Implementation of Recommendations for the Management of Psoriasis During Preconception, Pregnancy, Postpartum, Breastfeeding, and Perinatal Care

Autores de IDIVAL

• 

  Susana Armesto Alonso

  Autor

Autores ajenos al IDIVAL

• Belinchón I
• de la Cueva P
• Ferrándiz L
• Díaz RR
• Carrascosa JM

Abstract

Objective: To analyze degree of implementation of recommendations on the management of psoriasis during preconception, pregnancy, postpartum, breastfeeding, and perinatal care published by the Psoriasis Working Group of the Spanish Academy of Dermatology and Venereo-logy (AEDV). Methods: We designed a structured online survey consisting of closed questions. A link was emailed to all the members of the Psoriasis Working Group to collect their anonymous responses. We also collected sociodemographic, professional, and practice-related data related to the goals of the study and then compiled descriptive statistics to analyze the survey findings. Results: We received 53 responses for analysis. Overall, 96% of respondents were familiar with the recommendations, but very few of them worked in multidisciplinary maternity care units or had access to specific protocols on the management of psoriasis before, during, and after preg-nancy in their departments. Seventy percent of dermatologists regularly ask their patients about pregnancy plans, but only 46% ask both men and women. Women also receive more preconcep-tion advice than men (54% vs. 19%). Significant variations were observed in the type of advice given. Ninety percent of the dermatologists interrupt topical treatments during pregnancy, and nearly all suspend conventional systemic drugs with the exception of cyclosporin A. Most bio-logics are also being discontinued in the third trimester, with the exception of certolizumab pegol. Almost all the respondents indicated that they use topical treatments, phototherapy, and certolizumab pegol in breastfeeding mothers. The main barriers to implementing the working group's recommendations are a lack of time, a lack of support, and a lack of robust data. Conclusions: Although the AEDV psoriasis working group's recommendations are widely known, areas for improvement remain. (c) 2022 AEDV. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Copyright © 2022 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Keywords

• Breastfeeding; Embarazo; Fertilidad; Fertility; Implementación; Implementation; Lactancia; Posparto; Postpartum; Pregnancy; Psoriasis; Recomendaciones; Recommendations