Few Patients Experience Lasting Control Over Psoriasis

Moderate to severe cases saw few periods of remission over 20-year period, study reports

TUESDAY, Oct. 16 (HealthDay News) --Despite treatment, individuals with moderate to severe psoriasis appear to have a stable course of disease over decades, with few achieving lasting control of their psoriasis, according to the results of a study published in the Archives of Dermatology in September.

Tamar Nijsten, M.D., Ph.D., of Erasmus Medical Center in Rotterdam, the Netherlands, and colleagues assessed the severity of psoriasis over time by analyzing records of 815 patients with moderate to severe psoriasis who were initially treated with psoralen-UV-A (PUVA) in 1975 and 1976. The patients then underwent a series of dermatologic examinations over a 20-year period.

Psoriasis disease activity, as measured by providers on a physician global assessment (PGA) scale, did not change significantly over time, with the exception of more patients reporting remission in 2005 compared to previous years (9.6 percent versus 5.1 percent, p less than .03). Only 14 percent of patients had a change in PGA of more than one level between examinations, and the likelihood of remaining at the same PGA level one year later was 80 percent. Excluding patients who were free of psoriasis at baseline, patients experienced on average one year without psoriasis over the 20-year period.

"Three decades after this large diverse group of patients sought a cure for their psoriasis, they have not achieved consistent control of their disease. Additional prospective longitudinal studies that assess the (natural) course of psoriasis and its determinants are warranted," concluded the authors.

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