"The Laundry Bag Project"--unequal distribution of dermatological healthcare resources for male and female psoriatic patients in Sweden.

BACKGROUND: Psoriasis and eczema are common dermatological diseases that occur with approximately equal frequency in men and in women. The aim of this study was to determine whether men and women with dermatological diseases in need of ultra-violet radiation (UV) treatment receive equal care. METHODS: We conducted a retrospective analysis of records of all patients referred to and seen at our clinic during 2003 with diagnoses of psoriasis or eczema. We performed a gender-based analysis of the number, type, and estimated cost of the treatments given to each patient. We evaluated similar data from a Swedish Psoriasis Association (SPA) treatment center and from the state pharmacy monopoly (Apoteksstatistiken). RESULTS: Men with eczema or psoriasis received more help with emollients than did women and were given a greater number of UV treatments. At our clinic and at the SPA center, women constituted 37 and 42%, respectively, of the individuals who received UV treatment; yet, they received only 34 and 36% of the treatments, respectively. Women were prescribed self-care more often than men, with 61% of prescriptions for emollients and 48% of specific topical treatments for psoriasis dispensed to women. CONCLUSIONS: We discovered previously unrecognized gender differences in standard dermatological treatment for common diagnoses at our hospital. To ensure optimal care for each patient, treatment disparity should be recognized and gender-based analyzes be carried out when planning dermatological health care.

[The laundry-basket project--gender differences to the very skin. Different treatment of some common skin diseases in men and women]. / Tvättsäcksprojektet-- genusskillnader in på bara skinnet. Olika behandling för män och kvinnor vid några vanliga hudsjukdomar.

In this study, we have analysed the treatment traditions in a dermatological outpatient clinic, from a gender perspective. Eczema and psoriasis were of similar frequency in male and female patients, while a higher number of female patients had eczema of the hands. Ultraviolet light (UV) treatment was given to a higher number of male patients in all diagnostic groups including eczema of the hands. In addition, a higher number of given treatments was given to the male patients than to the female patients. As for prescriptions to male and female patients from our department and in Stockholm county (1.8 mill.), a much larger amount of preparations for local treatment was received by female patients, especially emollients. Male patients had received more of calcipotriol creme in addition to their being treated more intensively at the clinic. In a sub-group analysis on patients with psoriasis vulgaris on our clinic and in a patient cooperation-based treatment department, we found the same relation between male and female treatment as in the larger group. On follow-up, the number of female patients with psoriasis who were given treatment at our clinic had increased, but the number of treatments given to men was still higher than for female patients. An economic analysis of these findings show a great overweight of clinic-based treatment costs for male patients, while female patients receive emollients for self-care to a greater extent. We conclude that more studies are needed to clarify the basis of these findings.