Fernández-Torres Rosa María, Pita-Fernández Salvador, Fonseca Eduardo
Department of Dermatology, University Hospital of La Coruña, La Coruña, Spain.
Int J Dermatol. 2014 Nov;53(11):e507-11. doi: 10.1111/ijd.12294. Epub 2014 Sep 30.
BACKGROUND: Psoriasis can significantly affect the physical, psychological, and social aspects of a patient's life. Many studies have evaluated the effects of psoriasis on quality of life (QoL), but results in many cases are contradictory. OBJECTIVES: This study was conducted to assess the relationships between the characteristics of psoriasis (cutaneous severity, arthropathy, treatment) and comorbidities with QoL and to determine which factors have a major influence. METHODS: We assessed demographic data, the severity of cutaneous involvement, psoriasis treatment, presence of arthropathy, psoriasis duration, smoking status, alcohol intake, and the presence of comorbidities. Concomitant diseases were evaluated using the Charlson Comorbidity Index and the National Cholesterol Education Program Adult Treatment Panel III (ATP-III) criteria for metabolic syndrome. Quality of life was assessed using the Dermatology Life Quality Index (DLQI). RESULTS: Multivariate analysis showed that factors associated with QoL impairment included gender (women experienced greater impact: odds ratio [OR] 2.85, 95% confidence interval [CI] 1.48-5.49; P = 0.002); psoriasis duration (patients with longer durations of psoriasis and psoriasis treatment experienced less impairment: OR 0.96, 95% CI 0.94-0.99; P = 0.004); and treatment type (impact was lower in patients receiving biologic drugs than in those using topical treatment [OR 3.15, 95% CI 1.50-6.62; P = 0.002] and in those using biologics compared with those using conventional systemic treatment [OR 2.23, 95% CI 0.98-5.05; P = 0.053]). Psoriasis severity measured according to scores on the Psoriasis Area and Severity Index (PASI) and body surface area affected was not related to QoL impairment. Comorbidities were associated with impaired QoL in the univariate analysis but not after adjusting for other covariates. CONCLUSIONS: Factors associated with greater impairment of QoL were gender, psoriasis duration, and type of treatment. Patients receiving systemic and biologic therapies reported better QoL.
背景：银屑病会显著影响患者生活的身体、心理和社会层面。许多研究评估了银屑病对生活质量（QoL）的影响，但在很多情况下结果相互矛盾。 目的：本研究旨在评估银屑病的特征（皮肤严重程度、关节病、治疗）和合并症与生活质量之间的关系，并确定哪些因素具有主要影响。 方法：我们评估了人口统计学数据、皮肤受累的严重程度、银屑病治疗情况、关节病的存在、银屑病病程、吸烟状况、酒精摄入量以及合并症的存在。使用Charlson合并症指数和美国国家胆固醇教育计划成人治疗小组第三次报告（ATP-III）代谢综合征标准评估伴随疾病。使用皮肤病生活质量指数（DLQI）评估生活质量。 结果：多变量分析显示，与生活质量受损相关的因素包括性别（女性受影响更大：比值比[OR]2.85，95%置信区间[CI]1.48 - 5.49；P = 0.002）；银屑病病程（银屑病病程和治疗时间较长的患者受损较轻：OR 0.96，95%CI 0.94 - 0.99；P = 0.004）；以及治疗类型（接受生物制剂治疗的患者的影响低于使用局部治疗的患者[OR 3.15，95%CI 1.50 - 6.62；P = 0.002]，与使用传统全身治疗的患者相比，使用生物制剂的患者也是如此[OR 2.23，95%CI 0.98 - 5.05；P = 0.053]）。根据银屑病面积和严重程度指数（PASI）评分及受累体表面积衡量的银屑病严重程度与生活质量受损无关。在单变量分析中，合并症与生活质量受损相关，但在调整其他协变量后则不然。 结论：与生活质量受损程度较高相关的因素是性别、银屑病病程和治疗类型。接受全身治疗和生物治疗的患者报告的生活质量较好。
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