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Background: Patient-reported outcomes are relevant in clinical practice showing patient benefits, supporting clinicians' decision-making, and contributing to the delivery of high standards of care. Digital monitoring of patient-reported outcomes is still rare. The Patient Benefit Index (PBI) measures benefits and goals from patients' views and may be relevant for regular documentation and shared decision-making., Objective: This study aimed to develop electronic versions of the PBI to examine their feasibility and acceptability in clinical practice for patients with psoriasis., Methods: We developed an app and a web version of the existing, valid PBI using focus groups and cognitive debriefings with patients before conducting a quantitative survey on its feasibility and acceptability. Conduction took part in an outpatient dermatology care unit in Germany. Descriptive and subgroup analyses were conducted., Results: A total of 139 patients completed the electronic PBIs (ePBIs) and took part in the survey. The ePBI was understandable (n=129-137, 92.8%-98.6%) and feasible, for example, easy to read (n=135, 97.1%) and simple to handle (n=137, 98.5%). Acceptability was also high, for example, patients can imagine using and discussing the ePBI data in practice (n=91, 65.5%) and documenting it regularly (n=88, 63.3%). They believe it could support treatment decisions (n=118, 84.9%) and improve communication with their physician (n=112, 81.3%). They can imagine filling in electronic questionnaires regularly (n=118, 84.9%), even preferring electronic over paper versions (n=113, 81.2%). Older and less educated people show less feasibility, but the latter expected the relationship with their physician to improve and would be more willing to invest time or effort., Conclusions: The app and web version of the PBI are usable and acceptable for patients offering comprehensive documentation and patient participation in practice. An implementation strategy should consider patients' needs, barriers, and facilitators but also physicians' attitudes and requirements from the health care system., (©Marina Otten, Vahid Djamei, Matthias Augustin. Originally published in JMIR Dermatology (http://derma.jmir.org), 09.08.2024.)

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) held a trainee symposium at its 2018 annual meeting in Toronto, Ontario, Canada. Rheumatology and dermatology trainees engaged in psoriasis or psoriatic arthritis research presented their work. This report briefly reviews 5 oral presentations and 21 posters presented at the meeting.

At the 2017 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Amsterdam, the Netherlands, a trainees symposium was held. Rheumatology and dermatology trainees engaged in psoriasis or psoriatic arthritis research presented their work. This report briefly reviews 6 oral presentations and 25 posters presented at the meeting.

Psoriasis and psoriatic arthritis are common disease entities in the daily routine of dermatologists and rheumatologists. The clinical management of the diseases profits tremendously from interdisciplinary contacts and shared decision-making processes. For dermatologists, recognition of early clinical symptoms of inflammatory arthropathies is pivotal. Rheumatologists, on the other hand, are required to make an early assessment of skin and nail changes in patients, since they are important parameters in the clinical classification of inflammatory joint diseases, in particular for the diagnosis of psoriatic arthritis. In patients with psoriasis, lesions on the scalp, in the anal cleft, and nail changes as well as severe generalized skin disease are all regarded as risk factors for psoriatic arthritis. The symptoms of the associated joint and spinal afflictions can vary considerably and confirmation of the diagnosis, in particular in early stages of the disease often represents a considerable challenge. The most common clinical manifestations of psoriasis and psoriatic arthritis and their differential diagnostics are discussed.

Psoriasis is a chronic immune-mediated inflammatory skin disease. Psoriasis lesions are characterized by hyper-proliferation of epidermal keratinocytes associated with inflammatory cellular infiltrate in both dermis and epidermis. The epidermis is the natural source of vitamin D synthesis by sunlight action. Recently, a role for vitamin D in the pathogenesis of different skin diseases, including psoriasis, has been reported. Indeed, significant associations between low vitamin D status and psoriasis have been systematically observed. Due to its role in proliferation and maturation of keratinocytes, vitamin D has become an important local therapeutic option in the treatment of psoriasis. To date, the successful treatment based on adequate dietary intake of vitamin D or oral vitamin D supplementation in psoriasis represent an unmet clinical need and the evidence of its beneficial effects remains still controversial. This information is important either for Dermatologists and Nutritionists to increases the knowledge on the possible bi-directional relationships between low vitamin D status and psoriasis and on the potential usefulness of vitamin D in psoriasis with the aim not only to reduce its clinical severity, but also for delineating the risk profile for co-morbidities cardiac risk factors that may result from psoriasis. In the current review, we analyzed the possible bi-directional links between psoriatic disease and vitamin D.

At the 2015 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Stockholm, Sweden, rheumatology and dermatology trainees engaged in psoriasis or psoriatic arthritis research presented their work to meeting attendees in a trainees symposium. This report briefly reviews 6 oral presentations and 20 posters presented at the meeting.

Background: General practitioners/dermatologists may be aware of musculoskeletal symptoms in patients with psoriasis but may have difficulty accurately detecting psoriatic arthritis (PsA)., Objective: We sought to evaluate 3 PsA screening questionnaires-the Psoriasis and Arthritis Screening Questionnaire (PASQ), Psoriasis Epidemiology Screening Tool (PEST), and Toronto Psoriatic Arthritis Screen (ToPAS)-based on rheumatologist assessment in patients with psoriasis., Methods: Consecutive unselected patients with psoriasis, initially evaluated by dermatologists for plaque psoriasis, were randomized to receive 1 of 3 questionnaires. Patients were subsequently evaluated by rheumatologists to establish/exclude clinical PsA diagnosis. Using clinical PsA diagnosis as the standard for comparison, questionnaire accuracy was assessed by calculating sensitivity/specificity and positive/negative predictive values., Results: Of 949 patients with psoriasis evaluated by rheumatologists, 285 (30%) received a clinical diagnosis of PsA (95% confidence interval 27%-33%). Probable PsA was detected in 45.1%, 43.0%, and 42.9% of patients using PASQ, PEST, and ToPAS, respectively. Sensitivity ranged from 0.67 to 0.84; specificity, 0.64 to 0.75; positive predictive value, 0.43 to 0.60; and negative predictive value, 0.83 to 0.91., Limitations: Not all patients completed all questionnaires; lack of standardized diagnostic criteria introduced possible bias., Conclusion: PASQ, PEST, and ToPAS are useful screening tools that can help dermatologists identify patients without PsA and patients with possible PsA who may benefit from rheumatologist assessment., (Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

At the 2013 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Toronto, Ontario, Canada, 26 dermatology and rheumatology fellows engaged in psoriasis or psoriatic arthritis research were invited to present their work at the Trainees Symposium, which preceded the annual meeting and was also attended by GRAPPA members from around the world. Herein, we provide a brief overview of the 6 oral presentations and 25 posters presented, which reflect the focus and diversity of current basic and clinical research in psoriatic disease.

Background: Dactylitis is a characteristic feature of psoriatic arthritis (PsA). However, early diagnosis of mild dactylitis is challenging and image examination, such as ultrasonography (US), can be helpful. Objectives: We aimed to compare the clinical diagnosis of dactylitis made by the dermatologist and ultrasonographic diagnosis by the rheumatologist. Methods: Consecutive patients diagnosed with peripheral PsA seen in the dermatologic clinics were referred to the same dermatologist for evaluation of dactylitis. Consecutive patients with and without clinical dactylitis were diagnosed in 19 and 19 patients, respectively, by the referred dermatologist. All patients were then referred to an experienced rheumatologist unaware of the clinical diagnosis for sonographic examination of all 20 digits. Dactylitis under US was diagnosed when both proximal and distal parts of a digit were at least 0.25 mm larger than the contralateral digit. Results: For the clinical dactylitis group, 7 (36.8%) patients had more dactylitis diagnosed by US than clinically, and 2 (10.5%) patients had no dactylitis diagnosed by US. For the clinically no dactylitis group, 4 (21.1%) patients had no diagnosis of dactylitis by US, and most of these patients (78.9%) were diagnosed with dactylitis under US by the rheumatologist. More digits affected by dactylitis were found for both groups, although no statistically significant differences were found, probably due to the small sample size. Conclusion: The results revealed concordance between the dermatologist and rheumatologist for clinical dactylitis but not for patients without dactylitis. For PsA patients, US is more sensitive and useful for early dactylitis diagnosis in a dermatologic clinic.

Introduction: The management of psoriasis is a daily challenge for dermatologists as most patients present with varied morphological presentations and exacerbations at every visit. This exerts a heightened responsibility on the dermatologists to tailor their treatments according to each patient. Aims: This study was conducted to assess the variation in treatment practices in the management of psoriasis patients among dermatologists of Kerala. Materials and Methods: A questionnaire-based survey was conducted among the practicing dermatologists of Kerala, South India. Conclusions: At the end of this questionnaire-based study, we concluded that there is a wide variation in the treatment practices among practicing dermatologists of Kerala. Dermatology Life Quality Index (DLQI) is not assessed by majority of dermatologists while planning treatment. Most dermatologists rely on body surface area while planning treatment due to time constraints and did not perform PASI (Psoriasis Area and Severity Index) or PGA (Physician Global Assessment) scoring. Satisfaction and challenges related to current therapies also impact treatment rates. Our dermatologists adhered to their own individual guidelines while treating and expressed a dire need for a unified guideline.

Introduction: Psoriasis is a chronic inflammatory skin disease affecting about 2% of the general population. Although there are many treatment options, and new medications have been introduced, the disease is considered not curable, and it may seriously affect patients' quality of life. Aim: The authors present contemporary treatment patterns used by dermatologists in Poland to manage plaque psoriasis and psoriatic arthritis, particularly regarding systemic treatment. The authors also aimed to analyse how these treatment patterns are influenced by the guidelines of the Polish Dermatological Society. Material and methods: The author's questionnaire, consisting of 13 questions was used. It included demographic and professional characteristics of questioned dermatologists, as well as the assessment of the attitudes towards management of plaque psoriasis and psoriatic arthritis. Results: A total of 132 dermatologists completed the questionnaire. Most of the specialists worked in out-patient clinics and private practices. The most commonly used topicals for psoriasis included: glucocorticosteroids, a combination of glucocorticosteroid and vitamin D analogue and salicylic acid. Regarding the treatment of psoriatic arthritis, most of the specialists declared using systemic therapy and a combination of systemic therapy and phototherapy. The majority of the respondents were particularly concerned with possible side effects or difficulties in qualifying and monitoring the patients, and less frequently on the cost of the therapy. Conclusions: Observations suggest that 60% of physicians have some reservation to initiate systemic treatment in outpatient clinics, and they admit that they lack additional training. On the other hand, it seems also that the organization of systemic treatment in psoriasis may generate these difficulties and thus necessitate additional effort. Another factor could be the budget -- not only regarding healthcare professionals, but also the patient, sometimes financing various investigations from private resources. [ABSTRACT FROM AUTHOR]

Background: Dactylitis is a characteristic feature of psoriatic arthritis (PsA). However, early diagnosis of mild dactylitis is challenging and image examination, such as ultrasonography (US), can be helpful. Objectives: We aimed to compare the clinical diagnosis of dactylitis made by the dermatologist and ultrasonographic diagnosis by the rheumatologist. Methods: Consecutive patients diagnosed with peripheral PsA seen in the dermatologic clinics were referred to the same dermatologist for evaluation of dactylitis. Consecutive patients with and without clinical dactylitis were diagnosed in 19 and 19 patients, respectively, by the referred dermatologist. All patients were then referred to an experienced rheumatologist unaware of the clinical diagnosis for sonographic examination of all 20 digits. Dactylitis under US was diagnosed when both proximal and distal parts of a digit were at least 0.25 mm larger than the contralateral digit. Results: For the clinical dactylitis group, 7 (36.8%) patients had more dactylitis diagnosed by US than clinically, and 2 (10.5%) patients had no dactylitis diagnosed by US. For the clinically no dactylitis group, 4 (21.1%) patients had no diagnosis of dactylitis by US, and most of these patients (78.9%) were diagnosed with dactylitis under US by the rheumatologist. More digits affected by dactylitis were found for both groups, although no statistically significant differences were found, probably due to the small sample size. Conclusion: The results revealed concordance between the dermatologist and rheumatologist for clinical dactylitis but not for patients without dactylitis. For PsA patients, US is more sensitive and useful for early dactylitis diagnosis in a dermatologic clinic. [ABSTRACT FROM AUTHOR]

Introduction: The management of psoriasis is a daily challenge for dermatologists as most patients present with varied morphological presentations and exacerbations at every visit. This exerts a heightened responsibility on the dermatologists to tailor their treatments according to each patient. Aims: This study was conducted to assess the variation in treatment practices in the management of psoriasis patients among dermatologists of Kerala. Materials and Methods: A questionnaire-based survey was conducted among the practicing dermatologists of Kerala, South India. Conclusions: At the end of this questionnaire-based study, we concluded that there is a wide variation in the treatment practices among practicing dermatologists of Kerala. Dermatology Life Quality Index (DLQI) is not assessed by majority of dermatologists while planning treatment. Most dermatologists rely on body surface area while planning treatment due to time constraints and did not perform PASI (Psoriasis Area and Severity Index) or PGA (Physician Global Assessment) scoring. Satisfaction and challenges related to current therapies also impact treatment rates. Our dermatologists adhered to their own individual guidelines while treating and expressed a dire need for a unified guideline. [ABSTRACT FROM AUTHOR]

Background: Prompt identification and treatment of psoriatic arthritis (PsA) in patients with psoriasis is critical to reducing the risk of joint damage, disability, and comorbidities. Objective: We sought to estimate PsA prevalence in patients with plaque psoriasis in 34 dermatology centers in 7 European and North American countries. Methods: Consecutive patients were evaluated by dermatologists for plaque psoriasis and subsequently by rheumatologists for PsA. PsA prevalence was estimated primarily based on rheumatologists' assessment of medical history, physical examination, and laboratory tests. Results: Of 949 patients evaluated, 285 (30%) had PsA (95% confidence interval 27-33) based on rheumatologists' assessment. PsA diagnosis changed in 1.2% of patients when diagnostic laboratory tests were added to medical history and physical examination. Of 285 patients given the diagnosis of PsA, 117 (41%) had not been previously given the diagnosis. Limitations: Bias may have been introduced by lack of standardized diagnostic criteria and unbalanced recruitment based on country populations. Conclusions: In this study, almost a third of patients with psoriasis seen in dermatology centers had PsA as determined by rheumatologists. More than a third of patients with PsA had not been previously given the diagnosis. Clinical evaluation alone is often sufficient basis for PsA diagnosis, but laboratory test results may be helpful in some patients. [Copyright &y& Elsevier]