasis patients? A cross‐sectional survey study

Abstract

Background: Psoriasis is a chronic skin disease that needs continuous medical care.During COVID-19, delivering medical service was negatively affected. Aims:To describe the impact of COVID-19 on psoriasis healthcare delivery, management, and practice. Methods:This observational cross-sectional study was conducted on 197 dermatologists using a validated online questionnaire. The survey evaluated the effect of COVID-19 on the decisions, prescription patterns, appointments rescheduling, and healthcare delivery for psoriasis patients by dermatologists. The questionnaire was developed and validated with a reliability score >0.7.Results: During the pandemic, most dermatologists delayed initiating biological/immunosuppressive therapy for psoriasis unless urgently needed by the patient. For patients already receiving biologics or immunosuppressive treatment, most dermatologists favored continuation of therapy. Almost half (44.2%) of participants do not perform SARS-CoV-2 PCR screening before initiating biologics/immunosuppressive therapy. Dermatologists also reported an increased prescription of topical medications (79.2%), natural sunlight (28.4%), acitretin (26.9%), and home UVB (21.3%). Opinions regarding the use of hydroxychloroquine for COVID-19 treatment/prophylaxis for psoriasis patients were controversial. Intervals between face-to-face follow-up visits were prolonged by 71.6% of dermatologists. More than half of participants reported that their patients discontinued treatment without medical consultation. More than three fourth of responders either agreed or strongly agreed that COVID-19 negatively affected psoriasis patients. Conclusions:The COVID-19 pandemic has a negative impact on psoriasis management and healthcare delivery. Dermatologists are cautious about using biologics and immunosuppressive drugs during the pandemic, making case-by-case decisions.Psoriasis patients need compliance monitoring, and psychological support during the pandemic, which can be facilitated by teledermatology.

Types of Psoriasis and Their Effects on the Immune System

“…In addition to risk-reducing behaviours like social distance suggested by the World Health Organization, people who were deemed to be more sensitive, such as those using immunosuppressants, were encouraged to adopt greater measures of social isolation [ 37 ]. The COVID-19 pandemic negatively affects the treatment of psoriasis and the provision of healthcare [ 38 ]. Patients with psoriasis who have had biological treatment or another sort of systemic therapy may develop a mild case of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection, while they may also briefly experience an aggravation of skin lesions [ 39 ].…”

Telemedicine and psoriasis: A review based on statements of the telemedicine working group of the International Psoriasis Council

“…This delay affected patients psychologically (34.4%), interfered with drug compliance (40.4%) and worsened psoriasis manifestations (23.8%). 42 During the COVID-19 pandemic, dermatologists had to use TM application to continue care for patients with psoriasis.…”

Effect of COVID‐19 pandemic on psoriatic patients dermatology admissions and biologic treatment adherences: A single‐center retrospective study

“…At the beginning of pandemic, dermatologists were having disagreements on the continuation or initiation of biologic drugs, as there was insufficient information about course of COVID-19 disease in psoriatic patients and the effect of biologics on the disease. 2,3 Patient attitude about receiving treatment also changed during this period due to either healthcare access difficulties or concern on the safety of these drugs. 4,5 In Turkey, patients were able to receive their previously prescribed biologics during EC and LC period owing to regulations for lowering hospital admissions.…”