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Covid-19’s impact on psoriasis patients receiving infliximab treatment

Psoriasis patients who had their infliximab treatment interrupted during the Covid-19 pandemic had lesion exacerbation and increased anxiety, according to an observational study conducted in China.

The study, published online ahead of print in the journal Dermatologic Therapy (Oct. 30, 2020), followed 56 psoriatic patients who had their infliximab treatment interrupted due to congested hospitals as a result of Covid-19. The aim of the study was to understand the consequences of treatment interruption.

The study’s authors followed up with 56 psoriasis patients who were receiving regular infliximab treatment (5mg/kg) once every eight weeks at the department of dermatology at the Second Xiangya Hospital in China. All 56 patients had their Infliximab treatment stopped due to the dermatology ward closing for two-and-a-half months.

The patients’ pathogenic condition, psychologic status and their solutions to treatment interruption were obtained by telephone follow-up.

Researchers found that all 56 patients showed signs of subclinical anxiety. According to the investigators, the patients were concerned about the effect of treatment interruption on the control of the disease.

The study’s authors saw high rates of recurrence in all subtypes of psoriasis. The most prominent manifestation was thickening of the scales, occurring in 80% of patients. Additionally, more than half of the patients complained the lesions enlarged in size. Joint pain was observed in one erythrodermic psoriasis patient and one plaque psoriasis patient.

The investigators found that when patients used common treatments for psoriasis at home, it partly lightened the stress of relapse. Patients reported that calcipotriol was effective to relieve the thickening of scales. Also, calcipotriol combined with betamethasone limited lesion size, the study’s authors said.

When patients were asked whether they looked for help from telemedicine, most said they were unaware of teledermatology options. None of the 56 patients observed in the study made an appointment with a dermatologist via telemedicine.

“It is necessary for patients to reserve a handful of drugs for unexpected need,” the authors wrote. “The reserved drugs can be seen as temporary substitutes for infliximab. It not only relieves symptoms partly, but also makes patients less uneasy. According to information provided by some patients, calcipotriol and betamethasone can be considered as the reserved drugs.”

The researchers concluded that patients with psoriasis should keep in regular contact with their physicians during the Covid-19 outbreak and make use of telemedicine services during an epidemic outbreak.

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