Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany.
Dermatol Ther. 2022 Aug;35(8):e15622. doi: 10.1111/dth.15622. Epub 2022 Jun 21.
Psoriasis is a chronic inflammatory skin disease showing a high burden due to its aesthetic, social, psychological, and quality of life (QoL) implications which also affect patient-physician relationship and, consequently, the adherence to treatments. Limited data on the natural history of psoriasis and factors predicting its prognosis are available. The aim of this study was to investigate patients' global characteristics, including treatments, associated with QoL impairment in psoriasis. Questionnaires evaluating sociodemographic features and Dermatology Life Quality Index (DLQI) were administered to patients. Multiple regression analysis was performed to evaluate factors associated with a large effect on patient's life (DLQI > 10), moderate effect on patient's life (DLQI ≥ 6 ≤ 10), small effect on patient's life (DLQI ≥ 2 < 6), and no effect on patient's life (DLQI < 2). Overall, 1052 consecutive patients affected by mild-to-severe psoriasis were recruited. Our logistic regression analysis showed that the influencing factors for a large effect on QoL were living in Southern Italy, depression, psoriatic arthritis, and psoriasis localization on facial, intertriginous, palmoplantar, trunk and scalp regions. For a moderate effect on patient's life, phototherapy and non-biological systemic therapies resulted to be the predictive factors. Mild psoriasis, living in social housing and the isolated involvement of scalp psoriasis had a small effect on QoL. Lastly, mild psoriasis and current biological therapies including anti-IL-12/23, anti-IL-17, and anti-TNF-α were positively associated with no life quality impairment. Perceived quality of life impairment in psoriasis not only depends on the skin disease but rather on patients' global characteristics. Therefore, the individual background of these patients should be respected in the selection of treatment options.
银屑病是一种慢性炎症性皮肤病，由于其美学、社会、心理和生活质量（QoL）的影响，负担沉重，这也会影响医患关系，进而影响治疗的依从性。目前关于银屑病自然史和预测其预后的因素的数据有限。本研究旨在调查患者的整体特征，包括治疗方法，这些特征与银屑病患者的生活质量受损有关。向患者发放评估社会人口学特征和皮肤病生活质量指数（DLQI）的问卷。采用多元回归分析评估与患者生活质量（DLQI>10）、中度影响（DLQI≥6≤10）、轻度影响（DLQI≥2<6）和无影响（DLQI<2）有较大影响的因素。共纳入 1052 例轻至重度银屑病患者。我们的逻辑回归分析表明，对 QoL 有较大影响的因素有居住在意大利南部、抑郁、银屑病关节炎和面部、皱褶、手掌和足底、躯干和头皮的银屑病定位。对中度影响患者生活质量的因素是光疗和非生物系统治疗。轻度银屑病、居住在社会住房和头皮银屑病孤立性受累与 QoL 轻度影响有关。最后，轻度银屑病和目前的生物治疗，包括抗 IL-12/23、抗 IL-17 和抗 TNF-α，与生活质量无损害有正相关。银屑病患者感知的生活质量受损不仅取决于皮肤疾病，还取决于患者的整体特征。因此，在选择治疗方案时应尊重这些患者的个体背景。
