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Gao Y, Li C, Tong M, Hu Y, Li Y. Characterization of psoriasis patients in special body areas: real-world evidence from the Chinese Psoriasis Standardized Diagnosis and Treatment Center. J DERMATOL TREAT 2024; 35:2337264. [PMID: 38991550 DOI: 10.1080/09546634.2024.2337264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/18/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND While extensive research has provided a wealth of information on psoriasis in general, there remains a critical gap in understanding the unique characteristics of psoriasis in special body areas, such as the scalp, nails, palms, and genitals. OBJECTIVE To investigate the characterization and treatment of psoriasis patients in special body areas. METHODS The study was a retrospective analysis of patients with psoriasis enrolled in the Psoriasis Standardized Diagnosis and Treatment Center Project between January 2020 and September 2021. RESULTS The study encompassed 346 patients, 81% of them had psoriasis in at least two special body areas, with the nails as the most common area. Patients with genital psoriasis reported higher Dermatology Life Quality Index (DLQI) scores. A higher propensity for scalp and palmoplantar psoriasis was noted in patients with genital psoriasis. The proportion of patients treated with biologics rose, as the number of specific areas involved increased. CONCLUSIONS Patients with genital psoriasis are more likely to have scalp and palmoplantar psoriasis. This study highlights the significant escalation in the proportion of biologics when the involvement of special body areas was ≥2.
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Affiliation(s)
- Yuge Gao
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
| | - Chao Li
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Meng Tong
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yizhou Hu
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - Yuzhen Li
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Poizeau F, Leducq S, Fardet L, Beylot-Barry M, Chaby G, Chastagner M, Corgibet F, Gouillon L, Jouan N, Jullien D, Acher A, Amatore F, Amici JM, Aubert H, Aubin F, Beneton N, Bouilly D, Bursztejn AC, Buzenet C, Chamaillard-Pujol M, Charles J, Cottencin-Charriere AC, Duval Modeste B, Fauconneau A, Fougerousse AC, Girard C, Goujon C, Khemis A, Le Ru Y, Lepelley-Dupont C, Mahé E, Marcellin X, Nicolas C, Pallure V, Parier J, Quiles N, Stoebner PE, Tauber M, Vermersch A, Viguier M, Villani AP, Chosidow O, Guillot B. Treatment of moderate-to-severe psoriasis in adults: An expert consensus statement using a Delphi method to produce a decision-making algorithm. Ann Dermatol Venereol 2024; 151:103287. [PMID: 39013256 DOI: 10.1016/j.annder.2024.103287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/22/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND New highly effective drugs for moderate-to-severe cutaneous psoriasis are regularly marketed, and the hierarchy of treatments thus requires frequent review. OBJECTIVES A Delphi method was used to enable a structured expert consensus on the use of systemic treatments and phototherapy among adults with moderate-to-severe psoriasis. METHODS The Delphi method consists in achieving a convergence of opinions among a panel of experts using several rounds of questionnaires with controlled feedback between rounds. A two-part Delphi questionnaire was administered online to French psoriasis experts. In the first part, 180 items related to the prescription of systemic treatments and phototherapy for adult patients with moderate-to-severe psoriasis were grouped into 21 sections covering different lines of treatment and different forms of cutaneous psoriasis. The experts voted on each proposal using an ordinal 7-point Likert scale. The second part comprised 11 open-ended questions about special indications for each therapeutic class. These were converted into 101 questions for subsequent rounds. Consensus was deemed to have been reached if more than 80% of the experts agreed with a given proposal. RESULTS Three rounds of questionnaires were sequentially sent to 35 participants between November 2021 and March 2022. Thirty-three (94%) completed all three rounds. For plaque psoriasis, only methotrexate was recommended by the experts as first-line systemic treatment (89% of votes). Cyclosporin was advocated in pustular and erythrodermic psoriasis, and acitretin was suggested for hyperkeratotic and palmoplantar psoriasis. In the event of failure of or intolerance to non-biological systemic treatments, guselkumab, risankizumab, ixekizumab or secukinumab were recommended by more than 80% of the experts. Tumor Necrosis Factor (TNF) inhibitors remain useful for patients with cardiovascular risk factors. Special indications were provided for each therapeutic class (methotrexate/narrowband ultraviolet B phototherapy, psoralen/ultraviolet A phototherapy, cyclosporin, acitretin, apremilast, TNF inhibitors, interleukin (IL)-12/23 inhibitors, IL-17(R)A inhibitors, and IL-23 inhibitors). CONCLUSIONS This expert consensus statement indicate that newly available IL-17 and IL-23 inhibitors may be favored over TNF and IL-12/23 inhibitors as first-line biologics. The Centre of Evidence of the French Society of Dermatology has drawn up a decision-making algorithm to guide clinicians in the therapeutic management of moderate-to-severe psoriasis.
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Affiliation(s)
- F Poizeau
- Univ Rennes, Rennes University Hospital, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000 Rennes, France; Dermatology, Rennes University Hospital, Rennes, France; Centre of Evidence of The French Society of Dermatology, Paris, France.
| | - S Leducq
- Centre of Evidence of The French Society of Dermatology, Paris, France; University of Tours, Nantes University, INSERM, SPHERE 1246, Tours, France; Dermatology, Tours University Hospital, Tours, France
| | - L Fardet
- Centre of Evidence of The French Society of Dermatology, Paris, France; Dermatology, Private Practitioner, Nogent-sur-Marne, France
| | - M Beylot-Barry
- Centre of Evidence of The French Society of Dermatology, Paris, France; Dermatology, Bordeaux University Hospital, Bordeaux, France
| | - Guillaume Chaby
- Centre of Evidence of The French Society of Dermatology, Paris, France; Dermatology, Amiens-Picardie University Hospital, Amiens, France
| | - M Chastagner
- Hospices Civils de Lyon, Claude Bernard Lyon I University, Dermatology, Edouard Herriot Hospital, Lyon, France
| | - F Corgibet
- Centre of Evidence of The French Society of Dermatology, Paris, France; Dermatology, Private Practitioner, Dijon, France
| | - L Gouillon
- Hospices Civils de Lyon, Claude Bernard Lyon I University, Dermatology, Edouard Herriot Hospital, Lyon, France
| | - N Jouan
- Centre of Evidence of The French Society of Dermatology, Paris, France; Dermatology, Private Practitioner, Brest, France
| | - D Jullien
- Centre of Evidence of The French Society of Dermatology, Paris, France; Hospices Civils de Lyon, Claude Bernard Lyon I University, Dermatology, Edouard Herriot Hospital, Lyon, France
| | - A Acher
- Dermatology, Private Practitioner, Caen, France
| | - F Amatore
- Dermatology, Nord University Hospital, Aix-Marseille University, Marseille, France
| | - J-M Amici
- Dermatology, Bordeaux University Hospital, Bordeaux, France
| | - H Aubert
- Dermatology, Nantes University Hospital, Nantes, France
| | - F Aubin
- Dermatology, Besançon University Hospital, Besançon, France
| | - N Beneton
- Dermatology, Le Mans Hospital, Le Mans, France
| | | | | | - C Buzenet
- Dermatology, Private Practitioner, Bayonne, France
| | | | - J Charles
- Dermatology, Grenoble Alpes University Hospital, La Tronche, France
| | | | | | - A Fauconneau
- Dermatology, Bordeaux University Hospital, Bordeaux, France; Dermatology, Private Practitioner, Gradignan, France
| | - A-C Fougerousse
- Dermatology, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France; ResoPso, Paris, France
| | - C Girard
- Dermatology, Montpellier University Hospital, Montpellier, France
| | - C Goujon
- Dermatology, Lyon Sud Hospital, Lyon, France
| | - A Khemis
- Dermatology, Private Practitioner, Nice, France
| | - Y Le Ru
- Dermatology, Private Practitioner, Brest, France
| | | | - E Mahé
- Dermatology, Argenteuil Hospital, Argenteuil, France
| | - X Marcellin
- Dermatology, Private Practitioner, Villeurbanne, France
| | - C Nicolas
- Dermatology, Private Practitioner, Commercy, France
| | - V Pallure
- Dermatology, Perpignan Hospital, Perpignan, France
| | - J Parier
- Dermatology, Private Practitioner, Saint-Maur-des-Fossés, France
| | - N Quiles
- Dermatology, Saint Joseph Hospital, Marseille, France
| | - P-E Stoebner
- Dermatology, Nîmes University Hospital, Nîmes, France
| | - M Tauber
- Clinical Immunology and Allergology, Lyon University Hospital, Lyon, France
| | - A Vermersch
- Dermatology, Calais Hospital, Calais, France
| | - M Viguier
- Dermatology, Reims University Hospital, Reims, France
| | - A P Villani
- Hospices Civils de Lyon, Claude Bernard Lyon I University, Dermatology, Edouard Herriot Hospital, Lyon, France
| | - O Chosidow
- Centre of Evidence of The French Society of Dermatology, Paris, France; Dermatology, Hôpital Henri-Mondor APHP, Créteil, France
| | - B Guillot
- Centre of Evidence of The French Society of Dermatology, Paris, France; Dermatology, Univ Montpellier, Montpellier, France
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Greiling T, Young M, Seal MS, Higham RC, Armstrong A. Patient Perspectives on the Prevalence and Burden of Intertriginous Psoriasis: Results from a National Survey of Adults with Psoriasis in the United States. Dermatol Ther (Heidelb) 2024; 14:1839-1847. [PMID: 38874893 PMCID: PMC11265023 DOI: 10.1007/s13555-024-01190-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION A survey was conducted by The Harris Poll on behalf of Arcutis Biotherapeutics in the USA to understand perspectives and burden of patients with psoriasis using prescription topical treatments for their disease. This manuscript presents results from the subset of patients with intertriginous psoriasis. METHODS The survey was conducted online October 21-November 24, 2021, among 507 US adults aged 18+ years with psoriasis diagnosed by a healthcare provider and currently using prescription topical treatment. Participants with intertriginous psoriasis were patients with plaque psoriasis reporting symptoms in the armpit, groin, under breast, stomach fold, or between the buttocks. RESULTS Of the 507 respondents, 320 (64%) reported symptoms in intertriginous areas at some point, typically between the buttocks (31%). Most patients with intertriginous psoriasis reported it made them feel embarrassed (80%), anxious (79%), or depressed (69%). In addition, 45% of these patients reported intertriginous psoriasis caused a negative impact on sexual anxiety or distress. Quality of life impact was reported as "very strong negative impact" in 16% of patients with groin involvement vs. 6% in patients with no groin involvement and 15% in women vs. 6% in men. Patients with intertriginous psoriasis reported that itch (61%), scaling (53%), redness (49%), and skin cracking (46%) related to intertriginous psoriasis had the greatest negative impact on quality of life. Most (86%) of these patients said they would be more adherent if a single treatment option could be used to treat all affected areas of their body. CONCLUSION Psoriasis involvement in intertriginous areas over the course of disease is common and has a negative impact on these patients' quality of life, particularly emotional well-being and sexual health.
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Affiliation(s)
- Teri Greiling
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
| | - Melodie Young
- Mindful Dermatology, Modern Research Associates, Dallas, TX, USA
| | - Melissa S Seal
- Arcutis Biotherapeutics, Inc., Westlake Village, CA, USA.
| | | | - April Armstrong
- Department of Dermatology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Wu M, Fischer G. Adult genital psoriasis: An updated review for clinicians. Australas J Dermatol 2024; 65:e1-e12. [PMID: 38419192 DOI: 10.1111/ajd.14227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 01/25/2024] [Accepted: 02/04/2024] [Indexed: 03/02/2024]
Abstract
Genital psoriasis is a chronic inflammatory skin condition that has been reported in up to 63% of patients with psoriasis on other parts of their skin. It has a profound impact on quality of life and sexual function which is often overlooked by current severity scores. Despite its prevalence and disease burden, genital psoriasis remains largely under-reported and under-treated. Historically, this was due to the impracticality and limited efficacy data of standard psoriasis treatments when applied to genital skin. However, there have been recent advancements with several new agents currently being developed and evaluated for genital psoriasis. This clinical review aims to provide an overview of the current evidence regarding the clinical features of genital psoriasis, available management options and tools for assessing patients' quality of life. Key takeaways from this review emphasise the recognition of genital psoriasis as a chronic and debilitating condition, unique in its impact on patients' quality of life, necessitating sensitive and attentive approaches to address their needs.
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Affiliation(s)
- Michelle Wu
- Northern Clinical School, University of Sydney, Camperdown, New South Wales, Australia
| | - Gayle Fischer
- Northern Clinical School, University of Sydney, Camperdown, New South Wales, Australia
- Department of Dermatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
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5
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Gerdes S, Ostendorf R, Süß A, Schadeck T, Taut F, Makuc J, Scharfenberger L, Jacobsen S, Trenkler N, Behrens J, Joks G, Tabori S, Mortazawi D. Effectiveness, safety and impact of guselkumab on sexuality and perceived stigmatization in patients with psoriasis in routine clinical practice: Week 28 results from the prospective German multicentre G-EPOSS study. J Eur Acad Dermatol Venereol 2024. [PMID: 38602225 DOI: 10.1111/jdv.19927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/16/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND G-EPOSS is a prospective, non-interventional, German multicentre study of patients with moderate-to-severe plaque psoriasis receiving guselkumab, a therapeutic monoclonal antibody targeting interleukin-23, in a real-world setting. OBJECTIVES The objective of the study was to evaluate the effectiveness and safety of guselkumab, including its impact on skin, health-related quality of life (HRQoL), sexuality, and perceived stigmatization. METHODS Patients (≥18 years old) received guselkumab per routine clinical practice. The primary endpoint was the proportion of patients achieving absolute Psoriasis Area and Severity Index (PASI) ≤ 3 at Week (W)28. Secondary endpoint assessments over 28 weeks included the Nail Psoriasis Severity Index (NAPSI), anogenital Physician's Global Assessment (aPGA), and Dermatology Life Quality Index (DLQI). Sexuality and perceived stigmatization were assessed by patients using the Relationship and Sexuality Scale (RSS) and Perceived Stigmatization Questionnaire (PSQ), respectively. RESULTS Overall, 293 patients were included in the evaluable set population. Mean age and disease duration were 45.6 and 17.6 years, respectively. At baseline, mean PASI, aPGA and DLQI scores were 15.3, 2.7 and 11.3, respectively. In total, 25.9% of patients had received a prior biologic. Overall, 83.0% of patients achieved PASI ≤ 3, and 56.2%/35.1% achieved PASI ≤ 1/PASI = 0, respectively, at W28. Among those with NAPSI ≥ 1 and aPGA ≥ 1 at baseline, NAPSI = 0 and aPGA = 0 were achieved by 39.2% and 61.1% of patients, respectively, and 61.4% of patients achieved DLQI 0-1 at W28. Improvements were observed over 28 weeks across individual items of the DLQI, RSS and PSQ, indicating improved HRQoL and sex life, and decreased perceived stigmatization. Based on DLQI Question (Q)9, 53.6% of patients experienced sexual difficulties at baseline, which decreased to 12.1% at W28. DLQI Q9 responses were consistent with RSS item responses, highlighting DLQI Q9 as a sentinel for sexual impairment. CONCLUSIONS Guselkumab improved overall skin symptoms and HRQoL in patients with psoriasis and decreased sexual impairment and perceived stigmatization. No new safety signals were observed. STUDY CODE CNTO1959PSO4008.
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Affiliation(s)
- S Gerdes
- Psoriasis Center Kiel, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | | | - A Süß
- Dermatology Practice Dr. med. Anke Süß, Wittlich, Germany
| | - T Schadeck
- Dermatology Practice Tobias Schadeck, Bogen, Germany
| | - F Taut
- Taut Science and Service GmbH, Konstanz, Germany
| | - J Makuc
- Janssen-Cilag GmbH, Neuss, Germany
| | | | | | | | | | - G Joks
- Janssen-Cilag Pty Ltd, Sydney, New South Wales, Australia
| | - S Tabori
- Janssen-Cilag GmbH, Neuss, Germany
| | - D Mortazawi
- Dermatology Practice Dariusch Mortazawi, Remscheid, Germany
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Thapar M, Patel M, Gordon K. Bimekizumab for the treatment of psoriasis. Immunotherapy 2024; 16:431-446. [PMID: 38506262 DOI: 10.2217/imt-2023-0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Psoriasis is a chronic inflammatory skin condition characterized by Th17 T cell-mediated inflammation. An emerging treatment option for psoriasis is bimekizumab, a humanized monoclonal antibody targeting cytokines IL-17A and IL-17F. Phase I trials evaluating bimekizumab reported strong safety, tolerability, and clinical efficacy with most common treatment emergent adverse events being mild to moderate in nature. Phase II trials evaluated dosing intervals, revealing that higher dosages or more frequent administration of bimekizumab resulted in minimal increases in adverse events. Phase III trials and open label extension studies demonstrated a rapid, sustained clinical response when compared with placebo and active comparators. Bimekizumab shows strong efficacy in the treatment of psoriasis and has potential in the treatment of other Th17-mediated pathologies.
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Affiliation(s)
- Molly Thapar
- Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 532261, USA
| | - Milan Patel
- Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 532261, USA
| | - Kenneth Gordon
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Orsini D, Frascione P, Assorgi C, Pacifico A, Sperduti I, Gargiulo L, Ibba L, Valenti M, Costanzo A, Narcisi A. Risankizumab for the treatment of genital psoriasis: A 1-year, real-world experience. J Eur Acad Dermatol Venereol 2024; 38:e256-e258. [PMID: 37795669 DOI: 10.1111/jdv.19562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Affiliation(s)
- D Orsini
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - P Frascione
- Dermatology Oncology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - C Assorgi
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - A Pacifico
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - I Sperduti
- Biostatistical Unit, IRCCS 'Regina Elena' National Cancer Institute, Rome, Italy
| | - L Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Italy
| | - L Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Italy
| | - M Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Italy
| | - A Costanzo
- Biostatistical Unit, IRCCS 'Regina Elena' National Cancer Institute, Rome, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - A Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
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Quality of Life and Body Region Affected by Psoriasis: A Systematic Review. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T33-T38. [PMID: 36368576 DOI: 10.1016/j.ad.2022.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/28/2022] [Indexed: 11/11/2022] Open
Abstract
PURPOSE Psoriasis is a chronic skin condition that affects approximately 1-3% of the world's population and is known to decrease patients' quality of life. However, it is yet to be ascertained whether the specific location of psoriatic lesions on the body influences one's quality of life. METHODS A systematic review was conducted with a search of MEDLINE, EMBASE, and Web of Science databases. Only non-case report and non-review studies with explicitly stated body regions affected by psoriasis were included in the review. FINDINGS Psoriatic patches and plaques in different areas of the body were not found to influence patients' quality of life to differing extents. CONCLUSIONS While the body of evidence is limited and presents unstandardized results, the results of this review point to the fact that all psoriatic patches and plaques decrease patients' quality of life, with neither one region doing so to a significantly greater extent than another.
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Nabieva K, Vender R. Quality of Life and Body Region Affected by Psoriasis: A Systematic Review. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:33-38. [PMID: 36030828 DOI: 10.1016/j.ad.2022.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 03/20/2022] [Accepted: 07/28/2022] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Psoriasis is a chronic skin condition that affects approximately 1-3% of the world's population and is known to decrease patients' quality of life. However, it is yet to be ascertained whether the specific location of psoriatic lesions on the body influences one's quality of life. METHODS A systematic review was conducted with a search of MEDLINE, EMBASE, and Web of Science databases. Only non-case report and non-review studies with explicitly stated body regions affected by psoriasis were included in the review. FINDINGS Psoriatic patches and plaques in different areas of the body were not found to influence patients' quality of life to differing extents. CONCLUSIONS While the body of evidence is limited and presents unstandardized results, the results of this review point to the fact that all psoriatic patches and plaques decrease patients' quality of life, with neither one region doing so to a significantly greater extent than another.
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Affiliation(s)
- K Nabieva
- University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - R Vender
- Dermatrials Research Inc., Hamilton, Canada.
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10
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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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11
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da Silva N, Augustin M, Hilbring C, Braren-von Stülpnagel CC, Sommer R. Psychological (co)morbidity in patients with psoriasis: the impact of pruritus and anogenital involvement on symptoms of depression and anxiety and on body dysmorphic concerns - a cross-sectional study. BMJ Open 2022; 12:e055477. [PMID: 36153012 PMCID: PMC9511542 DOI: 10.1136/bmjopen-2021-055477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES While stress plays a paramount role on the onset/exacerbation of psoriasis, via overactivation of the hypothalamic-pituitary-adrenal axis and increased release of pro-inflammatory cytokines, cutaneous inflammatory response induces, in turn, anxiety/depression symptoms, via body disfigurement and stigmatisation. The intensity of pruritus and anogenital involvement are additional risk factors for psychological comorbidity.Aims were to (1) examine the effects of intensity of pruritus and anogenital psoriasis on disease burden and psychological comorbidity and (2) identify the variables associated with the presence of clinically significant depression, anxiety, and dysmorphic concerns. DESIGN Cross-sectional study. SETTING Conducted at the University Medical Center Hamburg-Eppendorf (UKE). PARTICIPANTS 107 patients with psoriasis (mean age = 46.3, SD = 14.6 years; 53.3% male): 64 with none/mild pruritus; 43 with moderate/severe pruritus; 31 with anogenital psoriasis; 76 not affected in the anogenital area. PRIMARY/SECONDARY OUTCOMES MEASURES Disease severity was assessed with Psoriasis Area and Severity Index and intensity of pruritus was rated by patients. Patient-reported outcomes included the Dermatology Life Quality Index, ItchyQoL, Patient Benefit Index, Perceived Stigmatisation Questionnaire, and Relationship and Sexuality Scale. Psychological morbidity was assessed with the Patient Health Questionnaire, Generalised Anxiety Disorder, and Dysmorphic Concern Questionnaire. RESULTS Patients with moderate/severe pruritus reported more quality of life impairments, depression, anxiety and dysmorphic concerns, and less treatment benefits than those with none/mild pruritus. Moderate/severe pruritus had a deleterious effect on depression and stigmatisation for patients without anogenital involvement. Less patient benefits were associated with a higher likelihood of clinically significant depression/anxiety. CONCLUSION Pruritus induces significant burden and psychological morbidity, particularly for patients without anogenital involvement. However, coping strategies used by patients with anogenital psoriasis might be dysfunctional for overall psychosocial adaptation. Patient-centred healthcare might be the best way to prevent psychological comorbidity. ETHICS APPROVAL Ethics Committee of the Medical Association of Hamburg (process number PV6083, 28 May 2019).
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Affiliation(s)
- Neuza da Silva
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Caroline Hilbring
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Catharina C Braren-von Stülpnagel
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Rachel Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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12
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Jaworecka K, Rzepko M, Marek-Józefowicz L, Tamer F, Stefaniak AA, Szczegielniak M, Chojnacka-Purpurowicz J, Gulekon A, Szepietowski JC, Narbutt J, Owczarczyk-Saczonek A, Reich A. The Impact of Pruritus on the Quality of Life and Sleep Disturbances in Patients Suffering from Different Clinical Variants of Psoriasis. J Clin Med 2022; 11:jcm11195553. [PMID: 36233422 PMCID: PMC9572740 DOI: 10.3390/jcm11195553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022] Open
Abstract
Background: Quality of life (QoL) and sleep, which are essential for well-being in the mental, physical, and socioeconomic domains, are impaired in psoriatic patients. However, the exact role of the clinical subtype of psoriasis in this aspect remains poorly studied. Objectives: The aim of this study was to investigate differences in QoL impairment and sleeping problems in patients suffering from various clinical subtypes of psoriasis and to evaluate the effects of pruritus on QoL. Methods: This cross-sectional, multicenter study included 295 eligible subjects with diagnosed psoriasis. Each patient was examined with the use of the same questionnaire. Measures included predominant subtype of psoriasis, disease severity, pruritus scores, patients’ health-related QoL and the incidence of sleep disturbance. Results: The QoL of most patients was decreased irrespectively of clinical psoriasis subtype, however, the most impaired QoL was in patients with erythrodermic psoriasis. The majority of patients reported sleep disturbances caused by pruritus, albeit there was no relevant differences between analyzed subgroups in this aspect of patients’ well-being. Pruritus was an important factor determining QoL and sleeping problems in the studied population. Conclusions: Identifying the most disturbing area of life and recognizing the most bothersome subjective symptoms of psoriasis are pivotal to focusing on the most relevant treatment goal and achieving therapeutic success.
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Affiliation(s)
- Kamila Jaworecka
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Marian Rzepko
- Institute of Physical Culture Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Luiza Marek-Józefowicz
- Department of Dermatology and Venerology, Faculty of Medicine, Nicolaus Copernicus University in Toruń, Ludwik Rydygier, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
| | - Funda Tamer
- Department of Dermatology, Gazi University School of Medicine, 06570 Ankara, Turkey
| | - Aleksandra A. Stefaniak
- Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Magdalena Szczegielniak
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Łódź, 92-215 Lodz, Poland
| | - Joanna Chojnacka-Purpurowicz
- Department and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-720 Olsztyn, Poland
| | - Ayla Gulekon
- Department of Dermatology, Gazi University School of Medicine, 06570 Ankara, Turkey
| | - Jacek C. Szepietowski
- Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Joanna Narbutt
- Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Łódź, 92-215 Lodz, Poland
| | - Agnieszka Owczarczyk-Saczonek
- Department and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-720 Olsztyn, Poland
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
- Correspondence: ; Tel.: +48-605-076722
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13
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Galache C, Vázquez‐Losada B, Armesto S, González‐Gay MA, Vázquez‐López F, Santos‐Juanes J. External auditory canal psoriasis: prevalence, clinical features, and impact on quality of life. Clin Exp Dermatol 2022; 47:2265-2268. [DOI: 10.1111/ced.15352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Cristina Galache
- Department of Dermatology Hospital Universitario Central de Asturias Oviedo
- Group of investigation on Dermatology (GRIDER) Universidad de Oviedo Oviedo Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario Oncológico del Principado de Asturias (IUOPA) 33001 Oviedo Asturias Spain
| | | | - Susana Armesto
- Department of Dermatology Hospital Universitario Marqués de Valdecilla Santander Spain
| | - Miguel A. González‐Gay
- Department of Rheumatology Hospital Universitario Marqués de Valdecilla, University of Cantabria Santander Spain
| | - Francisco Vázquez‐López
- Department of Dermatology Hospital Universitario Central de Asturias Oviedo
- Group of investigation on Dermatology (GRIDER) Universidad de Oviedo Oviedo Spain
- Área de Dermatología, Departamento de Medicina Universidad de Oviedo Oviedo Spain
| | - Jorge Santos‐Juanes
- Department of Dermatology Hospital Universitario Central de Asturias Oviedo
- Group of investigation on Dermatology (GRIDER) Universidad de Oviedo Oviedo Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario Oncológico del Principado de Asturias (IUOPA) 33001 Oviedo Asturias Spain
- Área de Dermatología, Departamento de Medicina Universidad de Oviedo Oviedo Spain
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14
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Galluzzo M, Talamonti M, Cioni A, Maffei V, Shumak RG, Tofani L, Bianchi L, Campione E. Efficacy of Tildrakizumab for the Treatment of Difficult-to-Treat Areas: Scalp, Nail, Palmoplantar and Genital Psoriasis. J Clin Med 2022; 11:jcm11092631. [PMID: 35566756 PMCID: PMC9100809 DOI: 10.3390/jcm11092631] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 12/14/2022] Open
Abstract
Tildrakizumab, an IL-23 inhibitor, is effective and safe for the improvement of moderate-to-severe chronic plaque psoriasis. However, little evidence is available on the use of this biologic in psoriasis in difficult-to-treat locations. In this retrospective analysis, we treated patients with 100 mg tildrakizumab at Day 0, after 4 weeks and every 12 weeks thereafter. Disease severity and treatment response was assessed by the Psoriasis Area and Severity Index (PASI), the static Physician’s Global Assessment of Genitalia (sPGA-G), the Psoriasis Scalp Severity Index (PSSI), Nail Psoriasis Severity Index (NAPSI) and the Palmoplantar Psoriasis Area and Severity Index (ppPASI) at baseline and after 4, 12 and 28 weeks. We followed 18 patients (mean age 49.1 ± 12.7 years, 61.1% male) with psoriasis localized to the genital region (N = 7), scalp (N = 6), nails (N = 5) and palmar/plantar areas (N = 7). PASI score decreased from 11.5 at baseline to 3.1 and 2.4 at 12 and 28 weeks. Tildrakizumab treatment decreased sPGA-G (3.3 to 0.2), PSSI (36.2 to 2.7), NAPSI (48.4 to 15.7) and ppPASI (5.3 to 0) from baseline to 28 weeks, respectively. Data from this real-life retrospective analysis shows that tildrakizumab is an effective option for the management of psoriasis in difficult-to-treat areas.
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Affiliation(s)
- Marco Galluzzo
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.T.); (A.C.); (V.M.); (R.G.S.); (L.T.); (L.B.); (E.C.)
- Dermatology Unit, Fondazione Policlinico “Tor Vergata”, 00133 Rome, Italy
- Correspondence: ; Tel.: +39-06-2090-2743
| | - Marina Talamonti
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.T.); (A.C.); (V.M.); (R.G.S.); (L.T.); (L.B.); (E.C.)
- Dermatology Unit, Fondazione Policlinico “Tor Vergata”, 00133 Rome, Italy
| | - Arnaldo Cioni
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.T.); (A.C.); (V.M.); (R.G.S.); (L.T.); (L.B.); (E.C.)
- Dermatology Unit, Fondazione Policlinico “Tor Vergata”, 00133 Rome, Italy
| | - Virginia Maffei
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.T.); (A.C.); (V.M.); (R.G.S.); (L.T.); (L.B.); (E.C.)
- Dermatology Unit, Fondazione Policlinico “Tor Vergata”, 00133 Rome, Italy
| | - Ruslana Gaeta Shumak
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.T.); (A.C.); (V.M.); (R.G.S.); (L.T.); (L.B.); (E.C.)
- Dermatology Unit, Fondazione Policlinico “Tor Vergata”, 00133 Rome, Italy
| | - Lorenzo Tofani
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.T.); (A.C.); (V.M.); (R.G.S.); (L.T.); (L.B.); (E.C.)
- Dermatology Unit, Fondazione Policlinico “Tor Vergata”, 00133 Rome, Italy
| | - Luca Bianchi
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.T.); (A.C.); (V.M.); (R.G.S.); (L.T.); (L.B.); (E.C.)
- Dermatology Unit, Fondazione Policlinico “Tor Vergata”, 00133 Rome, Italy
| | - Elena Campione
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.T.); (A.C.); (V.M.); (R.G.S.); (L.T.); (L.B.); (E.C.)
- Dermatology Unit, Fondazione Policlinico “Tor Vergata”, 00133 Rome, Italy
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15
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Dauendorffer JN. Male genital dermatology: Why and how? Ann Dermatol Venereol 2021; 149:1-2. [PMID: 34949442 DOI: 10.1016/j.annder.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J-N Dauendorffer
- Department of Dermatology, St Louis University Hospital, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
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16
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Staubach P, Plavic-Radeka N, Peveling-Oberhag A, Sohn A, Zimmer S, Weyer-Elberich V, Lang BM. Hohe Prävalenz und geringes Bewusstsein bei Patienten mit chronisch‐entzündlichen Hauterkrankungen und genitaler Beteiligung. J Dtsch Dermatol Ges 2021; 19:1443-1450. [PMID: 34661344 DOI: 10.1111/ddg.14437_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/26/2020] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | - Anna Sohn
- Hautklinik, Universitätsmedizin Mainz
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17
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Staubach P, Plavic-Radeka N, Peveling-Oberhag A, Sohn A, Zimmer S, Weyer-Elberich V, Lang BM. High prevalence and little awareness in patients with chronic inflammatory skin diseases and genital involvement. J Dtsch Dermatol Ges 2021; 19:1443-1448. [PMID: 34396689 DOI: 10.1111/ddg.14437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/26/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Genital involvement in patients with chronic inflammatory skin diseases is frequent, yet insufficiently acknowledged. OBJECTIVE To evaluate the prevalence of genital symptoms in psoriasis and chronic urticaria patients, effects on quality of life, physician-patient relations and disease management. PATIENTS AND METHODS 100 patients with psoriasis and 100 with chronic urticaria from our outpatient clinic, as well as 50 healthy controls were included. Data was collected using questionnaires developed by dermatological experts. RESULTS Out of 250 subjects, 74 % had already experienced genital symptoms - 70 % of psoriasis patients and 58 % of urticaria patients. Seven out of ten even complained about recurrent genital involvement. 50 % of psoriasis and 41 % of urticaria patients reported an impact on quality of life. 41 % identified genital pruritus as the main symptom, with one out of three expecting a better management for this specific problem. Furthermore, 74 % complained about a lack of awareness among physicians: 79 % of urticaria patients and 58 % of psoriasis patients reported never having been questioned about genital symptoms by their physicians. CONCLUSIONS The majority of patients with psoriasis and chronic urticaria suffer from genital involvement and an impaired quality of life. Patient and physician reported outcomes should include genital symptoms as an influencing factor for quality of life.
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Affiliation(s)
- Petra Staubach
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | | | | | - Anna Sohn
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - Sebastian Zimmer
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
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18
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Calianno G, Esposito M, Fidanza R, Palmieri M, Fargnoli MC. Ixekizumab improves disease severity, clinical symptoms and quality of life in patients with genital psoriasis: A 24-week real-life experience. Dermatol Ther 2021; 34:e14993. [PMID: 34029442 DOI: 10.1111/dth.14993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/12/2021] [Accepted: 05/12/2021] [Indexed: 01/13/2023]
Abstract
Genital psoriasis (GenPs) has been traditionally considered a difficult to treat psoriasis area. Ixekizumab was the first biologic agent demonstrating efficacy and safety in a formal clinical trial on GenPs; however, real-life experiences are limited. To assess real-life effectiveness and safety of ixekizumab in the treatment of GenPs in a case series of patients with moderate-to-severe plaque psoriasis. Adult patients with moderate-to-severe plaque psoriasis involving the genital area received subcutaneous ixekizumab. Evaluation of disease severity, clinical symptoms, and quality of life was performed at baseline, after 4, 16, and 24 weeks of treatment. Assessment tools were: Static Physician's Global Assessment of Genitalia (sPGA-G), Psoriasis Area and Severity Index (PASI) score, Itch Numerical-Rating-Score (Itch-NRS), and Dermatology-Life-Quality-Index (DLQI). Adverse events were recorded. A total of 14 patients were treated with ixekizumab achieving consistent and significant reduction of disease and quality of life parameters, with a mean percentage reduction from baseline to week 24 of 91.4% for sPGA-G, 95.2% for PASI, 95.6% for Itch-NRS, and 93.7% for DLQI. Ixekizumab treatment was well tolerated. Ixekizumab significantly improved disease severity, itch, and quality of life with an acceptable safety profile in a real-life setting in adult patients affected by GenPs.
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Affiliation(s)
- Gianluca Calianno
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria Esposito
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Maria Palmieri
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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19
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Validation of Sinhala version of Psoriasis Epidemiology Screening Tool. Clin Rheumatol 2021; 40:3127-3134. [PMID: 33594634 DOI: 10.1007/s10067-021-05633-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/07/2021] [Accepted: 02/03/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION/OBJECTIVES Psoriatic arthritis (PsA) occurs in one-third of patients with psoriasis and mostly remains undetected leading to debilitating deforming arthritis, eventually. The Psoriasis Epidemiology Screening Tool (PEST) is a quick and valid tool, widely used to detect PsA in clinical practice, and it has been validated to many languages. In this study, we intended to validate a Sinhala version of the PEST and assess its psychometric properties. METHODS The Sinhala version of the questionnaire was tested on 199 patients with psoriasis attending the dermatology clinic at a tertiary care National Hospital in Sri Lanka. Patients who were detected to have PsA previously (n = 5) and those with other rheumatologic conditions (n = 12) were excluded. All patients were examined by a dermatologist, and demographic and disease characteristics were obtained. All patients were assessed by two rheumatologists who were blinded to the answers provided in the questionnaire. The diagnosis of PsA was made based on the CASPAR criteria. RESULTS We observed the total PEST score of 3 or more to be the best cutoff value to screen for PsA. This cutoff value showed the highest Youden index (sensitivity = 0.89, specificity = 0.95). In the ROC analysis, the area under the curve of the PEST_sv was 0.95 (SE 0.02, p < 0.001). PEST_sv total score showed a significant correlation with body surface area involved but not with Dermatology Life Quality Index or Psoriasis area and severity index score. CONCLUSION The Sinhala version of PEST demonstrated satisfactory performance as a screening tool for PsA. Key Points • Psoriatic arthritis (PsA) is the most debilitating complication of psoriasis and lack of quick, valid screening tool is a limiting factor for early identification in Sri Lankan context. • Sinhala version of the Psoriasis Epidemiology Screening Tool (PEST_sv) was tested on 199 patients with psoriasis and examined for the diagnosis of PsA according to Classification of Psoriatic Arthritis (CASPAR) criteria. • PEST_sv score of 3 or more was observed to be the best cutoff value to screen for PsA with sensitivity and specificity of 0.89 and 0.95 respectively. • PEST_sv demonstrated satisfactory performance as a screening tool for PsA.
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Lespessailles E, Mahé E, Reguiai Z, Begon E, Maccari F, Beneton N, Chaby G, Rosenberg C, Dernis E, Roux F, Henry-Desailly I, Charles B, Ferdynus C, Marty M, Esteve E. Psychometric validation of a patient-reported outcome questionnaire (Qualipsosex) assessing the impact of psoriasis and psoriatic arthritis on patient perception of sexuality. Medicine (Baltimore) 2021; 100:e24168. [PMID: 33429800 PMCID: PMC7793412 DOI: 10.1097/md.0000000000024168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/30/2020] [Accepted: 12/10/2020] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Psoriasis (Pso) and psoriatic arthritis (PsA) frequently have a negative impact on patients' sexual health. We have developed a specific questionnaire assessing the impact of Pso and PsA on patient perception of sexuality: the QualipsoSex Questionnaire (QSQ). The aim of the present study was to further validate this questionnaire by checking its psychometric properties including validity, reliability, and responsiveness.A cross sectional observational study with a longitudinal component for responsiveness and test-retest reliability was performed in 12 centers in France including 7 dermatologists and 5 rheumatologists. Psychometric properties were examined according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) check-list.At baseline, 114 patients had Pso and 35 patients had PsA including 17 peripheral arthritis, 4 axial disease, 13 patients with both axial disease and peripheral arthritis and one patient with an undifferentiated phenotype. The mean Pso Area and Severity Index score was 12.5. Genital organs were involved in 44.7% of Pso cases. Internal consistency, construct validity, and reliability were good with Cronbach's α coefficient, measure of sampling adequacy and intraclass correlation coefficient respectively at 0.87, 0.84, and 0.93. The QSQ also demonstrated acceptable sensitivity to change.The QSQ has demonstrated good psychometric properties fulfilling the validation process relative to the recommendations of the COSMIN check list. The QSQ is simple to score and may hopefully be valuable in clinical practice and in clinical trials.
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Affiliation(s)
- Eric Lespessailles
- Department of Rheumatology, Regional Hospital of Orleans
- University of Orleans, EA 4708, I3MTO Laboratory
| | - Emmanuel Mahé
- Department of Dermatology, Hôpital Victor Dupouy, Argenteuil
| | - Ziad Reguiai
- Department of Dermatology, Polyclinique Courlancy-Bezannes, Reims
| | - Edouard Begon
- Department of Dermatology, Hôpital René Dubos, Pontoise
| | | | | | - Guillaume Chaby
- Department of Dermatology, Hôpital Nord, University of Amiens-Picardie, Amiens
| | | | | | - Fabienne Roux
- Department of Rheumatology, Saint Joseph Hospital, Paris
| | | | | | - Cyril Ferdynus
- CHU La Réunion, Unité de Soutien Méthodologique, F-97400, Saint-Denis, La Réunion
- INSERM, CIC 1410, F-97410, Saint Pierre, La Réunion
| | - Marc Marty
- Department of Rheumatology, Henri Mondor Hospital, Creteil
| | - Eric Esteve
- University of Orleans, EA 4708, I3MTO Laboratory
- Department of Dermatology, Regional Hospital of Orleans, Orleans, France
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21
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Affiliation(s)
- Catarina Estevinho
- Obstetrics and Gynaecology, Centro Hospitalar Tâmega e Sousa EPE, Guilhufe, Porto, Portugal
| | - Elisa Soares
- Obstetrics and Gynaecology, Centro Hospitalar Tâmega e Sousa EPE, Guilhufe, Porto, Portugal
| | - Ana Portela Carvalho
- Obstetrics and Gynaecology, Centro Hospitalar Tâmega e Sousa EPE, Guilhufe, Porto, Portugal
| | - Fernanda Costa
- Obstetrics and Gynaecology, Centro Hospitalar Tâmega e Sousa EPE, Guilhufe, Porto, Portugal
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22
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Mahé E. Optimal Management of Plaque Psoriasis in Adolescents: Current Perspectives. PSORIASIS-TARGETS AND THERAPY 2020; 10:45-56. [PMID: 33274179 PMCID: PMC7708777 DOI: 10.2147/ptt.s222729] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/29/2020] [Indexed: 11/25/2022]
Abstract
The skin is at the interface between the body and its environment and is therefore at the center of adolescent concerns during this period of identity formation and increased awareness of body image issues, and stigmatization. Managing an adolescent with psoriasis involves managing the illness and the individual during their transition from being an older child to a young adult. In addition to ensuring that the patient adheres to treatments and is engaged with the therapeutic strategy, dermatologists may also need to manage issues linked to unspoken suffering or conflicts between the adolescent and their parents, who are often present during consultations. The impact of psoriasis on the social interactions, school life and sexuality of the patients, together with the influence of the internet and social networks, also have to be taken into account. In this review, we summarize the epidemiologic, clinical, and therapeutic data available on psoriasis in adolescents, and propose specific management strategies, adapted to the 21st century, for patients in this age group.
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Affiliation(s)
- Emmanuel Mahé
- Service De Dermatologie Et Médecine Vasculaire, Hôpital Victor Dupouy, Argenteuil 95100, France
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23
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van Muijen ME, van Hal TW, Groenewoud HMM, van den Reek JMPA, de Jong EMGJ. The Skin May Clear But the Arthritis Won't Disappear: Focusing on Concomitant and New-Onset Psoriatic Arthritis in a Daily Practice Cohort of Psoriasis Patients on Biologic Therapy. PSORIASIS-TARGETS AND THERAPY 2020; 10:29-37. [PMID: 33117661 PMCID: PMC7547182 DOI: 10.2147/ptt.s270619] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/14/2020] [Indexed: 11/23/2022]
Abstract
Background Previously identified risk factors for psoriatic arthritis (PsA); nail dystrophy and scalp lesions are highly prevalent in patients with moderate-to-severe psoriasis. Therefore, these variables may not be useful as predictors for PsA in this population. Objective We assessed the predictive value of demographic and clinical characteristics for development of PsA in a cohort of patients with moderate-to-severe psoriasis, currently treated with biologics. Furthermore, we reported the incidence of new-onset PsA in this population and described the characteristics of patients that developed PsA during biologic treatment. Methods Demographics and treatment characteristics of psoriasis patients currently using biologic therapy were extracted from the BioCAPTURE database (n=427). Poisson regression was used to calculate incidence rates. Multivariable logistic regression was performed to identify factors independently associated with PsA onset. Patient and treatment characteristics of patients that developed PsA during biologic treatment were described. Results The incidence of PsA was 1.0 (95% CI 0.8–1.2) per 100 psoriasis-years. Except for a lower risk for PsA in male gender (OR 0.58, 95% CI 0.34–0.98, p-value 0.04), no clinical factors were significantly associated with an altered risk of developing PsA. During biologic therapy, 32 patients (9.4%) newly developed PsA. In this group, 53.8% had PASI<5 at PsA diagnosis. The incidence rate of PsA was 1.6 (95% CI 1.1–2.2) per 100 years on biologic therapy. Conclusion Clinical risk factors might be inaccurate to predict PsA onset in patients with moderate-to-severe psoriasis on biologics. Even with low disease activity, psoriasis patients on biologics are still prone to develop PsA.
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Affiliation(s)
- Marloes E van Muijen
- Department of Dermatology, Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands.,Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands
| | - Tamara W van Hal
- Department of Dermatology, Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands.,Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands.,Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Hans M M Groenewoud
- Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands
| | - Juul M P A van den Reek
- Department of Dermatology, Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands.,Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands
| | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands.,Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands.,Radboud University, Nijmegen, the Netherlands
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24
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Uppala R, Tsoi LC, Harms PW, Wang B, Billi AC, Maverakis E, Michelle Kahlenberg J, Ward NL, Gudjonsson JE. "Autoinflammatory psoriasis"-genetics and biology of pustular psoriasis. Cell Mol Immunol 2020; 18:307-317. [PMID: 32814870 DOI: 10.1038/s41423-020-0519-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/20/2020] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin condition that has a fairly wide range of clinical presentations. Plaque psoriasis, which is the most common manifestation of psoriasis, is located on one end of the spectrum, dominated by adaptive immune responses, whereas the rarer pustular psoriasis lies on the opposite end, dominated by innate and autoinflammatory immune responses. In recent years, genetic studies have identified six genetic variants that predispose to pustular psoriasis, and these have highlighted the role of IL-36 cytokines as central to pustular psoriasis pathogenesis. In this review, we discuss the presentation and clinical subtypes of pustular psoriasis, contribution of genetic predisposing variants, critical role of the IL-36 family of cytokines in disease pathophysiology, and treatment perspectives for pustular psoriasis. We further outline the application of appropriate mouse models for the study of pustular psoriasis and address the outstanding questions and issues related to our understanding of the mechanisms involved in pustular psoriasis.
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Affiliation(s)
- Ranjitha Uppala
- Graduate Program in Immunology, University of Michigan, Ann Arbor, MI, USA.,Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA.,Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Bo Wang
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Allison C Billi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, Sacramento, CA, USA
| | - J Michelle Kahlenberg
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.,A. Alfred Taubman Medical Research Institute, Ann Arbor, MI, USA
| | - Nicole L Ward
- Departments of Nutrition and Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Johann E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA. .,A. Alfred Taubman Medical Research Institute, Ann Arbor, MI, USA.
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25
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Sex-related impairment and patient needs/benefits in anogenital psoriasis: Difficult-to-communicate topics and their impact on patient-centred care. PLoS One 2020; 15:e0235091. [PMID: 32609733 PMCID: PMC7329077 DOI: 10.1371/journal.pone.0235091] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 06/08/2020] [Indexed: 12/11/2022] Open
Abstract
Genital psoriasis affects 2-5% of psoriasis patients; generalised plaque or intertriginous psoriasis also affects the genital area in 29-40% of cases. Anogenital psoriasis has been associated with significant quality of life impairments, but little is known about specific patient needs/treatment goals. This study aimed to examine the overall and sex-related disease burden, patient needs and treatment benefits in patients with anogenital psoriasis, compared to patients with psoriasis not affecting the anal/genital areas. Within the cross-sectional nationwide survey, 2,009 participants were consecutively recruited in 157 randomly assigned German dermatology practices and clinics, according to the following inclusion criteria aged 18 years or over; diagnosis of psoriasis vulgaris; ability to answer the questionnaires; and written informed consent. Based on a high-resolution grid on the topical distribution of psoriasis, two groups were formed: anogenital psoriasis (n = 622) and comparison group (n = 1,303). Clinical severity was assessed by the Psoriasis Area and Severity Index (PASI). Patients completed the EuroQoL visual analogue scale (EQ VAS), the Dermatology Life Quality Index (DLQI), and the Patient Benefit Index (PBI). Patients with anogenital psoriasis had higher PASI (13.0±10.6 vs. 8.9±7.6, P < 0.001) and more DLQI impairments (8.9±6.9 vs. 7.0±6.2, P = 0.002) than controls. At the item-level, they also reported more sex-related DLQI impairments (DLQI-i9: 0.5±0.8 vs. 0.3±0.7, P < 0.001) and treatment needs (PBI-i17: 2.2±1.8 vs. 1.9±1.8, P = 0.001). A great percentage of missing/not-relevant responses was found for sex-related items (23.3-41.9%). These results suggest that the assessment of sex-related impairments and treatment needs should be prioritised in patients with anogenital psoriasis. Questionnaires may be used as a less uncomfortable way for patients to discuss their genital lesions and sexual function during healthcare visits. However, the great percentage of missing/not-relevant responses to sex-related items calls for in-depth assessments and effective patient-physician communication regarding these sensitive topics.
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26
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Egeberg A, See K, Garrelts A, Burge R. Epidemiology of psoriasis in hard-to-treat body locations: data from the Danish skin cohort. BMC DERMATOLOGY 2020; 20:3. [PMID: 32434510 PMCID: PMC7238562 DOI: 10.1186/s12895-020-00099-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 05/10/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Having psoriasis in hard-to-treat areas, i.e. the scalp, face, palms, soles, nails, and genitals, respectively, can impair patients' quality of life. We investigated the prevalence of hard-to-treat body locations of psoriasis, and described patients' clinical and demographic characteristics, and quality of life impacts in a population-based cohort. METHODS We performed a cross-sectional study using a total of 4016 adults (≥18 years) with psoriasis from the Danish Skin Cohort. Groups were compared to patients without involvement of hard-to-treat areas. RESULTS The most frequently affected hard-to-treat area was the scalp (43.0%), followed by the face (29.9%), nails (24.5%), soles (15.6%), genitals (14.1%), and palms (13.7%), respectively. Higher prevalence was generally seen with increasing psoriasis severity. Among all patients 64.8, 42.4, and 21.9% of patients had involvement of ≥1, ≥2, or ≥ 3 hard-to-treat areas. Those with involvement of certain hard-to-treat areas such as hands, feet, and genitals had clinically relevant DLQI impairments. Having involvement of one hard-to-treat area was significantly associated with other hard-to-treat areas affected even after adjusting for age, sex, and psoriasis severity. CONCLUSION Psoriasis commonly affects hard-to-treat locations, even in patients with mild disease. For some of these areas, patient-reported disease burden, e.g. as measured by DLQI, is impaired.
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Affiliation(s)
- Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark.
| | - Kyoungah See
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | | | - Russel Burge
- Eli Lilly and Company, Indianapolis, Indiana, USA.,Division of Pharmaceutical Sciences, University of Cincinnati, Cincinnati, OH, USA
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27
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Grodner C, Mezzarobba M, Weill A, Sbidian E. Evolution of topical steroids consumption before and after initiation of systemic treatment in psoriasis: epidemiologic study in a real‐world analysis of the French national health insurance database. J Eur Acad Dermatol Venereol 2020; 34:e259-e262. [DOI: 10.1111/jdv.16238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C. Grodner
- Département de Dermatologie AP‐HP Hôpitaux universitaires Henri Mondor UPEC Créteil France
| | - M. Mezzarobba
- Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAM) Paris France
| | - A. Weill
- Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAM) Paris France
- GIS‐EPIPHARE, Groupement d'intérêt scientifique Epidémiologie des produits de santé ANSM‐CNAM Paris France
| | - E. Sbidian
- GIS‐EPIPHARE, Groupement d'intérêt scientifique Epidémiologie des produits de santé ANSM‐CNAM Paris France
- Centre d'Investigation Clinique 1430 INSERM Créteil France
- EA 7379 EpidermE Université Paris‐Est Créteil UPEC Créteil France
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28
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Merola JF, Ghislain PD, Dauendorffer JN, Potts Bleakman A, Brnabic AJM, Burge R, Riedl E. Ixekizumab improves secondary lesional signs, pain and sexual health in patients with moderate-to-severe genital psoriasis. J Eur Acad Dermatol Venereol 2020; 34:1257-1262. [PMID: 31919919 PMCID: PMC7318177 DOI: 10.1111/jdv.16181] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022]
Abstract
Background Epithelial surface disruption in genital psoriatic lesions may manifest as erosions, fissures and/or ulcers, causing pain and significantly impacting a patient's sexual health. Objective To evaluate the impact of erosions, fissures and/or ulcers in genital psoriatic lesions on pain and sexual activity in patients with moderate‐to‐severe genital psoriasis (GenPs) and treatment responses to ixekizumab vs. placebo until Week 12. Methods This post hoc subgroup analysis of patients presenting with and without erosions, fissures and/or ulcers in genital lesions from a phase IIIb multicentre, randomized, double‐blind, placebo‐controlled study (IXORA‐Q; NCT02718898) in 149 adults with moderate‐to‐severe GenPs treated with subcutaneous ixekizumab (80 mg every 2 weeks; n = 75) or placebo (n = 74) evaluated outcomes for clinician‐rated GenPs severity (static Physician's Global Assessment of Genitalia; sPGA‐G) and patient‐reported genital pain and itch (Genital Psoriasis Symptoms Scale; GPSS) and sexual health (Genital Psoriasis Sexual Frequency Questionnaire; GenPs‐SFQ). Results At baseline, 38% (n = 57) of patients presented with genital erosions, fissures and/or ulcers independent of overall body surface area involvement (<10% or ≥10%). These signs were associated with higher scores for disease severity (sPGA‐G) and pain (GPSS) but not sexual health (GenPs‐SFQ). Complete resolution of these signs was observed in 62% of ixekizumab‐treated patients (25% for placebo) at Week 1 and 83% (21% for placebo) at Week 12. Patients treated with ixekizumab reported significant improvements in pain, itch, disease severity and sexual health over 12 weeks compared to placebo and irrespective of the presence/absence of genital erosions, fissures and/or ulcers at baseline. Conclusion Ixekizumab led to rapid and sustained resolution of erosions, fissures and/or ulcers and significant improvements in GenPs severity, genital pain and sexual health. Ixekizumab may help to improve the well‐being of patients with GenPs.
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Affiliation(s)
- J F Merola
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - P-D Ghislain
- Department of Dermatology, Cliniques Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | | | | | | | - R Burge
- Eli Lilly and Company, Indianapolis, IN, USA
| | - E Riedl
- Eli Lilly and Company, Indianapolis, IN, USA.,Department of Dermatology, Medical University of Vienna, Vienna, Austria
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29
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Ingen-Housz-Oro S. Quoi de neuf en dermatologie clinique? Ann Dermatol Venereol 2019; 146:12S1-12S10. [DOI: 10.1016/s0151-9638(20)30100-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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30
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da Silva N, von Stülpnagel C, Langenbruch A, Danckworth A, Augustin M, Sommer R. Disease burden and patient needs and benefits in anogenital psoriasis: developmental specificities for person-centred healthcare of emerging adults and adults. J Eur Acad Dermatol Venereol 2019; 34:1010-1018. [PMID: 31715033 DOI: 10.1111/jdv.16076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 10/24/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Establishing romantic relationships involving cohabitation and/or sexual intercourse is an overriding task for many people during emerging adulthood, i.e. from their late teens through the twenties. The diagnosis of anogenital psoriasis may hinder social/intimate relationships, resulting in higher disease burden in this age group. OBJECTIVES To compare the disease burden and patient needs/benefits between emerging adults (18-30 years) and adults (>30 years) with psoriasis, with and without anogenital involvement; and to identify sociodemographic/clinical variables accounting for better patient-reported outcomes. METHODS Patients aged ≥18 years with psoriasis vulgaris were recruited within a cross-sectional nationwide survey randomly assigning 157 dermatology practices/clinics in Germany. Anogenital involvement was established based on a high-resolution grid on the topology of psoriasis. The main outcome measures were the Psoriasis Area and Severity Index (PASI), the EuroQoL visual analogue scale (EQ-VAS), the Dermatology Life Quality Index (DLQI) and the Patient Benefit Index (PBI). RESULTS Participants were 1921 patients: 173 emerging adults and 1749 adults >30 years. Anogenital involvement was observed in 621 patients (32.3%). Patient with anogenital psoriasis reported decreased health and more QoL impairments compared with those without anogenital lesions. Emerging adults presented more QoL impairments and less treatment benefits than older patients, and they were more prone to underrate a wide range of needs, except when the anogenital area was affected. Beyond anogenital involvement and higher disease severity, less treatment benefits were associated with more QoL impairments, particularly for emerging adults. CONCLUSIONS The developmental instability of many emerging adults may result in difficulties to establish/adhere to treatment goals and thus in decreased perception of treatment benefit and more QoL impairments. Anogenital involvement is a risk factor for increased disease burden regardless of age. Assessing anogenital involvement in all patients and helping younger patients to define/adhere to treatment goals should be prioritized in patient-centred healthcare for psoriasis.
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Affiliation(s)
- N da Silva
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - C von Stülpnagel
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - A Langenbruch
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - A Danckworth
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - R Sommer
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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31
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Ryan C. Genital psoriasis: the failure of dermatologists to identify genital involvement. Br J Dermatol 2019; 180:460-461. [PMID: 30821387 DOI: 10.1111/bjd.17505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- C Ryan
- Department of Dermatology, Suite 16, Blackrock Clinic, Rock Road, Blackrock, Dublin, Ireland.,Charles Institute of Dermatology, University College Dublin, Ireland
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32
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Abstract
Psoriasis involving the genital skin occurs in up to two-thirds of psoriasis patients but is often overlooked by physicians. Furthermore, psoriasis objective and subjective severity indexes for common plaque psoriasis often neglect the impact this small area of psoriasis can have on a patient. It can have a significant impact on patients' psychosocial function due to intrusive physical symptoms such as genital itch and pain, and a detrimental impact on sexual health and impaired relationships. The mainstay of treatment is topical therapy. In patients with genital psoriasis refractory to traditional topical treatment, biologic treatments may greatly improve patient outcomes.
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Affiliation(s)
- Aine Kelly
- Dermatology Department, St. Vincent's University Hospital, Elm Park Rd, Dublin 4, Ireland.
| | - Caitriona Ryan
- Dermatology Department, St. Vincent's University Hospital, Elm Park Rd, Dublin 4, Ireland
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