ABSTRACT
INTRODUCTION: In daily practice management of psoriasis, evaluation of risk factors for infections is having a growing influence. Indeed, in psoriatic patients, risk of infections may be due to psoriasis itself, immunomodulatory therapy, and comorbidities that may increase this risk and patient hospitalization. AREAS COVERED: Given the greater understanding of psoriasis pathogenesis and the increasing number of treatment options, it is particularly important to customize therapy according to each, single patient; psoriasis features and comorbidities are also essential to tailor treatment goals. EXPERT OPINION: In this perspective, the current knowledge on the infectious risk in psoriatic patient, related to comorbidities, such as diabetes mellitus, cardiovascular disease, and chronic obstructive pulmonary, to 'special populations,' to chronic infections, such as latent tuberculosis, chronic hepatitis B and C, and HIV, and to the most recent Covid-19 pandemic scenario, is reviewed and discussed in order to suggest the most appropriate approach and achieve the best available therapeutic option.
Subject(s)
COVID-19/prevention & control , Psoriasis/therapy , Risk Assessment/methods , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , COVID-19/virology , Cardiovascular Diseases/epidemiology , Comorbidity , Humans , Pandemics , Psoriasis/epidemiology , Risk Assessment/statistics & numerical data , Risk Factors , SARS-CoV-2/physiology , Virus Diseases/epidemiologyABSTRACT
BACKGROUND: The beginning of 2020 has been marked by COVID-19 pandemic, with a strong impact on several national health systems worldwide. OBJECTIVE: To describe the impact of COVID-19 pandemic in a cohort of Italian psoriatic patients treated with biologics. METHODS: A telephone survey was conducted in May 4-10 2020 about the Italian lockdown period (March 9-May 3 2020) in a cohort of psoriatic patients treated with biologics, asking about any exposure to COVID-19, disease status, continuation of therapy, work activity and psychological status through Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS) and Brief Resilience Scale (BRS). RESULTS: 226 patients were interviewed, with no COVID-19 positive cases. Sixty-three of 226 (27.9%) described worsening of the disease with a correlation to drug withdrawal [43/226 (19%)]. Correlation was also found between the worsening of psoriasis and HADS anxiety, HADS depression, BRS and PSS abnormal scores considered both as categorical and continuous variables. No correlation was found between worsening of psoriasis and work activity. CONCLUSION: Uncertainty about whether biologics could increase the risk of SARS-CoV-2 infection led to drug withdrawal with subsequent worsening of psoriasis. Moreover, psychological status also had a direct influence on the clinical course of the disease.