Experiences of Dermatologists and Patients Regarding Psoriasis and Its Connection to Psoriatic Arthritis in Saudi Arabia

Mohammad I Fatani,1 Ibrahim Al-homood,2 Mohamed Bedaiwi,3 Sahar Al Natour,4 Alper Erdogan,5 Aya Alsharafi,5 Suzan M Attar6 1Department of Dermatology, Heraa Hospital, Mecca, Makkah, Kingdom of Saudi Arabia; 2Department of Rheumatology, King Fahad Medical City (KFMC), Riyadh, Riyadh Province, Kingdom of Saudi Arabia; 3Department of Rheumatology, King Saud University, Riyadh, Riyadh Province, Kingdom of Saudi Arabia; 4Department of Dermatology, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Kingdom of Saudi Arabia; 5Eli Lilly and Company, Riyadh, Riyadh Province, Kingdom of Saudi Arabia; 6Department of Internal Medicine, King Abdulaziz University, Jeddah, Makkah, Kingdom of Saudi ArabiaCorrespondence: Mohammad I Fatani, Department of Dermatology, Heraa Hospital, Al Madinah Al Munawarah Road, Mecca, Makkah, 24227, Kingdom of Saudi Arabia, Email m_fatani@yahoo.comPurpose: Psoriasis is a chronic, inflammatory, immune-mediated skin disease that has significant impact on a patient’s quality of life, yet it remains challenging for dermatologists to successfully identify and manage. Without effective screening, diagnosis and treatments, psoriasis can potentially progress to psoriatic arthritis. A descriptive, observational cross-sectional study of Saudi Arabian dermatologists and patients with psoriasis was conducted to explore dermatologist and patient perspectives of psoriasis, including diagnosis, management, disease course and unmet needs.Patients and Methods: This study involved a quantitative questionnaire administered to 31 dermatologists and 90 patients with psoriasis at eight medical centers and was analyzed using descriptive statistics.Results: Dermatologists and patients perceived that psoriasis treatment was initiated promptly and that follow-up visits were sufficient. Their perspectives differed in the time to diagnosis and patient reaction, symptom severity, input into treatment goals and educational needs. The dermatologists’ concerns about underdiagnosed psoriasis (13%) were primarily related to patient awareness (87%), physician awareness (58%), and the absence of a regular screening program (52%). Only 31% of patients with psoriasis were highly satisfied with their psoriasis treatment, with 78% experiencing unpleasant symptoms of pain or swelling in joints indicative of psoriatic arthritis. However, only 56% of these patients reported these symptoms to their physicians. When dermatologists were made aware of this difference, referrals to a rheumatologist increased.Conclusion: The study highlights the importance of strengthening psoriasis management by enhancing dermatologist referral and screening practices, adopting a multidisciplinary approach to care, and improving education and resources for physicians and patients. These results can help to inform the improvement of psoriasis screening, diagnosis and treatment strategies and ensure that expectations meet treatment outcomes. Further research exploring the dermatologist and patient perspectives of the disease pathway from psoriasis to psoriatic arthritis and tailor-made treatment approaches is recommended.Keywords: autoimmune disease, disease pathway, patient satisfaction, provider perspective