Management of Psoriasis by Family Physicians: Referral Algorithm and Shared Management with Dermatology

Authors

  • Tiago Torres Departamento de Dermatologia. Centro Hospitalar Universitário do Porto. Porto. Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto. Porto. Instituto Médico de Estudos Imunológicos. Porto.
  • Martinha Henrique Serviço de Dermatologia. Centro Hospitalar de Leiria. Leiria.
  • Hugo Oliveira Unidade de Fototerapia. Consulta de Fototerapia e Psoríase. Serviço de Dermatologia. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Madalena Rodrigues Unidade de Saúde Familiar Castelo. Agrupamento de Centros de Saúde Arrábida. Sesimbra.
  • Paulo Ferreira Unidade de Psoríase. Hospital CUF Descobertas. Lisboa.
  • Paulo Morais Serviço de Dermatologia. Centro Hospitalar de Trás-os-Montes e Alto Douro. Vila Real.
  • Sérgio Alves Serviço de Dermatologia. Hospital das Forças Armadas. Porto. Portugal.
  • Tiago Castro Lopes Unidade de Saúde Familiar Serzedelo. Agrupamento de Centros de Saúde Alto Ave. Guimarães.
  • Rui Cernadas Serviços de Saúde Ocupacional. Continental Mabor. Lousado.

DOI:

https://doi.org/10.20344/amp.13159

Keywords:

Dermatology, Family Medicine, General Practice, Psoriasis/therapy, Referral and Consultation

Abstract

Introduction: The implementation of models capable of improving referral quality, limiting the growth of waiting lists in hospitals, and ensuring the best possible treatment and follow-up of the psoriatic patient is of the utmost importance.
Material and Methods: A panel of Family Physicians and Dermatologists discussed and created a simple and effective algorithm of referral for patients with psoriasis.
Results: The proposed algorithm starts when the Family Physician suspects of psoriasis. In case of diagnostic doubt, the patient should be referred to Dermatology. In case of a confirmed diagnosis, the Family Physician should assess the patient’s severity and responder profile, evaluate comorbidities and assess the presence of psoriatic arthritis. If psoriasis is mild, topical treatments should be initiated, and if there is no clinical improvement or worsening of the disease, the patient should be referred to Dermatology. If psoriasis is moderate to severe, is located in high impact locations, or in pediatric age, the patient should be referred to Dermatology. In order to enable shared management in terms of follow-up and treatment of these patients, it is critical that the Family Physician has the necessary knowledge regarding the systemic treatments used in psoriasis and their side effects.
Discussion and Conclusion: Only a shared management of the psoriatic patient can allow for the best treatment and follow-up of these patients, a more rational use of available medical resources, thus giving the patient the best possible quality of life.

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Author Biography

Tiago Torres, Departamento de Dermatologia. Centro Hospitalar Universitário do Porto. Porto. Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto. Porto. Instituto Médico de Estudos Imunológicos. Porto.

Assistente Hospitalar no Serviço de Dermatologia do Centro Hospitalar e Universitário do Porto Professor Auxiliar Convidado, Mestrado Integrado em Medicina do Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto

Published

2021-10-01

How to Cite

1.
Torres T, Henrique M, Oliveira H, Rodrigues M, Ferreira P, Morais P, Alves S, Lopes TC, Cernadas R. Management of Psoriasis by Family Physicians: Referral Algorithm and Shared Management with Dermatology. Acta Med Port [Internet]. 2021 Oct. 1 [cited 2024 Jul. 25];34(10):682-9. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13159

Issue

Section

Review Articles