Welcome

The Psoriasis toolkit is a resource to support healthcare professionals in identifying, managing and reviewing patients living with psoriasis in the primary care setting. It is only intended for use by qualified healthcare professionals and staff working in healthcare organisations in the United Kingdom.

Before accessing the toolkit, please confirm:

I am a UK based healthcare professional

The development of the toolkit and its delivery has been funded by Leo Pharma. The content has been developed in accordance with the ABPI code and has been reviewed for compliance.

UK MAT 82713 May 2025

Identifying, managing and reviewing psoriasis in primary care

A toolkit to improve the clinical care of people living with psoriasis

Includes a succinct and user-friendly template, four targeted search reports and three alerts. FREE to download

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More information
Overview What is Psoriasis Features

Prioritising psoriasis patients for review

The Psoriasis Audit and Review Toolkit is a simple resource designed to support practitioners in identifying and proritising those patients who will most benefit from a psoriasis review without contributing unduly to practice workload burden. The toolkit comprises a series of discrete searches and alerts quickly highlighting patients whose condition may be undiagnosed, poorly controlled and/or sub-optimally managed. It also includes an intuitive, concise and user-friendly template that guides practitioners through the key elements of a psoriasis review.

What is Psoriasis?

One in four people in England and Wales (13.2m) see their GP about a dermatological condition every year (1). Psoriasis is one of the most common skin conditions in the UK and, whilst many people with milder symptoms often self-treat and never seek medical advice, it is thought to affect 2.1 million people or around 3% of the general population (2).

Psoriasis affects 2.1 million people in the UK (2)

Psoriasis is a complex, chronic condition requiring long-term management. Whilst it often follows a relapsing and remitting course with intermittent flare ups, pathology can be unpredictable. Some patients have mild disease that remains stable for many years, while for others, psoriasis can quickly progress to moderate-to-severe disease (3). There are several different forms of psoriasis, which can make diagnosis difficult. Indeed, research suggests that the diagnosis of psoriasis may be missed or delayed in UK primary care by up to 5 years, leading to a detrimental delay in treatment (4).

Diagnosis of psoriasis in the UK may be delayed by up to 5 years (4)

Chronic plaque psoriasis is the commonest type accounting for 80% (5) to 90% (6) of cases and can occur as large plaque, small plaque or guttate psoriasis. Although this can occur anywhere on the body, the most frequently affected sites are the knees, elbows, and the lower back. Pustular psoriasis is the second most common type and usually affects the palms of the hands and the soles of the feet (7).

Psoriasis is more than just a skin condition however, and it can affect people physically, socially and psychologically. Quality of life is often significantly impaired even when a small percentage of body surface area is affected, with patients experiencing stigmatisation, social exclusion and discrimination (8). In turn, this can impact the mental health of those affected, leading to time off work or school, loss of earnings, sleep loss, loneliness and avoidance of social engagements (8,9,10,11,12,13).

Individuals with psoriasis are also reported to be at increased risk of developing other serious clinical conditions: approximately 75% will have at least one comorbid condition, with many having multiple comorbidities (9). Around 1 in 4 people with psoriasis – 325,000 people, or around 0.5% of the UK population – are estimated to develop associated psoriatic arthritis, which causes pain and swelling in the joints and tendons, accompanied by stiffness particularly in the mornings (14).

Seventy-five per cent of people with psoriasis will have at least one comorbid condition with many having multiple comorbidities. (9)

However, whilst psoriatic arthritis is often assumed to be the most common comorbidity in people with psoriasis, it is actually cardiometabolic disease — obesity and the combination of atherosclerosis, diabetes, and dyslipidemias (15). A higher prevalence of modifiable risk factors for cardiovascular disease (16), means that people with psoriasis and psoriatic arthritis are at a substantially higher risk for myocardial infarction and the risk increases with rising severity of psoriatic disease (16,17). Patients with psoriasis are estimated to have a 5-year shorter life expectancy, most frequently due to cardiovascular disease (18), and as a result the British Association of Dermatologists recommends that patients with psoriasis should always be assessed for cardiovascular risk factors (19). Researchers have also indicated that patients with moderate to severe psoriasis should be screened and aggressively treated for cardiovascular disease risk factors (18).

Patients with psoriasis have a 5-year shorter life expectancy, most frequently due to cardiovascular disease, and should be assessed for cardiovascular risk factors. (18,19)

Despite the personal impact of psoriasis and psoriatic arthritis on people, adherence to topical regimes appears to be poor with some research indicating that patients fail to redeem nearly 50% of their initial prescriptions (20) and 39% of patients are non-compliant with their recommended treatment regime (21).

Patients fail to redeem nearly 50% of their initial prescriptions (20)

Features

Template

Easy-to-use psoriasis review template to support optimal patient management.

Reports & Alerts

Practical search reports and protocol alerts to identify patients displaying signs of poor disease control.

Identification

Identifies psoriasis patients missing a coded diagnosis, whose condition maybe uncontrolled and at increased cardiovascular risk.

Free to Use

Available to download and free to use. Compatible with EMIS Web.

Partnership

Developed in partnership between the Midlands Practice Pharmacy Network, NECS and Prescribing Decision Support Ltd at Keele University.

Contributors

With special thanks to the following who provided clinical and technical expertise to support the toolkit’s development:

Jaz Dhillon, Clinical Pharmacist, Walsall and committee member of the Midlands Practice Pharmacy Network.
Dr Stephanie Gallard, GPwSI in Dermatology, Liverpool University Hospitals NHS Foundation Trust and executive committee member of the Primary Care Dermatology Society.
Katie Horton, Claims and Administration Manager, Walsall.
Javed Iqbal, Clinical Pharmacist, Cannock.
Mei Kee Kok, Clinical Pharmacist, Shropshire.
Bharat Patel, Clinical Pharmacist, Walsall and Chair of the Midlands Practice Pharmacy Network.
Dr Julian Peace, Speciality Doctor in Dermatology, Barnsley; Executive Chair of the Primary Care Dermatology Society.
Dr Ahsan Raza, GPwER and Clinical Lead for South Lancashire, Community Dermatology, Clitheroe.
Jagdeep Sangha, Pharmaceutical Advisor, Dudley Integrated Health & Care NHS Trust.
Arfaan Sultan, Clinical Pharmacist, Dudley.
NECS (North of England Commissioning Support) Primary Care Data Quality Team.

References

1. Association of the British Pharmaceutical Industry Dermatology Initiative. Making real our shared vision for the NHS: optimising the treatment and care of people with long-term skin conditions in England. 2018. Available at https://www.abpi.org.uk/media/4qvbpc3y/der-0080-0517-dermatology_initiative_report_rev16.pdf. Last accessed April 2025.
2. Thomas S, Thomas S and Mehta S (Wilmington Health). More than Skin Deep: The Underlying Burdens of Psoriasis and Psoriatic Arthritis. December 2021.
3. Griffiths CEM et al. Psoriasis. Lancet. 2021;397(10281):1301–1315.
4. Abo-Tabik, M. et al. Mapping opportunities for the earlier diagnosis of psoriasis in primary care settings in the UK: results from two matched case-control studies. Br. J. Gen. Pract. 2022; 72, e834–e841.
5. Yoo LJH, Storan E. Chronic plaque psoriasis. DermNet 2023. Available at https://dermnetnz.org/topics/chronic-plaque-psoriasis. Last accessed April 2025.
6. Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370(9583):263–71.
7. McKechnie D. Patient.info. 2023. Available at https://patient.info/skin-conditions/psoriasis-leaflet. Last accessed April 2025.
8. WHO Global Report on Psoriasis 2016. Available at: https://www.who.int/publications/i/item/9789241565189. Last accessed April 2025.
9. Lebwohl MG et al. J Am Acad Dermatol 2014;70(5):871-81.
10. World Psoriasis Happiness Report 2018. Available at https://psoriasishappiness.report/. Last accessed April 2025.
11. Warren RB et al. Br J Dermatol 2011;164 Suppl1:1-14.
12. Dubertret L et al. European patient perspectives on the impact of psoriasis: the EUROPSO patient membership survey. Br J Dermatol. 2006;155:729–736.
13. De Korte J et al. Quality of life in patients with psoriasis: a systematic literature review. J Investig Dermatol Symp Proc. 2004;9(2):140–7.
14. Psoriasis and psoriatic arthritis statistics. The Psoriasis and Psoriatic Arthritis Alliance. Available at https://www.papaa.org/. Last accessed April 2025.
15. Gelfand JM et al. Cardiovascular Effects of Psoriasis: The Importance of Making the Connection. Medscape 2024.
16. Garshick MS et al. Cardiovascular Risk in Patients With Psoriasis: JACC Review Topic of the Week. J Am Coll Cardiol. 2021; 77(13):1670–1680.
17. Gelfand JM et al. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296(14): 1735–1741.
18. Siegel, D et al. Inflammation, Atherosclerosis, and Psoriasis. Clinic Rev Allerg Immunol. 2013;44:194–204.
19. British Association of Dermatologists. Dermatology Referral Management Guidelines / Psoriasis. Accessed June 2024.
20. Storm A et al. One in 3 prescriptions are never redeemed: primary nonadherence in an outpatient clinic. J Am Acad Dermatol. 2008;59(1):27–33.
21. Richards HL et al. Patients with psoriasis and their compliance with medication. J Am Acad Dermatol. 1999;41(4):581–3.

01782 479790
enquiries@pds-keele.co.uk

Prescribing Decision Support, Centre for Medicines Optimisation, The Hornbeam, Keele University, Keele, Staffordshire, ST5 5BG.

Developed in partnership between the Midlands Practice Pharmacy Network and Prescribing Decision Support Ltd at the Centre for Medicines Optimisation, Keele University. Both parties reserve the right to update and change the Toolkit at any time in order to address changes in clinical guidance and best practice, improve functionality and reflect changing user and business needs. Both parties also reserve the right to withdraw the Toolkit if and when its content is out of date and no longer consistent with clinical guidance.

UK MAT 82713 May 2025

© 2025 PDS Ltd

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This non-promotional Toolkit is intended for UK healthcare professionals only.
The development of the toolkit and its delivery has been funded by Leo Pharma. The content has been developed in accordance with the ABPI code and has been reviewed for compliance.