Assessment and management of psoriasis: summary of NICE guidance

Psoriasis is a common inflammatory skin condition affecting about 1.3–2.2% of the UK population1 and may be associated with psoriatic arthritis.2 People with psoriasis, especially those with severe disease, are also at increased risk of cardiovascular disease,3 diabetes,4 and depression.5 Psoriasis may result in functional, psychological, and social morbidity, even in people with minimal involvement (less than the equivalent of three palm areas). However, doctors, including dermatologists, often fail to appreciate the extent of this disability,6 and many people with psoriasis are dissatisfied with their treatment.6 Yet, highly effective and cost effective treatments are available, and improving outcomes therefore requires better assessment and management of psoriasis, including its impact on a patient’s wellbeing, by healthcare professionals. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on the management of psoriasis.7 NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Principles of care [Based on the experience and opinion of the Guideline Development Group (GDG)] ### Assessment of disease severity and impact, and when to refer for specialist care [Based on the experience and opinion of the GDG]