title: [Treatment of moderate-to-severe psoriasis in clinical practice: a survey of Spanish dermatologists].
abstract: OBJECTIVE
  Various treatment options are available for use in moderate-to-severe psoriasis and election is dependent upon the clinical criteria applied by the attending physician. We undertook a survey among dermatologists to assess the treatment of moderate-to-severe psoriasis currently used in clinical practice in Spain.
  
  
  METHODS
  A cross-sectional study was performed by sending a questionnaire to dermatologists in Spain who treat patients with moderate-to-severe psoriasis. The questionnaire comprised 33 items distributed in 6 sections: profile of the dermatologist, case load, patient profile, follow-up and management of the disease, treatment regimens, and assessment of pharmacological treatments.
  
  
  RESULTS
  According to the responses of the 164 dermatologists surveyed, 6.8% of patients seen in their clinics have moderate-to-severe psoriasis; of those, 45.8% receive systemic treatment and 22.9% are treated with biologic drugs. In many of those patients (50.2%), the dermatologist felt that a change in treatment was necessary; in 51.1% of cases, this change would be from systemic therapy to a biologic drug. The principal reason for the change (50.8%) would be lack of efficacy or the appearance of adverse effects. Efficacy and safety were considered essential criteria in the choice of an appropriate treatment (82.9% and 28.0% of dermatologists, respectively). Patient quality of life was also considered an essential consideration in choice of treatment by 28.0% of dermatologists.
  
  
  CONCLUSIONS
  Optimal treatment for moderate-to-severe psoriasis should be effective and safe, and improve patient quality of life. This makes it essential to use drugs with an excellent efficacy and safety profile.
authors.affiliation: Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen Macarena de Sevilla, Seville, Spain. dmoreno@e-derma.org
authors.forename: D
authors.initials: D
authors.lastname: Moreno-Ramírez
authors.forename: E
authors.initials: E
authors.lastname: Fonseca
authors.forename: P
authors.initials: P
authors.lastname: Herranz
authors.forename: M
authors.initials: M
authors.lastname: Ara
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003880:Dermatology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011565:Psoriasis / Q000188:drug therapy*; D012720:Severity of Illness Index; D013030:Spain; D011795:Surveys and Questionnaires