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Influence of Psoriasis on Household Chores and Time Spent on Skin Care at Home: A Questionnaire Study. Dermatol Ther (Heidelb) 2015; 5:107-16. [PMID: 25940304 PMCID: PMC4470958 DOI: 10.1007/s13555-015-0076-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Previous studies have shown that psoriasis has a significant effect on patients' health-related quality of life. The impact of psoriasis on household chores and the need for assistance with such tasks are not well documented. The aim of this study was to estimate the impact of psoriasis on the ability to carry out household chores, the time spent on skin care at home and the assistance that patients with psoriasis require with these activities. METHODS In a questionnaire study 262 patients with moderate-to-severe psoriasis, visiting a tertiary level dermatological clinic during a 1-year study period, listed household chores which they considered were particularly affected by psoriasis. This was done without a predefined list of chores. Questions on their ability to perform household chores as well as time spent on skin care at home were asked. The need for outside assistance with household chores and help received were also determined. RESULTS More than half of the patients (57.8%) reported difficulties with household chores because of psoriasis. Psoriasis affected a wide range of everyday household activities, with physically demanding tasks and those involving contact with water mentioned most often. Most of the patients (84.6%) reported that they have increased the time spent on skin care because of psoriasis, on average by 87 min per week. A quarter of patients received assistance in household chores. Women received more assistance than men (p < 0.01). The need for additional assistance was reported by a fifth of patients, women more often than men (p < 0.05). CONCLUSION When estimating the overall burden of psoriasis, considering only the economic and productivity consequences may underestimate the impact of the disease. The impact on everyday life events such as the ability to perform household chores should also be taken into account. FUNDING This study was supported by unconditional grants from the research funds of the Hospital District of Southwest Finland. Hospital District of Southwest Finland's research permission K44/10/EVO13043.
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Autoimmune blistering diseases in females: a review. Int J Womens Dermatol 2015; 1:4-12. [PMID: 28491949 PMCID: PMC5418673 DOI: 10.1016/j.ijwd.2015.01.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 10/23/2014] [Accepted: 01/13/2015] [Indexed: 12/31/2022] Open
Abstract
The autoimmune blistering diseases (AIBDs) are a group of heterogeneous skin diseases with autoantibodies directed against structural proteins in the skin. A new interest in the female bias towards autoimmune diseases in general has led to our attention to focus on how and why this female bias manifests in AIBD. The authors aim to review and explore the various aspects of AIBD affecting females more than males, including the higher prevalence, worse quality of life, and complex management issues such as pregnancy and lactation. What is already known on this topic? Echoing autoimmune diseases in general, most autoimmune blistering diseases (AIBDs) have a female predominance, but the exact level of predominance is unknown. Pregnancy raises several complicated management issues for females with an AIBD.
What does this article add to our knowledge? Review of sex-specific epidemiology and etiology of each AIBD. Exploration and explanation of the key factors underlying the detrimental impacts of AIBD on women’s quality of life (QOL). Discussion of management issues in pregnancy and lactation for females with an AIBD.
How does this information impact clinical practice and/or change patient care? An awareness and understanding of the female predominance in AIBDs will ensure more appropriate diagnosis, evaluation, and future research. Emphasizing holistic care targeting the debilitating effects of AIBDs on women’s QOL. Informing the reader of optimal, yet safe interventions for pregnant women with an AIBD.
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Ng CY, Yang YW, Liu SH, Lu JFR, Yang LC, Yang CH, Huang YH. SF-36 healty survey on psoriasis quality-of-life: a study of 414 Taiwanese patients. J Dermatol 2015; 42:159-65. [PMID: 25583163 DOI: 10.1111/1346-8138.12748] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 11/13/2014] [Indexed: 11/30/2022]
Abstract
Psoriasis is a chronic debilitating disease that impairs patients' physical and social functioning. The assessment of health-related quality of life (HRQoL) provides a comprehensive insight into the actual disease burden that are not captured by the traditional clinical parameters. The objective of this study is to identify factors that may impact patients' HRQoL. We conducted a cross-sectional study, recruiting a total of 414 psoriasis vulgaris patients between January 2008 and December 2011. Our study found no significant correlation between disease severity or duration of psoriasis with HRQoL. Female patients have poorer HRQoL. Psoriatic arthritis, nail involvement, burning and itching sensation have a detrimental effect on HRQoL. This study highlighted that specific disease-associated symptoms such as itching and burning sensation, nail involvement and/or concomitant arthritis were important factors that may impact patients' HRQoL devoid of clinical severity. Physicians should carefully consider these factors when treating psoriasis patients.
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Affiliation(s)
- Chau Yee Ng
- Department of Dermatology, Chang Gung Memorial Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Tabolli S, Pagliarello C, Paradisi A, Cianchini G, Giannantoni P, Abeni D. Burden of disease during quiescent periods in patients with pemphigus. Br J Dermatol 2015; 170:1087-91. [PMID: 24428431 DOI: 10.1111/bjd.12836] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Studies conducted using different tools have invariably observed that physical and mental components of health status are seriously compromised in patients with pemphigus. An improvement in quality of life (QoL) has been commonly observed over the treatment period. OBJECTIVES The aim of the study is to verify whether the patients' wellbeing is affected by pemphigus also in absence of cutaneous and mucosal lesions. MATERIALS AND METHODS The clinical records of 203 patients were analysed. A total of 47 patients were without bullae/erosions and reported a score = 0 for both the Patient Global Assessment and the Ikeda index. In order to assess the QoL we used the Skindex-17 and the 12-item General Health Questionnaire (GHQ-12). RESULTS Patients without bullae/erosions had a better QoL when compared with patients with active lesions. This difference, with a reduction of approximately 30% of the Skindex-17 scores in the patients without lesions, was statistically significant, for both the symptoms and the psychosocial scales. The proportion of patients at risk of anxiety/depression (GHQ-positive cases) was 44% lower in patients without lesions compared with patients with lesions. In a multiple linear regression model the presence of bullae/erosions negatively influences QoL with an average increase of Skindex-17 symptoms and psychosocial scale scores of 11·7 and 10·6 points, respectively. Female patients had a statistically significantly worse QoL than males on the symptoms but not on the psychosocial Skindex-17 scales. CONCLUSIONS While patients without lesions reported a better QoL than patients with bullae/erosions, their Skindex-17 scores remained elevated. Dermatologists should be aware that a clearing of the skin manifestations does not mean 'perfect health' for the patient.
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Affiliation(s)
- S Tabolli
- Health Services Research Unit, IDI IRCCS, Rome, Italy
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Gahalaut P, Soodan PS, Mishra N, Rastogi MK, Soodan HS, Chauhan S. Clinical efficacy of psoralen + sunlight vs. combination of isotretinoin and psoralen + sunlight for the treatment of chronic plaque-type psoriasis vulgaris: a randomized hospital-based study. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2014; 30:294-301. [PMID: 24828298 DOI: 10.1111/phpp.12125] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/05/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Isotretinoin has been used in combination with oral psoralen + UVA (PUVA) and narrowband UVB (NBUVB) for treating psoriasis, especially in women of child-bearing age. The efficacy of oral psoralen + sun exposure (PUVAsol) is comparable to that of PUVA. This study was planned to compare the efficacy of oral PUVAsol with that of the combination of oral isotretinoin and PUVAsol in patients with chronic plaque psoriasis. METHODS Forty patients with psoriasis vulgaris were randomized to two groups. Group A (control group) received PUVAsol only. Group B (intervention group) received PUVAsol + isotretinoin (0.5 mg/kg/day). Psoriasis Area Severity Index (PASI) score was recorded at baseline and weeks 4, 8 and 12. Dermatology Life Quality Index was assessed at baseline and 12 weeks. The end point of the study was PASI 75 or 12 weeks, whichever came earlier. RESULTS Thirty-five patients completed the study. There were statistically significant differences between the two study groups for the number of patients achieving the endpoint of PASI 75, PASI scores at the end of 12 weeks, mean duration to achieve PASI 75, number of PUVAsol sessions needed to achieve PASI75 and mean cumulative dosage of 8-methoxypsoralen needed to achieve PASI 75. CONCLUSION The combination of isotretinoin with PUVAsol is more effective compared with PUVAsol alone for treating chronic plaque psoriasis.
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Affiliation(s)
- Pratik Gahalaut
- Department of Dermatology, Sri Ram Murti Smarak Institute of Medical Sciences, Bareilly, India
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Herédi E, Rencz F, Balogh O, Gulácsi L, Herszényi K, Holló P, Jókai H, Kárpáti S, Péntek M, Remenyik É, Szegedi A, Brodszky V. Exploring the relationship between EQ-5D, DLQI and PASI, and mapping EQ-5D utilities: a cross-sectional study in psoriasis from Hungary. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2014; 15 Suppl 1:S111-S119. [PMID: 24832842 DOI: 10.1007/s10198-014-0600-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 03/31/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND There is a growing interest in policy making for using utility measures and identifying algorithms to convert disease-specific measures into utilities. OBJECTIVES To analyse the relationship between EQ-5D, Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI) in psoriasis. To transform DLQI scores, and key clinical, demographic and health service utilisation variables into utilities. METHODS A cross-sectional questionnaire survey of 200 consecutive adult patients with moderate to severe psoriasis was carried out in two Hungarian university clinics. The relationship between the outcome measures were analysed with correlations and with the known-groups method. Bivariate and multivariate regression algorithms on EQ-5D scores were formulated. RESULTS The mean age of respondents was 51 years (SD = 12.9), 68.5% were male, and 51.5% received biological therapy. Median EQ-5D, DLQI, and PASI scores were 0.73, 3.0, and 3.45, respectively. EQ-5D showed a moderate correlation with the DLQI and with the PASI (r s = -0.48 and -0.43, p < 0.05). Strong correlation was found between DLQI and PASI (r s = 0.81, p < 0.05). DLQI and PASI discriminated better among groups categorised by the localisation of the lesions than EQ-5D. Presence of psoriasis on the neck and/or décolletage was associated with the greatest health related quality of life (HRQOL) impairment. Ten variables were incorporated in a multivariate algorithm that accounted for 48.8% of EQ-5D variance (ANOVA p < 0.001). CONCLUSIONS This study provided the first evidence that patients with visible psoriatic lesions have significantly worse HRQOL compared to those with non-visible lesions, measured not only with DLQI but also with EQ-5D. In addition to demographic and clinical variables, our model included health service utilisation variables related to psoriasis, and explained higher proportion of EQ-5D variance than any previous findings in the literature.
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Affiliation(s)
- Emese Herédi
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary
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Milčić D, Janković S, Vesić S, Milinković M, Janković J. Assessment of quality of life in patients with psoriasis: a study from Serbia. Int J Dermatol 2014; 54:523-8. [PMID: 24738764 DOI: 10.1111/ijd.12391] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Psoriasis has a substantial impact on patients' quality of life. OBJECTIVES The aims of this study were to assess the impact of the clinical severity of psoriasis on patients' quality of life and to determine the effects of psoriasis-related stress on patients' everyday life. METHODS The cross-sectional study was conducted at the Institute of Dermatovenereology, Clinical Center of Serbia, Belgrade. The study included 201 patients (124 men and 77 women), aged 18-70 with a diagnosis of psoriasis, hospitalized or treated as outpatients during 2009. For the assessment of patients' quality of life, the psoriasis disability index (PDI) was used. The stress related to psoriasis was measured with the psoriasis life stress inventory (PLSI) and disease severity with the psoriasis area and severity index (PASI). RESULTS We found moderate correlation between PLSI and all PDI subscales and overall score (correlation coefficients ranged from 0.334 to 0.521). The correlation between PASI and PDI subscales was weak, while we failed to find any significant correlation between PASI and the PLSI. The results of multiple regression analysis indicated that stress, more severe disease, and lower educational level are significant determining factors of a poorer quality of life in patients with psoriasis. CONCLUSION Our results support the importance of assessing the quality of life in psoriasis and effects of stress in patients' adjustment to their condition and may have important implications for a psychological stress management approach in the clinical management of psoriasis.
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Affiliation(s)
- Danijela Milčić
- Institute of Dermatovenereology, Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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In psoriasis, levels of hope and quality of life are linked. Arch Dermatol Res 2014; 306:661-6. [PMID: 24566824 PMCID: PMC4139595 DOI: 10.1007/s00403-014-1455-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 01/22/2014] [Accepted: 02/07/2014] [Indexed: 11/01/2022]
Abstract
Psychological resources such as hope have been suggested to positively influence quality of life (QoL) in chronic disorders. Here, we determined hope levels of psoriasis vulgaris in-patients and analyzed their relation to QoL. A total of 60 (29 male) patients were assessed for their QoL with a generic tool (WHOQOL-BREF) and a skin disease-specific instrument, the Dermatology Life Quality Index (DLQI). Hope levels were determined by use of the Basic Hope Inventory. We found a positive correlation between hope and all domains of WHOQOL-BREF (physical: r = 0.446, p = 0.000; psychological r = 0.464, p = 0.000; social r = 0.302, p = 0.019; environmental r = 0.480, p = 0000; and global r = 0.501, p = 0.000) and a negative correlation with DLQI (r = -0.281, p = 0.030) indicating higher QoL in patients with high hope. Hope was not correlated with disease severity or duration. Hope may play a substantial role in preventing QoL impairment in psoriasis. Psychotherapeutic interventions aimed at strengthening hope could improve QoL in this condition.
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Wong JW, Koo JYM. Dermatogeriatrics: a case for developing a new dermatology subspecialty. J DERMATOL TREAT 2013; 24:324-6. [DOI: 10.3109/09546634.2012.671913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jillian W. Wong
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center,
San Francisco, CA, USA
- University of Utah School of Medicine,
Salt Lake City, Utah, USA
| | - John Y. M. Koo
- Department of Dermatology, University of California San Francisco, Psoriasis and Skin Treatment Center,
San Francisco, CA, USA
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Sojević Timotijević Z, Janković S, Trajković G, Majcan P, Perišić S, Dostanić N, Janićijević Hudomal S, Janković J. Identification of psoriatic patients at risk of high quality of life impairment. J Dermatol 2013; 40:797-804. [PMID: 23961725 DOI: 10.1111/1346-8138.12201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 04/18/2013] [Indexed: 11/28/2022]
Abstract
Psoriasis is a systematic chronic disease with large influence on patients' quality of life (QoL). The aim of this study was to assess the QoL of patients with psoriasis using generic, dermatology-specific and psoriasis-specific instruments simultaneously, to investigate the relationships between dimensions or subscales of the questionnaires and to identify categories of patients at risk of a high QoL impairment. The study comprised 100 consecutive patients with psoriasis treated at the Department of Dermatology, Clinical Center "Zvezdara", Belgrade, from January to December 2011. Three QoL questionnaires were administered: the EuroQol-5D (EQ-5D), the Dermatological Life Quality Index (DLQI) and the Psoriasis Disability Index (PDI). The Psoriasis Area and Severity Index was used in evaluating disease severity. According to our results the QoL of psoriatic patients was impaired (the overall DLQI and PDI scores were 10.5 ± 7.2 and 13.4 ± 8.7, respectively, while EQ visual analog scale score was 48.8 ± 25.1). The most predictive factor of QoL impairment was disease severity, followed by sole and nail involvement. Psoriatic arthritis and bleeding were also associated with impaired QoL. Significant correlations between the instruments used in this study were in the expected directions. Mainly strong and moderate significant correlations ranging 0.26-0.84 were seen between DLQI and PDI instruments. A detailed approach to QoL assessment may give to the dermatologist useful information that could be of help in identifying patients belonging to categories at risk of high QoL impairment due to psoriasis, thus guiding them in clinical practice.
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Khoudri I, Lamchahab FZ, Ismaili N, Senouci K, Hassam B, Abouqal R. Measuring quality of life in patients with psoriasis using the Arabic version for Morocco of the Dermatology Life Quality Index. Int J Dermatol 2013; 52:795-802. [PMID: 23488573 DOI: 10.1111/j.1365-4632.2011.05450.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Psoriasis has been demonstrated to have substantial impacts on dermatology-related functional limitations and health-related quality of life (HRQL). This study evaluated the HRQL in Moroccan psoriatics using the Arabic version of the Dermatology Life Quality Index (DLQI) and examined the psychometric properties of the questionnaire. MATERIALS AND METHODS The Moroccan Arabic version of the DLQI was developed and approved by the author of the questionnaire. The DLQI was administered to inpatient and outpatient adult psoriatics. Some participants completed the DLQI for a second time. Demographic and clinical characteristics were collected. Reliability of the DLQI was tested using Cronbach's coefficient alpha and intraclass correlation coefficient (ICC). Factor structure was tested by explanatory and confirmatory factor analysis. Construct validity was tested by known-groups comparison using the generalized linear model to assess factors influencing patients' HRQL. RESULTS A total of 176 psoriatics completed the questionnaire. The mean age was 36 ± 14 years. The mean Psoriasis Area and Severity Index (PASI) score was 11.8 ± 7.9. The mean DLQI score was 12.7 ± 5.9 (the higher the score the greater the impairment of HRQL). Cronbach's alpha coefficient was 0.84. ICC was 0.97. The principal component analysis confirmed the bidimensional structure of the questionnaire. Factors associated with poorer HRQL were higher PASI (P < 0.001), pustular and erythrodermal clinical forms (P < 0.001), and older age (P = 0.001). CONCLUSIONS The Arabic version for Morocco of the DLQI is reliable and valid. Severity of the psoriasis, older age, and severe clinical forms influence the HRQL of patients.
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Affiliation(s)
- Ibtissam Khoudri
- Department of Dermatology, Ibn Sina University Hospital, Rabat, Morocco
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Seibert DC, Darling TN. Physical, Psychological and Ethical issues in Caring for Individuals with Genetic Skin Disease. J Nurs Scholarsh 2013; 45:89-95. [DOI: 10.1111/jnu.12004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Skin disease is highly prevalent in the United States, and it has been well-documented that patients with skin disease experience financial, psychological, social, and quality-of-life (QoL) burdens beyond those of the general population. Pediatric patients and their caregivers are particularly vulnerable to the burden of skin disease. Over the past decade disease-specific indices for QoL measurement in pediatric dermatology have been developed. Most of this research has focused on acne, atopic dermatitis, hemangiomas, ichythosis, psoriasis, and vitiligo. This article provides an overview of QoL assessment in pediatric dermatology for these six conditions.
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Affiliation(s)
- Megan M Brown
- Department of Dermatology, University of New Mexico School of Medicine, 1021 Medical Arts Avenue Northeast, Albuquerque, NM 87131, USA
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Tabolli S, Naldi L, Pagliarello C, Sampogna F, di Pietro C, Spagnoli A, Abeni D. Evaluation of the impact of writing exercises interventions on quality of life in patients with psoriasis undergoing systemic treatments. Br J Dermatol 2012; 167:1254-64. [DOI: 10.1111/j.1365-2133.2012.11147.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S. Tabolli
- IDI‐IRCCS Health Services Research, Via Monti di Creta 104, 00167 Rome, Italy
| | - L. Naldi
- Centro Studi GISED, Via Garibaldi 13/15, 24122 Bergamo, Italy
| | - C. Pagliarello
- IDI‐IRCCS Health Services Research, Via Monti di Creta 104, 00167 Rome, Italy
| | - F. Sampogna
- IDI‐IRCCS Health Services Research, Via Monti di Creta 104, 00167 Rome, Italy
| | - C. di Pietro
- IDI‐IRCCS Health Services Research, Via Monti di Creta 104, 00167 Rome, Italy
| | - A. Spagnoli
- IDI‐IRCCS Health Services Research, Via Monti di Creta 104, 00167 Rome, Italy
| | - D. Abeni
- IDI‐IRCCS Health Services Research, Via Monti di Creta 104, 00167 Rome, Italy
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Lesuis N, Befrits R, Nyberg F, van Vollenhoven RF. Gender and the treatment of immune-mediated chronic inflammatory diseases: rheumatoid arthritis, inflammatory bowel disease and psoriasis: an observational study. BMC Med 2012; 10:82. [PMID: 22853635 PMCID: PMC3414735 DOI: 10.1186/1741-7015-10-82] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Accepted: 08/01/2012] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA), inflammatory bowel disease (IBD), and psoriasis are immune-mediated inflammatory diseases with similarities in pathophysiology, and all can be treated with similar biological agents. Previous studies have shown that there are gender differences with regard to disease characteristics in RA and IBD, with women generally having worse scores on pain and quality of life measurements. The relationship is less clear for psoriasis. Because treatment differences between men and women could explain the dissimilarities, we investigated gender differences in the disease characteristics before treatment initiation and in the biologic treatment prescribed. METHODS Data on patients with RA or IBD were collected from two registries in which patients treated with biologic medication were enrolled. Basic demographic data and disease activity parameters were collected from a time point just before the initiation of the biologic treatment. For patients with psoriasis, the data were taken from the 2010 annual report of the Swedish Psoriasis Register for systemic treatment, which included also non-biologic treatment. For all three diseases, the prescribed treatment and disease characteristics were compared between men and women. RESULTS In total, 4493 adult patients were included in the study (1912 with RA, 131 with IBD, and 2450 with psoriasis). Most of the treated patients with RA were women, whereas most of the patients with IBD or psoriasis were men. There were no significant differences between men and women in the choice of biologics. At treatment start, significant gender differences were seen in the subjective disease measurements for both RA and psoriasis, with women having higher (that is, worse) scores than men. No differences in objective measurements were found for RA, but for psoriasis men had higher (that is, worse) scores for objective disease activity measures. A similar trend to RA was seen in IBD. CONCLUSIONS Women with RA or psoriasis scored significantly higher on subjective, but not on objective, disease activity measures than men, and the same trend was seen in IBD. This indicates that at the same level of treatment, the disease has a greater effect in women. These findings might suggest that in all three diseases, subjective measures are discounted to some extent in the therapeutic decision-making process, which could indicate undertreatment in female patients.
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Affiliation(s)
- Nienke Lesuis
- Medical Faculty, Radboud University, Geert Grooteplein 21, 6500 HB, Nijmegen, The Netherlands.
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Depression and Anxiety Disorders among Patients with Psoriasis: A Hospital-Based Case-Control Study. Dermatol Res Pract 2012; 2012:381905. [PMID: 22844272 PMCID: PMC3403219 DOI: 10.1155/2012/381905] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 05/30/2012] [Accepted: 06/06/2012] [Indexed: 12/27/2022] Open
Abstract
Background. Psoriasis is a common, genetically determined inflammatory and proliferative disease of the skin. Psychological stress can exacerbate the disease. This study sought to investigate the depression and anxiety disorders among patients with psoriasis and control group. Method. In this hospital-based case-control study, One hundred patients with psoriasis (case) referred to the dermatology department and 100 patients with otolaryngology problems and dermatological healthy volunteers (control) who referred to the Otolaryngology Department of Bouali Sina Hospital in Sari, Iran, in 2007 were studied. Demographic characteristics were recorded. Beck Depression Inventory and Spielberger State-Trait Anxiety Scale I-II were administered to the patients in both groups. Data were analyzed using SPSS statistical software and descriptive statistical tests. Results. From One-hundred patients in each group, 44 (45%) were men. Depression score was 67% and 12% in psoriatic patients and control, respectively. The Beck depression scores of patients with psoriasis were significantly higher than scores of the control group (P < 0.05). Based on Spielberger State-Trait Anxiety Scale, anxiety was found in 45% of patients in case group and 18% of controls. Conclusion. The results revealed that psoriatic patients reported significantly higher degrees of depression and anxiety than controls. In addition, psoriatic women were more depressed than psoriatic men.
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Sebaratnam DF, Frew JW, Davatchi F, Murrell DF. Quality-of-Life Measurement in Blistering Diseases. Dermatol Clin 2012; 30:301-7, ix. [DOI: 10.1016/j.det.2011.11.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Sebaratnam DF, McMillan JR, Werth VP, Murrell DF. Quality of life in patients with bullous dermatoses. Clin Dermatol 2012; 30:103-7. [PMID: 22137233 DOI: 10.1016/j.clindermatol.2011.03.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Genetic and acquired bullous dermatoses can severely affect multiple domains of a patient's quality of life (QOL). Integrating formal evaluation of QOL into the clinical evaluation of patients facilitates an objective assessment of disease severity, mapping of disease trajectory, and captures therapeutic intervention outcomes. There have been 5 studies evaluating QOL in autoimmune dermatoses and 4 studies reviewing QOL in the genodermatoses. All literature to date indicates a significant disease burden in this setting. The development of formal QOL instruments has facilitated quantification of QOL deficits in this arena and offers promising tools for patient assessment in the future.
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Affiliation(s)
- Deshan F Sebaratnam
- Department of Dermatology, St. George Hospital, University of New South Wales, Kogarah, Australia.
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Hashimoto T, Kawakami T, Tsuruta D, Hamada T, Natsuaki Y, Fukuda S, Koga H, Sogame R, Ohyama B, Ono F, Karashima T, Nakama T, Dainichi T, Ishii N, Yasumoto S. Low-dose cyclosporin improves the health-related quality of life in Japanese psoriasis patients dissatisfied with topical corticosteroid monotherapy. Australas J Dermatol 2012; 53:202-6. [DOI: 10.1111/j.1440-0960.2011.00870.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Tabolli S, Spagnoli A, di Pietro C, Pagliarello C, Paradisi A, Sampogna F, Abeni D. Assessment of the health status of 2499 dermatological outpatients using the 12-item Medical Outcomes Study Short Form (SF-12) questionnaire. Br J Dermatol 2011; 165:1190-6. [DOI: 10.1111/j.1365-2133.2011.10532.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Manjula VD, Sreekiran S, Saril PS, Sreekanth MP. A study of psoriasis and quality of life in a tertiary care teaching hospital of kottayam, kerala. Indian J Dermatol 2011; 56:403-6. [PMID: 21965848 PMCID: PMC3179003 DOI: 10.4103/0019-5154.84767] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Psoriasis is a chronic skin disease which has an impact on health-related quality of life (QoL). The psoriasis disability index (PDI) is a simple 15-item questionnaire which is used to assess overall psoriasis disability. Objectives: (1) To assess the health-related QoL among patients with psoriasis, attending dermatology OPD of Medical College Hospital, Kottayam. (2) To find out the association of QoL with age and gender. Materials and Methods: This was a descriptive case series study conducted in Dermatology OPD of Medical College Hospital, Kottayam, Kerala. Psoriasis patients attending the Dermatology OPD of Medical College Hospital for 2 months were assessed. Results: Out of the total 32 patients, 56.2% were males, whose mean age was 45; 72% were married, 47% had education above plus two and were employed. Also, 34% had income above Rs. 3000 per month. Among the PDI subsets, daily activities were affected the most (90.6%), followed by work (84.4%), leisure activities (71.9%), problems with treatment (68.7%) and the least affected was personal relations (62.5%). Overall PDI score (median 14.5, interquartile range 4.5–22) showed that the QoL was affected in 75% of which 9.4% were mild (score < 9), 31.2% were moderate (score 10–18) and 34.4% were severe (score > 18). There was no association between the total PDI score and age or gender. Conclusion: QoL was affected in 75% of psoriasis patients. There was no association between QoL and age or gender.
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Affiliation(s)
- V D Manjula
- Medical College Hospital, Kottayam, Kerala, India
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Grozdev IS, Van Voorhees AS, Gottlieb AB, Hsu S, Lebwohl MG, Bebo BF, Korman NJ. Psoriasis in the elderly: From the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol 2011; 65:537-545. [DOI: 10.1016/j.jaad.2010.05.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 05/10/2010] [Accepted: 05/10/2010] [Indexed: 02/08/2023]
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Jankovic S, Raznatovic M, Marinkovic J, Jankovic J, Kocev N, Tomic-Spiric V, Vasiljevic N. Health-related quality of life in patients with psoriasis. J Cutan Med Surg 2011; 15:29-36. [PMID: 21291653 DOI: 10.2310/7750.2010.10009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Psoriasis is a chronic skin disease that has a significant impact on patients' lives. OBJECTIVE The purpose of the study was to assess factors that might influence the health-related quality of life (HRQoL) of patients with psoriasis. METHODS We conducted a cross-sectional study of 110 outpatients with psoriasis. To assess the HRQoL, The Short Form 36 Health Survey (SF-36) and Skindex-29 were administered. Stressful life events during the last 12 months were assessed with Paykel's Interview for Recent Life Events. RESULTS HRQoL was significantly more impaired in older patients, those with age at onset of 40 years or more, who had a positive family history and who experienced stressful life events in the 12 months preceding the interview. Sex and clinical severity were not significantly related to patients' HRQoL. CONCLUSION Psoriasis patients have poorer HRQoL than the general population. This study supports the decision to use both generic and skin-specific instruments to assess the impact of psoriasis on HRQoL.
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Affiliation(s)
- Slavenka Jankovic
- The Institute of Epidemiology, School of Medicine, Universtity of Belgrade, Serbia.
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OKUBO Y, NATSUME S, USUI K, AMAYA M, TSUBOI R. Low-dose, short-term ciclosporin (Neoral®) therapy is effective in improving patients’ quality of life as assessed by Skindex-16 and GHQ-28 in mild to severe psoriasis patients. J Dermatol 2010; 38:465-72. [DOI: 10.1111/j.1346-8138.2010.01041.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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AKSOY B, ALTAYKAN-HAPA A, EGEMEN D, ATAKAN N. Indicators of health quality in 154 Turkish patients with psoriasis. J Dermatol 2010; 38:600-3. [DOI: 10.1111/j.1346-8138.2010.01047.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kossakowska MM, Cieścińska C, Jaszewska J, Placek WJ. Control of negative emotions and its implication for illness perception among psoriasis and vitiligo patients. J Eur Acad Dermatol Venereol 2009; 24:429-33. [PMID: 19744257 DOI: 10.1111/j.1468-3083.2009.03432.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purpose of the study was to determine the intensity of control over negative emotions of anger, depressed mood, and anxiety in certain skin diseases such as psoriasis and vitiligo, and to define the predictors of this emotional control in terms of the illness perception in the following context: duration of illness, age at onset, subjective knowledge of the causes of illness, subjective sense of control over the disease. METHODS The study included 60 patients with psoriasis (n = 30) and vitiligo (n = 30) as well as healthy persons (n = 60) matched to the experimental group in terms of gender, age, and level of education. Control of negative emotions was examined by means of Watson and Greer's Courtauld Emotional Control Scale (Polish adaptation by Juczynski) and the illness perception by means of Kossakowska's Chronic Patients Questionnaire. RESULTS The research concludes that psoriasis patients control negative emotions more intensively than healthy people. Vitiligo patients on the other hand do not differ in the control of negative emotions compared with healthy subjects. There are no significant predictors of negative emotional control in vitiligo. In psoriasis gender and age are the main contributors to negative emotional control and anger control is predicted by the age at onset as well. CONCLUSION The specificity of the skin disease affects maladaptive negative emotional control and the suggestion is to use psychological treatment in hospitalised psoriasis in particular.
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Affiliation(s)
- M M Kossakowska
- Department of Clinical and Health Psychology, Warsaw School of Social Sciences and Humanities Faculty in Sopot, Sopot, Poland.
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Abstract
Psoriasis is a chronic inflammatory hyperproliferative disease of the skin, scalp, nails, and joints. The physical symptoms of psoriasis include itching, irritation, burning/stinging, sensitivity, and pain. Patients also suffer psychological distress, especially as a result of stigmatization, self-consciousness, and embarrassment, which can in turn affect employment and social activities. Relatively high rates of depression are reported in patients with psoriasis. Inflammatory cytokines such as tumor necrosis factor alpha, interferon gamma, and other type 1 cytokines play an important role in the pathogenesis and comorbidities of psoriasis. Data from both animal and human studies suggest that these cytokines are linked to depression. Some psoriasis treatments have demonstrated improvements in symptoms of psoriasis as well as in measures of depression and health-related quality of life. Physicians managing patients with psoriasis must be aware of the psychological effects of psoriasis and need to use a multifaceted approach to managing this disease, focusing on both the physical and psychological aspects.
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Affiliation(s)
- Abby S Van Voorhees
- Psoriasis and Phototherapy Treatment Center, University of Pennsylvania, Dept of Dermatology, Philadelphia, PA 19104, USA.
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Sampogna F, Frontani M, Baliva G, Lombardo G, Alvetreti G, Di Pietro C, Tabolli S, Russo G, Abeni D. Quality of life and psychological distress in patients with cutaneous lymphoma. Br J Dermatol 2009; 160:815-22. [DOI: 10.1111/j.1365-2133.2008.08992.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Paradisi A, Sampogna F, Di Pietro C, Cianchini G, Didona B, Ferri R, Abeni D, Tabolli S. Quality-of-life assessment in patients with pemphigus using a minimum set of evaluation tools. J Am Acad Dermatol 2009; 60:261-9. [DOI: 10.1016/j.jaad.2008.09.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Revised: 09/01/2008] [Accepted: 09/09/2008] [Indexed: 10/21/2022]
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Sampogna F, Johansson V, Axtelius B, Abeni D, Söderfeldt B. A multilevel analysis of factors affecting the difference in dental patients’ and caregivers’ evaluation of oral quality of life. Eur J Oral Sci 2008; 116:531-7. [DOI: 10.1111/j.1600-0722.2008.00578.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Basra MKA, Fenech R, Gatt RM, Salek MS, Finlay AY. The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol 2008; 159:997-1035. [PMID: 18795920 DOI: 10.1111/j.1365-2133.2008.08832.x] [Citation(s) in RCA: 254] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The Dermatology Life Quality Index (DLQI) is one of the most widely used dermatology-specific quality of life instruments. Over the last 5 years there has been great interest in its use. OBJECTIVES To collect and present all information regarding the technical properties and the clinical use of the DLQI from the date it was published to the end of 2007 for use as a single source of reference. METHODS A detailed literature search was conducted using electronic reference databases and the DLQI library in the Department of Dermatology, Cardiff University. All publications mentioning any aspect of the DLQI, from the time of its development to the end of 2007, were identified and the data concerning the DLQI in terms of its psychometric analysis, and use in clinical trials, epidemiological studies and health services research, were extracted and tabulated with all the relevant references. RESULTS In total, 272 full articles which have included the DLQI were reviewed. Studies described in these articles were divided into five main categories: psychometric studies, descriptive/epidemiological studies, drug (topical and systemic) trials, clinical practice research, and therapeutic interventions. The DLQI has been used in 33 different skin conditions in 32 countries and is available in 55 languages. Psychometric aspects of the DLQI such as validity, reliability, responsiveness to change, factor structure, and minimal important difference were described in 115 studies. The DLQI has been used in 33 studies assessing the effectiveness of 14 different types of therapeutic interventions and in 37 studies evaluating nine types of clinical practice research. Sixty studies have used it alone or in parallel with other instruments as an outcome measure in clinical trials of 18 systemic drugs while 22 studies have used it in 14 different topical drug trials. The DLQI has also been used in 27 multinational studies. CONCLUSIONS During the last 14 years there has been a gradual increase in the international use of the DLQI. The brevity and simplicity of use of the DLQI has resulted in its popularity both in clinical practice and in research. However, there are various issues in particular regarding its unidimensionality, differential item functioning, and minimal clinically important difference, which require further research. This article should facilitate the work of potential users of the DLQI by providing a readily available source of references for different aspects of the DLQI.
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Affiliation(s)
- M K A Basra
- Department of Dermatology, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, U.K.
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[Addictions and psoriasis: an example of the dermatologist's implication in preventive medicine ?]. Ann Dermatol Venereol 2008; 135 Suppl 4:S259-62. [PMID: 18466794 DOI: 10.1016/s0151-9638(08)70545-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Association between psoriasis and addictive disorders has been longtime suspected and several studies are supporting the association of psoriasis and alcohol, and of psoriasis and tobacco. The association of psoriasis and other addictive disorders has not yet been reported. The association of psoriasis and alcohol is not restricted to alcoholism (defined as excessive alcohol consumption with psychic and/or psychic (correction of physic) dependence). It has been suggested that psoriasis is more closely linked to alcohol misuse than it is to alcoholism. The association of psoriasis and alcohol seems not been influenced by the gender, and shows a dose-effect relation. The most striking link between cigarette smoking and psoriasis has been established in palmo-plantar pustulosis. This link also seems to exist for other forms of psoriasis, with a dose-effect relation. Cigarette smoking could be involved in the high prevalence of lung cancer and cardio vascular disorders in psoriatic patients. There are a number of difficulties in the assessment of the correlation between psoriasis, cigarette smoking, and alcohol, and even more so in establishing a causal or etiologic relationship between the three, because of several confusion factors. This must not occult the reality of this association and its impact of psoriatic patients' health and the importance of detecting and preventing them. The detection and the prevention of the complications of these addictions belong to the dermatologists.
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Sampogna F, Raskovic D, Guerra L, Pedicelli C, Tabolli S, Leoni L, Alessandroni L, Abeni D. Identification of categories at risk for high quality of life impairment in patients with vitiligo. Br J Dermatol 2008; 159:351-9. [DOI: 10.1111/j.1365-2133.2008.08678.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Delfino M, Holt EW, Taylor CR, Wittenberg E, Qureshi AA. Willingness-to-pay stated preferences for 8 health-related quality-of-life domains in psoriasis: a pilot study. J Am Acad Dermatol 2008; 59:439-47. [PMID: 18639364 DOI: 10.1016/j.jaad.2008.05.032] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 04/25/2008] [Accepted: 05/27/2008] [Indexed: 12/17/2022]
Abstract
BACKGROUND Psoriasis is a chronic skin condition that has a major impact on health-related quality of life (QOL). We evaluated health-related QOL via willingness to pay and a ranking task for 8 domains of health relevant to psoriasis: intimacy, physical comfort, self-care, ability to work or volunteer, ability to concentrate, emotional health, social comfort, and ability to sleep. OBJECTIVE The goals of the study were to pilot test a new method to measure QOL impact in psoriasis and identify the areas of life most affected by psoriasis. METHODS Forty participants with a history of psoriasis were interviewed in a face-to-face format. First, participants were asked to rank the 8 domains of health we were investigating. Second, patients were asked how much money they would be willing to pay for a hypothetical cure for each domain of health. Responses in US dollars were interpreted as strength of preference rather than absolute monetary values. RESULTS About half of the patients in the sample (48%) were female, 60% had a college degree or further education, and 38% had an income level over $45,000/y. Physical comfort, social comfort, and emotional health were highly ranked by more than 75% of respondents. Ability to concentrate was least likely to be affected by psoriasis with just a quarter (25.7%) of respondents ranking this domain as important. The median amount patients were willing to pay for a hypothetical cure of psoriasis specific to a particular domain was highest for physical comfort ($2000, 25th quartile = $500, 75th quartile = $5500) and emotional health ($2000, 25th quartile = $250, 75th quartile = $5000), and lowest for ability to sleep ($625, 25th quartile = $50, 75th quartile = $5000). LIMITATIONS The sample size is modest for this pilot study. Willingness to pay as a method of eliciting stated preferences for qualitative aspects of health may be influenced by individual perception of money. CONCLUSIONS This study successfully pilot tested a willingness-to-pay method and a ranking task to measure the relative severity of 8 domains of health-related QOL and found that physical comfort, social comfort, and emotional health were the domains of health most affected by psoriasis.
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Affiliation(s)
- Matthew Delfino
- Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA
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Abstract
Psoriasis is a chronic and debilitating inflammatory disease associated with serious comorbidities. Psoriasis can have a significant impact on a patient's quality of life and is associated with loss of productivity, depression, and an increased prevalence of malignancy. Emerging comorbidities of psoriasis include cardiovascular disease and metabolic syndrome. Psoriasis patients have an increased prevalence of the core components of metabolic syndrome, including obesity, dyslipidemia, and insulin resistance. The relationship between psoriasis and comorbidities such as metabolic syndrome and cardiovascular disease is likely linked to the underlying chronic inflammatory nature of psoriasis. The molecular mechanisms involved in psoriasis-associated dysregulation of metabolic function are believed to be due, in large part, to the action of increased levels of proinflammatory factors, such as tumor necrosis factor-alpha, that are central to the pathogenesis of psoriasis. Recent studies investigating the effects of tumor necrosis factor antagonists on the treatment of cardiovascular disease and metabolic syndrome support this concept.
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Janowski K, Steuden S. Severity of psoriasis and health-related quality of life: the moderating effects of temperament. Br J Dermatol 2007; 158:633-5. [DOI: 10.1111/j.1365-2133.2007.08381.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sampogna F, Tabolli S, Mastroeni S, Di Pietro C, Fortes C, Abeni D. Quality of life impairment and psychological distress in elderly patients with psoriasis. Dermatology 2007; 215:341-7. [PMID: 17911993 DOI: 10.1159/000107628] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Accepted: 05/01/2007] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/AIMS The management of psoriasis, which has a major impact on quality of life (QoL), deserves a specific attention to elderly patients' problems and needs. Our aim was to describe the QoL of elderly patients with psoriasis. METHODS This is a cross-sectional study on 305 psoriatic inpatients, aged > or = 65 years. QoL, measured by the Skindex-29, was compared in groups of patients based on clinical and sociodemographic characteristics, and the possible determinants of psychological distress were investigated. RESULTS The mean age of the patients was 71 years (range: 65-93). Clinical severity tended to increase with age. Psychological distress was higher in patients > 70 years of age, while QoL showed an improvement for all the Skindex-29 scales in older age groups. Gender (women vs. men), and Skindex-29 emotions and functioning scales emerged as associated with psychological distress, after adjusting for age and clinical severity. CONCLUSION These observations indicate that clinical severity of psoriasis increases among very elderly patients and is associated with different levels of skin-related QoL and psychological distress. It is important for dermatologists to be aware of the specific impact of psoriasis in the different subgroups of the elderly population, to meet the peculiar needs of each group.
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Affiliation(s)
- F Sampogna
- Health Services Research Unit, Istituto Dermopatico dell'Immacolata (IDI-IRCCS), Rome, Italy.
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Soder S, Diepgen TL, Radulescu M, Apfelbacher CJ, Bruckner T, Weisshaar E. Occupational skin diseases in cleaning and kitchen employees: Course and quality of life after measures of secondary individual prevention. J Dtsch Dermatol Ges 2007; 5:670-6. [PMID: 17659040 DOI: 10.1111/j.1610-0387.2007.06419.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cleaning and kitchen employees have an increased risk of suffering from occupational dermatoses. Prevention including improving individual skin care and skin protection behavior, health education, optimizing diagnostics and therapy as well as avoidance of occupational skin disease (BK 5101) is important. PATIENTS AND METHODS Participants in the courses were patients suspected of having an occupational skin disease. Besides socio-demographic and disease-related data, health-related quality of life (QL) was measured using the SF-36 and Skindex-29. One year later all participants were interviewed by telephone about the course of their skin disease. RESULTS Out of 212 participants, 84.0 % were female. The mean age was 41.6 (SD = 10.8) years.168 patients (79.2 %) suffered from hand dermatitis,with irritant contact dermatitis being the predominant diagnosis (46.2 %,n = 98). One year later 65.4 % (n = 85) of the patients interviewed still suffered from hand dermatitis.9.2 % (n = 12) had meanwhile quit their job due to the skin disease. QL was impaired in all age groups being lower with increasing age of the patients. CONCLUSIONS The follow-up confirmed the positive impact of the skin protection courses on patients' skin disease and well-being. Occupational skin diseases impair health-related quality of life in these professions but disease severity does not seem to play a key role.
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Affiliation(s)
- Stefanie Soder
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Germany
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Eghlileb AM, Davies EEG, Finlay AY. Psoriasis has a major secondary impact on the lives of family members and partners. Br J Dermatol 2007; 156:1245-50. [PMID: 17459044 DOI: 10.1111/j.1365-2133.2007.07881.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Psoriasis affects the quality of life (QoL) of relatives and partners of patients with psoriasis, but little is known about this secondary impact. OBJECTIVES To identify the different ways in which the lives of relatives and partners of people with psoriasis are affected by the disease. METHODS Relatives and partners of patients with psoriasis participated. Subjects were excluded if they had any skin disease. The severity of the psoriasis of the patients was measured using the Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI) and Psoriasis Disability Index (PDI). Subjects either had intensive qualitative interviews with one researcher or responded to a postal questionnaire. Both methods identified ways in which their relative's or partner's psoriasis had affected their lives. RESULTS Thirty-three subjects were interviewed and 30 replied by postal questionnaire. Twenty-eight of the 63 subjects were relatives (seven men and 21 women) and 35 were partners (16 men and 19 women). The median age was 51 years (range 20-80). The patients (n = 63) had a mean DLQI of 10, mean PDI of 13.8 and mean PASI of 5.2. Forty different aspects of QoL impairment of relatives and partners were identified. The percentage of subjects in whom any of these aspects were mentioned is illustrated in six different categories. Seventy per cent stated that the treatment of their relative or partner resulted in them having to spend extra time on housework; 57% described psychological pressures including anxiety, being upset and being worried about the patient's future; 55% described social disruption due to lack of social confidence either because of embarrassment or because of the time required for care duties; 44% described limitations to holiday plans, sport and leisure activities and evenings out; 37% described limitations on their daily activities such as shopping, work and time spent with other family members; 37% felt that their close relationships had deteriorated. Only 8% described no effect at all on their QoL. The QoL of the relatives and partners (number of categories affected) was more closely related to the patients' QoL (DLQI: r = 0.77, P < 0.001; PDI: r = 0.67, P < 0.001) than to the objective disease severity scores (PASI: r = 0.34, P < 0.05). CONCLUSIONS The QoL of partners and relatives of people with psoriasis can be significantly affected. Many different aspects of everyday life that are affected and the psychological impacts of having a partner or relative with psoriasis have been identified. It is of great importance to identify these issues to allow clinicians to develop appropriate care strategies not only for patients with psoriasis, but also for their partner and family.
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Affiliation(s)
- A M Eghlileb
- Department of Dermatology, Wales College of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK.
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Verhoeven EWM, Kraaimaat FW, van de Kerkhof PCM, van Weel C, Duller P, van der Valk PGM, van den Hoogen HJM, Bor JHJ, Schers HJ, Evers AWM. Psychosocial well-being of patients with skin diseases in general practice. J Eur Acad Dermatol Venereol 2007; 21:662-8. [PMID: 17447981 DOI: 10.1111/j.1468-3083.2007.02049.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Skin diseases are a substantial part of the problems dealt with by general practitioners. Although the psychosocial consequences of skin diseases in secondary care has been extensively studied, little is known about the psychosocial well-being of patients with skin diseases in primary care. OBJECTIVE To investigate the psychosocial well-being of patients with skin diseases in primary care. PATIENTS/METHODS Questionnaires about the psychosocial consequences of skin diseases were sent to patients with a skin disease who were registered within a research network (continuous morbidity registration) of general practices that continuously have recorded morbidity data since 1971. Questionnaires completed by 532 patients were eventually suitable for analyses. RESULTS Compared with the general population, patients with skin diseases reported significantly lower scores for psychosocial well-being. Furthermore, a lower psychosocial wellbeing was significantly related with higher levels of disease-severity, lower disease-related quality of life, longer disease duration, more comorbidity and more physical symptoms of itch, pain and fatigue. After demographic variables and comorbidity were controlled for, sequential regression analyses showed that disease duration, disease severity and physical symptoms (itch, pain and fatigue) were significant predictors of psychosocial well-being. CONCLUSION The psychosocial well-being of patients with skin diseases in primary care is lower than that of the general population. Special attention has to be directed to those patients with lowered psychosocial well-being who might be at risk of developing severe psychosocial impairments such as clinical depression.
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Affiliation(s)
- E W M Verhoeven
- Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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