Jeffrey M. Weinberg, MD

Over the last several years, we have come to understand that patients with inflammatory diseases may be at higher risk for major adverse cardiovascular events (MACEs) and cardiovascular death. In an article published online on October 28 in the Annals of the Rheumatic Diseases, Ogdie et al reported on a study of the risk for MACEs among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA), and psoriasis without known PsA compared with the general population after adjusting for traditional cardiovascular risk factors.

The authors performed a population-based longitudinal cohort study (1994-2010) in The Health Improvement Network (THIN), a primary care medical record database in the United Kingdom. Patients aged 18 to 89 years with the applicable diagnoses were included. Up to 10 unexposed controls were selected for each patient with PsA, matched on practice and index date.

The study outcomes included the following: cardiovascular death, myocardial infarction, cerebrovascular accidents, and the composite outcome (MACE). Cox proportional hazards models were utilized to calculate the hazard ratios (HRs) for each of the outcomes after adjusting for traditional risk factors. The authors’ preliminary hypothesis was that there was an interaction between disease status and disease-modifying antirheumatic drug (DMARD) use.

In the analysis, the authors identified individuals with PsA (N=8706), RA (N=41,752), psoriasis (N=138,424), and unexposed controls (N=81,573). After adjusting for traditional risk factors, the risk for MACE was higher in the following populations: patients with PsA not prescribed a DMARD (HR, 1.24; 95% confidence interval [CI], 1.03-1.49), patients with RA (no DMARD: HR, 1.39; 95% CI, 1.28-1.50; DMARD: HR, 1.58; 95% CI, 1.46-1.70), patients with psoriasis not prescribed a DMARD (HR, 1.08; 95% CI, 1.02-1.15), and patients with severe psoriasis (DMARD: HR, 1.42; 95% CI, 1.17-1.73).

The authors concluded that cardiovascular risk should be addressed with all patients affected by psoriasis, PsA, or RA. These results suggest the need for improved screening and management of traditional cardiovascular risk factors in patients with inflammatory diseases.

What’s the issue?

Although there has been literature on MACE in these diseases, existing studies have not examined the risk for incident MACE including myocardial infarction, cerebrovascular accidents, and cardiovascular death in PsA compared with matched internal controls from a population-based perspective after accounting for the presence of traditional cardiovascular risk factors. This study is an additional piece of evidence that supports the need for comprehensive management of these patients. How do you currently address the concern for MACE?

We want to know your views! Tell us what you think.

Over the last several years, we have come to understand that patients with inflammatory diseases may be at higher risk for major adverse cardiovascular events (MACEs) and cardiovascular death. In an article published online on October 28 in the Annals of the Rheumatic Diseases, Ogdie et al reported on a study of the risk for MACEs among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA), and psoriasis without known PsA compared with the general population after adjusting for traditional cardiovascular risk factors.

The authors performed a population-based longitudinal cohort study (1994-2010) in The Health Improvement Network (THIN), a primary care medical record database in the United Kingdom. Patients aged 18 to 89 years with the applicable diagnoses were included. Up to 10 unexposed controls were selected for each patient with PsA, matched on practice and index date.

The study outcomes included the following: cardiovascular death, myocardial infarction, cerebrovascular accidents, and the composite outcome (MACE). Cox proportional hazards models were utilized to calculate the hazard ratios (HRs) for each of the outcomes after adjusting for traditional risk factors. The authors’ preliminary hypothesis was that there was an interaction between disease status and disease-modifying antirheumatic drug (DMARD) use.

In the analysis, the authors identified individuals with PsA (N=8706), RA (N=41,752), psoriasis (N=138,424), and unexposed controls (N=81,573). After adjusting for traditional risk factors, the risk for MACE was higher in the following populations: patients with PsA not prescribed a DMARD (HR, 1.24; 95% confidence interval [CI], 1.03-1.49), patients with RA (no DMARD: HR, 1.39; 95% CI, 1.28-1.50; DMARD: HR, 1.58; 95% CI, 1.46-1.70), patients with psoriasis not prescribed a DMARD (HR, 1.08; 95% CI, 1.02-1.15), and patients with severe psoriasis (DMARD: HR, 1.42; 95% CI, 1.17-1.73).

The authors concluded that cardiovascular risk should be addressed with all patients affected by psoriasis, PsA, or RA. These results suggest the need for improved screening and management of traditional cardiovascular risk factors in patients with inflammatory diseases.

What’s the issue?

Although there has been literature on MACE in these diseases, existing studies have not examined the risk for incident MACE including myocardial infarction, cerebrovascular accidents, and cardiovascular death in PsA compared with matched internal controls from a population-based perspective after accounting for the presence of traditional cardiovascular risk factors. This study is an additional piece of evidence that supports the need for comprehensive management of these patients. How do you currently address the concern for MACE?

We want to know your views! Tell us what you think.

Over the last several years, we have come to understand that patients with inflammatory diseases may be at higher risk for major adverse cardiovascular events (MACEs) and cardiovascular death. In an article published online on October 28 in the Annals of the Rheumatic Diseases, Ogdie et al reported on a study of the risk for MACEs among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA), and psoriasis without known PsA compared with the general population after adjusting for traditional cardiovascular risk factors.

The authors performed a population-based longitudinal cohort study (1994-2010) in The Health Improvement Network (THIN), a primary care medical record database in the United Kingdom. Patients aged 18 to 89 years with the applicable diagnoses were included. Up to 10 unexposed controls were selected for each patient with PsA, matched on practice and index date.

The study outcomes included the following: cardiovascular death, myocardial infarction, cerebrovascular accidents, and the composite outcome (MACE). Cox proportional hazards models were utilized to calculate the hazard ratios (HRs) for each of the outcomes after adjusting for traditional risk factors. The authors’ preliminary hypothesis was that there was an interaction between disease status and disease-modifying antirheumatic drug (DMARD) use.

In the analysis, the authors identified individuals with PsA (N=8706), RA (N=41,752), psoriasis (N=138,424), and unexposed controls (N=81,573). After adjusting for traditional risk factors, the risk for MACE was higher in the following populations: patients with PsA not prescribed a DMARD (HR, 1.24; 95% confidence interval [CI], 1.03-1.49), patients with RA (no DMARD: HR, 1.39; 95% CI, 1.28-1.50; DMARD: HR, 1.58; 95% CI, 1.46-1.70), patients with psoriasis not prescribed a DMARD (HR, 1.08; 95% CI, 1.02-1.15), and patients with severe psoriasis (DMARD: HR, 1.42; 95% CI, 1.17-1.73).

The authors concluded that cardiovascular risk should be addressed with all patients affected by psoriasis, PsA, or RA. These results suggest the need for improved screening and management of traditional cardiovascular risk factors in patients with inflammatory diseases.

What’s the issue?

Although there has been literature on MACE in these diseases, existing studies have not examined the risk for incident MACE including myocardial infarction, cerebrovascular accidents, and cardiovascular death in PsA compared with matched internal controls from a population-based perspective after accounting for the presence of traditional cardiovascular risk factors. This study is an additional piece of evidence that supports the need for comprehensive management of these patients. How do you currently address the concern for MACE?

We want to know your views! Tell us what you think.

In the October 2014 issue of the Journal of Clinical and Aesthetic Dermatology (2014;7:10-19), Wu et al published the top 100 most-cited psoriasis articles in clinical dermatologic journals from 1970 to 2012. Given the explosion of literature in this area, I was very excited to rush to find the list online.  

The authors conducted a citation analysis of major clinical dermatologic journals from 1970 to 2012 limited to the subject of psoriasis. They used the search term psoriasis in the Science Citation Index from 1970 to 2012 and included articles that have received 100 or more citations. The top 100 articles were further stratified by country, institution, and study type.

The authors found that half of the top 100 cited articles were from the United States; 81 of them were original articles. The majority of the top 100 articles were from dermatology programs in the United States, but institutions in the United Kingdom and Germany also made notable contributions.

There were 2 periods of particular note in their analysis. The high numbers of citations from 1985 to 1989 correlated with the elucidation of the immune-mediated pathogenesis of psoriasis at that time. The high number of top citations from 2000 to 2004 correlated with the development of biologic agents in psoriasis therapy.

What’s the issue?

It is interesting to see which studies have been most influential in this highly active area of dermatology. What articles have most influenced your approach to psoriasis?

We want to know your views! Tell us what you think.

In the October 2014 issue of the Journal of Clinical and Aesthetic Dermatology (2014;7:10-19), Wu et al published the top 100 most-cited psoriasis articles in clinical dermatologic journals from 1970 to 2012. Given the explosion of literature in this area, I was very excited to rush to find the list online.  

The authors conducted a citation analysis of major clinical dermatologic journals from 1970 to 2012 limited to the subject of psoriasis. They used the search term psoriasis in the Science Citation Index from 1970 to 2012 and included articles that have received 100 or more citations. The top 100 articles were further stratified by country, institution, and study type.

The authors found that half of the top 100 cited articles were from the United States; 81 of them were original articles. The majority of the top 100 articles were from dermatology programs in the United States, but institutions in the United Kingdom and Germany also made notable contributions.

There were 2 periods of particular note in their analysis. The high numbers of citations from 1985 to 1989 correlated with the elucidation of the immune-mediated pathogenesis of psoriasis at that time. The high number of top citations from 2000 to 2004 correlated with the development of biologic agents in psoriasis therapy.

What’s the issue?

It is interesting to see which studies have been most influential in this highly active area of dermatology. What articles have most influenced your approach to psoriasis?

We want to know your views! Tell us what you think.

In the October 2014 issue of the Journal of Clinical and Aesthetic Dermatology (2014;7:10-19), Wu et al published the top 100 most-cited psoriasis articles in clinical dermatologic journals from 1970 to 2012. Given the explosion of literature in this area, I was very excited to rush to find the list online.  

The authors conducted a citation analysis of major clinical dermatologic journals from 1970 to 2012 limited to the subject of psoriasis. They used the search term psoriasis in the Science Citation Index from 1970 to 2012 and included articles that have received 100 or more citations. The top 100 articles were further stratified by country, institution, and study type.

The authors found that half of the top 100 cited articles were from the United States; 81 of them were original articles. The majority of the top 100 articles were from dermatology programs in the United States, but institutions in the United Kingdom and Germany also made notable contributions.

There were 2 periods of particular note in their analysis. The high numbers of citations from 1985 to 1989 correlated with the elucidation of the immune-mediated pathogenesis of psoriasis at that time. The high number of top citations from 2000 to 2004 correlated with the development of biologic agents in psoriasis therapy.

What’s the issue?

It is interesting to see which studies have been most influential in this highly active area of dermatology. What articles have most influenced your approach to psoriasis?

We want to know your views! Tell us what you think.

Psoriasis is associated with multiple comorbidities, including cardiovascular diseases. With the advent of anti-inflammatory therapy, there has been much investigation into whether treatments for psoriasis may reduce the risk for cardiovascular events. In a Journal of the European Academy of Dermatology and Venereology article published online on October 10, Ahlehoff et al examined the rate of cardiovascular events—cardiovascular death, myocardial infarction, and stroke—in patients with severe psoriasis treated with systemic anti-inflammatory drugs.

Individual-level linkage of administrative registries was utilized to perform a longitudinal nationwide cohort study in Denmark. Time-dependent multivariable adjusted Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of cardiovascular events associated with use of biological drugs, methotrexate, cyclosporine, retinoids, and other antipsoriatic therapies (ie, topical treatments, phototherapy, climate therapy).

The investigators included a total of 6902 patients (9662 treatment exposures) with a maximum follow-up of 5 years. Incidence rates per 1000 patient-years for cardiovascular events were highest for retinoids and other therapies (18.95 and 14.63, respectively) followed by methotrexate, cyclosporine, and biological drugs (6.28, 6.08, and 4.16, respectively). Relative to other therapies, methotrexate (HR, 0.53; 95% CI, 0.34-0.83) was associated with reduced risk for the composite end point. A comparable but nonsignificant protective effect was observed with biological drugs (HR, 0.58; 95% CI, 0.30-1.10), whereas no protective effect was apparent with cyclosporine (HR, 1.06; 95% CI, 0.26-4.27) and retinoids (HR, 1.80; 95% CI, 1.03-2.96). Tumor necrosis factor inhibitors (HR, 0.46; 95% CI, 0.22-0.98) were linked to reduced event rates but the IL-12/IL-23 inhibitor ustekinumab (HR, 1.52; 95% CI, 0.47-4.94) was not.

The authors concluded that systemic anti-inflammatory treatment with methotrexate was associated with lower rates of cardiovascular events during long-term follow-up compared to patients treated with other antipsoriatic therapies.

What’s the issue?

This study is consistent with other investigations evaluating the cardioprotective benefit of therapies for psoriasis. The cardioprotective benefits of methotrexate and tumor necrosis factor inhibitors have been previously reported. Further investigation will help to elucidate the role of these drugs as well as newer therapies in the reduction of comorbidities. Does this study influence your perception of therapies for psoriasis?

We want to know your views! Tell us what you think.

Psoriasis is associated with multiple comorbidities, including cardiovascular diseases. With the advent of anti-inflammatory therapy, there has been much investigation into whether treatments for psoriasis may reduce the risk for cardiovascular events. In a Journal of the European Academy of Dermatology and Venereology article published online on October 10, Ahlehoff et al examined the rate of cardiovascular events—cardiovascular death, myocardial infarction, and stroke—in patients with severe psoriasis treated with systemic anti-inflammatory drugs.

Individual-level linkage of administrative registries was utilized to perform a longitudinal nationwide cohort study in Denmark. Time-dependent multivariable adjusted Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of cardiovascular events associated with use of biological drugs, methotrexate, cyclosporine, retinoids, and other antipsoriatic therapies (ie, topical treatments, phototherapy, climate therapy).

The investigators included a total of 6902 patients (9662 treatment exposures) with a maximum follow-up of 5 years. Incidence rates per 1000 patient-years for cardiovascular events were highest for retinoids and other therapies (18.95 and 14.63, respectively) followed by methotrexate, cyclosporine, and biological drugs (6.28, 6.08, and 4.16, respectively). Relative to other therapies, methotrexate (HR, 0.53; 95% CI, 0.34-0.83) was associated with reduced risk for the composite end point. A comparable but nonsignificant protective effect was observed with biological drugs (HR, 0.58; 95% CI, 0.30-1.10), whereas no protective effect was apparent with cyclosporine (HR, 1.06; 95% CI, 0.26-4.27) and retinoids (HR, 1.80; 95% CI, 1.03-2.96). Tumor necrosis factor inhibitors (HR, 0.46; 95% CI, 0.22-0.98) were linked to reduced event rates but the IL-12/IL-23 inhibitor ustekinumab (HR, 1.52; 95% CI, 0.47-4.94) was not.

The authors concluded that systemic anti-inflammatory treatment with methotrexate was associated with lower rates of cardiovascular events during long-term follow-up compared to patients treated with other antipsoriatic therapies.

What’s the issue?

This study is consistent with other investigations evaluating the cardioprotective benefit of therapies for psoriasis. The cardioprotective benefits of methotrexate and tumor necrosis factor inhibitors have been previously reported. Further investigation will help to elucidate the role of these drugs as well as newer therapies in the reduction of comorbidities. Does this study influence your perception of therapies for psoriasis?

We want to know your views! Tell us what you think.

Psoriasis is associated with multiple comorbidities, including cardiovascular diseases. With the advent of anti-inflammatory therapy, there has been much investigation into whether treatments for psoriasis may reduce the risk for cardiovascular events. In a Journal of the European Academy of Dermatology and Venereology article published online on October 10, Ahlehoff et al examined the rate of cardiovascular events—cardiovascular death, myocardial infarction, and stroke—in patients with severe psoriasis treated with systemic anti-inflammatory drugs.

Individual-level linkage of administrative registries was utilized to perform a longitudinal nationwide cohort study in Denmark. Time-dependent multivariable adjusted Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of cardiovascular events associated with use of biological drugs, methotrexate, cyclosporine, retinoids, and other antipsoriatic therapies (ie, topical treatments, phototherapy, climate therapy).

The investigators included a total of 6902 patients (9662 treatment exposures) with a maximum follow-up of 5 years. Incidence rates per 1000 patient-years for cardiovascular events were highest for retinoids and other therapies (18.95 and 14.63, respectively) followed by methotrexate, cyclosporine, and biological drugs (6.28, 6.08, and 4.16, respectively). Relative to other therapies, methotrexate (HR, 0.53; 95% CI, 0.34-0.83) was associated with reduced risk for the composite end point. A comparable but nonsignificant protective effect was observed with biological drugs (HR, 0.58; 95% CI, 0.30-1.10), whereas no protective effect was apparent with cyclosporine (HR, 1.06; 95% CI, 0.26-4.27) and retinoids (HR, 1.80; 95% CI, 1.03-2.96). Tumor necrosis factor inhibitors (HR, 0.46; 95% CI, 0.22-0.98) were linked to reduced event rates but the IL-12/IL-23 inhibitor ustekinumab (HR, 1.52; 95% CI, 0.47-4.94) was not.

The authors concluded that systemic anti-inflammatory treatment with methotrexate was associated with lower rates of cardiovascular events during long-term follow-up compared to patients treated with other antipsoriatic therapies.

What’s the issue?

This study is consistent with other investigations evaluating the cardioprotective benefit of therapies for psoriasis. The cardioprotective benefits of methotrexate and tumor necrosis factor inhibitors have been previously reported. Further investigation will help to elucidate the role of these drugs as well as newer therapies in the reduction of comorbidities. Does this study influence your perception of therapies for psoriasis?

We want to know your views! Tell us what you think.

We are always conscious of the use of systemic medications in older patients, as they may have the potential for more toxicity. For dermatologists, use of systemic medications in psoriasis represents a large share of our total use. Theoretically, we are concerned that older patients may be more likely to develop serious infections and malignancies. Older psoriasis patients also represent a growing demographic, and they are underrepresented in clinical trials.

In an article published online on September 3, 2014, in the Journal of the European Academy of Dermatology and Venereology, Medina et al performed an analysis to evaluate the safety of systemic psoriasis therapy in patients older than 65 years compared to younger patients. Patients registered in Biobadaderm, a Spanish national registry of psoriasis patients treated with systemic therapy, were divided into 2 categories: elderly (≥65 years) and younger patients (<65 years). Rates of adverse events (AEs) were described by severity and type. The risks were compared in both groups, taking into account exposure to classic or biologic drugs using Cox regression.

In the overall study population, 175 (9.8%) of 1793 patients were elderly. The authors found that overall risk for AEs was not higher in elderly patients; the drug group–adjusted hazard ratio (HR) was 1.09 (95% confidence interval [CI], 0.93-1.3). However, serious AEs were more common in older patients, with a drug group–adjusted HR of 3.2 (95% CI, 2.0-5.1). Age-adjusted HR of all AEs was lower for patients exposed to biologics compared to classic drugs in the whole sample (HR, 0.7 [95% CI, 0.6-0.7]). Age did not seem to modify the effect of therapy (biologic vs classic) in the risk for AEs (likelihood ratio test for interaction: P=.12 for all AEs; P=.09 for serious AEs).

The authors concluded that serious AEs were more common in elderly patients. They argued, however, that these serious AEs might be related to other factors associated with this age group and not due to the treatment itself. Use of biologics was associated with lower risk for AEs in the whole group. There were no differences in this association between young and old. These results are reassuring, though uncontrolled confounding could not be excluded as an explanation for these findings. The power of the study to detect differences was low.

What’s the issue?

The results indicate that overall there is no increase in AEs in older patients. More data will need to be evaluated to see if the incidence of serious AEs is due to medication use or endogenous health factors. How do you approach the use of systemic medications in older patients?

We want to know your views! Tell us what you think.

We are always conscious of the use of systemic medications in older patients, as they may have the potential for more toxicity. For dermatologists, use of systemic medications in psoriasis represents a large share of our total use. Theoretically, we are concerned that older patients may be more likely to develop serious infections and malignancies. Older psoriasis patients also represent a growing demographic, and they are underrepresented in clinical trials.

In an article published online on September 3, 2014, in the Journal of the European Academy of Dermatology and Venereology, Medina et al performed an analysis to evaluate the safety of systemic psoriasis therapy in patients older than 65 years compared to younger patients. Patients registered in Biobadaderm, a Spanish national registry of psoriasis patients treated with systemic therapy, were divided into 2 categories: elderly (≥65 years) and younger patients (<65 years). Rates of adverse events (AEs) were described by severity and type. The risks were compared in both groups, taking into account exposure to classic or biologic drugs using Cox regression.

In the overall study population, 175 (9.8%) of 1793 patients were elderly. The authors found that overall risk for AEs was not higher in elderly patients; the drug group–adjusted hazard ratio (HR) was 1.09 (95% confidence interval [CI], 0.93-1.3). However, serious AEs were more common in older patients, with a drug group–adjusted HR of 3.2 (95% CI, 2.0-5.1). Age-adjusted HR of all AEs was lower for patients exposed to biologics compared to classic drugs in the whole sample (HR, 0.7 [95% CI, 0.6-0.7]). Age did not seem to modify the effect of therapy (biologic vs classic) in the risk for AEs (likelihood ratio test for interaction: P=.12 for all AEs; P=.09 for serious AEs).

The authors concluded that serious AEs were more common in elderly patients. They argued, however, that these serious AEs might be related to other factors associated with this age group and not due to the treatment itself. Use of biologics was associated with lower risk for AEs in the whole group. There were no differences in this association between young and old. These results are reassuring, though uncontrolled confounding could not be excluded as an explanation for these findings. The power of the study to detect differences was low.

What’s the issue?

The results indicate that overall there is no increase in AEs in older patients. More data will need to be evaluated to see if the incidence of serious AEs is due to medication use or endogenous health factors. How do you approach the use of systemic medications in older patients?

We want to know your views! Tell us what you think.

We are always conscious of the use of systemic medications in older patients, as they may have the potential for more toxicity. For dermatologists, use of systemic medications in psoriasis represents a large share of our total use. Theoretically, we are concerned that older patients may be more likely to develop serious infections and malignancies. Older psoriasis patients also represent a growing demographic, and they are underrepresented in clinical trials.

In an article published online on September 3, 2014, in the Journal of the European Academy of Dermatology and Venereology, Medina et al performed an analysis to evaluate the safety of systemic psoriasis therapy in patients older than 65 years compared to younger patients. Patients registered in Biobadaderm, a Spanish national registry of psoriasis patients treated with systemic therapy, were divided into 2 categories: elderly (≥65 years) and younger patients (<65 years). Rates of adverse events (AEs) were described by severity and type. The risks were compared in both groups, taking into account exposure to classic or biologic drugs using Cox regression.

In the overall study population, 175 (9.8%) of 1793 patients were elderly. The authors found that overall risk for AEs was not higher in elderly patients; the drug group–adjusted hazard ratio (HR) was 1.09 (95% confidence interval [CI], 0.93-1.3). However, serious AEs were more common in older patients, with a drug group–adjusted HR of 3.2 (95% CI, 2.0-5.1). Age-adjusted HR of all AEs was lower for patients exposed to biologics compared to classic drugs in the whole sample (HR, 0.7 [95% CI, 0.6-0.7]). Age did not seem to modify the effect of therapy (biologic vs classic) in the risk for AEs (likelihood ratio test for interaction: P=.12 for all AEs; P=.09 for serious AEs).

The authors concluded that serious AEs were more common in elderly patients. They argued, however, that these serious AEs might be related to other factors associated with this age group and not due to the treatment itself. Use of biologics was associated with lower risk for AEs in the whole group. There were no differences in this association between young and old. These results are reassuring, though uncontrolled confounding could not be excluded as an explanation for these findings. The power of the study to detect differences was low.

What’s the issue?

The results indicate that overall there is no increase in AEs in older patients. More data will need to be evaluated to see if the incidence of serious AEs is due to medication use or endogenous health factors. How do you approach the use of systemic medications in older patients?

We want to know your views! Tell us what you think.

For more information, access Dr. Weinberg's editorial from the September 2014 issue, "Under Pressure."

For more information, access Dr. Weinberg's editorial from the September 2014 issue, "Under Pressure."

For more information, access Dr. Weinberg's editorial from the September 2014 issue, "Under Pressure."

One of the most important elements of a psoriasis patient’s medical history is the medication list. We are aware of the possible association between induction or exacerbation of psoriasis and intake of drugs including beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, lithium, and nonsteroidal anti-inflammatory drugs. However, we are lacking comprehensive data on these putative relationships.

Wu et al¹ evaluated the association of hypertension and antihypertensive medications with risk for psoriasis. The authors pointed out that psoriasis patients have an increased risk for hypertension, and medications for hypertension, especially beta-blockers, have been associated with the development of psoriasis. They noted, however, that there has been no prospective assessment of the association of existing hypertension and antihypertensive medications with risk for incident psoriasis.¹

The authors performed a prospective cohort study (June 1996 to June 1998) of 77,728 women from the Nurses’ Health Study who provided biennially updated data on hypertension and antihypertensive medications.¹ They documented 843 incidents of psoriasis during 1,066,339 person-years of follow-up. Women with hypertension tended to be older and had a higher body mass index. In addition, they had proportionately higher prevalence rates of cardiovascular disease, type 2 diabetes mellitus, and hypercholesterolemia. They also were less physically active than subjects without hypertension. Compared with those with normal blood pressure, women with hypertension lasting 6 years or more were at higher risk for development of psoriasis (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.03-1.57). In stratified analysis, the risk for psoriasis was higher among hypertensive women without medication use (HR, 1.49; 95% CI, 1.15-1.92) and among hypertensive women with current medication use (HR, 1.31; 95% CI, 1.10-1.55) when compared with those without hypertension and without medication use.¹

Among the individual antihypertensive drugs, only beta-blockers were associated with an increased risk for psoriasis.¹ Of interest, this association persisted in a duration-dependent manner, with a higher risk for psoriasis found among women who regularly used beta-blockers with a duration of use of 6 years or more (HR, 1.39; 95% CI, 1.11-1.73; P for trend=.009). No association was found between any other individual hypertension medication and the development of psoriasis.¹

The authors concluded that their study provided evidence that a history of long-term hypertension was associated with an increased risk for psoriasis.¹ Among the individual medications analyzed in the study, only beta-blockers were linked to an increased risk for psoriasis after long-term regular use (≥6 years). They noted that these findings provided insights into the relationship between hypertension, medications for the condition, and psoriasis. However, further work is necessary to confirm these findings and clarify the biological mechanisms that may explain these links.¹

As we further evaluate the associations between psoriasis and systemic comorbidities, we are learning more about the complex interrelationship between these conditions. The findings reported by Wu et al¹ serve as another reminder that clinicians should be proactive in having psoriasis patients actively monitor their blood pressure, either with the dermatologist or with the primary care physician. This type of novel prospective information serves as another piece of the puzzle in our comprehensive management of psoriasis.

One of the most important elements of a psoriasis patient’s medical history is the medication list. We are aware of the possible association between induction or exacerbation of psoriasis and intake of drugs including beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, lithium, and nonsteroidal anti-inflammatory drugs. However, we are lacking comprehensive data on these putative relationships.

Wu et al¹ evaluated the association of hypertension and antihypertensive medications with risk for psoriasis. The authors pointed out that psoriasis patients have an increased risk for hypertension, and medications for hypertension, especially beta-blockers, have been associated with the development of psoriasis. They noted, however, that there has been no prospective assessment of the association of existing hypertension and antihypertensive medications with risk for incident psoriasis.¹

The authors performed a prospective cohort study (June 1996 to June 1998) of 77,728 women from the Nurses’ Health Study who provided biennially updated data on hypertension and antihypertensive medications.¹ They documented 843 incidents of psoriasis during 1,066,339 person-years of follow-up. Women with hypertension tended to be older and had a higher body mass index. In addition, they had proportionately higher prevalence rates of cardiovascular disease, type 2 diabetes mellitus, and hypercholesterolemia. They also were less physically active than subjects without hypertension. Compared with those with normal blood pressure, women with hypertension lasting 6 years or more were at higher risk for development of psoriasis (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.03-1.57). In stratified analysis, the risk for psoriasis was higher among hypertensive women without medication use (HR, 1.49; 95% CI, 1.15-1.92) and among hypertensive women with current medication use (HR, 1.31; 95% CI, 1.10-1.55) when compared with those without hypertension and without medication use.¹

Among the individual antihypertensive drugs, only beta-blockers were associated with an increased risk for psoriasis.¹ Of interest, this association persisted in a duration-dependent manner, with a higher risk for psoriasis found among women who regularly used beta-blockers with a duration of use of 6 years or more (HR, 1.39; 95% CI, 1.11-1.73; P for trend=.009). No association was found between any other individual hypertension medication and the development of psoriasis.¹

The authors concluded that their study provided evidence that a history of long-term hypertension was associated with an increased risk for psoriasis.¹ Among the individual medications analyzed in the study, only beta-blockers were linked to an increased risk for psoriasis after long-term regular use (≥6 years). They noted that these findings provided insights into the relationship between hypertension, medications for the condition, and psoriasis. However, further work is necessary to confirm these findings and clarify the biological mechanisms that may explain these links.¹

As we further evaluate the associations between psoriasis and systemic comorbidities, we are learning more about the complex interrelationship between these conditions. The findings reported by Wu et al¹ serve as another reminder that clinicians should be proactive in having psoriasis patients actively monitor their blood pressure, either with the dermatologist or with the primary care physician. This type of novel prospective information serves as another piece of the puzzle in our comprehensive management of psoriasis.

One of the most important elements of a psoriasis patient’s medical history is the medication list. We are aware of the possible association between induction or exacerbation of psoriasis and intake of drugs including beta-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, lithium, and nonsteroidal anti-inflammatory drugs. However, we are lacking comprehensive data on these putative relationships.

Wu et al¹ evaluated the association of hypertension and antihypertensive medications with risk for psoriasis. The authors pointed out that psoriasis patients have an increased risk for hypertension, and medications for hypertension, especially beta-blockers, have been associated with the development of psoriasis. They noted, however, that there has been no prospective assessment of the association of existing hypertension and antihypertensive medications with risk for incident psoriasis.¹

The authors performed a prospective cohort study (June 1996 to June 1998) of 77,728 women from the Nurses’ Health Study who provided biennially updated data on hypertension and antihypertensive medications.¹ They documented 843 incidents of psoriasis during 1,066,339 person-years of follow-up. Women with hypertension tended to be older and had a higher body mass index. In addition, they had proportionately higher prevalence rates of cardiovascular disease, type 2 diabetes mellitus, and hypercholesterolemia. They also were less physically active than subjects without hypertension. Compared with those with normal blood pressure, women with hypertension lasting 6 years or more were at higher risk for development of psoriasis (hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.03-1.57). In stratified analysis, the risk for psoriasis was higher among hypertensive women without medication use (HR, 1.49; 95% CI, 1.15-1.92) and among hypertensive women with current medication use (HR, 1.31; 95% CI, 1.10-1.55) when compared with those without hypertension and without medication use.¹

Among the individual antihypertensive drugs, only beta-blockers were associated with an increased risk for psoriasis.¹ Of interest, this association persisted in a duration-dependent manner, with a higher risk for psoriasis found among women who regularly used beta-blockers with a duration of use of 6 years or more (HR, 1.39; 95% CI, 1.11-1.73; P for trend=.009). No association was found between any other individual hypertension medication and the development of psoriasis.¹

The authors concluded that their study provided evidence that a history of long-term hypertension was associated with an increased risk for psoriasis.¹ Among the individual medications analyzed in the study, only beta-blockers were linked to an increased risk for psoriasis after long-term regular use (≥6 years). They noted that these findings provided insights into the relationship between hypertension, medications for the condition, and psoriasis. However, further work is necessary to confirm these findings and clarify the biological mechanisms that may explain these links.¹

As we further evaluate the associations between psoriasis and systemic comorbidities, we are learning more about the complex interrelationship between these conditions. The findings reported by Wu et al¹ serve as another reminder that clinicians should be proactive in having psoriasis patients actively monitor their blood pressure, either with the dermatologist or with the primary care physician. This type of novel prospective information serves as another piece of the puzzle in our comprehensive management of psoriasis.

Patch testing is one of the major diagnostic tools in the evaluation of allergic contact dermatitis. One limitation of patch testing is the use of steroids prior to testing. Because steroids may suppress a positive test reaction, the use of topical steroids on the test site or oral steroids should be discontinued for at least 2 weeks prior to testing. Therefore, it is interesting to consider the effect of biologics on the reliability of patch testing.

Kim et al (Dermatitis. 2014;25:182-190) evaluated the prevalence of positive patch tests in psoriasis patients receiving biologics and whether these results differed from those of psoriasis patients who were not receiving biologics. An institutional review board–approved retrospective chart review was performed for individuals with psoriasis who were patch tested from January 2002 to 2012 at Tufts Medical Center in Boston, Massachusetts. Patients were selected if they had a history of psoriasis, psoriatic arthritis, and patch testing as identified by International Classification of Diseases, Ninth Revision, codes 696.1, 696.0, and 95044, respectively, in their medical records. Patients were patch tested using a modified North American Contact Dermatitis Group standard and cosmetics series. Readings were performed at 48 hours and 72 to 96 hours. The North American Contact Dermatitis Group grading system was used to grade reactions. 

The chart review included 15 psoriasis patients who were on biologics (cases) and 16 psoriasis patients who were not on biologics (control subjects). The biologics used were ustekinumab (n=7), etanercept (n=4), adalimumab (n=3), and infliximab (n=1). The authors determined that 80% (12/15) of cases had at least 1 positive reaction compared with 81% (13/16) of control subjects, 67% (10/15) of cases had 2+ positive reactions compared with 63% (10/16) of control subjects, and 27% (4/15) of cases had 3+ positive reactions compared with 38% (6/16) of control subjects. These differences were not statistically significant.

Given the limitation of the small number of patients evaluated, the authors concluded that biologics do not appear to influence the abilities of patients with psoriasis to mount a positive patch test.

What’s the issue?

This study is small, but the findings do give an indication that the biologic agents utilized for psoriasis do not suppress patch test reactions. These data are not typically what we collect in this population, but it is nice to know. What has been your experience in patch testing patients on biologic therapy?

We want to know your views! Tell us what you think.

Patch testing is one of the major diagnostic tools in the evaluation of allergic contact dermatitis. One limitation of patch testing is the use of steroids prior to testing. Because steroids may suppress a positive test reaction, the use of topical steroids on the test site or oral steroids should be discontinued for at least 2 weeks prior to testing. Therefore, it is interesting to consider the effect of biologics on the reliability of patch testing.

Kim et al (Dermatitis. 2014;25:182-190) evaluated the prevalence of positive patch tests in psoriasis patients receiving biologics and whether these results differed from those of psoriasis patients who were not receiving biologics. An institutional review board–approved retrospective chart review was performed for individuals with psoriasis who were patch tested from January 2002 to 2012 at Tufts Medical Center in Boston, Massachusetts. Patients were selected if they had a history of psoriasis, psoriatic arthritis, and patch testing as identified by International Classification of Diseases, Ninth Revision, codes 696.1, 696.0, and 95044, respectively, in their medical records. Patients were patch tested using a modified North American Contact Dermatitis Group standard and cosmetics series. Readings were performed at 48 hours and 72 to 96 hours. The North American Contact Dermatitis Group grading system was used to grade reactions. 

The chart review included 15 psoriasis patients who were on biologics (cases) and 16 psoriasis patients who were not on biologics (control subjects). The biologics used were ustekinumab (n=7), etanercept (n=4), adalimumab (n=3), and infliximab (n=1). The authors determined that 80% (12/15) of cases had at least 1 positive reaction compared with 81% (13/16) of control subjects, 67% (10/15) of cases had 2+ positive reactions compared with 63% (10/16) of control subjects, and 27% (4/15) of cases had 3+ positive reactions compared with 38% (6/16) of control subjects. These differences were not statistically significant.

Given the limitation of the small number of patients evaluated, the authors concluded that biologics do not appear to influence the abilities of patients with psoriasis to mount a positive patch test.

What’s the issue?

This study is small, but the findings do give an indication that the biologic agents utilized for psoriasis do not suppress patch test reactions. These data are not typically what we collect in this population, but it is nice to know. What has been your experience in patch testing patients on biologic therapy?

We want to know your views! Tell us what you think.

Patch testing is one of the major diagnostic tools in the evaluation of allergic contact dermatitis. One limitation of patch testing is the use of steroids prior to testing. Because steroids may suppress a positive test reaction, the use of topical steroids on the test site or oral steroids should be discontinued for at least 2 weeks prior to testing. Therefore, it is interesting to consider the effect of biologics on the reliability of patch testing.

Kim et al (Dermatitis. 2014;25:182-190) evaluated the prevalence of positive patch tests in psoriasis patients receiving biologics and whether these results differed from those of psoriasis patients who were not receiving biologics. An institutional review board–approved retrospective chart review was performed for individuals with psoriasis who were patch tested from January 2002 to 2012 at Tufts Medical Center in Boston, Massachusetts. Patients were selected if they had a history of psoriasis, psoriatic arthritis, and patch testing as identified by International Classification of Diseases, Ninth Revision, codes 696.1, 696.0, and 95044, respectively, in their medical records. Patients were patch tested using a modified North American Contact Dermatitis Group standard and cosmetics series. Readings were performed at 48 hours and 72 to 96 hours. The North American Contact Dermatitis Group grading system was used to grade reactions. 

The chart review included 15 psoriasis patients who were on biologics (cases) and 16 psoriasis patients who were not on biologics (control subjects). The biologics used were ustekinumab (n=7), etanercept (n=4), adalimumab (n=3), and infliximab (n=1). The authors determined that 80% (12/15) of cases had at least 1 positive reaction compared with 81% (13/16) of control subjects, 67% (10/15) of cases had 2+ positive reactions compared with 63% (10/16) of control subjects, and 27% (4/15) of cases had 3+ positive reactions compared with 38% (6/16) of control subjects. These differences were not statistically significant.

Given the limitation of the small number of patients evaluated, the authors concluded that biologics do not appear to influence the abilities of patients with psoriasis to mount a positive patch test.

What’s the issue?

This study is small, but the findings do give an indication that the biologic agents utilized for psoriasis do not suppress patch test reactions. These data are not typically what we collect in this population, but it is nice to know. What has been your experience in patch testing patients on biologic therapy?

We want to know your views! Tell us what you think.

In this time of evolving medical care, many factors are impinging on the physician-patient relationship. Unfortunately, one of the biggest barriers between our patients and us is a computer screen.

Before I started using an electronic health record (EHR) nearly 4 years ago, I was very anxious about the transition. How would I be able to maintain my patient volume while trying to create a comprehensive electronic document for each patient? Now I love my EHR. It creates a beautiful note quickly and effectively, and I can check all of my medical records from any location. I love e-prescribing, and, best of all, there is never a lost medical record. As I have become more connected to my EHR, however, I think my patients sometimes feel left out. As many of us can attest, it is often hard to maintain good eye contact and communication with patients while completing their electronic record.

Recently, several studies have evaluated the effects of novel technologies on interactions between the patient and health care professionals (HCPs). Montague and Asan¹ examined eye gaze patterns between patients and HCPs while EHRs were used to support patient care. Gaze was used because it provides a more objective and measurable indication of attention and communication. In their study, patient visits were recorded using 3 high-resolution video cameras placed at different angles to accurately capture gaze and avoid ambiguity of the gaze direction caused by a single camera angle. One hundred patients and 10 HCPs participated in the study.¹

Results indicated that on average HCPs spent nearly one-third of the visit length gazing at the EHR.¹ Paper medical records also were used during 79% of the visits with HCPs spending approximately 9% of the visit length gazing at the record. There were times when the patient gaze was undetermined and accounted for more than 28% of the visit length. This unknown gaze might have occurred when the HCP used the computer and the patient disengaged eye contact with the HCP. Another scenario recorded was when patients gazed at the HCP and the HCP gazed at the EHR, an event that accounted for more than 21% of the visit time. The investigators concluded that the patient-physician eye contact dynamic differed with EHRs compared to paper medical records. They also noted that when HCPs spent too much time looking at the computer screen in the examination room, nonverbal cues might have been overlooked. Also, the HCP’s ability to pay attention and communicate with patients was affected.¹

Asan et al² quantitatively examined and compared clinically experienced physician interactions with patients using paper medical records or EHRs in ambulatory primary care settings. Eight experienced family medicine physicians and 80 patients participated in the study. A total of 80 visits—40 with paper and 40 with EHRs—were recorded. The proportion of time physicians spent gazing at medical records was significantly more during EHR visits compared to paper chart visits (35.2% vs 22.1%; P=.001). A significantly smaller proportion of physician time was spent gazing at the patient when using an EHR compared to a paper medical record (52.6% vs 45.6%; P=.041).²

As our use of EHRs increases and evolves, it will be important to factor in these issues to maintain the centrality of the physician-patient rapport. We should attempt to place the computer screen and the patient in physical locations that facilitate the ability to maximally interact with the patient while entering the data. It will be important for those who design the next generation of EHRs to do so with this communication in mind. Until then, I will do my best to give the appropriate attention to both my patient and my EHR.

In this time of evolving medical care, many factors are impinging on the physician-patient relationship. Unfortunately, one of the biggest barriers between our patients and us is a computer screen.

Before I started using an electronic health record (EHR) nearly 4 years ago, I was very anxious about the transition. How would I be able to maintain my patient volume while trying to create a comprehensive electronic document for each patient? Now I love my EHR. It creates a beautiful note quickly and effectively, and I can check all of my medical records from any location. I love e-prescribing, and, best of all, there is never a lost medical record. As I have become more connected to my EHR, however, I think my patients sometimes feel left out. As many of us can attest, it is often hard to maintain good eye contact and communication with patients while completing their electronic record.

Recently, several studies have evaluated the effects of novel technologies on interactions between the patient and health care professionals (HCPs). Montague and Asan¹ examined eye gaze patterns between patients and HCPs while EHRs were used to support patient care. Gaze was used because it provides a more objective and measurable indication of attention and communication. In their study, patient visits were recorded using 3 high-resolution video cameras placed at different angles to accurately capture gaze and avoid ambiguity of the gaze direction caused by a single camera angle. One hundred patients and 10 HCPs participated in the study.¹

Results indicated that on average HCPs spent nearly one-third of the visit length gazing at the EHR.¹ Paper medical records also were used during 79% of the visits with HCPs spending approximately 9% of the visit length gazing at the record. There were times when the patient gaze was undetermined and accounted for more than 28% of the visit length. This unknown gaze might have occurred when the HCP used the computer and the patient disengaged eye contact with the HCP. Another scenario recorded was when patients gazed at the HCP and the HCP gazed at the EHR, an event that accounted for more than 21% of the visit time. The investigators concluded that the patient-physician eye contact dynamic differed with EHRs compared to paper medical records. They also noted that when HCPs spent too much time looking at the computer screen in the examination room, nonverbal cues might have been overlooked. Also, the HCP’s ability to pay attention and communicate with patients was affected.¹

Asan et al² quantitatively examined and compared clinically experienced physician interactions with patients using paper medical records or EHRs in ambulatory primary care settings. Eight experienced family medicine physicians and 80 patients participated in the study. A total of 80 visits—40 with paper and 40 with EHRs—were recorded. The proportion of time physicians spent gazing at medical records was significantly more during EHR visits compared to paper chart visits (35.2% vs 22.1%; P=.001). A significantly smaller proportion of physician time was spent gazing at the patient when using an EHR compared to a paper medical record (52.6% vs 45.6%; P=.041).²

As our use of EHRs increases and evolves, it will be important to factor in these issues to maintain the centrality of the physician-patient rapport. We should attempt to place the computer screen and the patient in physical locations that facilitate the ability to maximally interact with the patient while entering the data. It will be important for those who design the next generation of EHRs to do so with this communication in mind. Until then, I will do my best to give the appropriate attention to both my patient and my EHR.

In this time of evolving medical care, many factors are impinging on the physician-patient relationship. Unfortunately, one of the biggest barriers between our patients and us is a computer screen.

Before I started using an electronic health record (EHR) nearly 4 years ago, I was very anxious about the transition. How would I be able to maintain my patient volume while trying to create a comprehensive electronic document for each patient? Now I love my EHR. It creates a beautiful note quickly and effectively, and I can check all of my medical records from any location. I love e-prescribing, and, best of all, there is never a lost medical record. As I have become more connected to my EHR, however, I think my patients sometimes feel left out. As many of us can attest, it is often hard to maintain good eye contact and communication with patients while completing their electronic record.

Recently, several studies have evaluated the effects of novel technologies on interactions between the patient and health care professionals (HCPs). Montague and Asan¹ examined eye gaze patterns between patients and HCPs while EHRs were used to support patient care. Gaze was used because it provides a more objective and measurable indication of attention and communication. In their study, patient visits were recorded using 3 high-resolution video cameras placed at different angles to accurately capture gaze and avoid ambiguity of the gaze direction caused by a single camera angle. One hundred patients and 10 HCPs participated in the study.¹

Results indicated that on average HCPs spent nearly one-third of the visit length gazing at the EHR.¹ Paper medical records also were used during 79% of the visits with HCPs spending approximately 9% of the visit length gazing at the record. There were times when the patient gaze was undetermined and accounted for more than 28% of the visit length. This unknown gaze might have occurred when the HCP used the computer and the patient disengaged eye contact with the HCP. Another scenario recorded was when patients gazed at the HCP and the HCP gazed at the EHR, an event that accounted for more than 21% of the visit time. The investigators concluded that the patient-physician eye contact dynamic differed with EHRs compared to paper medical records. They also noted that when HCPs spent too much time looking at the computer screen in the examination room, nonverbal cues might have been overlooked. Also, the HCP’s ability to pay attention and communicate with patients was affected.¹

Asan et al² quantitatively examined and compared clinically experienced physician interactions with patients using paper medical records or EHRs in ambulatory primary care settings. Eight experienced family medicine physicians and 80 patients participated in the study. A total of 80 visits—40 with paper and 40 with EHRs—were recorded. The proportion of time physicians spent gazing at medical records was significantly more during EHR visits compared to paper chart visits (35.2% vs 22.1%; P=.001). A significantly smaller proportion of physician time was spent gazing at the patient when using an EHR compared to a paper medical record (52.6% vs 45.6%; P=.041).²

As our use of EHRs increases and evolves, it will be important to factor in these issues to maintain the centrality of the physician-patient rapport. We should attempt to place the computer screen and the patient in physical locations that facilitate the ability to maximally interact with the patient while entering the data. It will be important for those who design the next generation of EHRs to do so with this communication in mind. Until then, I will do my best to give the appropriate attention to both my patient and my EHR.

We are all aware of the burden of psoriatic arthritis (PsA). Although psoriasis is more common, the arthritic component is a major factor in the morbidity of psoriatic disease. Accordingly, the National Psoriasis Foundation (NPF) is taking steps to expand the focus on PsA.

Last month, the NPF launched the largest realignment and expansion of its PsA program since the organization began its services almost 20 years ago. The NPF’s PsA Project will focus on 4 major areas: (1) Decrease the time to diagnosis. (2) Help those with PsA better manage their disease. (3) Reduce barriers to health care and treatments. (4) Improve understanding of PsA symptoms, disease management, and impact on patient quality of life among health care providers.

Through the PsA Project, the NPF has the following specific goals: (1) Reduce the average time of diagnosis of PsA from 4 years to 1 year. (2) Increase by 50% the number of people with PsA who are receiving the right treatment to 62% total. (3) Reduce from 50% to 30% the number of people who report PsA is a problem in their everyday lives. (4) Double the number of health resources available to people diagnosed with PsA. (5) Increase by 50% the number of National Institutes of Health–funded scientists studying psoriatic disease to 42 scientists to boost care, improve treatment, and find a cure for PsA.

What’s the issue?

Our patients with PsA deserve more resources. The earlier we diagnose this condition the less likely an individual is to suffer pain and possible joint destruction. A project such as the one created by the NPF can only help to raise awareness among both patients and physicians. How will you contribute to expanding awareness of psoriatic arthritis in your community?

We want to know your views! Tell us what you think.

We are all aware of the burden of psoriatic arthritis (PsA). Although psoriasis is more common, the arthritic component is a major factor in the morbidity of psoriatic disease. Accordingly, the National Psoriasis Foundation (NPF) is taking steps to expand the focus on PsA.

Last month, the NPF launched the largest realignment and expansion of its PsA program since the organization began its services almost 20 years ago. The NPF’s PsA Project will focus on 4 major areas: (1) Decrease the time to diagnosis. (2) Help those with PsA better manage their disease. (3) Reduce barriers to health care and treatments. (4) Improve understanding of PsA symptoms, disease management, and impact on patient quality of life among health care providers.

Through the PsA Project, the NPF has the following specific goals: (1) Reduce the average time of diagnosis of PsA from 4 years to 1 year. (2) Increase by 50% the number of people with PsA who are receiving the right treatment to 62% total. (3) Reduce from 50% to 30% the number of people who report PsA is a problem in their everyday lives. (4) Double the number of health resources available to people diagnosed with PsA. (5) Increase by 50% the number of National Institutes of Health–funded scientists studying psoriatic disease to 42 scientists to boost care, improve treatment, and find a cure for PsA.

What’s the issue?

Our patients with PsA deserve more resources. The earlier we diagnose this condition the less likely an individual is to suffer pain and possible joint destruction. A project such as the one created by the NPF can only help to raise awareness among both patients and physicians. How will you contribute to expanding awareness of psoriatic arthritis in your community?

We want to know your views! Tell us what you think.

We are all aware of the burden of psoriatic arthritis (PsA). Although psoriasis is more common, the arthritic component is a major factor in the morbidity of psoriatic disease. Accordingly, the National Psoriasis Foundation (NPF) is taking steps to expand the focus on PsA.

Last month, the NPF launched the largest realignment and expansion of its PsA program since the organization began its services almost 20 years ago. The NPF’s PsA Project will focus on 4 major areas: (1) Decrease the time to diagnosis. (2) Help those with PsA better manage their disease. (3) Reduce barriers to health care and treatments. (4) Improve understanding of PsA symptoms, disease management, and impact on patient quality of life among health care providers.

Through the PsA Project, the NPF has the following specific goals: (1) Reduce the average time of diagnosis of PsA from 4 years to 1 year. (2) Increase by 50% the number of people with PsA who are receiving the right treatment to 62% total. (3) Reduce from 50% to 30% the number of people who report PsA is a problem in their everyday lives. (4) Double the number of health resources available to people diagnosed with PsA. (5) Increase by 50% the number of National Institutes of Health–funded scientists studying psoriatic disease to 42 scientists to boost care, improve treatment, and find a cure for PsA.

What’s the issue?

Our patients with PsA deserve more resources. The earlier we diagnose this condition the less likely an individual is to suffer pain and possible joint destruction. A project such as the one created by the NPF can only help to raise awareness among both patients and physicians. How will you contribute to expanding awareness of psoriatic arthritis in your community?

We want to know your views! Tell us what you think.

As dermatologists we are all aware of the serious nature of psoriasis and its impact on the quality of life of patients. In the last decade we have more clearly recognized the comorbidities of the condition, including increased risk for cardiovascular disease and malignancy. However, there are many people, within and outside the medical community, who are not aware of the potentially serious nature of this disease.

Hopefully the tide is turning. According to News Medical, at the recent 67th World Health Assembly, the World Health Organization member states adopted a resolution on psoriasis, recognizing it as “a chronic, non-communicable, painful, disfiguring, and disabling disease for which there is no cure.” This resolution also acknowledged the psychosocial burden of the disease as well as the fact that many people with psoriasis suffer due to lack of awareness and access to sufficient treatment.

On this occasion, Wolfram Sterry, MD, president of the International League of Dermatological Societies, commented with the following:

“As a dermatologist I have seen first-hand how deeply psoriasis affects people in their daily lives, as have the many members of our worldwide organization. Together with the psoriasis patient associations, we have been able to educate policy makers on the impact this disease has and what can be done to ease its burden. This resolution gives us a platform from which we can engage even further with policy makers to help improve access to the treatment and care that people with psoriasis need and deserve.”

For many years, dermatologic societies and the National Psoriasis Foundation have been active in raising awareness about the impact of psoriasis, but it is gratifying to see a more global body take steps to increase public awareness of the disease.

What’s the issue?

Awareness of psoriasis is not at the level where it should be, which is especially true among the patients with the disease who often do not know where to find care and are unaware of the treatment options available in 2014. This acknowledgment by the World Health Organization is a nice step in the right direction. What will you do to increase awareness in your community?

We want to know your views! Tell us what you think.

As dermatologists we are all aware of the serious nature of psoriasis and its impact on the quality of life of patients. In the last decade we have more clearly recognized the comorbidities of the condition, including increased risk for cardiovascular disease and malignancy. However, there are many people, within and outside the medical community, who are not aware of the potentially serious nature of this disease.

Hopefully the tide is turning. According to News Medical, at the recent 67th World Health Assembly, the World Health Organization member states adopted a resolution on psoriasis, recognizing it as “a chronic, non-communicable, painful, disfiguring, and disabling disease for which there is no cure.” This resolution also acknowledged the psychosocial burden of the disease as well as the fact that many people with psoriasis suffer due to lack of awareness and access to sufficient treatment.

On this occasion, Wolfram Sterry, MD, president of the International League of Dermatological Societies, commented with the following:

“As a dermatologist I have seen first-hand how deeply psoriasis affects people in their daily lives, as have the many members of our worldwide organization. Together with the psoriasis patient associations, we have been able to educate policy makers on the impact this disease has and what can be done to ease its burden. This resolution gives us a platform from which we can engage even further with policy makers to help improve access to the treatment and care that people with psoriasis need and deserve.”

For many years, dermatologic societies and the National Psoriasis Foundation have been active in raising awareness about the impact of psoriasis, but it is gratifying to see a more global body take steps to increase public awareness of the disease.

What’s the issue?

Awareness of psoriasis is not at the level where it should be, which is especially true among the patients with the disease who often do not know where to find care and are unaware of the treatment options available in 2014. This acknowledgment by the World Health Organization is a nice step in the right direction. What will you do to increase awareness in your community?

We want to know your views! Tell us what you think.

As dermatologists we are all aware of the serious nature of psoriasis and its impact on the quality of life of patients. In the last decade we have more clearly recognized the comorbidities of the condition, including increased risk for cardiovascular disease and malignancy. However, there are many people, within and outside the medical community, who are not aware of the potentially serious nature of this disease.

Hopefully the tide is turning. According to News Medical, at the recent 67th World Health Assembly, the World Health Organization member states adopted a resolution on psoriasis, recognizing it as “a chronic, non-communicable, painful, disfiguring, and disabling disease for which there is no cure.” This resolution also acknowledged the psychosocial burden of the disease as well as the fact that many people with psoriasis suffer due to lack of awareness and access to sufficient treatment.

On this occasion, Wolfram Sterry, MD, president of the International League of Dermatological Societies, commented with the following:

“As a dermatologist I have seen first-hand how deeply psoriasis affects people in their daily lives, as have the many members of our worldwide organization. Together with the psoriasis patient associations, we have been able to educate policy makers on the impact this disease has and what can be done to ease its burden. This resolution gives us a platform from which we can engage even further with policy makers to help improve access to the treatment and care that people with psoriasis need and deserve.”

For many years, dermatologic societies and the National Psoriasis Foundation have been active in raising awareness about the impact of psoriasis, but it is gratifying to see a more global body take steps to increase public awareness of the disease.

What’s the issue?

Awareness of psoriasis is not at the level where it should be, which is especially true among the patients with the disease who often do not know where to find care and are unaware of the treatment options available in 2014. This acknowledgment by the World Health Organization is a nice step in the right direction. What will you do to increase awareness in your community?

We want to know your views! Tell us what you think.