Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Dermatology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
J Eur Acad Dermatol Venereol. 2018 Sep;32(9):1499-1506. doi: 10.1111/jdv.14865. Epub 2018 Mar 5.
Psychological aspect and quality of life should be considered in treating patients with psoriasis.
We sought to ascertain which clinical characteristics including presence of exposed lesions are associated with impairment of health-related quality of life (HRQoL) in patients with psoriasis.
The EPI-PSODE study was a nationwide, multicenter, cross-sectional study conducted in Korea that included 1260 adult patients with psoriasis. In addition to clinical characteristics including presence of exposed lesions, data were collected using the Psoriatic Arthritis (PsA) Screening and Evaluation (PASE), Dermatology Life Quality Index (DLQI), MOS 36-Item Short-Form Health Survey (SF-36), Work Productivity and Activity Impairment Questionnaire Psoriasis (WPAI: PSO) and Medication Satisfaction Questionnaire (MSQ).
Patients with a DLQI score > 5 (n = 990) were younger, had an earlier onset of psoriasis, scored higher on the Psoriasis Area and Severity Index (PASI), had higher body surface area (BSA) and had higher PASE scores than patients with DLQI ≤ 5 (n = 266). The group of patients with exposed lesions (n = 871) were younger and male predominance, earlier onset of psoriasis, longer disease duration, higher PASI/BSA score and a higher proportion with drinking and smoking history each than the group of patients without exposed lesions (n = 389). Presence of exposed lesions negatively influenced DLQI, 36-Item Short-Form Health Survey (SF-36) (mental component), presenteeism, total work productivity impairment and total activity impairment in the WPAI: PSO. In multiple regression model, PASI score was the only variable which was significantly associated with all HRQoL measures. Presence of exposed lesions was a significant factor affecting DLQI and SF-36 (mental).
The presence of exposed lesions has a negative impact on quality of life, mental health and work productivity. Therefore, effective treatments are particularly needed for psoriasis patients with exposed lesions.
在治疗银屑病患者时，应考虑心理方面和生活质量。
我们旨在确定哪些临床特征（包括暴露病变的存在）与银屑病患者的健康相关生活质量（HRQoL）受损有关。
EPI-PSODE 研究是一项在韩国进行的全国性、多中心、横断面研究，纳入了 1260 名成年银屑病患者。除了包括暴露病变的临床特征外，还使用关节炎筛查和评估量表（PASE）、皮肤病生活质量指数（DLQI）、MOS 36 项简短健康调查（SF-36）、工作生产力和活动障碍问卷-银屑病（WPAI：PSO）和药物满意度问卷（MSQ）收集数据。
DLQI 评分>5 的患者（n=990）较 DLQI 评分≤5 的患者（n=266）更年轻、银屑病发病更早、PASI 评分更高、体表面积（BSA）更大、PASE 评分更高。暴露病变组（n=871）较无暴露病变组（n=389）更年轻、男性居多、银屑病发病更早、病程更长、PASI/BSA 评分更高，且有饮酒和吸烟史的比例更高。暴露病变的存在对 DLQI、36 项简短健康调查（SF-36）（心理成分）、旷工、总工作生产力受损和 WPAI：PSO 总活动障碍有负面影响。在多元回归模型中，PASI 评分是唯一与所有 HRQoL 指标均显著相关的变量。暴露病变的存在是影响 DLQI 和 SF-36（心理）的一个重要因素。
暴露病变的存在对生活质量、心理健康和工作生产力有负面影响。因此，特别需要对有暴露病变的银屑病患者进行有效的治疗。
