Acta Dermato-Venereologica 99-1CompleteContent | Page 11

18 CLINICAL REPORT Prevalence of Psoriasis and Psoriatic Arthritis and Patient Perceptions of Severity in Sweden, Norway and Denmark: Results from the Nordic Patient Survey of Psoriasis and Psoriatic Arthritis Kjersti DANIELSEN 1,2 , Albert DUVETORP 3,4 , Lars IVERSEN 5 , Mikkel ØSTERGAARD 6 , Oliver SEIFERT 3,7 , Kåre STEINAR TVEIT 8 and Lone SKOV 9 UiT, The Arctic University of Norway, 2 University Hospital of North Norway, Tromsø, Norway, 3 Linköping University, Linköping, Sweden, Skånes Universitetssjukhus, Malmö, Sweden, 5 Aarhus University Hospital, Aarhus, Denmark, 6 University of Copenhagen, Copenhagen, Denmark, 7 Ryhov Hospital, Jönköping, Sweden, 8 Haukeland University Hospital, Bergen, Norway, and 9 Herlev and Gentofte Hospital, University of Copenhagen, Denmark 1 4 Optimal clinical management of psoriasis and psoria- tic arthritis (PsA) requires understanding of the impact on patients. The NORdic PAtient survey of Psoriasis and PsA (NORPAPP) aimed to obtain current data on disease prevalence and patient perceptions in Swe- den, Denmark and Norway. Among 22,050 individuals questioned, the reported prevalence of psoriasis and/ or PsA was 9.7% (5.7% physician-diagnosed plus 4.0% self-diagnosed only); prevalence was similar in Sweden (9.4%) and Denmark (9.2%) but significantly higher in Norway (11.9%). Of those reporting a physician’s diag- nosis, 74.6% reported psoriasis alone, 10.3% PsA alone and 15.1% both. Patients with PsA perceived their di- sease to be more severe than those with psoriasis; pa- tients with PsA and psoriasis reported greater disease severity than those with each condition alone. Patient’s perceptions of psoriasis severity correlated weakly (Spearman’s rho 0.42) with clinical severity; both pa- tient perceptions and clinical measures are important in the assessment and management of psoriasis. Key words: psoriasis; psoriatic arthritis; severity; prevalence; diagnosis. Accepted Aug 7, 2018; Epub ahead of print Aug 7, 2018 Acta Derm Venereol 2019; 99: 18–25. Corr: Kjersti Danielsen, Department of Dermatology, University Hospi- tal of North Norway, NO-9038 Tromsø, Norway. E-mail: kjerstidaniel- [email protected] P soriasis (PsO) is a chronic, immune-mediated, in- flammatory skin condition that can have a major im- pact on a patient’s health-related quality of life (HRQoL) (1). Estimates of the global prevalence of PsO in adults span a wide range (0.5–11.4%) and published figures vary according to the region (lower in Asia, higher in Europe), the population studied (general population, hospital cohort, patient registry) and the diagnosis and reporting method (2, 3). Estimates from studies in Norway, Swe- den and Denmark suggest a relatively high prevalence of PsO in the Scandinavian region (2.2–11.4%) (4–10). Approximately 30–35% of individuals with PsO can also develop painful joint inflammation, known as psoriatic arthritis (PsA) (11–14). The timing of PsA symptoms is very variable, although PsA often manifests approx- doi: 10.2340/00015555-3017 Acta Derm Venereol 2019; 99: 18–25 SIGNIFICANCE The NORdic PAtient survey of Psoriasis and Psoriasis arthritis (NORPAPP) collected data on disease prevalence and patient perceptions in Sweden, Denmark and Norway. Among 22,050 individuals questioned, the reported preva- lence of psoriasis and/or psoriatic arthritis was 9.7% (5.7% physician-diagnosed plus 4.0% self-diagnosed only). Of pa- tients with a physician’s diagnosis, 74.6% reported psoria- sis alone, 10.3% psoriatic arthritis alone and 15.1% both. Patients with psoriatic arthritis perceived their disease to be more severe than those with psoriasis; patients with psoriatic arthritis and psoriasis reported greater disease severity than those with each condition alone. Psoriasis is common and has a large impact on patient’s life. imately 10 years after the initial appearance of psoriasis symptoms on the skin (11) it can also precede them. In addition to controlling the clinical manifestations of PsO and PsA, optimal clinical management of these conditions requires a clear understanding of the impact of the disease on individual patients, taking into consi- deration their own perception of severity and treatment success (15, 16). Numerous small patient surveys (sum- marized by Lebwohl et al. in 2014 (17)) carried out over the past 50 years have provided useful information about the prevalence and treatment of PsO, but few were population-based and many lacked information on pa- tient perceptions. To address this gap, the Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey was carried out in 2012 (17). While the MAPP survey provided much valuable information, it excluded the Nordic countries. The NORdic PAtient survey of Psoriasis and Psoriatic arthritis (NORPAPP) was conducted to gain a better understanding of patients with PsO and PsA in Sweden, Denmark and Norway. The purpose of the NORPAPP was to provide some insight into the main challenges faced by people living with PsO and PsA in these countries and to understand the patients’ perspectives on their disease, communication with the healthcare system and the different treatments prescribed. In this paper, we describe the NORPAPP survey population and results relating to disease diagnosis, prevalence and This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica.