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Shah SFH, Merchant SA, Shah SA. Female sexual dysfunction in psoriasis: a systematic review and meta-analysis using the Female Sexual Function Index. Int J Impot Res 2024; 36:232-241. [PMID: 36456639 DOI: 10.1038/s41443-022-00650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022]
Abstract
Psoriasis is an inflammatory skin condition that can negatively affect numerous domains for quality of life, including sexual function. We aimed to systematically compare sexual function between women with and without psoriasis through meta-analysis. Databases were searched for studies assessing sexual function in women with and without psoriasis using the Female Sexual Function Index (FSFI). Meta-analyses were conducted in R (v4.1.2) to determine: (i) the odds ratio (OR) of sexual dysfunction and (ii) the mean difference (MD) for FSFI scores and sub-scores. Eight studies (five case-control, three cross-sectional) were eligible for review, encompassing 563 women with psoriasis and 525 controls. Risk of bias for included studies was considered as low to moderate. Psoriasis was associated with greater odds of female sexual dysfunction (OR 2.67, 95% CI 1.93,3.69; p < 0.0001). Compared to controls, women with psoriasis had significantly lower mean scores for desire (p < 0.0001), arousal (p = 0.002), lubrication (p = 0.003), orgasm (p < 0.0001), satisfaction (p < 0.0001) and total scores (p < 0.0001). Mean pain scores did not significantly differ between psoriasis patients and controls (p = 0.051). We identified significantly impaired sexual function in women with psoriasis compared to controls, suggesting that routine assessment of sexual health may be beneficial. Prospective studies of larger sample size are required in order to explore the underlying mechanisms and risk factors.
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Wu M, Zeng S, Zhang Y, Liu Y, Li B, Yi X, Shi Y, Zhu X. Disease Burden and Coping Strategies of Spouses of Patients with Psoriasis: A Qualitative Study. J Multidiscip Healthc 2024; 17:1653-1662. [PMID: 38646019 PMCID: PMC11032675 DOI: 10.2147/jmdh.s458075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/09/2024] [Indexed: 04/23/2024] Open
Abstract
Background Psoriasis is a chronic autoimmune inflammatory skin condition characterized by erythema, papules, and scales. It imposes a heavy psychological and social strain on both patients and their families. Surprisingly, there's limited research delving into the disease burden and coping strategies of spouses contending with psoriasis. Objective The objective is to explore the disease burden faced and coping strategies utilized by spouses of individuals living with psoriasis. This exploration aims to offer insights crucial for devising mental health support and intervention strategies. Methods The research methodology employed in this study was phenomenological, a qualitative approach. A total of fifteen spouses of patients with psoriasis were selected using an objective sampling method for in-depth, semi-structured interviews. Thematic analysis was then applied to the recorded interview data to derive meaningful themes. Results This study has identified and analyzed three core themes concerning the disease burden and coping strategies of spouses of patients with psoriasis: Overwhelming disease burden; Lack of support system; Coping strategies (Problem - centered coping strategies: Proactive acquisition of disease knowledge; Active confrontation of illness - related issues; Behavioral habit alteration; and Emotional - centered coping strategies: Active acceptance and normalization; Passive acceptance and internalized stigma; Avoidance of disease - related problems). Conclusion This study adds valuable insights into comprehending the disease burden encountered by spouses of patients with psoriasis and sheds light on the coping strategies they employ. Healthcare providers should proactively recognize and address the burden experienced by spouses early on. Establishing a robust support network is crucial, and promoting adaptive coping strategies can significantly aid spouses in effectively navigating and managing the complexities associated with psoriasis.
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Affiliation(s)
- Min Wu
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
| | - Sining Zeng
- Nursing Department, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Yi Zhang
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
| | - Yanru Liu
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
| | - Bingbing Li
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
| | - Xuemei Yi
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
| | - Yuling Shi
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
- Institute of Psoriasis, Tongji University School of Medicine, Shanghai, 200443, People’s Republic of China
| | - Xiaoping Zhu
- Nursing Department, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
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Nowowiejska J, Karny A, Nesterowicz M, Purpurowicz P, Baran A, Kaminski TW, Purpurowicz Z, Flisiak I. Sexual dysfunctions in psoriatic patients. Front Public Health 2024; 12:1339196. [PMID: 38694987 PMCID: PMC11061483 DOI: 10.3389/fpubh.2024.1339196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/21/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Psoriasis is one the most common skin diseases associated with a great decrease in the quality of patients' lives. Methods We aimed to study sexual dysfunctions in psoriatic patients using the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men via an anonymous online survey. The study included 80 psoriatic patients and 75 controls without dermatoses. Results There was a downward trend in the total IIEF score in psoriatic men compared to controls. 58% of male patients and 76% of controls had a normal IIEF score. There was no significant difference in IIEF between patients treated and not with systemic agents. 62% of female patients had a decreased FSFI score, whereas in the control group, the majority of subjects (54%) had a normal FSFI score. There was no significant difference in FSFI score between patients and controls. Female patients treated with systemic antipsoriatic agents had significantly worse lubrication, satisfaction with sexual life, and pain. Discussion Our study has shown that the majority of questioned female psoriatic patients had sexual dysfunction according to FSFI, particularly they had worse satisfaction with sexual life and less sexual desire compared to women without psoriasis. The majority of male patients did not have sexual dysfunction according to IIEF, however, they had significantly worse overall satisfaction with sexual life and confidence to keep an erection. Systemic antipsoriatic treatment does not probably influence sexual dysfunctions in men but it does in women although we were not able to assess the severity or resolution of lesions after those treatments. However embarrassing, psoriatic patients should be questioned about their sexual lives by dermatologists, and more studies are needed to explore this matter.
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Affiliation(s)
- Julia Nowowiejska
- Department of Dermatology and Venereology, Medical University of Białystok, Białystok, Poland
| | - Agata Karny
- Department of Dermatology and Venereology, Medical University of Białystok, Białystok, Poland
| | - Miłosz Nesterowicz
- Department of Dermatology and Venereology, Medical University of Białystok, Białystok, Poland
| | - Piotr Purpurowicz
- Department of Urology and Urological Oncology, Municipal Polyclinical Hospital, Olsztyn, Poland
| | - Anna Baran
- Department of Dermatology and Venereology, Medical University of Białystok, Białystok, Poland
| | - Tomasz W. Kaminski
- Pittsburgh Heart, Lung and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Zbigniew Purpurowicz
- Department of Urology and Urological Oncology, Municipal Polyclinical Hospital, Olsztyn, Poland
| | - Iwona Flisiak
- Department of Dermatology and Venereology, Medical University of Białystok, Białystok, Poland
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Iocca F, Burlando M, Angelo NL, Ragucci F, Pugi D, Parodi A, Dèttore D, Pozza A. Sexual functioning in patients with psoriasis: the role of body dissatisfaction and cognitive biases toward sexuality. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:439-455. [PMID: 38288968 DOI: 10.1080/0092623x.2024.2302959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Psoriasis is a chronic disease, involving skin and joints, characterized by inflamed lesions. Psoriasis negatively impacts the patients' quality of life due to the physical, emotional, and social burden that accompanies this condition. Also, psoriasis is associated with a number of psychiatric comorbidities, including sexual dysfunctions. The present study investigates the variables associated with sexual functioning in psoriasis patients. One-hundred-three psoriasis patients and 101 matched control subjects took part in the present study. Each participant completed five self-report measures investigating the presence of depression, anxiety and stress symptoms, body image, quality of life, and sexual experience. Our results show that differences in sexual activity, but not in sexual functioning, emerged between groups. In men with psoriasis, more sexual difficulties were associated with more negative automatic thoughts about sexuality. In women, more sexual difficulties were associated with more negative automatic thoughts; anxiety, depression, and stress; severity of symptoms; comorbid disease; age; quality of life. Our findings expand the current knowledge about sexual functioning in psoriasis and shed light on specific cognitive, psychological, and demographic variables associated with sexual impairment in men and women with psoriasis.
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Affiliation(s)
- Francesco Iocca
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Martina Burlando
- Department of Dermatology, Dipartimento di Scienze della Salute- DISSAL, University of Genoa, Genova, Italy
- UO Clinica Dermatologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Nicole Loren Angelo
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Federica Ragucci
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Daniele Pugi
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Aurora Parodi
- Department of Dermatology, Dipartimento di Scienze della Salute- DISSAL, University of Genoa, Genova, Italy
- UO Clinica Dermatologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Andrea Pozza
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
- Psychology Unit, Department of Mental Health, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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Elsaie ML, Hanafy NS, Hussein SM, Abou Zeid OO, Zaky MS, Eldahshan RM, Nada HA, Sayedahmed O, El Zawahry YB. Prevalence of Female Sexual Dysfunction Among Psoriatic Females: A Cross Sectional Case Controlled Study. Dermatol Pract Concept 2023; 13:e2023209. [PMID: 37557143 PMCID: PMC10412072 DOI: 10.5826/dpc.1303a209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Sexual relationships are an integral part of females psychological and physiological wellbeing. OBJECTIVES The study aimed to identify prevalence and impact of Female Sexual Dysfunction (FSD) in women affected with psoriasis. METHODS This cross-sectional study was carried out on 150 married females who were interviewed to answer Female Sexual Function Index (FSFI) questionnaire and were divided into two groups: the first group included 100 female patients complaining of psoriasis (50 suffering from moderate psoriasis and 50 with severe psoriasis). The disease severity was graded according to the Psoriasis Area and Severity Index (PASI) while the second group included 50 age matched women who served as controls. RESULTS Female sexual dysfunction (FSD) in psoriasis female groups was higher than that in the control group (47%, 24%, P < 0.05). The mean total scores of FSFI ranged from 12.30 to 34.20 and were significantly lower in the severe PASI affected group (22.34 ± 5.35) when compared to moderate PASI group (26.24 ± 2.67) or control group (28.79 ± 2.22). In addition, total scores were significantly lower among moderate PASI affected females when compared to control group. CONCLUSIONS Sexual dysfunction should be routinely investigated in female patients with psoriasis in the case of moderate-severe disease due to its negative impact on quality of life. Further research over the effect of certain interventional programs on FSD should be considered for patients suffering from psoriasis.
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Affiliation(s)
- Mohamed L. Elsaie
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Egypt
| | - Noha S. Hanafy
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Egypt
| | - Sherief M. Hussein
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Egypt
| | - Ola O. Abou Zeid
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Egypt
| | - Mohamed S. Zaky
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Ramadan M. Eldahshan
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Hesham A. Nada
- Department of Dermatology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Osama Sayedahmed
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Yasmin B. El Zawahry
- Department of Dermatology, Medical Research and Clinical Studies Institute, National Research Centre, Egypt
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Barberis N, Cannavò M, Trovato M, Verrastro V. Pathways from Trait Emotional Intelligence to factors of distress in Rosacea: The mediating role of Social Phobia and Self-Esteem. J Affect Disord 2023; 331:362-368. [PMID: 36906111 DOI: 10.1016/j.jad.2023.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Rosacea is a skin disease characterized by facial erythema and inflammatory pustules that may result in emotional distress. Social Phobia and Self-Esteem appear to be linked to the development of higher levels of distress in dermatological conditions, while Trait Emotional Intelligence (Trait EI) has been consistently associated with greater levels of adaptation to one's chronic condition. Hence, it seems extremely relevant to observe the interplay between these dimensions in the context of Rosacea. The goal of the current study is to test the hypothesis that an association between Trait EI and General Distress, in individuals with Rosacea would be mediated by Self-Esteem and Social Phobia. METHODS Questionnaires were administered to 224 individuals suffering from Rosacea to assess Trait EI, Social Phobia, Self-Esteem, and General Distress. RESULTS Results highlighted that Trait EI was positively related to Self-Esteem and negatively related to Social Phobia and General Distress. In addition, both Self-Esteem and Social Phobia showed a mediating role in the relationship between Trait EI and General Distress. LIMITATIONS The main limitations of this work consist in the cross-sectional nature of the data, the small number of participants, also it was not possible to differentiate the participants according to the type of rosacea. DISCUSSION These results emphasize how individuals with Rosacea may be vulnerable to internalizing states and how high levels of Trait EI may constitute a protective factor for the onset of distressing states and it would be useful to create programs aimed at fostering Trait EI in Rosacea sufferers.
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Affiliation(s)
- Nadia Barberis
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
| | - Marco Cannavò
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy
| | - Mariachiara Trovato
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
| | - Valeria Verrastro
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
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Salle R, Halioua B, Le Fur G, Aubert R, Shourick J, Taieb C. Psoriasis and sexuality: Patients express their feelings. SKIN HEALTH AND DISEASE 2022. [DOI: 10.1002/ski2.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Romain Salle
- Department of General and Oncologic Dermatology Université Paris‐Saclay USQY, EA4340‐BECCOH, AP‐HP Ambroise‐Paré hospital Boulogne‐Billancourt France
| | | | | | - Roberte Aubert
- President of France Psoriasis [patient association] Paris France
| | - Jason Shourick
- Department of Epidemiology, Clinical Epidemiology and Public Health UMR 1027 INSERM‐University of Toulouse III Toulouse University Hospital (CHU) Toulouse France
| | - Charles Taieb
- French Society of Human Skin Sciences, [SFSHP] Maison de la dermatologie Paris France
- Patient Priority Department EMMA Fontenay sous Bois France
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Jalenques I, Bourlot F, Martinez E, Pereira B, D'Incan M, Lauron S, Rondepierre F. Prevalence and Odds of Anxiety Disorders and Anxiety Symptoms in Children and Adults with Psoriasis: Systematic Review and Meta-analysi. Acta Derm Venereol 2022; 102:adv00769. [DOI: 10.2340/actadv.v102.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The magnitude of the association between psoriasis and depression has been evaluated, but not that between psoriasis and anxiety. The aim of this systematic review and meta-analysis was to examine the prevalence and odds of anxiety disorders and symptoms in patients with psoriasis. Five medical databases (Cochrane Database, EMBASE, PubMed, PsychINFO, ScienceDirect) were searched for relevant literature. A total of 101 eligible articles were identified. Meta-analysis revealed different prevalence rates depending on the type of anxiety disorder: 15% [95% confidence interval [CI] 9–21] for social anxiety disorder, 11% [9–14] for generalized anxiety disorder, and 9% [95% CI 8–10] for unspecified anxiety disorder. There were insufficient studies assessing other anxiety disorders to be able to draw any conclusions on their true prevalence. Meta-analysis also showed a high prevalence of anxiety symptoms (34% [95% CI 32–37]). Case-control studies showed a positive association between psoriasis and unspecified anxiety disorder (odds ratio 1.48 [1.18; 1.85]) and between psoriasis and anxiety symptoms (odds ratio 2.51 [2.02; 3.12]). All meta-analyses revealed an important heterogeneity, which could be explained in each case by methodological factors. The results of this study raise the necessity of screening for the presence of anxiety disorders, as previously recommended for depressive disorders, in patients with psoriasis and, if necessary, to refer such patients for evaluation by a mental health professional and appropriate treatment.
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Fatás-Lalana B, Cantón-Sandoval J, Rodríguez-Ruiz L, Corbalán-Vélez R, Martínez-Menchón T, Pérez-Oliva AB, Mulero V. Impact of Comorbidities of Patients with Psoriasis on Phototherapy Responses. Int J Mol Sci 2022; 23:ijms23179508. [PMID: 36076906 PMCID: PMC9455671 DOI: 10.3390/ijms23179508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/15/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022] Open
Abstract
A retrospective study of 200 psoriasis patients and 100 healthy donors in a Spanish cohort was carried out to study the comorbidities associated with psoriasis and their association with the response to phototherapy. The results showed a higher incidence of psychiatric disease, liver disease, kidney disease, hypertension, heart disease, vascular disease, diabetes, gastrointestinal disease, autoimmune and infectious diseases, dyslipidemia, and psoriatic arthritis in patients with psoriasis than in the control group. The incidence of comorbidities was higher in psoriasis patients over 40 years old than in the control individuals of the same age, which could be indicative of premature aging. Phototherapy was seen to be an effective treatment in cases of moderate-severe psoriasis, total whitening being achieved in more than 30% of patients, with women showing a better response than men. Narrow-band ultraviolet B was found to be the most effective type of phototherapy, although achievement of PASI100 was lower in patients with liver disease, hypertension, heart disease, vascular disease, or diabetes. Strikingly, liver disease and anemia comorbidities favored therapeutic failure. Finally, zebrafish and human 3D organotypic models of psoriasis point to the therapeutic benefit of inhibiting the glucose transporter GLUT1 and the major regulator of blood glucose dipeptidyl peptidase 4. Our study reveals that specific comorbidities of psoriasis patients are associated to failure of phototherapy and, therefore, need to be considered when planning treatment for these patients.
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Affiliation(s)
- Belén Fatás-Lalana
- Departamento de Biología Celular e Histología, Facultad de Biología, Universidad de Murcia, 30100 Murcia, Spain
| | - Joaquín Cantón-Sandoval
- Departamento de Biología Celular e Histología, Facultad de Biología, Universidad de Murcia, 30100 Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, 30120 Murcia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Lola Rodríguez-Ruiz
- Departamento de Biología Celular e Histología, Facultad de Biología, Universidad de Murcia, 30100 Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, 30120 Murcia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Raúl Corbalán-Vélez
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, 30120 Murcia, Spain
- Servicio de Dermatología, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain
| | - Teresa Martínez-Menchón
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, 30120 Murcia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Servicio de Dermatología, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain
- Correspondence: (T.M.-M.); (A.B.P.-O.); (V.M.)
| | - Ana B. Pérez-Oliva
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, 30120 Murcia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (T.M.-M.); (A.B.P.-O.); (V.M.)
| | - Victoriano Mulero
- Departamento de Biología Celular e Histología, Facultad de Biología, Universidad de Murcia, 30100 Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, 30120 Murcia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (T.M.-M.); (A.B.P.-O.); (V.M.)
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Bu J, Ding R, Zhou L, Chen X, Shen E. Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review. Front Immunol 2022; 13:880201. [PMID: 35757712 PMCID: PMC9226890 DOI: 10.3389/fimmu.2022.880201] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/28/2022] [Indexed: 11/18/2022] Open
Abstract
Psoriasis is a chronic autoimmune inflammatory disease that remains active for a long period, even for life in most patients. The impact of psoriasis on health is not only limited to the skin, but also influences multiple systems of the body, even mental health. With the increasing of literature on the association between psoriasis and extracutaneous systems, a better understanding of psoriasis as an autoimmune disease with systemic inflammation is created. Except for cardiometabolic diseases, gastrointestinal diseases, chronic kidney diseases, malignancy, and infections that have received much attention, the association between psoriasis and more systemic diseases, including the skin system, reproductive system, and oral and ocular systems has also been revealed, and mental health diseases draw more attention not just because of the negative mental and mood influence caused by skin lesions, but a common immune-inflammatory mechanism identified of the two systemic diseases. This review summarizes the epidemiological evidence supporting the association between psoriasis and important and/or newly reported systemic diseases in the past 5 years, and may help to comprehensively recognize the comorbidity burden related to psoriasis, further to improve the management of people with psoriasis.
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Affiliation(s)
- Jin Bu
- Hospital for Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Ruilian Ding
- Hospital for Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Liangjia Zhou
- Hospital for Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Xiangming Chen
- Sino-French Hoffmann Institute, School of Basic Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Erxia Shen
- Sino-French Hoffmann Institute, School of Basic Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
- The State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
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11
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Kowalewska B, Krajewska-Kułak E, Sobolewski M. The Impact of Stress-Coping Strategies and the Severity of Psoriasis on Self-Esteem, Illness Acceptance and Life Satisfaction. Dermatol Ther (Heidelb) 2022; 12:529-543. [PMID: 35041156 PMCID: PMC8764316 DOI: 10.1007/s13555-021-00669-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/16/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction The visibility of skin lesions is a significant burden for patients with psoriasis, who experience social hostility as well as many emotional and psychological problems. The recurrent nature of cutaneous manifestations and their location are also a source of emotional distress, which in turn is one of the main factors that intensifies skin lesions in these patients. The aim of the study was to assess the impact of the severity of psoriasis and stress-coping strategies on general psychometric measures in the affected patients. Methods The study used a short demographic questionnaire, Psoriasis Area and Severity Index (PASI), and four standardised general psychometric tools: Rosenberg Self-Esteem Scale (SES), Satisfaction With Life Scale (SWLS), Coping Inventory for Stressful Situations (CISS) and Acceptance of Illness Scale (AIS). A total of 111 patients participated in the study. Results The mean PASI score was 14.0 (12.1–15.9). The mean SWLS score was below average, i.e., 18.5 (17.3–19.7), and the SES score—26.8 points (26.1–27.5)—indicated self-esteem slightly above average among patients with psoriasis. The mean stress-coping level measured with CISS was 53.6 (51.9–55.2) for the task-oriented strategy (TOS), 46.2 (43.8–48.6) for the emotion-oriented strategy (EOS) and 50.1 (48.5–51.8) for the avoidance-oriented strategy (AOS). Higher PASI was associated with lower illness acceptance among men (r = 0.48) and lower self-esteem among women (r = 0.44). The level of life satisfaction was lower in respondents with higher PASI scores (mainly in the group of women, r = 0.44). Conclusions Higher severity of psoriasis (PASI) and greater frequency of emotion-oriented stress-coping mechanisms (CISS) are factors that negatively affect the overall psychophysical condition of respondents.
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Affiliation(s)
- Beata Kowalewska
- The Department of Integrated Medical Care, Medical University in Białystok, 7A MC Skłodowskiej Str., 15-096, Białystok, Poland.
| | - Elżbieta Krajewska-Kułak
- The Department of Integrated Medical Care, Medical University in Białystok, 7A MC Skłodowskiej Str., 15-096, Białystok, Poland
| | - Marek Sobolewski
- Faculty of Management, Rzeszow University of Technology, Rzeszow, Poland
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12
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Jing D, Xiao H, Shen M, Chen X, Han X, Kuang Y, Zhu W, Xiao Y. Association of Psoriasis With Anxiety and Depression: A Case-Control Study in Chinese Patients. Front Med (Lausanne) 2022; 8:771645. [PMID: 35004741 PMCID: PMC8738085 DOI: 10.3389/fmed.2021.771645] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/08/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Patients with psoriasis are prone to suffer from anxiety and depression during their lifetime. This study aimed to investigate the association of psoriasis with anxiety and depression in Chinese patients. Methods: A case-control study in Chinese patients with psoriasis vulgaris and healthy controls was conducted. Clinical information based on patient-reported, clinical information, and reliable structured questionnaires were collected. Multivariable logistic regression was used to investigate the associations, in terms of adjusted odds ratios (AORs). Results: We continuously selected 1,571 patients who were firstly diagnosed with psoriasis vulgaris, and 1,571 healthy controls, matched by age and sex. The risk of depression in the psoriasis vulgaris group was higher than that in the healthy controls (AOR = 1.30, P = 0.047), while no differences were found in the risk of anxiety between the two groups (AOR = 1.18, P = 0.381). Subgroup analysis by disease onsets showed that late-onset psoriasis (LOP) was significantly associated with a higher risk of anxiety (AOR = 1.47, P = 0.033) and depression symptoms (AOR = 1.85, P = 0.012) but not with early-onset psoriasis (EOP). Subgroup analysis by disease severity indicated that no difference was observed in the associations of mild psoriasis vulgaris, moderate-to-severe psoriasis vulgaris with anxiety and depression. Conclusion: Patients with psoriasis vulgaris were more likely to develop depression compared with the general population. LOP patients were positively associated with anxiety and depression. We believe the screening of emotional disorders should be included in the daily management of psoriasis patients.
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Affiliation(s)
- Danrong Jing
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
| | - Hui Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China.,Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
| | - Xi Han
- ULink College Guangzhou, Guangzhou, China
| | - Yehong Kuang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
| | - Wu Zhu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
| | - Yi Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Central South University, Changsha, China
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13
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Nowowiejska J, Baran A, Grabowska P, Lewoc M, Kaminski TW, Flisiak I. Assessment of Life Quality, Stress and Physical Activity Among Patients with Psoriasis. Dermatol Ther (Heidelb) 2021; 12:395-406. [PMID: 34918196 PMCID: PMC8850505 DOI: 10.1007/s13555-021-00662-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Psoriasis is a chronic, autoimmune, inflammatory skin disease affecting 2–4% of the general population, which nowadays is even perceived as a systemic illness. The nature of this dermatosis may negatively influence patients’ general condition, life expectancy, and quality of life, which highlights the severity of the problem and the need to perform further investigation. We aimed to assess quality of life, stress severity, and physical activity of patients with psoriasis in relation to demographic and clinical data and comparison to the control group without dermatoses. Methods A set of surveys was conducted in 56 patients with psoriasis hospitalized at the Department of Dermatology, Medical University of Bialystok. Questionnaires used involved the Dermatology Life Quality Index, WHO Quality of Life questionnaire, International Questionnaire of Physical Activity, and a self-invented stress survey. Obtained data were compared to a sex- and age-matched control group without dermatoses. Statistical analysis was performed using GraphPad Prism. Results Patients with psoriasis were found to be significantly less satisfied with their health and had lower scores in WHO social, environmental, and psychological domains, comparing to controls. Patients reported higher stress severity and lower satisfaction with sex life and physical appearance than controls. Patients with psoriasis also tended to perform less intensive physical activity than controls. Conclusions This study highlights the perception of psoriasis as not only affecting skin but also having a multifactorial impact on psychological and internal condition. Described lifestyle abnormalities can be easily evaluated with validated questionnaires, which could be introduced to patients in order to raise their awareness of comorbidities and mobilize them to modify incorrect lifestyle habits. Screening for other disorders and introduction of a holistic approach to every patient could be beneficial because the improvement of patients’ life quality is one of the most important issues.
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Affiliation(s)
- Julia Nowowiejska
- Department of Dermatology and Venereology, Medical University of Bialystok, Zurawia 14 St, 15-540, Bialystok, Poland.
| | - Anna Baran
- Department of Dermatology and Venereology, Medical University of Bialystok, Zurawia 14 St, 15-540, Bialystok, Poland
| | - Paulina Grabowska
- Department of Endocrinology, Diabetology and Internal Diseases, Medical University of Bialystok, Sklodowskiej 24a St., 15-276, Bialystok, Poland
| | - Marta Lewoc
- I Department of General and Endocrine Surgery, Medical University of Bialystok, Sklodowskiej 24a, 15-276, Bialystok, Poland
| | - Tomasz W Kaminski
- Pittsburgh Heart, Lung and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Iwona Flisiak
- Department of Dermatology and Venereology, Medical University of Bialystok, Zurawia 14 St, 15-540, Bialystok, Poland
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14
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Salle R, Taïeb C, Aubert R, Heller U, Halioua B, Shourick J. Evaluation of factors associated with sexual dysfunction in psoriasis in a cohort of 1409 patients. Clin Exp Dermatol 2021; 47:964-966. [PMID: 34905631 DOI: 10.1111/ced.15058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Romain Salle
- Faculté de Médecine, Université de Paris, Paris, France
| | - Charles Taïeb
- European Market Maintenance Assessment, Patients Priority, France
| | | | | | | | - Jason Shourick
- Department of Epidemiology and Public Health, UMR 1027 INSERM, Toulouse University Hospital, Toulouse, France
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15
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Kowalewska B, Jankowiak B, Krajewska-Kułak E, Milewski R, Sobolewski M. Skin-Disease Specific and Generic Psychometric Measures in Patients with Psoriasis. Dermatol Ther (Heidelb) 2021; 11:1999-2015. [PMID: 34585342 PMCID: PMC8478271 DOI: 10.1007/s13555-021-00609-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/08/2021] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Psychosocial problems of patients with chronic dermatoses, such as psoriasis, add to their somatic ailments, which results in the lack of illness acceptance, lowered self-esteem, deteriorated quality of life, and an array of somatic comorbidities. The aim of this study was to analyze the effect of psoriasis on the quality of life, sense of stigmatization, self-esteem, and satisfaction with life in patients with psoriasis. METHODS The study was based on a short survey prepared by the authors and five validated scales: Dermatology Life Quality Index (DLQI), 6-Item Stigmatization Scale, 33-Item Feelings of Stigmatization Questionnaire, Rosenberg Self-Esteem Scale (SES), and Satisfaction With Life Scale (SWLS). The study included 111 patients with psoriasis (46.8% women and 53.2% men). The inclusion criteria of the study were the diagnosis of plaque psoriasis and written informed consent to participate. RESULTS DLQI scores ranged between 0 and 28 points (pts) (mean 10.8 pts). Mean stigmatization scores determined with the 33- and 6-Item Stigmatization Scale were 81.6 pts and 7.5 pts, respectively. The mean SWLS score for the study group (18.5 pts) was slightly below the average. The mean score SES of 27 pts implies that the study respondents' self-esteem level was slightly above the average. CONCLUSIONS Satisfaction with life turned out to be significantly modulated by overall stigmatization level on the 33-Item Stigmatization Scale (the stronger the sense of stigmatization, the lower the satisfaction with life) and education (respondents with higher education presented with higher satisfaction with life than those with non-higher education).
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Affiliation(s)
- Beata Kowalewska
- The Department of Integrated Medical Care, Medical University in Białystok, 7A MC Skłodowskiej Str., 15-096, Białystok, Poland.
| | - Barbara Jankowiak
- The Department of Integrated Medical Care, Medical University in Białystok, 7A MC Skłodowskiej Str., 15-096, Białystok, Poland
| | - Elżbieta Krajewska-Kułak
- The Department of Integrated Medical Care, Medical University in Białystok, 7A MC Skłodowskiej Str., 15-096, Białystok, Poland
| | - Rafał Milewski
- Doctoral Studies at Faculty of Health Sciences, Department of Primary Healthcare, Medical University of Bialystok, Białystok, Poland
| | - Marek Sobolewski
- Faculty of Management, Rzeszow University of Technology, Rzeszów, Poland
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Barisone M, Bagnasco A, Hayter M, Rossi S, Aleo G, Zanini M, Catania G, Pellegrini R, Dasso N, Ghirotto L, Sasso L. Dermatological diseases, sexuality and intimate relationships: A qualitative meta-synthesis. J Clin Nurs 2020; 29:3136-3153. [PMID: 32531872 DOI: 10.1111/jocn.15375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 05/11/2020] [Accepted: 05/17/2020] [Indexed: 02/03/2023]
Abstract
AIMS AND OBJECTIVES To conduct a systematic review and meta-synthesis of findings from qualitative research about sexuality and intimate relationship among patients with dermatological diseases. BACKGROUND Over the last few decades, there has been an increase in clinical research investigating aspects related to sex and sexuality in patients living with dermatological diseases. In fact, studies recognise a negative impact on various aspects of intimacy, such as sexual function, self-esteem and romantic relationships. The body of qualitative literature about sexuality in the context of dermatological diseases is emerging but consists mainly of small studies that would benefit from aggregation, synthesis and interpretation to highlight and summarise the overarching dimensions to this clinical issue. DESIGN A systematic review and meta-synthesis of qualitative studies. METHODS BioMed Central, Cochrane Library, MEDLINE, CINAHL, PsycINFO, PsycARTICLES, ERIC, Scopus, and Web of Science were searched between June-November 2017 with no publication date limits. Screening and selection of studies was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). After retrieval, the qualitative data were subject to meta-synthesis to identify overarching themes. RESULTS Ten qualitative studies were found. We identified four themes: (a) Embarrassment and shame; (b) Impaired sense of attractiveness and sexual avoidance; (c) Relationship issues; and (d) Lack of professional support. The patients in these studies adopted negative coping styles, such as avoidance and hiding their bodies. CONCLUSION When assessing and evaluating patient care in dermatology, it is important that sexuality and the impact the disease could have on relationships is included. RELEVANCE TO CLINICAL PRACTICE An important part of nursing care is ensuring that patients are helped to develop positive coping strategies rather than negative ones. Patients with dermatological conditions also need advice and treatment to address any physically related sexual problems. Nurses need to be the initiators of these sensitive conversations to put patients at ease and work together to implement positive measures to reduce the sexuality-related issues patients face.
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Affiliation(s)
- Michela Barisone
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Mark Hayter
- School of Health & Social Work, University of Hull, Hull, UK
| | - Silvia Rossi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Nicoletta Dasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Luca Ghirotto
- Arcispedale Santa Maria Nuova - IRCCS, Direzione Scientifica, Reggio Emilia, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
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