A consensus-based approach on the management of patients with both psoriasis and psoriatic arthritis in the dermatological and rheumatological settings in Italy: The ADOI PSO-Amore Project


Submitted: 4 June 2022
Accepted: 20 July 2022
Published: 26 September 2022
Abstract Views: 839
PDF: 460
HTML: 28
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Psoriasis is a complex disease often needing a multidisciplinary approach. In particular, the collaboration between dermatologist and rheumatologist is crucial for the management of patients suffering from both psoriasis (PSO) and psoriatic arthritis (PsA). Here we report a series of recommendations from a group of experts, as a result of a Consensus Conference, defining the circumstances in which it is preferable or even mandatory, depending on the available settings, to rely on the opinion of the two specialists, jointly or in a deferred manner. Indications are given on how to organize a 3rd level joint Dermatology- Rheumatology care unit, in connection with 1st and 2nd level clinicians of both specialties, GPs, and other specialists involved in the management of psoriasis. A potential patient journey is suggested, that can be used as a basis for future design and validation of national and/or local diagnostic therapeutic and assistance pathways.


Conrad C, Gilliet M. Psoriasis: from Pathogenesis to Targeted Therapies. Clin Rev Allergy Immunol 2018;54:102–13. DOI: https://doi.org/10.1007/s12016-018-8668-1

Kim WB, Jerome D, Yeung J. Diagnosis and management of psoriasis. Can Fam Physician 2017;63https://pubmed.ncbi.nlm.nih.gov/28404701/.

ADIPSO, ADOI, AIDA, SIDeMaST, SIMG. Report PACTA. La Psoriasi. Una patologia cutanea multiorgano. Nuovi paradigmi e strategie di tutela assistenziale. 2016.

de Oliveira M de FSP, Rocha B de O, Duarte GV. Psoriasis: classical and emerging comorbidities. An Bras Dermatol 2015;90:9. DOI: https://doi.org/10.1590/abd1806-4841.20153038

Daniel BS. The multiple comorbidities of psoriasis: The importance of a holistic approach. Aust J Gen Pract 2020;49:433–7. DOI: https://doi.org/10.31128/AJGP-08-19-5035

Ruderman EM, Tambar S. Psoriatic arthritis: prevalence, diagnosis, and review of therapy for the dermatologist. Dermatol Clin 2004;22:477–86. DOI: https://doi.org/10.1016/S0733-8635(03)00127-X

Gladman DD. Psoriatic arthritis. Moderate-to-Severe Psoriasis, Third Ed 2008;8:239–58. DOI: https://doi.org/10.1007/978-0-387-68566-3_8

Moll JMH, Wright V. Psoriatic arthritis. Semin Arthritis Rheum 1973;3:55–78. DOI: https://doi.org/10.1016/0049-0172(73)90035-8

Ogdie A, Weiss P. The Epidemiology of Psoriatic Arthritis. Rheum Dis Clin North Am 2015;41:545–68. DOI: https://doi.org/10.1016/j.rdc.2015.07.001

Reich K, Krüger K, Mössner R, Augustin M. Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol 2009;160:1040–7. DOI: https://doi.org/10.1111/j.1365-2133.2008.09023.x

Radtke MA, Reich K, Blome C, Rustenbach S, Augustin M. Prevalence and clinical features of psoriatic arthritis and joint complaints in 2009 patients with psoriasis: results of a German national survey. J Eur Acad Dermatol Venereol 2009;23:683–91. DOI: https://doi.org/10.1111/j.1468-3083.2009.03159.x

Khraishi M, Chouela E, Bejar M, et al. High prevalence of psoriatic arthritis in a cohort of patients with psoriasis seen in a dermatology practice. J Cutan Med Surg 2012;16:122–7. DOI: https://doi.org/10.2310/7750.2011.10101

Zhang F, Yang Q, Qu L, et al. Prevalence and characteristics of psoriatic arthritis in Chinese patients with psoriasis. J Eur Acad Dermatol Venereol 2011;25:1409–14. DOI: https://doi.org/10.1111/j.1468-3083.2011.03985.x

Eder L, Haddad A, Rosen CF, et al. The Incidence and Risk Factors for Psoriatic Arthritis in Patients With Psoriasis: A Prospective Cohort Study. Arthritis Rheumatol (Hoboken, NJ) 2016;68:915–23.

Wilson FC, Icen M, Crowson CS, McEvoy MT, Gabriel SE, Kremers HM. Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum 2009;61:233–9. DOI: https://doi.org/10.1002/art.24172

Villani AP, Rouzaud M, Sevrain M, et al. Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: Systematic review and meta-analysis. J Am Acad Dermatol 2015;73:242–8. DOI: https://doi.org/10.1016/j.jaad.2015.05.001

Karmacharya P, Wright K, Achenbach SJ, et al. Diagnostic Delay in Psoriatic Arthritis: A Population-based Study. J Rheumatol 2021;48:1410–6. DOI: https://doi.org/10.3899/jrheum.201199

Kavanaugh A, Helliwell P, Ritchlin CT. Psoriatic Arthritis and Burden of Disease: Patient Perspectives from the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) Survey. Rheumatol Ther 2016;3:91–102. DOI: https://doi.org/10.1007/s40744-016-0029-z

Lebwohl MG, Kavanaugh A, Armstrong AW, Van Voorhees AS. US Perspectives in the Management of Psoriasis and Psoriatic Arthritis: Patient and Physician Results from the Population-Based Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) Survey. Am J Clin Dermatol 2016;17:87–97. DOI: https://doi.org/10.1007/s40257-015-0169-x

Ocampo V, Gladman D. Psoriatic arthritis. In: Moderate-to-Severe Psoriasis, Third Edition. CRC Press; 2008. p. 239–58.

Daudé E, Castañ eda S, Suá rez C, et al. Clinical practice guideline for an integrated approach to comorbidity in patients with psoriasis. J Eur Acad Dermatology Venereol 2013;27:1387–404. DOI: https://doi.org/10.1111/jdv.12024

Gottlieb A, Merola JF. Psoriatic arthritis for dermatologists. J Dermatolog Treat 2020;31:662–79.

Ritchlin CT, Kavanaugh A, Gladman DD, et al. Treatment recommendations for psoriatic arthritis. Ann Rheum Dis 2009;68:1387–9. DOI: https://doi.org/10.1136/ard.2008.094946

Gisondi P, Altomare G, Ayala F, et al. Consensus on the management of patients with psoriatic arthritis in a dermatology setting. J Eur Acad Dermatol Venereol 2018;32:515–28. DOI: https://doi.org/10.1111/jdv.14741

Cañete JD, Daudén E, Queiro R, et al. Recommendations for the coordinated management of psoriatic arthritis by rheumatologists and dermatologists: a Delphi study. Actas Dermosifiliogr 2014;105:216–32. DOI: https://doi.org/10.1016/j.adengl.2013.07.003

Queiro R, Coto P. Multidisciplinary care for psoriatic disease: Where we are and where we need to go. Rheumatology (Oxford) 2017;56:1829–31. DOI: https://doi.org/10.1093/rheumatology/kew485

Cobo-Ibáñez T, Villaverde V, Seoane-Mato D, et al. Multidisciplinary dermatology-rheumatology management for patients with moderate-to-severe psoriasis and psoriatic arthritis: a systematic review. Rheumatol Int 2016;36:221–9. DOI: https://doi.org/10.1007/s00296-015-3377-z

Queiro R, Coto P, Rodríguez J, et al. Multidisciplinary Care Models for Patients With Psoriatic Arthritis. Reumatol Clin 2017;13:85–90. DOI: https://doi.org/10.1016/j.reumae.2016.03.007

Velez NF, Wei-Passanese EX, Husni ME, Mody EA, Qureshi AA. Management of psoriasis and psoriatic arthritis in a combined dermatology and rheumatology clinic. Arch Dermatol Res 2012;304:7–13. DOI: https://doi.org/10.1007/s00403-011-1172-6

Soleymani T, Reddy SM, Cohen JM, Neimann AL. Early Recognition and Treatment Heralds Optimal Outcomes: the Benefits of Combined Rheumatology-Dermatology Clinics and Integrative Care of Psoriasis and Psoriatic Arthritis Patients. Curr Rheumatol Rep 2017;20. DOI: https://doi.org/10.1007/s11926-017-0706-0

Luelmo J, Gratacós J, Moreno Martínez-Losa M, et al. Multidisciplinary psoriasis and psoriatic arthritis unit: report of 4 years’ experience. Actas Dermosifiliogr 2014;105:371–7. DOI: https://doi.org/10.1016/j.adengl.2013.10.010

Samycia M, McCourt C, Shojania K, Au S. Experiences From a Combined Dermatology and Rheumatology Clinic: A Retrospective Review. J Cutan Med Surg 2016;20:486–9. DOI: https://doi.org/10.1177/1203475416649138

Black N, Murphy M, Lamping D, et al. Consensus development methods: a review of best practice in creating clinical guidelines. J Health Serv Res Policy 1999;4:236–48. DOI: https://doi.org/10.1177/135581969900400410

Candiani G, Colombo C, Daghini R, et al. Manuale Metodologico SNLG-ISS. Come organizzare una conferenza di consenso. 2013. https://www.psy.it/wp-content/uploads/2018/02/Manuale-Metodologico-Consensus.pdf.

Napolitano M, Caso F, Scarpa R, et al. Psoriatic arthritis and psoriasis: differential diagnosis. Clin Rheumatol 2016;35:1893–901. DOI: https://doi.org/10.1007/s10067-016-3295-9

Menter A. Psoriasis and psoriatic arthritis overview. Am J Manag Care 2016;22:s216–24.

Eder L, Haddad A, Rosen CF, et al. The Incidence and Risk Factors for Psoriatic Arthritis in Patients With Psoriasis: A Prospective Cohort Study. Arthritis Rheumatol (Hoboken, NJ) 2016;68:915–23. DOI: https://doi.org/10.1002/art.39494

Gottlieb A, Merola JF. Psoriatic arthritis for dermatologists. J Dermatolog Treat 2020;31:662–79. DOI: https://doi.org/10.1080/09546634.2019.1605142

Brandon A, Mufti A, Gary Sibbald R. Diagnosis and Management of Cutaneous Psoriasis: A Review. Adv Skin Wound Care 2019;32:58–69. DOI: https://doi.org/10.1097/01.ASW.0000550592.08674.43

Girolomoni G, Griffiths CEM, Krueger J, et al. Early intervention in psoriasis and immune-mediated inflammatory diseases: A hypothesis paper. J Dermatolog Treat 2015;26:103–12. DOI: https://doi.org/10.3109/09546634.2014.880396

Ibrahim G, Buch M, Lawson C, Waxman R, Helliwell P. Evaluation of an existing screening tool for psoriatic arthritis in people with psoriasis and the development of a new instrument: the Psoriasis Epidemiology Screening Tool (PEST) questionnaire - PubMed. Clin Exp Rheumatol 2009;27:469–74.

Tinazzi I, Adami S, Zanolin EM, et al. The early psoriatic arthritis screening questionnaire: a simple and fast method for the identification of arthritis in patients with psoriasis. Rheumatology (Oxford) 2012;51:2058–63. DOI: https://doi.org/10.1093/rheumatology/kes187

Amatore F, Villani AP, Tauber M, et al. French guidelines on the use of systemic treatments for moderate-to-severe psoriasis in adults. J Eur Acad Dermatol Venereol 2019;33:464–83. DOI: https://doi.org/10.1111/jdv.15340

Gisondi P, Altomare G, Ayala F, et al. Italian guidelines on the systemic treatments of moderate-to-severe plaque psoriasis. J Eur Acad Dermatol Venereol 2017;31:774–90. DOI: https://doi.org/10.1111/jdv.14114

Lambert JLW, Segaert S, Ghislain PD, et al. Practical recommendations for systemic treatment in psoriasis in case of coexisting inflammatory, neurologic, infectious or malignant disorders (BETA-PSO: Belgian Evidence-based Treatment Advice in Psoriasis; part 2). J Eur Acad Dermatol Venereol 2020;34:1914–23. DOI: https://doi.org/10.1111/jdv.16683

Gossec L, Baraliakos X, Kerschbaumer A, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis 2020;79:S700–12. DOI: https://doi.org/10.1136/annrheumdis-2020-217159corr1

Menter A, Strober BE, Kaplan DH, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. J Am Acad Dermatol 2019;80:1029–72. DOI: https://doi.org/10.1016/j.jaad.2018.11.057

Menter A, Gelfand JM, Connor C, et al. Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management of psoriasis with systemic nonbiologic therapies. J Am Acad Dermatol 2020;82:1445–86. DOI: https://doi.org/10.1016/j.jaad.2020.02.044

Elmets CA, Lim HW, Stoff B, et al. Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy. J Am Acad Dermatol 2019;81:775–804. DOI: https://doi.org/10.1016/j.jaad.2019.04.042

Elmets CA, Korman NJ, Prater EF, et al. Joint AAD-NPF Guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures. J Am Acad Dermatol 2021;84:432–70. DOI: https://doi.org/10.1016/j.jaad.2020.07.087

Elmets CA, Leonardi CL, Davis DMR, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. J Am Acad Dermatol 2019;80:1073–113. DOI: https://doi.org/10.1016/j.jaad.2018.11.058

De Pasquale R, Foti R, Pettinato M, Visalli E. Psoriasis and Psoriatic Arthitis. The experience of the P.O. “Vittorio Emanuele” Catania: PDTA presentation. Exp Manag Psoriatric Arthitis (EMPATHY). 2019.

Malara G. Percorso Diagnostico Terapeutico Assistenziale (PDTA) del paziente con Psoriasi [Diagnostic Therapeutic Assistance Path of patients with Psoriasis]. 2020. https://ospedalerc.it/files/simonecarullo/PDTA/pdta psoriasi.pdf. Accessed 8 Feb 2022.

Visalli E, Crispino N, Foti R. Multidisciplinary Management of Psoriatic Arthritis: The Benefits of a Comprehensive Approach. Adv Ther 2019;36:806–16. DOI: https://doi.org/10.1007/s12325-019-00901-0

Gisondi P, Fargnoli MC, Amerio P, et al. Italian adaptation of EuroGuiDerm guideline on the systemic treatment of chronic plaque psoriasis. Ital J Dermatol Venerol 2022;157:1-78. DOI: https://doi.org/10.23736/S2784-8671.21.07132-2

Cusano, F., Sampogna, F., Brunasso Vernetti, A. M. G., Stisi, S., Sandri, G., Malara, G., Naldi, L., Pellegrino, M., Tripepi, G. L., di Luzio Paparatti, U., Agnusdei, C. P., Bonifati, C., Celano, A., Corazza, V., D’Agostino, F., De Pasquale, R., Filippucci, E., Foti, R., Galdo, G., Gai, F., Ganzetti, G., Graceffa, D., Maccarone, M., Mazzotta, A., Melchionda, G., Molinaro, F., Paoletti, F., Tonolo, S., Vercellone, A., Vitetta, R., Massone, C. ., & Sebastiani, G. D. (2022). A consensus-based approach on the management of patients with both psoriasis and psoriatic arthritis in the dermatological and rheumatological settings in Italy: The ADOI PSO-Amore Project. Dermatology Reports, 14(3). https://doi.org/10.4081/dr.2022.9541

Downloads

Download data is not yet available.

Citations