Clinical characteristics of patients with facial psoriasis in Malaysia

Abstract

This study found that facial psoriasis is not as rare as previously thought. Ambient ultraviolet light, sebum, and contact with chemicals from facial products may reduce the severity of facial psoriasis, but these factors do not reduce the prevalence of facial psoriasis. The association with younger age, younger age of onset, higher percentage of body surface area involvement, higher DLQI of > 10, nail involvement, and hospitalization due to psoriasis support the notion that facial psoriasis is a marker of severe disease.

Facial involvement and the severity of psoriasis

“…Early onset of psoriasis (before 40 years old) is often associated with a more severe course of the condition . Several authors have found a relationship between the early onset of symptoms and the presence of facial involvement on psoriasis . In line with these findings, our study found that 52.4% of patients with lesions on the face had a diagnosis of psoriasis established before the 5th decade of life, while only 34.9% of patients without facial lesions had a diagnosis until this cutoff.…”

“…There was no predominance of gender between the two groups, which was also found in some previous studies . However, two studies observed a 1.6–2.5 times greater prevalence of facial involvement in males …”

“…Nail involvement is considered a clinically important feature of psoriasis, since patients with nail psoriasis have worse severity scores . Mean prevalence of nail involvement in patients with facial involvement (60.3%) vs. nonaffected individuals (54.8%) had no statistically significant difference, similar to what was previously described …”

“…Facial psoriasis may cause embarrassment, emotional distress, and negative psychosocial impact, as well as pruritus‐like symptoms, because of its occurrence in a high‐visibility, hard‐to‐cover body region. All these act together in a negative way, influencing patients’ quality of life . Syed Nong Chek et al ., also point out that facial psoriasis is associated with higher DLQI scores, with a mean of 9.96 points, meaning a moderate impact on patient's life.…”

“…All these act together in a negative way, influencing patients’ quality of life . Syed Nong Chek et al ., also point out that facial psoriasis is associated with higher DLQI scores, with a mean of 9.96 points, meaning a moderate impact on patient's life. We have identified a mean of 7.5 points on DLQI scores on the group with facial lesions, which, although lower than what was found by Syed Nong Chek et al ., still represents a moderate impact on patient's life.…”