Korman N J, Zhao Y, Pike J, Roberts J
Clinical Trials Unit, University Hospitals Case Medical Center, Cleveland, OH, USA.
Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
Clin Exp Dermatol. 2016 Jul;41(5):514-21. doi: 10.1111/ced.12841. Epub 2016 Apr 8.
Psoriasis is a chronic disease, and many patients experience itching, painful skin and scaling. The relationship between psoriasis severity and symptom severity, quality of life (QoL) and work productivity is not fully understood.
To examine how QoL, work productivity and clinical symptoms vary between patients with mild, moderate and severe psoriasis.
During a recent US survey, dermatologists provided information on overall disease severity, symptom severity and comorbidities. Patients with psoriasis completed QoL and work productivity instruments: the EuroQoL 5-Dimension Health (EQ-5D) questionnaire, the Dermatology Life Quality Index (DLQI), and the Work Productivity and Activity Impairment (WPAI) questionnaire. Multivariate regression was used to explore the relationship between these outcome variables and psoriasis severity, controlling for differences in demographics and comorbidities.
The study analysed 694 patients (55% male; mean age: 44 years); 48%, 46% and 6% had mild, moderate and severe psoriasis, respectively. Scaling was the most common symptom, which was experienced by 82% of patients, followed by itching (73%) and pain (32%). Increased psoriasis severity was associated with increased itching, pain and scaling, and with reduced QoL (decrease in EQ-5D scores: moderate vs. mild -0.04, severe vs. mild -0.18; increase in DLQI: moderate vs. mild 2.97, severe vs. mild 7.95). WPAI scores increased with severity, indicating greater impairment (moderate vs. mild: 11.77, severe vs. mild 18.73).
Patients with more severe psoriasis experienced more severe symptoms and had a greater reduction in QoL and work productivity. It is important that physicians recognize the impact of severe disease on patients' lives and take steps to address this.
银屑病是一种慢性疾病，许多患者会经历瘙痒、皮肤疼痛和脱屑。银屑病严重程度与症状严重程度、生活质量（QoL）和工作效率之间的关系尚未完全明确。
研究轻度、中度和重度银屑病患者的生活质量、工作效率和临床症状如何变化。
在最近一项美国调查中，皮肤科医生提供了关于整体疾病严重程度、症状严重程度和合并症的信息。银屑病患者完成了生活质量和工作效率评估工具：欧洲五维健康量表（EQ-5D）问卷、皮肤病生活质量指数（DLQI）和工作效率与活动障碍问卷（WPAI）。采用多变量回归分析这些结果变量与银屑病严重程度之间的关系，并控制人口统计学和合并症的差异。
该研究分析了694例患者（55%为男性；平均年龄：44岁）；分别有48%、46%和6%的患者患有轻度、中度和重度银屑病。脱屑是最常见的症状，82%的患者出现，其次是瘙痒（73%）和疼痛（32%）。银屑病严重程度增加与瘙痒、疼痛和脱屑加剧以及生活质量下降相关（EQ-5D评分下降：中度与轻度相比为-0.04，重度与轻度相比为-0.18；DLQI增加：中度与轻度相比为2.97，重度与轻度相比为7.95）。WPAI评分随严重程度增加，表明损害更大（中度与轻度相比：11.77；重度与轻度相比：18.73）。
银屑病更严重的患者症状更严重，生活质量和工作效率下降幅度更大。医生认识到严重疾病对患者生活的影响并采取措施加以应对很重要。
