The Impact of Pruritus on the Quality of Life and Sleep Disturbances in Patients Suffering from Different Clinical Variants of Psoriasis

Jaworecka, Kamila; Rzepko, Marian; Marek-Józefowicz, Luiza; Tamer, Funda; Stefaniak, Aleksandra; Szczegielniak, Magdalena; Chojnacka‐Purpurowicz, Joanna; Gülekon, Ayla; Szepietowski, Jacek C.; Owczarczyk‐Saczonek, Agnieszka; Reich, Adam

doi:10.3390/jcm11195553

Cited by 17 publications

(11 citation statements)

References 36 publications

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“…Jaworecka et al demonstrated that 39.3% ( n = 116) of patients reported occasional difficulties in falling asleep, and 22.7% of them ( n = 67) had such problems almost every day. Moreover, 20.3% ( n = 60) woke up during sleep almost every night, and a further 33.6% ( n = 99) reported such problem sporadically 33 . A study by Nowowiejska et al reported poor sleep quality, was noticed in 47 patients (78.3%), 24 patients (40.0%) subjectively assessed their sleep quality as fairly bad or bad 32 .…”

Section: Discussionmentioning

confidence: 98%

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Evaluation of sleep quality and pruritus severity in psoriatic patients and their impact on quality of life: a cross section correlational study

Zaky,

Elgamal,

Abd Al Maksoud

et al. 2023

Sci Rep

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Psoriasis is a chronic inflammatory condition associated with genetic and immunological susceptibility. The objective of the study was to evaluate pruritus and sleep quality in correlation (r) to psoriasis severity and to detect their impact on quality of life. Two hundred (200) patients with psoriasis were included. Psoriasis severity was determined using the psoriasis area severity index (PASI), the quality of life (QoL) was assessed by the psoriasis disability index (PDI) questionnaire, and the sleep quality was evaluated by the Pittsburgh sleep quality index (PSQI). Finally, the severity of itching was evaluated using a 12-item pruritus severity scale (PSS). Poor sleep quality was found in 16.0% of patients in this study. Poor sleep was detected among 50.0% of cases with severe psoriasis. PASI scores correlated significantly with sleep quality, duration and sleep disturbances (p < 0.001). The global PSQI and PASI were also significantly correlated (p = 0.004). In conclusion patients complaining of psoriasis exacerbated by pruritus and sleep problems demonstrated lower quality of life in all domains. Sleep disturbances and depressive symptoms impairing quality of life should be taken into consideration when screening patients suffering from psoriasis.

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Section: Discussionmentioning

confidence: 98%

“…Studies determined that psoriatic patients complaining of pruritus show difficulty in falling asleep and have an increased frequency of sleep fragmentation and nocturnal awakening 16 , 37 . Meanwhile it was established that good sleep significantly reduces the intensity of itching related to psoriasis 33 , 38 , 39 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of sleep quality and pruritus severity in psoriatic patients and their impact on quality of life: a cross section correlational study

Zaky,

Elgamal,

Abd Al Maksoud

et al. 2023

Sci Rep

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“…We were able to show that an improvement in QoL (DLQI development) positively predicted a reduction in itch. In this regard, not only has a correlation between itch severity and DLQI been demonstrated [ 66 ], but a statistical mediation model has also been used to calculate DLQI in atopic dermatitis using characteristics such as itch, disease severity, and treatment with a specific crisaborole ointment [ 67 ]. In a cross-sectional study aimed at characterizing dermatosis-associated pruritus in Chinese patients, both the prevalence and severity of pruritus were associated and increased with age [ 68 ].…”

Section: Discussionmentioning

confidence: 99%

Automated Machine Learning Analysis of Patients With Chronic Skin Disease Using a Medical Smartphone App: Retrospective Study

Bibi,

Schaffert,

Blauth

et al. 2023

J Med Internet Res

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Background Rapid digitalization in health care has led to the adoption of digital technologies; however, limited trust in internet-based health decisions and the need for technical personnel hinder the use of smartphones and machine learning applications. To address this, automated machine learning (AutoML) is a promising tool that can empower health care professionals to enhance the effectiveness of mobile health apps. Objective We used AutoML to analyze data from clinical studies involving patients with chronic hand and/or foot eczema or psoriasis vulgaris who used a smartphone monitoring app. The analysis focused on itching, pain, Dermatology Life Quality Index (DLQI) development, and app use. Methods After extensive data set preparation, which consisted of combining 3 primary data sets by extracting common features and by computing new features, a new pseudonymized secondary data set with a total of 368 patients was created. Next, multiple machine learning classification models were built during AutoML processing, with the most accurate models ultimately selected for further data set analysis. Results Itching development for 6 months was accurately modeled using the light gradient boosted trees classifier model (log loss: 0.9302 for validation, 1.0193 for cross-validation, and 0.9167 for holdout). Pain development for 6 months was assessed using the random forest classifier model (log loss: 1.1799 for validation, 1.1561 for cross-validation, and 1.0976 for holdout). Then, the random forest classifier model (log loss: 1.3670 for validation, 1.4354 for cross-validation, and 1.3974 for holdout) was used again to estimate the DLQI development for 6 months. Finally, app use was analyzed using an elastic net blender model (area under the curve: 0.6567 for validation, 0.6207 for cross-validation, and 0.7232 for holdout). Influential feature correlations were identified, including BMI, age, disease activity, DLQI, and Hospital Anxiety and Depression Scale-Anxiety scores at follow-up. App use increased with BMI >35, was less common in patients aged >47 years and those aged 23 to 31 years, and was more common in those with higher disease activity. A Hospital Anxiety and Depression Scale-Anxiety score >8 had a slightly positive effect on app use. Conclusions This study provides valuable insights into the relationship between data characteristics and targeted outcomes in patients with chronic eczema or psoriasis, highlighting the potential of smartphone and AutoML techniques in improving chronic disease management and patient care.

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“…Pruritus is one of the most bothersome subjective symptoms of psoriasis; in our study, patients with higher severity of itching had higher depression scores, higher BMI, and are prone to expressing their anger internally. A lot of studies had shown the impact of pruritus on quality of life in psoriasis patients [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

The Psoriasis Disability Index in Romanian Psoriasis Patients during COVID-19 Pandemic: Contribution of Clinical and Psychological Variables

Mihu,

Popescu,

Neag

et al. 2023

JCM

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Background: Psoriasis is one of the most frequent chronic inflammatory skin diseases and has a negative impact on the interpersonal relationship and psychosocial well-being. The aims of this study were to examine the effects of intensity of pruritus on quality of life and depression, to investigate the relationship between anger, self-esteem, and depression, and to compare patients with early and late onset of psoriasis. As our study was carried out during the COVID-19 pandemic, we aimed also to investigate the safety concerns and anxiety related to COVID-19 in psoriasis patients. Methods: This cross-sectional study included 137 patients diagnosed with plaque psoriasis. The patients were classified as early-onset (age < 30 years) and late-onset psoriasis (age ≥ 30 years). Duration of disease, pruritus scores, and socio-demographic characteristics were recorded. Measures included the State-Trait Anger Expression Inventory (STAXI), Rosenberg Self-Esteem Scale, Beck Depression Inventory (BDI-II), Psoriasis Disability Index (PDI), and Fear and anxiety in relationship with COVID-19 Scale were used for determining anger, anger expression style, self-esteem, depression, anxiety, and quality of life. Results: The psoriasis patients had a lower score for self-esteem than the normative data from the Romanian general population. The average scores for state anger and trait anger are similar to the normative data from the Romanian general population, but the scores for anger-in and anger-out are higher. Patients with early onset had higher depression scores and lower quality of life. Self-esteem correlates negatively with depression, anger, severity of disability due to psoriasis, number of affected areas, and duration of disease. Lower level of self-esteem led to increased anger. Conclusions: Reduced self-esteem, increased anger levels, and depression are present in psoriasis patients. The effective treatment of psoriasis must, therefore, consist of a multidisciplinary approach, in which the personalized treatment of the skin condition is as important as the adjuvant therapies that reduce the patients’ stress level.

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The Impact of Pruritus on the Quality of Life and Sleep Disturbances in Patients Suffering from Different Clinical Variants of Psoriasis

Cited by 17 publications

References 36 publications

Evaluation of sleep quality and pruritus severity in psoriatic patients and their impact on quality of life: a cross section correlational study

Evaluation of sleep quality and pruritus severity in psoriatic patients and their impact on quality of life: a cross section correlational study

Automated Machine Learning Analysis of Patients With Chronic Skin Disease Using a Medical Smartphone App: Retrospective Study

The Psoriasis Disability Index in Romanian Psoriasis Patients during COVID-19 Pandemic: Contribution of Clinical and Psychological Variables

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