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Psoriasis involving special areas is associated with worse quality of life, depression, and limitations in the ability to participate in social roles and activities
Oregon Medical Research Center, OR, Portland, United States.
National Psoriasis Foundation, OR, Portland, United States.
National Psoriasis Foundation, OR, Portland, United States.
Instituto de Rehabilitación Psicofísica (IREP), Buenos Aires, Argentina.
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2023 (English)In: Journal of Psoriasis and Psoriatic Arthritis, ISSN 2475-5303, Vol. 8, no 3, p. 100-106Article in journal (Refereed) Published
Abstract [en]

Background: Psoriasis severity has traditionally been categorized as mild, moderate, and severe. Commonly, cut-offs for severe disease require a body surface area (BSA) involvement of ≥10% or a Psoriasis Area Severity Index (PASI) > 10. However, clinical experience challenges these traditional measures and requirements, as patients with less extensive psoriasis may have disease that severely impacts quality of life.

Objective: The objective of the present study was to further explore the extent of patient burden when psoriasis affects special locations.

Methods: A total of 69,190 individuals living in the U.S were invited to participate in a patient advocacy survey by telephone and or web interviews over the course of 3 years (2019-2021). The survey instrument consisted of validated patient-reported outcome measures, measuring disease-specific quality of life (Dermatology Life Quality Index, DLQI), depression (Patient Health Questionnaire (PHQ)-2 and (PHQ)-9), and the ability to participate in social roles and activities (PROMIS Ability to Participate in Social Roles and Activities (SF-4a). Chi-square tests were performed to explore association between psoriasis involvement on special locations and patient outcomes and multivariate logistic regression models were then constructed, to assess impact of having psoriasis on special locations patient outcomes, controlling for potential confounding factors.

Results: A total of 4129 individuals completed the survey. 3594 (84.4%) of patients surveyed reported psoriasis involving special areas of the bodysuch as the scalp, face, hands, feet, or genitalia. Involvement of special areas is associated with worse quality of life and depression. 35-71% of patients with 10% or less total BSA involvement experienced a moderate-to-extremely large effect on these life function domains. When adjusting for age, sex, and body surface area, psoriasis involvement of a special location was associated with poorer patient reported outcomes. including a 46% less likelihood of reporting their skin disease ass having “no or only a small effect on QoL,” a 30% less likelihood of having a “normal l ability to participate in social roles and activities,” and a 126% higher likelihood of f having depression.

Conclusion: Real-world data presented here demonstrate that psoriasis involving special areas is associated with adverse life consequences, including poor quality of life and depression.

Place, publisher, year, edition, pages
Sage Publications, 2023. Vol. 8, no 3, p. 100-106
Keywords [en]
disease severity, mental health, psoriasis, quality of life, treatment
National Category
Dermatology and Venereal Diseases
Identifiers
URN: urn:nbn:se:umu:diva-206464DOI: 10.1177/24755303231160683Scopus ID: 2-s2.0-85150955324OAI: oai:DiVA.org:umu-206464DiVA, id: diva2:1749343
Available from: 2023-04-06 Created: 2023-04-06 Last updated: 2023-12-05Bibliographically approved

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Schmitt-Egenolf, Marcus

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