Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis

Abstract

Background The impact of palmoplantar psoriasis on health-related quality of life (QoL) is largely unknown. Objective To compare clinical characteristics and patient-reported outcomes between patients with palmoplantar psoriasis and moderate-to-severe plaque psoriasis. Methods We conducted a cross-sectional study of patients with plaque psoriasis (N=1,153) and palmoplantar psoriasis (N=66) currently receiving systemic or light treatment for psoriasis. Results Patients with palmoplantar psoriasis were more likely to report Dermatology Life Quality Index scores that correspond to at least a moderate impact on QoL (odds ratio [OR] 2.08; 95% confidence interval [CI], 1.20-3.61); problems with mobility (OR 1.98; 95% CI, 1.10-3.58), self-care (OR 3.12; 95% CI, 1.24-7.86), and usual activities (OR 2.47; 95% CI, 1.44-4.22) on the European Quality of Life-5 Dimensions questionnaire; and heavy topical prescription use of at least twice daily in the preceding week (OR 2.81; 95% CI, 1.63-4.85) than those with plaque psoriasis. Limitations Our assessment tools may not account for all dimensions of health-related QoL affected by palmoplantar disease, and these results may not be generalizable to patients with milder forms of psoriasis. Conclusion Patients with palmoplantar psoriasis suffer from greater health-related QoL impairment and are more likely to report heavy use of topical prescriptions than those with moderate-to-severe plaque psoriasis.

Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: Results from the phase III, double-blinded, placebo- and active comparator–controlled VOYAGE 1 trial

“…1 Psoriasis affecting body regions such as the scalp, nails, hands, and feet can be particularly challenging to treat. [2][3][4][5] Elucidation of the pathogenesis of psoriasis [6][7][8] has led to effective biologic treatments targeting tumor necrosis factor-alpha (TNF-a), [9][10][11] both interleukin (IL)-12 and IL-23, 12,13 and, most recently IL-17 [14][15][16] and IL-23 alone. [17][18][19][20][21] Guselkumab (CNTO 1959; Janssen Research & Development LLC, Spring House, PA) is a fully human IgG1 lambda monoclonal antibody that binds to the p19 subunit of IL-23 and inhibits the intracellular and downstream signaling of IL-23, which is required for terminal differentiation and survival of T helper (Th)17 cells.…”

Sustained efficacy of secukinumab in patients with moderate‐to‐severe palmoplantar psoriasis: 2·5‐year results from GESTURE , a randomized, double‐blind, placebo‐controlled trial

“…[3][4][5] Palmoplantar psoriasis is therefore associated with a greater impairment of health-related quality of life (QoL) than plaque psoriasis on other parts of the body, and significant palmoplantar psoriasis is considered a severe form of psoriasis. 3,6 Palmoplantar psoriasis is more challenging to treat than psoriasis in other skin areas. The use of topical therapies, ultraviolet phototherapy, oral retinoids, methotrexate or anthralin often results in inadequate treatment results.…”

“…Patients with palmoplantar psoriasis have great disability and discomfort, as lesions on palms and soles significantly affect daily activities and mobility due to symptoms such as burning, skin soreness and pain . Palmoplantar psoriasis is therefore associated with a greater impairment of health‐related quality of life (QoL) than plaque psoriasis on other parts of the body, and significant palmoplantar psoriasis is considered a severe form of psoriasis …”

Efficacy of ixekizumab compared to etanercept and placebo in patients with moderate‐to‐severe plaque psoriasis and non‐pustular palmoplantar involvement: results from three phase 3 trials (UNCOVER‐1, UNCOVER‐2 and UNCOVER‐3)

“…Palmoplantar psoriasis is characterized by well-demarcated hyperkeratotic plaques that may or may not be associated with pustules. [4][5][6][7][8][9] Palmoplantar psoriasis is associated with greater physical disability than psoriasis without palm and sole involvement as well as overall greater disease severity, 10,11 more impairment of health-related quality of life and greater problems with mobility, self-care and usual activities, 4,11 higher levels of burning, skin soreness 10 and pain. 6 The relationship between palmoplantar types and subtypes is an area of significant interest and research especially relating to genetic similarities and differences and therapeutic options.…”