Dr Patrick Burnett on Clinical Research Needs, Awareness of Intertriginous Psoriasis

Patrick Burnett, MD, PhD, FAAD, chief medical officer of Arcutis Biotherapeutics, discusses the need for increased research and awareness on intertriginous disease in psoriasis.

More research on intertriginous disease in psoriasis is needed to better understand patient needs and gaps in care, as well as build awareness among dermatologists on the subtype, said Patrick Burnett, MD, PhD, FAAD, chief medical officer of Arcutis Biotherapeutics.


What are some next investigative steps following the findings shown in the Skin Insights: Uncovering Psoriasis Survey?

I think a survey like the one that we did, I think one of the advantages of that survey was that it was very robust. We're talking about over 500 patients and focused on a specific group, which is those patients who are currently being treated with topical therapy. That kind of research allows you to learn something new about this population that you maybe didn't [know] before.

I guess I'll take a step back and look at a previous example of this in psoriasis. There's a publication that Mark Lebwohl, MD, and others did looking at itch in psoriasis. And when I was training as a dermatologist, atopic dermatitis was the disease that itched—psoriasis could itch, but we said it was a relatively small fraction of patients. So, if somebody came in and you weren't sure if they had psoriasis or atopic dermatitis, if it itched, you would just say they must have atopic dermatitis.

I think what this publication by Dr. Lebwohl and others showed is that from a patient perspective, first of all, itch is very common, but also itch is the No. 1 driver for their perception of severity. Whereas when you ask the doctors what makes a patient have severe disease, the No. 1 factor that they identified was body surface area, because that's what a doctor can see. Unless you ask with a specific patient-related outcome assessment measure how much itch a patient is having, it's not visible to you when they walk into the office.

So, we learned that there is this disconnect between what the doctor is seeing, with regard to what makes the patient severe, and what the patient is experiencing. And that publication really changed how it is that we think about psoriasis and raised very much the visibility, and caused more research to be conducted on itch in psoriasis. So, now itch is commonly included in FDA labeling, even for topical products. I think it's that raised awareness.

I know that's kind of a long preamble, but coming back to our national survey, what I would like to see is these data that we have specifically around intertriginous psoriasis. Given that this is an area that there hasn't been a tremendous amount of research done, some of the findings that we've seen [are] with regard to an unwillingness of patients to tell their doctor that they have intertriginous disease and also a lack of recognition that the rash that they have within this area is exactly the same disease that they may be going to a dermatologist for already but they didn't recognize that those were the same thing.

I think this research was robust enough to start opening up that conversation, and I hope that it leads to additional research and in the end will lead to a greater awareness for both patients with psoriasis and dermatologists as to the needs of these specific subgroups of patients with psoriasis.

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