Department of Dermatology, Stavanger University Hospital, Stavanger, Norway.
Section of Biostatistics, Department of Research, Stavanger University Hospital, Stavanger, Norway.
Br J Dermatol. 2017 Aug;177(2):505-512. doi: 10.1111/bjd.15375. Epub 2017 Jun 24.
Fatigue is associated with various chronic inflammatory diseases, but few studies have focused on its occurrence in psoriasis.
To describe fatigue prevalence and degree among patients with chronic plaque psoriasis vs. age- and sex-matched healthy subjects, and to examine how fatigue is influenced by essential clinical and demographic factors.
In 84 patients and 84 healthy subjects, fatigue severity was assessed using three different generic fatigue instruments: the fatigue Visual Analogue Scale (fVAS), the Fatigue Severity Scale (FSS) and the Short Form 36 (SF-36) Vitality scale. Cut-off scores for clinically important fatigue were defined as ≥ 4 for FSS, ≥ 50 for fVAS and ≤ 35 for the SF-36 Vitality scale. Disease activity was evaluated using the Psoriasis Area and Severity Index (PASI), and the impact on quality of life with the Dermatology Life Quality Index (DLQI).
Patients and healthy control subjects, respectively, showed median fVAS scores of 51 [interquartile range (IQR) 21-67] and 11 (IQR 3-20); FSS scores of 4 (IQR 2·5-5·3) and 1·6 (IQR 1·1-2·2); and SF-36 Vitality scores of 43 (IQR 25-85) and 73 (IQR 65-85). The rates of clinically important fatigue among patients vs. healthy controls, respectively, were 51% vs. 4% (fVAS); 52% vs. 4% (FSS); and 42% vs. 2% (SF-36 Vitality) (P < 0·001 for all differences). Fatigue was associated with DLQI scores, but not PASI scores, in univariate analysis but not in multivariate analysis.
Nearly 50% of patients with psoriasis suffered from substantial fatigue. Fatigue severity was associated with smoking, pain and depression, but not with psoriasis severity.
疲劳与各种慢性炎症性疾病有关，但很少有研究关注其在银屑病中的发生。
描述慢性斑块型银屑病患者与年龄和性别匹配的健康对照者之间的疲劳发生率和严重程度，并探讨疲劳如何受到重要的临床和人口统计学因素的影响。
在 84 例患者和 84 例健康对照者中，使用三种不同的通用疲劳量表评估疲劳严重程度：疲劳视觉模拟量表（fVAS）、疲劳严重程度量表（FSS）和简明 36 健康调查量表（SF-36）活力量表。定义临床重要疲劳的截断值为 FSS≥4、fVAS≥50 和 SF-36 活力量表≤35。使用银屑病面积和严重程度指数（PASI）评估疾病活动度，使用皮肤病生活质量指数（DLQI）评估对生活质量的影响。
患者和健康对照组的 fVAS 中位数分别为 51[四分位距（IQR）21-67]和 11（IQR 3-20）；FSS 中位数分别为 4（IQR 2·5-5·3）和 1·6（IQR 1·1-2·2）；SF-36 活力量表中位数分别为 43（IQR 25-85）和 73（IQR 65-85）。与健康对照组相比，患者中分别有 51%和 4%存在临床显著疲劳（fVAS）；52%和 4%（FSS）；42%和 2%（SF-36 活力）（所有差异 P<0·001）。在单变量分析中，疲劳与 DLQI 评分相关，但与 PASI 评分无关，但在多变量分析中无相关性。
近 50%的银屑病患者存在明显的疲劳。疲劳严重程度与吸烟、疼痛和抑郁有关，但与银屑病严重程度无关。
