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Eveline De Brandt, Tom Hillary Department of Dermatology, University Hospitals Leuven, Leuven, BelgiumCorrespondence: Tom Hillary, Department of Dermatology, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium, Tel +3216337950 Email tom.hillary@uzleuven.bePurpose: To review the literature on guidance on the follow-up of psoriasis and its comorbidities and to provide practical recommendations.Patients and Methods: A PubMed search was conducted using MeSH terms and free text keywords related to “psoriasis”, “obesity”, “hypertension”, “diabetes”, “dyslipidemia”, “metabolic syndrome” and “Psoriatic arthritis”. The search was conducted between September 2021 and January 2022. References of selected articles were scanned to identify additional articles.Results: Recommendations on the follow-up of hypertension, obesity, dyslipidemia, type 2 diabetes, metabolic syndrome, psoriatic arthritis, non-alcoholic fatty liver disease and inflammatory bowel disease in psoriasis patients were extracted from the included articles. These data are presented in summary tables for both adults and children. A practical and feasible approach for each comorbidity is discussed.Conclusion: Awareness among dermatologists for relevant psoriasis-associated comorbidities is crucial. The dermatologist should function as gatekeeper and screen for comorbidities, in order to make timely referrals when indicated.Keywords: psoriasis, comorbidities, metabolic syndrome, psoriatic arthritis, screening, atherosclerosis, liver disease, cardiovascular disease

Tom Hillary,1 Jo Lambert2 1Department of Dermatology, University Hospitals Leuven, Leuven, 3000, Belgium; 2Department of Dermatology, Ghent University Hospital, Gent, 9000, BelgiumCorrespondence: Tom HillaryDepartment of Dermatology, University Hospitals Leuven, Herestraat 49, Leuven, 3000, BelgiumEmail tom.hillary@uzleuven.beObjective: To assess the feasibility of the future implementation of a recently published Belgian treat-to-target scoring in daily practice, we investigated to what extent Belgian dermatologists use metrics and take comorbidities into account in the follow-up of psoriasis patients.Methods: Belgian dermatologists were addressed to fill out an online questionnaire in April 2020.Results: A total of 149 dermatologists completed the survey. About 55% (n = 78) indicated to do a full-body examination during every visit. Psoriasis Area Severity Index (PASI) was the most frequently used clinical score: 25% (n = 35) and 61% (n = 87) indicated to use it every visit or sometimes (> 1/year), respectively. The most frequently used patient-reported outcome scoring system was the Dermatology Life Quality Index: 35% use it sometimes. Overall, there is awareness for the association with metabolic syndrome.Conclusion: Among tools for follow-up on moderate-to-severe psoriasis patients, Belgian dermatologists most frequently apply full-body examination and PASI score. Patient-reported outcome scoring systems are used infrequently. Psoriasis is perceived as a disease with comorbidities beyond the skin, especially obesity and hypertension. These real-world data on the use of clinical scores and PROs indicate a discrepancy from the academic setting in which new drugs are developed and evaluated. Furthermore, these data are imperative to estimate the feasibility of implementing a treat-to-target strategy published earlier by a Belgian expert group.Keywords: psoriasis, comorbidities, patient care, treat to target, metrics