Arcutis Biotherapeutics, Inc. recently shared findings from the Skin Insights: Uncovering Psoriasis Survey, a national survey of 507 adults 18+ diagnosed with plaque psoriasis who are on topical treatments. The online survey was conducted by The Harris Poll and was designed to reveal insights into the emotional impact of the disease and challenges related to currently available topical treatments. 

“The results from this survey illuminate the ongoing difficulties individuals with psoriasis are experiencing with their disease, as well as with their topical treatments,” said Frank Watanabe, President and CEO of Arcutis. “The insights for individuals with intertriginous psoriasis in particular are critical to increasing understanding of the significant negative impact the disease can have on emotional wellbeing, and the factors that may significantly contribute to overall disease burden for those living with psoriasis.”

The survey was conducted among 507 adults (18+) in the US with psoriasis who use topical treatments but are not on biologics. Of the 507 people surveyed, a subset of 320 respondents reported having psoriasis in intertriginous areas at some point in time. Intertriginous areas include areas of skin-on-skin contact such as the armpits, under the breasts, stomach folds, between the buttocks, and in the groin area.

Overall, individuals living with psoriasis want more effective and simpler to use topical treatment options. While topical therapy continues to be the standard of care for the vast majority of people living with plaque psoriasis in the United States, there hasn't been an FDA approval for a topical psoriasis therapy with a novel mechanism of action in over 20 years.

When asked about what they wished for when it came to using topical treatments, among all people surveyed:

• 90% wish there were more effective topical treatment options
• 90% wish they could use a single therapy anywhere on their body
• 81% wish they had more topical treatment alternatives to steroids 
• 68% want a product that provides both improvement in plaques and itch relief (68%). 

Additionally, of the respondents with psoriasis in intertriginous areas, 52% said they needed to use different topical treatments for different parts of their body, and described doing so to be time consuming (54%), expensive (40%), and frustrating (38%).

The survey also found there is a need for greater awareness, understanding, and identification of psoriasis that occurs in intertriginous areas. The survey’s finding that 64% of respondents have experienced psoriasis in intertriginous areas at some point in time is significantly higher than past epidemiological studies have suggested. Psoriasis may look different in intertriginous areas than in other areas of the body, potentially making it challenging to recognize or diagnose. Two in 5 survey respondents with psoriasis in intertriginous areas (40%) did not recognize they had intertriginous psoriasis symptoms until they saw pictures of intertriginous plaques.

Psoriasis in intertriginous areas can have a profoundly negative emotional and sexual impact. 

• Roughly three in four with psoriasis in intertriginous areas said dealing with psoriasis in these areas affected their wellbeing, including making them feel embarrassed (80%), anxious (79%), and depressed (69%).

• Nearly half of those with psoriasis in intertriginous areas (45%) reported a strong or very strong negative impact on sexual distress/anxiety, with more than a third reporting a negative impact on intimate relationships (39%) and sexual function (37%).

Most individuals with intertriginous psoriasis do not show their health care provider psoriasis in intertriginous areas of their body, suggesting a need for more dialogue between patients and their healthcare providers about the occurrence of psoriasis in intertriginous areas and treatment options.

Variability in exam routines include whether or not patients feel comfortable showing areas of skin that are “private” or covered by clothing, or whether or not patients are asked to disrobe.

• 64% of respondents with intertriginous disease avoid showing their healthcare providers intertriginous areas of their body, with the most common reason reported as embarrassment (27%). For example, psoriasis symptoms between the buttocks are the most common for these patients, yet 81% do not typically show this area of their body to their healthcare provider. 
• In addition, 43% of intertriginous patients that use different treatments for different parts of their body report using treatments on areas of their skin they did not discuss with their healthcare provider, and 31% of those with intertriginous psoriasis report using treatments for longer than prescribed by their healthcare provider.

“Psoriasis in intertriginous areas can be especially challenging for both those living with this condition as well as for their healthcare providers. People are either unaware or embarrassed about their psoriasis in these areas and shy away from showing or discussing their symptoms during an examination,” stated Dr. Teri Greiling, MD, PhD, Associate Professor and Vice-Chair of Dermatology Oregon Health & Science University.  “As a result, not only will patients continue to struggle with their physical symptoms, but also often experience psychological and emotional distress due to their condition. These survey results underscore the need for a more open dialogue between patients and their healthcare providers when it comes to the management of psoriasis in intertriginous areas.”

More information and additional findings from the survey are available online.