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Updated: Sep 30, 2025
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Implementation of Recommendations for the Management of Psoriasis During Preconception, Pregnancy, Postpartum,
I Belinchón1, S Armesto2, P de la Cueva3
1Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España.
Insights
Dermatologists know psoriasis management guidelines for pregnancy but rarely implement them due to barriers like time and data. Treatment often stops during pregnancy, with exceptions for specific topical and biologic therapies during breastfeeding.
Area of Science:
- Dermatology
- Obstetrics
- Public Health
Background:
- Psoriasis management during preconception, pregnancy, and postpartum requires specific guidelines.
- The Psoriasis Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) published recommendations for this patient group.
- Understanding the implementation degree of these recommendations is crucial for improving patient care.
Purpose of the Study:
- To analyze the extent to which dermatologists implement AEDV recommendations for psoriasis management in women of childbearing potential.
- To identify barriers hindering the adoption of these guidelines in clinical practice.
Main Methods:
- A structured online survey with closed questions was designed.
- The survey was distributed to members of the Psoriasis Working Group via email.
- Sociodemographic, professional, and practice-related data were collected and analyzed using descriptive statistics.
Main Results:
- 96% of 53 respondents were familiar with the recommendations, but few worked in multidisciplinary units or had specific protocols.
- 70% of dermatologists inquire about pregnancy plans, with women receiving more preconception advice than men.
- Most topical and conventional systemic treatments are interrupted during pregnancy; biologics are often discontinued in the third trimester, with certolizumab pegol being an exception. Topical treatments, phototherapy, and certolizumab pegol are used in breastfeeding mothers.
Conclusions:
- While AEDV psoriasis management recommendations are widely recognized, significant gaps exist in their clinical implementation.
- Lack of time, support, and robust data are primary barriers to guideline adherence.
- Further efforts are needed to integrate these recommendations into routine dermatological and perinatal care.
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 Venereology (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 pregnancy 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 preconception 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 biologics 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.
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