Clinical features, therapeutic choice and response by phototype in psoriasis: analysis of the French PsoBioTeq cohort

Background Little is known about phototype and the response to systemic treatment in psoriasis.Objectives To assess the characteristics of psoriasis, the therapeutic choice and its efficacy according to phototype.Methods We included patients from the PsoBioTeq cohort initiating a first biologic. Patients were classified according to their phototype. The evaluation included disease characteristics, choice of the initial biologic and therapeutic response at 12 months based on 90% improvement from baseline in Psoriasis Area and Severity Index (PASI 90) and Dermatology Life Quality Index (DLQI) 0/1.Results Of the 1400 patients included, 423 (30.2%), 904 (64.6%) and 73 (5.2%) were in the phototype I-II, III-IV and V-VI groups, respectively. The V-VI group had a higher initial DLQI, and more frequently initiated ustekinumab. Patients in the V-VI group maintained the initial biologic prescribed as did the other phototype groups, even though the proportion of patients reaching PASI 90 and DLQI 0/1 at 12 months was lower in this group than the other groups.Conclusions Patient phototype seems associated with quality of life and choice of the initial biologic in psoriasis. The phototype V-VI group less frequently switched treatments than did the other groups when the response was not efficient. Little is known about the impact of patient phototype on psoriasis management. In psoriasis, phototype seems associated with quality of life and the choice of the initial biologic agent. More work is needed to understand the negative effect of phototype on psoriasis management.