Coordinated Care Strategies for Psoriasis: Structured Referral Algorithms for Comorbidities

Overview

Psoriasis is a systemic inflammatory disease with frequently underdiagnosed comorbidities due to fragmented care. This study developed five multidisciplinary referral algorithms to guide dermatologists in timely identification and referral of psoriasis-associated comorbidities, aiming to improve patient outcomes through coordinated care.

Background

Psoriasis affects 1.9% to 2.3% of the Spanish population and is increasingly recognized as a multisystem disorder with significant comorbidities including psoriatic arthritis, inflammatory bowel disease, hepatic and endocrine disorders, and depression. Early diagnosis and intervention of these comorbidities are critical to improving quality of life. Current guidelines lack standardized, practical referral pathways, leading to delays in specialist care. This study addresses this gap by creating structured, multidisciplinary referral criteria to streamline cross-specialty coordination.

Data Highlights

Key Findings

• Psoriasis is a systemic inflammatory disease with high prevalence of multisystem comorbidities often underdiagnosed due to fragmented care.
• Five referral algorithms were developed for rheumatology, gastroenterology, hepatology, endocrinology/internal medicine, and psychological care to guide dermatologists.
• A three-phase methodology (literature review, specialty focus groups, nominal group consensus) ensured evidence-based and expert-validated pathways.
• Referral criteria include patient profiles, symptoms, investigations, and laboratory tests tailored to each comorbidity.
• Multidisciplinary pathways aim to reduce diagnostic delays, improve cross-specialty coordination, and enhance comprehensive care for psoriasis patients.

Clinical Implications

Dermatologists should adopt these structured referral algorithms to systematically screen for and identify psoriasis-associated comorbidities. Early and clear referral to appropriate specialists can mitigate disease burden and improve patient quality of life. Integrating these pathways into routine dermatology practice can streamline multidisciplinary collaboration and optimize comprehensive management.

Conclusion

This study provides a practical, multidisciplinary framework for timely identification and referral of psoriasis comorbidities, addressing a critical gap in current care. Implementation of these coordinated care strategies has the potential to improve outcomes and quality of life for patients with psoriasis.

References

1. European Academy of Dermatology and Venereology (EADV) -- Psoriasis Multisystem Nature
2. Spanish Academy of Dermatology and Venereology (AEDV) -- Psoriasis Guidelines
3. American Academy of Dermatology (AAD) -- Psoriasis Comorbidity Management
4. Scientific Committee of Coordinated Care Strategies for Psoriasis -- Coordinated Care Strategies for Psoriasis Study