Effects of the COVİD-19 pandemic on psoriatic disease severity and treatment

Objective: COVID-19 pandemic caused unexpected and drastic changes in the modus operandi of healthcare globally. Psoriasis is a dermatosis that necessitates the provision of special healthcare services in dermatology clinics, due to its chronicity, severe effects on quality of life, and socioeconomic consequences. This study aimed to identify pandemic-related problems experienced by psoriasis patients followed up in our outpatient clinic and their compliance with treatment, thereby revealing the effects of the COVID-19 pandemic on these patients. Materials and Methods: The study included 64 patients with plaque psoriasis who were followed up at the Psoriasis Outpatient Clinic of Aydın Adnan Menderes University Department of Dermatology and Venereology six months before and after the start of the pandemic in Turkey. A questionnaire was used to inquire how the patients were affected by the pandemic; median PASI scores and number of hospital visits were compared with pre-pandemic values. Results: Thirty-six patients (56.3%) stated that the pandemic had no effect on their disease, 20 patients (31.3%) reported a deterioration of their disease. The most common reasons thought to aggravate disease were pandemic-related stress and changes in treatment regimen. Treatment of 43 patients (67.2%) remained the same during the pandemic. There was a change in treatment in 21 patients (32.8%), and 11 patients changed their treatment without contacting our outpatient clinic. The median number of patient visits to our outpatient clinic was three before the pandemic, which dropped to 2 during the first six months of the pandemic (p=0.000). PASI scores were compared on an individual basis and 30 patients (46.9%) in the study group had an increase in their median PASI scores during the pandemic. Conclusion: The COVID-19 pandemic led to fewer patient visits to the hospital and difficulties in managing patient compliance to treatment. Our study showed that approximately half of the psoriatic patients being treated had an increase in the severity of their disease during the COVID-19 pandemic. A considerable percentage of these patients linked this deterioration with the pandemic. Even some patients who were under follow-up in the outpatient clinic and were personally known by the physicians made decisions on their own regarding change in treatment. Developments in communication technologies such as various phone and computer applications enabling better and continuous contact with patients who seek chronic care may prevent interruption of patient follow-up needed in such extraordinary times and emergency situations and may prove valuable in the future.