Moderate to Severe Psoriasis in Older Adults: Recommendations on Management from the Psoriasis Working Group of the Spanish Academy of Dermatology and Venereology (AEDV). / Recomendaciones del Grupo de Psoriasis de la Academia Española de Dermatología y Venereología sobre el manejo del paciente de edad avanzada con psoriasis en placas moderada-grave.

Managing moderate to severe psoriasis in older adults is complex due to factors characteristic of the later years of life, such as associated comorbidity, polypharmacy, and immunosenescence. This consensus statement discusses 17 recommendations for managing treatment for moderate to severe psoriasis in patients older than 65 years. The recommendations were proposed by a committee of 6 dermatologists who reviewed the literature. Fifty-one members of the Psoriasis Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) then applied the Delphi process in 2 rounds to reach consensus on which principles to adopt. The recommendations can help to improve management, outcomes, and prognosis for older adults with moderate to severe psoriasis.

A study of Internet searches for medical information in dermatology patients: The patient-physician relationship.

BACKGROUND: The use of the Internet to search for medical information is considered by some physicians as an invasion of their medical domain and a reflection of a lack of trust in their advice and recommendations. OBJECTIVE: The main objective of this study was to estimate the amount of medical information gathered from the Internet and to establish whether these online searches reflect a lower degree of patient satisfaction. PATIENTS AND METHODS: A survey was conducted among 175 patients seen at the melanoma and psoriasis units of San Cecilio University Hospital in Granada, Spain between May 2010 and December 2011. RESULTS: Online searches for medical information were performed by 44.4% of patients who returned correctly completed questionnaires. The main reasons given for these searches were to complement appropriate information provided by the physician (67.3%) and to gather information before consultation with the physician (36.5%). Variables associated with the search for medical information on the Internet in the multivariate analysis were a higher educational level, a higher score on two items in the Need for Cognition Scale, and consultation of mass media other than the Internet. LIMITATIONS: Studies with larger numbers of patients and other diseases, however, are required to confirm these results. CONCLUSIONS: The search for medical information is a widespread reality among patients with psoriasis and melanoma and it is not associated with a poor relationship with the physician. Dermatologists can play a beneficial role by recommending trustworthy Internet sites during the patient's visit and by promoting the development of pages by scientific societies to provide high-quality information.

[Analysis of unofficial consultations in a tertiary-level hospital]. / Estudio de las consultas extraoficiales en un hospital de tercer nivel.

BACKGROUND: Dermatologists are regularly consulted in their place of work by patients without an official appointment (individuals accompanying other patients, doctors from other specialties, hospital workers, etc). OBJECTIVES: To describe the characteristics of consulting patients, reasons for consultation, severity of complaint, diagnostic and therapeutic approach taken, and level of care provided by the consulted professionals. RESULTS: The typical patient would be a middle-aged female nurse consulting for the first time for a benign melanocytic lesion. In general, the dermatologist will take an empirical or informative therapeutic approach and consider the care provided to be similar to that offered to patients with an official appointment. CONCLUSIONS: Unofficial appointments, although commonly for trivial complaints, represent an additional workload in daily clinical practice.