rheumatologists stated that their hesitation to prescribe systemic therapy was related to tolerability and long-term safety concerns. Among the respondents, 53.0% of dermatologists and 30.5% of rheumatologists agreed that keeping a patient's symptoms at bay was the best the patients could expect from conventional oral therapy; 49.6% and 27.7%, respectively, felt that patients leaving their practice due to frustration or dissatisfaction with currently available therapies is an important issue; and 26.3% and 13.3%, respectively, felt the treatment options could be worse than the condition itself. The most important attributes of an ideal therapy, identified by the respondents, were largely related to efficacy and safety, which generally mirrored what they considered the greatest unmet therapeutic needs (Table 3). In addition, improved access to therapy and oral administration were among the five most commonly selected attributes; another oral option and new mechanism of action were among the five most commonly noted unmet therapeutic needs. MAPP is a unique large-scale, multinational survey containing both a patient and physician component aimed at gaining a better understanding of global perspectives on the burden of psoriasis and PsA and their treatment. Results from the multinational patient survey showed a significant burden of disease and unmet treatment needs.8 We report the findings from the physician portion of the survey, which included dermatologists and rheumatologists who care for patients with psoriasis and/or PsA. These findings largely support those of the patient survey, including a large disease burden, underdiagnosis of PsA, differing perceptions of disease severity and challenges with current treatment options. While dermatologists and rheumatologists recognized the emotional and social toll that psoriasis and PsA may place on patients, most acknowledged that the burden of disease is often underestimated. Dermatologists estimated that 20% of their psoriasis patients and 26% of their PsA patients had severe disease. In the patient portion of the MAPP survey, slightly more psoriasis patients (27%) and twice as many PsA patients (53%) rated their disease as severe.8 Reasons for the disconnect may be related to the use of standardized tools by physicians vs. more subjective assessments by patients. In addition, patients and physicians were not matched, so results cannot be directly compared. However, physicians and patients revealed notable differences in factors contributing to their assessment. While physicians reported that the most important factors contributing to disease severity were location and size of skin lesions in their psoriasis patients and pain and swelling of joints in their PsA patients, itching and location of skin lesions were cited as important factors in patients' assessment of disease severity.8 Current findings show these factors, notably itching, are often not cited by physicians (Fig. 5a,b); only 7% of dermatologists cited itching as the most important factor contributing to disease severity, compared with 38% of patients.8 Itching is not captured in most currently utilized assessment tools, indicating a potential need to examine how disease severity is assessed. Educating healthcare providers (HCPs) regarding the importance of this outcome, as well as increased use of pruritus assessment tools in clinical studies, may help to bridge this disconnect. rheumatologists acknowledged that PsA is likely