چکیده (انگلیسی):

Background:Scottish Intercollegiate Guidelines Network and National Institute of Health and Care Excellence
guidelines stress the importance of assessing patients with psoriasis for psoriatic arthritis, comorbidities associated
with severe disease and quality of life (QoL).
The purpose of the study was to evaluate the primary care management of psoriasis in relation to disease severity
and QoL from a patient’s perspective.
Methods:A cross-sectional survey of adults (≥18 years) with psoriasis managed in primary care was conducted in
Scotland over 1-year (2012–2013). Patients with psoriasis were identified and invited to participate in the online/
telephone survey. The questionnaires included; Dermatology Life Quality Index (DLQI), Self-Administered Psoriasis
Area and Severity Index (SAPASI), Psoriasis Epidemiology Screening Tool (PEST). The primary outcome measure was
DLQI. Secondary outcomes included; demographics; comorbidities; involvement of different body sites; SAPASI and
PEST scores. Relationships between measures were analysed using univariate analysis.
Results:The mean age of patients (n= 905) was 54.5 years (SD = 16.1), 436 (48.2 %) were men, and median DLQI
and SAPASI scores were 4.0 and 6.0, respectively. Current psoriasis treatments were topical only (587, 64.9 %), oral
medications or phototherapy (122, 13.5 %), biologics (26, 3 %) and none (156, 17.2 %). Despite SIGN
recommendations, 256 of 391 patients (65.5 %) with a DLQI >5 (at least a moderate effect on QoL) had not seen a
specialist during the past year. According to PEST scores, 259 patients (28.6 %) had symptoms suggestive of
psoriatic arthritis requiring rheumatology referral.
Conclusion:National recommendations are not being fully implemented in primary care in patients with psoriasis
or psoriatic arthritis.