Study Finds Sociodemographic Characteristics Associated with Psoriasis Burden

Emanuele Scala, PhD

New data on the implications of psoriasis on patient’s quality of life suggested that the impairment was not only influenced by the skin disease but on an individual’s global characteristics.

The burdens of psoriasis, be they related to the aesthetic, psychological, or social implications of the disease, have been thoroughly documented in previous research.

However, limited data exist regarding the natural history of the disease and the predictive factors related to its prognosis.

As such, an investigative team led by Emanuele Scala, PhD. From the Center for Molecular Medicine at the Karolinska Institute, Sweden, investigated the sociodemographic and clinical factors associated with quality of life impairment in a cohort of Italian patients with psoriasis.

The Methods

Scala and colleagues utilized 18 Italian University and/or hospital centers with psoriasis-specialized units to conduct their cross-sectional, multicenter study from September 2017 and February 2018.

Eligible patients had a diagnosis of mild to severe psoriasis performed in the past 6 months and were consecutively enrolled during the follow-up appointments at the aforementioned psoriasis units.

Patients were also tasked with completing the Dermatology Life Quality Index (DLQI) and an additional questionnaire that assessed the sociodemographic characteristics that were offered by patients. Disease severity, including comorbidities, pharmacological anamnesis, body mass index, and previous diagnosis of depression was measure via the Psoriasis Area Severity Index (PASI).

The Findings

Approximately half of all study participants were from Central Italy (n=532, 50.6%), with the rest hailing from Southern Italy (n=368, 34.9%) and Northern Italy (n=152, 14.4%). Participants were adults 18-65 years (68.7%) and elderly subjects over 65 years (31.3%), and the study population was predominantly comprised of males (60.1%).

A majority of patients had mild psoriasis (PASI<10)(n=755, 71.8%) or moderate-to-severe psoriasis (PASI≥10) (n =217, 20.6%).

Among the factors associated with psoriasis, the location of Southern Italy was considered to be the most influential. Investigators suggested that this was due to the undertreatment of psoriasis in that region of Italy, as well as the low use of marketed drugs such as biologics. These conclusions were made based on a recent population-based study from Southern Italy.

Additional factors included depression, the presence of psoriatic arthritis, and the location of psoriasis on the face as well as the intertriginous, palmoplantar, trunk, and scalp regions.

Meanwhile, living in social housing and the isolated involvement of scalp psoriasis were said to have a “small effect” of the quality of life of patients with mild psoriasis, and mild psoriasis and current biologic therapies were positively associated with no life quality impairment.

With sociodemographic characteristics appearing to play a prominent role in the perceived quality of life impairment associated with psoriasis, investigators suggested that the individual background of patients “should be respected in the selection of treatment options for psoriasis”.

“The reflects the World Health Organization statements regarding the implementation of person-centered care,” the team wrote. “Further studies, especially with a case-control design, are required to deeper investigate this topic.”

The study, "Sociodemographic, clinical and therapeutic factors as predictors of life quality impairment in psoriasis: a cross-sectional study in Italy," was published online in Dermatologic Therapy.