Journey of Patients with Psoriasis in an Italian Tertiary Centre, an 11-year Retrospective Analysis.

Abstract

Despite the improvement of psoriasis treatment achieved with the use of biological therapies, some patients still require hospitalization. A retrospective study was conducted including patients affected by psoriasis hospitalized at Fondazione Policlinico Agostino Gemelli IRCCS in Rome, from 1 January 2012 to 1 August 2023, to describe the psoriasis patient journey. Of the 2.223 patients with psoriasis, 1,500 had it as the primary diagnosis. Some 93.2% (2,071/2,223) of patients were affected by plaque psoriasis, 4.8% (108/2,223) presented with erythrodermic psoriasis, and 2.0% (44/2,223) had generalized pustular psoriasis. 1,455/2,223 (65.5%) reported in their medical history psoriatic arthritis, and 771/2,223 (34.7%) hypertension; 328/2,223 (14.8%) psoriatic patients accessed the emergency department (ED), 291 of whom (13.1%) were subsequently hospitalized in different inpatient clinics, while 37 (1.6%) were then discharged. Inpatient clinic admission after ED was required more frequently in generalized pustular or erythrodermic psoriasis (47.7% and 38% respectively) compared with plaque psoriasis (11%). Patients admitted to an inpatient clinic after ED had a longer recovery compared with those admitted electively to an inpatient clinic (13.6 days vs 7.7 days, p < 0.001). Only 490/2,223 (20.9%) patients were admitted to a dermatology service. This study showed a shift in patient management rather than a reduction in hospitalizations.