Results of the largest probability survey of patients with psoriasis and psoriatic arthritis (PsA) identified several unmet needs regarding quality of life and functioning that warrant additional attention and action, according to researchers.

Mark G. Lebwohl, MD, professor and chairman of the department of dermatology at The Icahn School of Medicine at Mount Sinai, New York, and colleagues conducted a large, multinational, population-based survey of psoriasis and/or PsA patients in North America and Europe.

The Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey screened 139,948 households, and 3,426 patients completed the survey. The prevalence of psoriasis/PsA ranged from 1.4% to 3.3%; 79% had psoriasis alone and 21% had PsA.

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Patients were selected by list-assisted random digit dialing and at the time of the survey were not required to be receiving treatment, under the care of a health care provider or a member of a patient organization.

When rating disease severity at its worst, 27% (psoriasis) and 53% (PsA ± psoriasis) of patients rated it as severe. Patients with psoriasis indicated that their most bothersome signs or symptoms were itching (43%), scales (23%), and flaking (20%).

Survey results confirmed the “profound effect” of psoriasis on patient quality of life and functioning, as assessed by Dermatology Life Quality Index and 8-item Health Assessment Questionnaire.

“These findings parallel those seen in a recent National Psoriasis Foundation report, which found that for the majority of psoriasis patients, their psoriasis activity had an effect on overall well-being, with greater physical and emotional impact as disease severity increases,” wrote the researchers.

Additionally, surveyed patients reported that the concomitant presence of joint symptoms had a substantial effect on disease severity and burden. In fact, nearly twice as many patients with both psoriasis and PsA rated their disease as severe compared with those with psoriasis alone.

Several unmet needs warrant additional attention and action, including improved severity assessment, psoriatic arthritis screening, and treatment options, according to the researchers.

 “The MAPP survey highlights the importance of screening and assessment of psoriasis patients for symptoms of PsA, the need to establish patient-specific treatment goals — which ensure optimal treatment regimens and realistic expectations with regard to the effectiveness and tolerability of available treatments — and the ongoing need for safe and effective therapies for patients with psoriasis and PsA,” wrote the researchers.


  1. Lebwohl MG. J Am Acad Dermatol. 2014;70:871-81.


See the complete study for a list of disclosures.