Systematic Review of Health-Related Quality of Life in Adolescents with Psoriasis

Abstract

Background: Many cases of psoriasis begin in adolescence. The affected adolescents face the combined physical and psychosocial challenges of their disease-free peers with the added complexity of a visible disease. Objective: To review the impact of psoriasis on the health-related quality of life (HRQL) in adolescents as compared to their peers with other chronic diseases and to determine the best tools to measure HRQL in this population. Methods: A systematic literature review was completed using PubMed. Results: 256 publications were screened for inclusion, 37 were relevant to objectives and included in the systematic review. Most studies are pediatric psoriasis studies with an adolescent subgroup, very few are dedicated to solely addressing HRQL in adolescents with psoriasis. Adolescents with psoriasis face both the challenges similar to an adult psoriasis population in addition to the complexities inherent to healthy adolescents. Studies often use a general pediatric HRQL measure, PedsQL 4.0, or a dermatology-specific measure adapted from an adult questionnaire. Only one psoriasis-specific measurement tool exists, and it is specifically for scalp psoriasis. Conclusion: Both dermatologists and primary care physicians should treat the visible cutaneous lesions and disease comorbidities and address the psychosocial impact of psoriasis in their adolescent patients. Use of both a general and dermatology-specific HRQL questionnaire may allow physicians to better identify the impact of the disease and recognize improvement or impairment over time.

Children with facial morphoea managing everyday life: a qualitative study

“…35,36 Similar to these populations, the effects were especially salient among children in our study during adolescence when physical appearance and peer approval plays an important role. 7,8 However, the rarity, uncertainty and lack of information about facial morphoea brought about additional challenges for our study participants, exemplified by the distress they experienced when trying to manage the barrage of intrusive questioning about their facial lesions. Without clear understanding about facial morphoea, children and parents struggled to provide appropriate answers, heightening their perceptions of being stigmatized.…”

“…5,6 Research on other visible chronic skin conditions among children and young people (e.g. psoriasis and atopic dermatitis) has reported lower health-related quality of life (HRQoL) 7 and negative impacts on psychosocial functioning. 8,9 The rarity of morphoea poses particular challenges with respect to gaps in knowledge about its aetiology, prognosis and treatment [10][11][12] and also about the HRQoL of individuals with this disorder.…”

Patient-Reported Outcome Measures for Pediatric Psoriasis: A Systematic Review and Critical Appraisal from International Dermatology Outcome Measures (IDEOM)

“…HRQoL and psoriasis symptoms were measured by all instruments, highlighting the importance of assessing clinical severity and psychosocial burden in this vulnerable population [27]. However, less agreement existed for the domains of treatment satisfaction, measured by one item in the CDLQI, and patient global, measured by one item in the SPI.…”

“…These instruments must adequately capture patient experiences during their inherently complex stages of development [27]. The dynamic nature of this population poses major challenges for measuring outcomes.…”

Conceptualization, development and validation of T‐QoL©(Teenagers’ Quality of Life): a patient‐focused measure to assess quality of life of adolescents with skin diseases

“…However, when measuring QoL in adolescence, researchers have generally used measures designed to be used across childhood . In a systematic review of the measurement of QoL in adolescents with psoriasis, measures used were a general paediatric measure, PedsQL 4 or the CDLQI …”