The Impact of Hypertension, Diabetes, Lipid Disorders, Overweight/Obesity and Nicotine Dependence on Health-Related Quality of Life and Psoriasis Severity in Psoriatic Patients Receiving Systemic Conventional and Biological Treatment

Abstract

Psoriasis, a chronic disease, is associated with a higher prevalence of comorbidities and has negative impact on health-related quality of life (HRQOL). The objective was to investigate the effect of comorbidities on HRQOL, and psoriasis severity measured appropriately by the dermatology life quality index (DLQI) and the psoriasis area severity index (PASI) before, and after a 3-month treatment and the median DLQI or PASI reduction from baseline in the adult psoriatic patients receiving various types of treatment. The study included 184 adult plaque psoriatic patients. DLQI and PASI scores were assessed in the studied patients before the therapy (a baseline visit) and after a 3-month treatment (a control visit) depending on the presence of comorbidities. Psoriatic patients with comorbidities had worse HRQOL and more severe skin lesions. The presence of comorbidities had a negative effect on the outcome of treatment with the use of conventional therapy. The outcome of therapy with biological agents was independent of each of the analyzed factors. Biological treatment had a high effectiveness on the psoriatic skin lesions improvement despite the presence of comorbidities, whereas methotrexate was effective even if the patients had co-existing hypertension. In psoriatic patients receiving systemic conventional treatment but not biological treatment, comorbidities had a negative impact on HRQOL and psoriasis severity.

The Impact of Psoriasis and Atopic Dermatitis on Quality of Life: A Literature Research on Biomarkers

“…Scientific evidence therefore indicates screening psoriatic patients for suicidal ideations and psychiatric disorders, with a focus on depression and anxiety, which are also well-known predictors of QoL impairment [106,115,120,121]. Joint and nail involvement, cutaneous comorbidities (e.g., vitiligo and AD) and metabolic syndrome symptoms have been shown to be associated with a reduction in QoL of patients as evidenced by DLQI, Skindex and PDI scores [88,[122][123][124][125]. In contrast, there is evidence that higher BMI is associated with a better mental-health related QoL in psoriatic patients [96,126].…”

“…Higher PASI score was associated with impaired QoL [92,98,108,115,116] Higher SCORAD showed more impaired QoL [100,103,105,113] Disease localization Isolated involvement of scalp, trunk, intertriginous, palmoplantar and nail PSO was associated with a higher QoL impairment [88,106,125] Isolated involvement of face, hand, genital and foot eczema was associated with low QoL [99,100]. Involvement of visible regions showed more impaired QoL than no involvement of visible regions in women [105] Comorbidities Patients with comorbidities such as hypertension, diabetes, lipid disorders, overweight/obesity, PSA, depression and anxiety had poorer QoL [98,106,124] Adults with AD concomitant other atopic diseases including asthma, allergic rhinitis, allergic conjunctivitis experienced greater QoL impairment than the patients with AD alone [103]. NS differences in QoL impairment between patients with AD only and patients with comorbid atopic diseases [99,113]…”

Knowledge Mapping and Research Hotspots of Comorbidities in Psoriasis: A Bibliometric Analysis from 2004 to 2022

“…Currently, psoriasis is considered to be a systemic disease, and chronic inflammation underlies the pathology of psoriasis and its comorbidities [ 19 ]. Psoriasis comorbidities, which lead to higher cost of living, poorer quality of life, and worse prognosis, have attracted much attention from scholars, and several relevant papers have been published [ 8 ]. In the face of explosive growth of publications, it is difficult and important to have a comprehensive and systematic understanding and to maintain sensitivity to research hotspots in the field of psoriasis comorbidities.…”

“…As research progresses, concepts, such as “psoriasis march” [ 4 ] and “systemic psoriasis” [ 5 ], have been proposed, revealing that psoriasis is a systemic disease that may be associated with several comorbidities, including psoriatic arthritis, metabolic syndrome, cardiovascular disease, inflammatory bowel disease, mental psychological diseases, malignant tumors, infections, and several skin diseases [ 3 , 6 ]. Approximately 57.9% of patients with psoriasis have at least one comorbidity [ 7 ], which not only influences their treatment options but also decreases their quality of life and shortens their life expectancy [ 8 , 9 ]. Therefore, a comprehensive and systematic review of research results in the field of psoriasis comorbidities and a summary of the development trends and research hotspots in this field are essential.…”

Mechanisms and inhibitors of ferroptosis in psoriasis

“…The heritability of psoriasis is approximately 66%–90%, which is one of the highest heritability rates of multifactorial genetic diseases ( Traks et al, 2019 ). Environmental factors, such as infection, obesity, nicotine dependence, etc., also induce and aggravate the progression of psoriasis ( Madden et al, 2020 ; Karpinska-Mirecka et al, 2021 ; Reolid et al, 2021 ). For example, drip psoriasis is closely related to acute streptococcal infection, which indicates a link between psoriasis and bacterial infection ( Madden et al, 2020 ; Zhou and Yao, 2022 ).…”