The Burden of Psoriasis Is Not Determined by Disease Severity Only

Abstract

Psoriasis is a chronic scaling and inflammatory skin disease that can affect patients' quality of life and daily functioning. We studied the scores of 85 patients suffering from moderate to severe plaque-type psoriasis, participating in a randomized controlled trial. We compared their scores on a generic quality-of-life instrument with data from two reference populations. We examined associations between clinical severity, as measured by the components of the Psoriasis Area and Severity Index (PASI), and the respective quality-of-life subdimensions, measured by the Medical Outcome Survey Short Form 36 (SF-36), to find out what elements of disease activity are related with impaired quality of life. Compared to the reference population, quality of life was impaired in terms of bodily pain and social functioning. There were no significant correlations between overall disease severity, as measured by PASI, and the SF-36 subdimensions. When examining the PASI components, we found significant correlations between desquamation on the upper limbs and mental health and bodily pain (r = -0.23 and r = -0.28, respectively) and between desquamation on the scalp and mental health (r = -0.29). In conclusion, we found that psoriasis patients had a lower quality of life than a reference population, without a significant relation between disease severity or disease area and quality of life. Yet psoriasis lesions located on visible body parts are significantly correlated with aspects of quality of life.

Impairment of Sexual Life in Patients with Psoriasis

“…Clinical severity as measured by the SAPASI had an important role especially in the IPSO question, which is different in that it includes different aspects of sexual life, such as ‘feeling physically unattractive’, compared to the other questions. Taken together, these results confirm the important issue that the different aspects of quality of life in psoriasis are not only associated with physical manifestations and clinical severity [8, 18], and that the association of quality of life impairment and psychological morbidity is very strong. Also, the questions concerning sexual life correlated with all the other questions concerning social relationships, as expected, but they were not particularly correlated with symptoms.…”

“…The desquamation scores obtained by the SAPASI were grouped into two classes: one regrouping scores 0, 1 and 2 (none, slight, and moderate desquamation), and the other regrouping the scores 3 and 4 (severe and extraordinarily severe desquamation). We chose to analyze the desquamation component of clinical severity, because it has been shown to be the one more associated with some components of quality of life and psychological well-being [18]. …”

Quality of Life Is Severely Compromised in Adult Patients With Atopic Dermatitis in Brazil, Especially Due to Mental Components

“…Children with AD had the quality of life inversely correlated with disease severity evaluated by Children's Dermatology Life Quality Index (CDLQI) and SCORAD, especially in the first visits 29 . The discrepancy of our data in suggesting some specific grouping in the sample was also suggested by others, specially in psoriasis when objective Psoriasis Area Severity Index(PASI) is evaluated, without correlation with QoL self assessment 32 . This correlation was attributed to some subgroups present in low numbers in the whole population which affect the main response of the sample.…”

Work Limitations and Productivity Loss Are Associated with Health-Related Quality of Life but Not with Clinical Severity in Patients with Psoriasis

“…Comparatively high acquisition costs of these new agents however evoked a debate about their appropriate use [12]. This is one reason why pharmacoeconomic analyses have recently gained more interest in the dermatological literature [13,14,15,16,17,18]. Guidelines for pharmacoeconomic studies recommend to use the societal perspective, which means that direct and indirect costs of disease need to be considered [19,20,21,22].…”