Romiti Ricardo, Fabrício Lincoln Helder Zambaldi, Souza Cacilda da Silva, Galvão Leticia Oba, de Castro Caio Cesar Silva, Terena Aripuanã Cobério, Carneiro Francisca Regina Oliveira, Oyafuso Luiza Keiko Matsuka, Carneiro Sueli, Gontijo Bernardo, Kobata Clarice Marie, de Oliveira Maria de Fátima Paim, Cestari Tania, Antônio João Roberto, Martins Gladys Aires, Marques Silvio Alencar, Chaibub Sulamita Costa Wirth, Arruda Ana Carolina Belini Bazán, Félix Paulo Antonio Oldani, Magalhães Renata Ferreira, Abulafia Luna Azulay, Ferreira Karine A, Medeiros da Silva Aline, Silva Bruno Leonardo, Souza Juliano
a Faculty of Medicine , Hospital das Clínicas, University of São Paulo , São Paulo , Brazil.
b Hospital Universitário Evangélico de Curitiba, Faculty of Medicine FEPAR , Curitiba , Brazil.
J Dermatolog Treat. 2018 Dec;29(8):775-785. doi: 10.1080/09546634.2018.1466023. Epub 2018 Jun 17.
Data on chronic plaque psoriasis severity and its potential clinical and lifestyle implications in the Brazilian population are limited. The primary aim of this study was to assess the clinical severity of plaque psoriasis in Brazil. Further objectives included evaluating potential associations between disease severity and demographic, lifestyle, and clinical characteristics, health-related quality of life (HRQOL), and work productivity.
This observational (non-interventional) cross-sectional study was conducted in 26 dermatologic clinics across 11 Brazilian states. Psoriasis severity was assessed using investigator judgment and Finlay's Rule of Tens: a Psoriasis Area and Severity Index (PASI) score >10, a Body Surface Area (BSA) > 10%, or a Dermatology Life Quality Index (DLQI) score >10.
Among 1125 patients, 205 (18.2%) had moderate-to-severe disease. On multiple regression analyses, psoriasis severity was significantly (directly) associated with the presence of physical inactivity and comorbid pain, anxiety, and depression; and significantly (inversely) associated with HRQOL and work productivity.
Cross-sectional studies cannot assess temporal trends, and observational studies cannot conclusively determine causality or exclude biases and confounding due to unmeasured variables.
Among Brazilian patients with moderate-to-severe psoriasis, disease severity had far-reaching adverse impacts on lifestyle, comorbidities, HRQOL, and work productivity.
关于慢性斑块状银屑病严重程度及其在巴西人群中潜在的临床和生活方式影响的数据有限。本研究的主要目的是评估巴西斑块状银屑病的临床严重程度。进一步的目标包括评估疾病严重程度与人口统计学、生活方式、临床特征、健康相关生活质量(HRQOL)和工作生产力之间的潜在关联。
这项观察性(非干预性)横断面研究在巴西11个州的26家皮肤科诊所进行。使用研究者判断和芬利十分制评估银屑病严重程度:银屑病面积和严重程度指数(PASI)评分>10、体表面积(BSA)>10%或皮肤病生活质量指数(DLQI)评分>10。
在1125名患者中,205名(18.2%)患有中度至重度疾病。在多元回归分析中,银屑病严重程度与身体活动不足以及合并疼痛、焦虑和抑郁显著(直接)相关;与HRQOL和工作生产力显著(反向)相关。
横断面研究无法评估时间趋势,观察性研究无法确凿地确定因果关系或排除由于未测量变量导致的偏差和混杂因素。
在巴西中度至重度银屑病患者中,疾病严重程度对生活方式、合并症、HRQOL和工作生产力产生了深远的不利影响。