Much NHS care for people with the skin condition psoriasis is seriously lacking, a report has said.
Psoriasis can cause intense distress for patients
The Royal College of Physicians and the British Association of Dermatologists surveyed 100 UK dermatology units.
It found wide variation in the quality of services, with a lack of specialist nurses, psychological support, washing facilities and access to new drugs.
The Department of Health said it was up to primary care trusts to choose local priorities for improving services.
Psoriasis causes skin cells to reproduce too quickly, leading to intensely itchy, flaky red patches.
Creams to treat psoriasis must be applied carefully, and any excess washed off to avoid damage to healthy skin.
But the survey found one in three units did not have adequate bathing and showering facilities for patients.
And in 41% of units treatment was applied by nurses with no specialist training, or by the patients themselves.
One in five units had no nurses who specialised in dermatology at all.
The survey also found 60% of units had no clinical psychology services to help patients - despite research suggesting as many as one in 10 is so distressed by their condition that they consider suicide.
Four out of 10 units also restricted the use of new generation biologic therapies - which target the cause of psoriasis, rather than just the symptoms - for financial reasons.
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On average, biologics cost about £10,000 a year - more than conventional treatments.
Dr Colin Holden, president of the British Association of Dermatologists, said: "Psoriasis is a chronic inflammatory skin disease which can have a huge physical and psychological impact, and as such patients require a high standard of care.
"This audit has produced data clearly showing that on a national level, the NHS is failing to provide patients with the level of care they deserve."
David Chandler, of the Psoriasis and Psoriatic Arthritis Alliance, said: "The report supports anecdotal evidence from those that contact us about the inconsistencies of treatment and facilities in the UK.
"Living with a disease that affects you 24 hours a day, 365 days a year is depressing enough, but to then find out that if you lived in a different location you would get better care is just an added burden."
A Department of Health spokeswoman said primary care trusts were responsible for determining local priorities.
She said the National Institute for Health and Clinical Excellence approved the use of three different types of biologic agents, which local trusts should follow.