Psoriasis Triggers and Disease Activity: Analysis of Survey Data from the PSODEEP1 Study

Numerous patients with psoriasis will associate disease triggers to changes in disease activity over time. Modern treatments induce remission, but relapse is common if the treatment is stopped. Exploring patients' first-hand experiences is a key starting point to identify triggers that may influence disease relapse. A cross-sectional digital questionnaire was distributed to 2716 individuals with psoriasis in Chile, Denmark, Sweden, and the Netherlands. 71% of participants reported psoriatic disease triggers. Triggers were classified into 24 subgroups dominated by stress (55.3%), infections (17.7%) and alcohol (10.8%). The majority (65%) of the participants experienced seasonal variation in disease activity, and approximately half reported fluctuating disease activity with periods of flare-ups. The self-reported trigger prevalence varied by gender, disease manifestation (skin psoriasis and/or psoriatic arthritis), and country of residence. The female participants more often reported stress and infections as triggers. Alcohol consumption is more often reported as a trigger in males. Chileans more often reported stress and less frequently reported infections as triggers. Insights into patient-reported disease variations and triggers can be used to aid patient-physician conversations and patient phenotyping during routine clinical practice. Trigger assessment and management could potentially contribute to patient counselling and motivate lifestyle changes.