{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:23:45Z","timestamp":1783470225534,"version":"3.55.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Immune-mediated inflammatory diseases (IMIDs) constitute a heterogenous group of chronic and highly disabling conditions. The clinical challenges they often pose led to formation of numerous dermo-rheumatological interdisciplinary units around the world, which are reported to benefit their patients in various ways. The present paper describes our experience with a multidisciplinary dermatology-rheumatology-gastroenterology unit DERREGA at the IRCCS Foundation Policlinico San Matteo of Pavia over a period of 5\u2009years of its activity (2017\u20132022). A digital database was created, containing the medical records of 146 patients referred to the dermatology unit only by rheumatologists or gastroenterologists belonging to the multidisciplinary unit DERREGA. Then, aspects such as demographics, initial basis of referral and final diagnosis among the patients were analyzed retrospectively. Patients were classified as either gastroenterological or rheumatological, and then categorized according to the specific basis of referral. Most of the gastroenterological patients (97%) were affected by inflammatory bowel diseases (IBDs). Rheumatological patients were divided in three subgroups, including patients referred with vasculitis, arthropathies (undifferentiated arthritis, psoriatic arthritis and other arthritis) and other rheumatological diseases. Then, final diagnoses were evaluated in each group. Almost a third of IBD patients received a diagnosis of paradoxical psoriasis. Dermatological examination allowed diagnosis of minimal psoriasis based on Caspar criteria in over 70% of the patients admitted with undifferentiated arthritis. A multidisciplinary approach is suggested to provide more effective management of IMIDs and, specifically, from a dermatological perspective, allows for the diagnosis of minimal manifestations of psoriasis in patients with a provisional diagnosis of undifferentiated arthritis.<\/jats:p>","DOI":"10.3389\/fmed.2023.1290018","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T08:44:03Z","timestamp":1701333843000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["A multidisciplinary dermatology-gastroenterology-rheumatology (DER.RE.GA) unit for the care of patients with immune-mediated inflammatory diseases: analysis of the first 5\u2009years from the dermatologist\u2019s perspective"],"prefix":"10.3389","volume":"10","author":[{"given":"Valeria","family":"Brazzelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Bobbio Pallavicini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Maggi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0141ukasz","family":"Ch\u0119tko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Isoletta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Di Giuli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Bonelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Fornaroli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1007\/s11926-018-0785-6","article-title":"Bridging the gaps in the care of psoriasis and psoriatic arthritis: the role of combined clinics","volume":"20","author":"Haberman","year":"2018","journal-title":"Curr Rheumatol Rep"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1007\/s12325-018-0672-6","article-title":"Multidisciplinary management of spondyloarthritis-related immune-mediated inflammatory disease","volume":"35","author":"Rizzello","year":"2018","journal-title":"Adv Ther"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e041871","DOI":"10.1136\/bmjopen-2020-041871","article-title":"Effectiveness of interdisciplinary combined dermatology\u2013gastroenterology\u2013rheumatology clinical care compared to usual care in patients with immune-mediated inflammatory diseases: a parallel group, non-blinded, pragmatic randomised trial","volume":"11","author":"Hjuler","year":"2021","journal-title":"BMJ Open"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1672","DOI":"10.1007\/s12325-019-00964-z","article-title":"Risk of developing additional immune-mediated manifestations: a retrospective matched cohort study","volume":"36","author":"Aletaha","year":"2019","journal-title":"Adv Ther"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"475","DOI":"10.2147\/JIR.S348079","article-title":"Helminth therapy for immune-mediated inflammatory diseases: current and future perspectives","volume":"15","author":"Shi","year":"2022","journal-title":"J Inflamm Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2","DOI":"10.3899\/jrheum.091461","article-title":"Epidemiology of immune-mediated inflammatory diseases: incidence, prevalence, natural history, and comorbidities","volume":"85","author":"El-Gabalawy","year":"2010","journal-title":"J Rheumatol Suppl"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"S32","DOI":"10.1002\/msc.1690","article-title":"The role of the multidisciplinary team in the management of psoriatic arthritis","volume":"20","author":"Jadon","year":"2022","journal-title":"Musculoskelet Care"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"700.1","DOI":"10.1136\/annrheumdis-2020-217159","article-title":"EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update","volume":"79","author":"Gossec","year":"2020","journal-title":"Ann Rheum Dis"},{"key":"ref9","unstructured":"DurandC\n            RemillardMA\n          New GRAPPA treatment recommendations for psoriatic arthritis2021"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"9541","DOI":"10.4081\/dr.2022.9541","article-title":"A consensus-based approach on the management of patients with both psoriasis and psoriatic arthritis in the dermatological and rheumatological settings in Italy: the ADOI PSO-amore project","volume":"14","author":"Cusano","year":"2022","journal-title":"Dermatol Rep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s00403-011-1172-6","article-title":"Management of psoriasis and psoriatic arthritis in a combined dermatology and rheumatology clinic","volume":"304","author":"Velez","year":"2012","journal-title":"Arch Dermatol Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.reumae.2014.01.005","article-title":"A report of 4 years of experience of a multidisciplinary unit of psoriasis and psoriatic arthritis","volume":"10","author":"Luelmo","year":"2014","journal-title":"Reumatol Clin"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2829","DOI":"10.1007\/s13555-022-00837-4","article-title":"Multidisciplinary Rheuma-derma clinics: 5 years of experience at the san Marco Hospital in Catania","volume":"12","author":"Foti","year":"2022","journal-title":"Dermatol Ther"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.reuma.2017.07.007","article-title":"Experience and satisfaction with a multidisciplinary care unit for patients with psoriasis an psoriatic arthritis","volume":"15","author":"Urruticoechea-Arana","year":"2019","journal-title":"Reumatol Clin"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2741","DOI":"10.1007\/s10067-018-4238-4","article-title":"Clinical outcomes and feasibility of the multidisciplinary management of patients with psoriatic arthritis: two-year clinical experience of a dermo-rheumatologic clinic","volume":"37","author":"Luchetti","year":"2018","journal-title":"Clin Rheumatol"},{"key":"ref16","volume-title":"High degree of patient satisfaction and exceptional feedback in a specialist combined dermatology and rheumatology clinic","author":"Foulkes","year":"2012"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1111\/ced.14390","article-title":"Analysis of the first 5 years of an interdisciplinary rheumatology\u2013dermatology clinic","volume":"46","author":"Argobi","year":"2021","journal-title":"Clin Exp Dermatol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1318","DOI":"10.1111\/j.1365-2036.2011.04866.x","article-title":"Psoriasis associated with anti-tumour necrosis factor therapy in inflammatory bowel disease: a new series and a review of 120 cases from the literature","volume":"34","author":"Cullen","year":"2011","journal-title":"Aliment Pharmacol Ther"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"7873","DOI":"10.3390\/ijms21217873","article-title":"Paradoxical psoriasis induced by anti-TNF\u03b1 treatment: evaluation of disease-specific clinical and genetic markers","volume":"21","author":"Bucalo","year":"2020","journal-title":"Int J Mol Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1001\/jamadermatol.2020.1300","article-title":"Melanoma risk in patients treated with biologic therapy for common inflammatory diseases: a systematic review and meta-analysis","volume":"156","author":"Esse","year":"2020","journal-title":"JAMA Dermatol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1111\/joim.13282","article-title":"Inflammatory bowel disease and psoriasis: modernizing the multidisciplinary approach (review)","volume":"290","author":"Hedin","year":"2021","journal-title":"J Intern Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1038\/nrrheum.2011.125","article-title":"Management of psoriatic arthritis from the view of the dermatologist","volume":"7","author":"Chang","year":"2011","journal-title":"Nat Rev Rheumatol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1002\/art.24172","article-title":"Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study","volume":"61","author":"Wilson","year":"2009","journal-title":"Arthritis Rheum"},{"key":"ref24","first-page":"333","article-title":"A multidisciplinary approach in psoriatic disease: the different models of dermatology-rheumatology collaborations in Portugal","volume":"46","author":"Mendes-Bastos","year":"2021","journal-title":"Acta Reumatol Port"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11926-017-0706-0","article-title":"Early recognition and treatment heralds optimal outcomes: the benefits of combined rheumatology\u2013dermatology clinics and integrative Care of Psoriasis and Psoriatic Arthritis Patients","volume":"20","author":"Soleymani","year":"2018","journal-title":"Curr Rheumatol Rep"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1007\/s00296-015-3377-z","article-title":"Multidisciplinary dermatology\u2013rheumatology management for patients with moderate-to-severe psoriasis and psoriatic arthritis: a systematic review","volume":"36","author":"Cobo-Ibanez","year":"2016","journal-title":"Rheumatol Int"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"693","DOI":"10.3899\/jrheum.170148","article-title":"Psoriasis and psoriatic arthritis clinics multicenter advancement network consortium (PPACMAN) survey: benefits and challenges of combined rheumatology-dermatology clinics","volume":"44","author":"Okhovat","year":"2017","journal-title":"J Rheumatol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1290018\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T08:44:08Z","timestamp":1701333848000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1290018\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,30]]},"references-count":27,"alternative-id":["10.3389\/fmed.2023.1290018"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1290018","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,30]]},"article-number":"1290018"}}