NICE is issuing new guidelines aimed at getting family doctors to think about how psoriasis might be affecting the daily lives of their patients.
In its first clinical guideline on the assessment and management of the condition, NICE advises GPs and other healthcare professionals to assess the impact that psoriasis has on the physical, psychological and social wellbeing of their patients.
They should do this when they first see their patients, before they refer them to specialists, and when they monitor how they are responding to treatments, according to the Institute.
Psoriasis is a skin condition characterised by red, flaky, crusty patches of skin covered with silvery scales. It is believed to affect up to 2.2% of the UK population - around 1.3 million people - with most cases seen in young people and adults under the age of 35.
The disease can contribute to low self-esteem, anxiety, embarrassment and depression, much like other chronic conditions – but NICE says this may be overlooked by healthcare professionals. For example, over a third of people who have psoriasis report clinically significant anxiety and depression.
The condition can also affect a person’s participation in social and physical activities, employment and education – it is for these reasons that NICE is looking to raise greater awareness of these elements of the disease to doctors.
Also in its new clinical guideline, NICE advises that everyone with psoriasis should be assessed for psoriatic arthritis on an annual basis, particularly during the first ten years as this is when the condition is most likely to develop.
Around one in seven people who have psoriasis will develop psoriatic arthritis, a progressive condition, which can cause pain, stiffness and swelling in and around the joints. Early diagnosis is important and so annual assessments will allow those with actual or suspected psoriatic arthritis to be referred to specialists sooner.
Dr Catherine Smith, a consultant dermatologist who chaired the development of the NICE guideline, said: “Psoriasis is much more than a skin irritation. The condition can have profound functional, psychological and social effects on a person’s life. It is vital that GPs and other healthcare professionals recognise these possible consequences when they first see their patients, and that they routinely assess the impact that the disease is having on their daily lives.”
NICE already recommends a number of drugs for the condition, including Pfizer’s Enbrel (etanercept), Abbott’s Humira (adalimumab) and Janssen’s Remicade (infliximab).
Psoriasis care ‘failing patients’
Meanwhile a new report: ‘Recognising the life impact of psoriasis’ released by Paul Beresford MP, chair of the All Parliamentary Group on Skin, has unveiled an urgent need for multi-disciplinary care for people suffering with psoriasis.
The report comes as part of a new collaboration between the Psoriasis Association and the Mental Health Foundation as part of the ‘See Psoriasis: Look Deeper’ campaign, which is partly funded by Abbott.