TY - JOUR
T1 - Psoriasis Involving Special Areas is Associated with Worse Quality of Life, Depression, and Limitations in the Ability to Participate in Social Roles and Activities
AU - Blauvelt, Andrew
AU - Gondo, George C.
AU - Bell, Stacie
AU - Echeverría, Cristina
AU - Schmitt-Egenolf, Marcus
AU - Skov, Lone
AU - van de Kerkhof, Peter
AU - McCormick Howard, Leah
AU - Strober, Bruce
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023/7
Y1 - 2023/7
N2 - 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 as 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.
AB - 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 as 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.
KW - disease severity
KW - mental health
KW - psoriasis
KW - quality of life
KW - treatment
UR - http://www.scopus.com/inward/record.url?scp=85150955324&partnerID=8YFLogxK
U2 - 10.1177/24755303231160683
DO - 10.1177/24755303231160683
M3 - Journal article
C2 - 39296315
AN - SCOPUS:85150955324
SN - 2475-5303
VL - 8
SP - 100
EP - 106
JO - Journal of Psoriasis and Psoriatic Arthritis
JF - Journal of Psoriasis and Psoriatic Arthritis
IS - 3
ER -