understand the unmet needs from the patient and physician perspective, and to gain deeper insight into the impact of psoriasis and PsA on patients' lives, a population-based survey of 4400 patients and 800 physicians in North America and Europe was conducted. The Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey is the first-of-its-kind, large-scale, multinational survey conducted. The survey explores the diagnosis and impact of psoriasis and PsA on health-related quality of life as well as attitudes towards current therapies. The MAPP survey was developed with patient and physician input and aims to provide a better reflection of psoriasis and PsA severity, including the impact of disease and its treatment on patients' daily lives from the physician perspective. Results from the multinational patient survey, published separately, identified unmet needs related to assessment of disease severity, PsA screening and diagnosis and treatment options.8 The current report includes results from the multinational physician survey. The survey was conducted by Abt SRBI, Inc (New York, NY, USA). Methodology and results of the patient survey have been reported.8 Dermatologists and rheumatologists were identified through national databases for each country. Physicians were contacted from this list through random sampling methods and offered participation in the survey. Screening criteria for dermatologists required that ≥ 50% of their practice be devoted to medical dermatology. A total of 6530 dermatologists and 5445 rheumatologists were screened; 391 dermatologists and 390 rheumatologists completed interviews. North American results combine findings from Canada and the United States; European results combine findings from France, Germany, Italy, Spain and United Kingdom. For this report, results reflect overall global findings, except when notable differences in responses were observed between North America and Europe. Further analyses of results by geographic regions are planned. Physician and practice demographics are summarized in Table 1. Dermatologists reported that 86.0% of office visits in a typical month were related to medical dermatology, with 16.1% specifically related to psoriasis and 4.1% to PsA. Rheumatologists reported that 15.0% of office visits were related to PsA. Overall, North American rheumatologists had twice as many PsA patients as European rheumatologists.Psoriasis patients were most often referred to the participating dermatologist by a primary care physician (63.9%), another specialist (16.2%) or another dermatologist (7.9%); PsA patients were most often referred by a primary care physician (51.2%), another specialist (21.0%) or another dermatologist (7.0%). PsA patients were most often referred to the participating rheumatologist by a primary care physician (51.7%), dermatologist (22.9%) or another specialist (18.4%). Disease severity Dermatologists classified 20.3% of their psoriasis patients and 25.7% of their PsA patients with severe disease, 38.1% and 38.3% with moderate and 40.5% and 32.9% with mild respectively. In psoriasis patients, dermatologists most commonly considered the location or size of skin lesions to be the most important factor contributing to disease severity (Fig. 1a). In PsA patients, 63.9% of dermatologists and 74.2% of rheumatologists most commonly considered pain or swelling of the joints to be the most important factor contributing to disease severity Most dermatologists (62.6%) reported that psoriasis impacted patients' daily activities and/or work, and 79.3% reported it affected their patients socially and/or emotionally; 92.1% agreed the disease burden of psoriasis is frequently underestimated. Dermatologists recognized that a higher proportion of their PsA patients (73.7%) were impacted in their daily activities and/or work, and 76.8% were affected socially and/or emotionally. Fewer rheumatologists recognized the effect of PsA on daily activities and/or work (57.2%) or its social and/or emotional toll (64.9%). However, most proactively discuss the effect of PsA on daily activities (85.3%) or its social and/or emotional toll (67.2%). Dermatologists reported discussing the possibility of developing joint disease in all (43.5%) or some (46.5%) of their psoriasis patients. However, most dermatologists and rheumatologists (> 75%) acknowledged that PsA is likely underdiagnosed because of a failure to connect skin and joint symptoms. According to dermatologists, 20.0% of their psoriasis patients complain of joint symptoms, with only 33.0% of these patients having a confirmed diagnosis of PsA, which was most often made by another physician (48.7%) or the participating dermatologist (39.1%). Collaborative rheumatologist/dermatologist care for PsA patients was reported by 75.6% of