Findings on psoriasis flare and mental health during the COVID-19 pandemic
Describing the burden of the COVID-19 pandemic in people with psoriasis: findings from a global cross-sectional study
Journal of the European Academy of Dermatology & Venereology. 2021; article in press
The pandemic has caused a rise in mental health illness in the general population and reduced access to routine healthcare. This has led to concern over the physical and psychological impact of the pandemic on people with psoriasis. We wanted to better understand this impact to inform immediate priorities for clinical care.
To do this, we invited people with psoriasis to provide information on their psoriasis and mental health. We collected this information through a series of structured questions in a web-based survey for people with psoriasis called PsoProtectMe (www.psoprotectme.org).
Four thousand and forty-three people (without COVID-19) from 86 countries (most frequently UK [2,215, 55%], USA [243, 6%], Portugal [227, 6%]) completed the PsoProtectMe survey between May 2020 and January 2021 (average age 47 years; more women [2,684, 66%] than men [1,359, 34%]). One thousand, seven hundred and twenty-eight participants (43%) reported that their psoriasis got worse during the pandemic.
A greater proportion of those reporting worsening psoriasis had signs of anxiety or depression (47%) compared to those without worsening psoriasis (29%). Individuals were also more likely to have worsening psoriasis in the pandemic if they were female, obese, shielding (not leaving home and minimising all face-to-face contact) or not taking their tablet or injection treatments for psoriasis (immunosuppressants). The commonest reason for patients to decide to stop treatment was a concern over complications related to COVID-19. This an important observation since current guidelines recommend continuing immunosuppressants to maintain disease control.
This study identifies a major burden of the pandemic in people with psoriasis: worsening psoriasis is common and is associated with poor mental health. Access to psychological support may help to reduce potentially long-lasting effects of the pandemic on people with psoriasis. The study also identifies a need for healthcare professionals to discuss and address their patients’ concerns around the risk of taking their tablet/injection treatment for psoriasis in the pandemic.