My Psoriasis is Fine

An adult female with severe psoriasis came to clinic for follow-up while taking ustekinumab, a biologic medication. Her dermatologist has all psoriasis patients change into a gown after being roomed to help the dermatologist assess how much the psoriasis is improving on treatment.

When the dermatologist entered the room, the patient was still in her active wear and told the doctor that her psoriasis is “doing fine” on ustekinumab. The dermatologist figured the psoriasis was much better, which explained why they patient hadn’t changed into a gown. However, her PRO scores were as follows:

PRO – Dermatology Scores

Skindex-16 Emotions 52

Skindex-16 Symptoms 78

Skindex-16 Functioning 16

Based on these surprisingly high scores, the dermatologist asked about how her psoriasis was really doing, and the patient started to cry. She explained that the dermatologist had been so positive about how well this medication worked that she didn’t want to disappoint the doctor. She didn’t think any medication would work for her, so she planned to just stay on the ustekinumab.

Ustekinumab currently costs about $25,000 per injection, so the dermatologist switched the patient to a newer, and likely, more effective biologic.