Background & Objective:
Psoriasis and Atopic dermatitis (AD) are chronic, noncommunicable, painful, and disabling diseases included in the so-called group of inflammatory skin diseases. Their rising prevalence and consequent quality-of-life impairment represent an important but still underestimated public health issue. An assessment of their costs may be useful in providing recommendations for policy and decision makers, in order to avoid incorrect or delayed diagnosis, inadequate treatment options and insufficient access to care. Thus, this study aimed to summarize existing literature regarding the costs of psoriasis and AD in Europe.

Methods:
A systematic literature review was performed querying three database (PubMed, Scopus, Web of Science) from January 2012 to October 2022. It included studies carried out in European countries, written in English language, and focused on the economic burden of psoriasis and AD in the adult population.

Results:
Overall, 18 studies were considered. Across countries, psoriasis and AD were associated with large healthcare expenditures. Annual direct costs per patient with psoriasis, whose main expenses were hospitalizations, medications, and outpatient care, ranged between €4755,00 and €7999,00. Similarly, pharmacological treatments, specialized care and hospitalizations contributed to total direct costs within a variable range of €3133,00-€5191,00 for AD patients. Mean out-of-pocket (OOP) expenditures to manage psoriasis and AD per patient per year were approximately €60,00-€531,00 and €350,00-€927,12, respectively. Productivity loss was the key driver of annual indirect costs, which amounted, per patient, to €379,00-€4221,00 for psoriasis and €370,00-€14.236,00 for AD. The severity of skin lesions, gender, age, and the involvement of comorbidity also affected the economic burden of these diseases.

Conclusion:
The management of psoriasis and AD requires an urgent need for public health measures in Europe, in order to save personal and social resources. Assessing the burden of lifelong conditions could guide the identification of the most appropriate patient-centred responses.