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Gooderham M, Vender R, Crowley J, Hong HCH, Feely M, Garrelts A, See K, Konicek B, Green L. Speed and Cumulative Responses According to Body Regions in Patients with Moderate-to-Severe Plaque Psoriasis Treated with Ixekizumab (Interleukin-17A Antagonist) versus Guselkumab (Interleukin-23p19 Inhibitor). Dermatol Ther (Heidelb) 2024; 14:441-451. [PMID: 38332436 PMCID: PMC10890986 DOI: 10.1007/s13555-023-01075-y] [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: 09/11/2023] [Accepted: 11/14/2023] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION When assessing the effect of a therapy for psoriasis (PsO), it is important to consider speed of response and cumulative response. However, responses among biologics may differ by body regions. This post hoc analysis compares speed of response and cumulative response for ixekizumab (IXE), an interleukin-17A antagonist, and guselkumab (GUS), an interleukin-23p19 inhibitor, in different body regions of patients with moderate-to-severe plaque PsO participating in the IXORA-R study, up to week 24. METHODS The IXORA-R design has been previously described. Patients received the respective on-label dosing of IXE or GUS. The median time to first Psoriasis Area and Severity Index (PASI) 50, 75, 90, and 100 response (50%, 75%, 90%, and 100% improvement from baseline, respectively) and the cumulative days with clear skin for PASI 50, 75, 90, and 100 responses were assessed in four body regions: head, trunk, upper extremities, and lower extremities. RESULTS A total of 1027 patients were enrolled and received IXE (N = 520) or GUS (N = 507). Median time to first PASI 50, 75, 90, and 100 response was shortest in the head region, followed by the remaining body regions in both IXE and GUS cohorts. In each body region, IXE was significantly faster than GUS (p < 0.001) in achieving PASI 50, 75, 90, and 100. Through 24 weeks, the number of days with clear skin for PASI 90 and 100 was greater in the head region, followed by trunk, upper extremities, and lastly lower extremities in both IXE and GUS cohorts. In each body region, through 24 weeks, patients on IXE experienced a significantly higher number of days with clear skin for PASI 50, 75, 90, and 100 than patients on GUS (p < 0.01). CONCLUSIONS As compared to GUS, IXE provided a faster skin clearance and more days with clear skin in all body regions of patients with moderate-to-severe plaque PsO through 24 weeks. TRIAL REGISTRATION NUMBER https://www. CLINICALTRIALS gov/ : NCT03573323 (IXORA-R).
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Affiliation(s)
- Melinda Gooderham
- Queen's University, Kingston, ON, Canada.
- Probity Medical Research Inc., Waterloo, ON, Canada.
- SKiN Centre for Dermatology, Peterborough, ON, Canada.
| | - Ronald Vender
- Dermatrials Research Inc., Hamilton, ON, Canada
- McMaster University, Hamilton, ON, Canada
| | - Jeffrey Crowley
- Bakersfield Dermatology and Skin Cancer Medical Group, Bakersfield, CA, USA
| | - H Chih-Ho Hong
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- Probity Medical Research Inch, Surrey, BC, Canada
| | - Meghan Feely
- Eli Lilly and Company, Indianapolis, IN, USA
- Mount Sinai, New York, NY, USA
| | | | | | | | - Lawrence Green
- George Washington University School of Medicine, Washington, DC, USA
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Yu Y, Zhou J, Huang D, Zhong X, Kong L, Ding Y, Bi X, Deng H, Chen J, Gu J, Lu J, Shi Y. Lesion area reduction and the amelioration of anxiety and depression states in psoriasis patients: A prospective clinical study. J Affect Disord 2024; 344:335-338. [PMID: 37827263 DOI: 10.1016/j.jad.2023.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/04/2023] [Accepted: 10/08/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Psoriasis patients are more likely to have mental disorders. The relationship between the reduction of involvement area and severity of lesions and the associated improvement in anxiety and depression in psoriasis patients, remains inadequately researched. METHODS 200 psoriasis patients were enrolled in this prospective study, and received 12-week narrowband ultraviolet B (NB-UVB) therapy. The Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), and Physician Global Assessment (PGA) scores were obtained as the objective assessments of disease, each reflecting distinct aspects of the disease. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate the anxiety and depression symptoms. RESULTS Successful treatment brought an improvement in anxiety and depression levels and rates (all p < 0.05). Statistical analysis revealed no significant improvements in the scores of HADS or rates of symptomatic anxiety and depression in patients who did not achieve a PASI 75 response (all p > 0.05). Reductions in PASI, BSA and PGA were all statistically associated with reductions in HADS (all p < 0.05). BSA 75 response was found to play a more crucial role in the transition of symptomatic psoriatic patients to asymptomatic status (all p < 0.01). LIMITATIONS The study focused on the short-term effects, and further research is needed to investigate the long-term effects. CONCLUSION Successful treatment of psoriasis resulted in improvements in anxiety and depression levels and rates. In comparison with the lesion severity, reduction in the lesion involvement area had a greater impact on the anxiety and depression symptoms.
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Affiliation(s)
- Yingyuan Yu
- Department of Dermatology, Institute of Psoriasis, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jing Zhou
- Department of Dermatology, Institute of Psoriasis, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Dawei Huang
- Department of Dermatology, Institute of Psoriasis, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoyuan Zhong
- Department of Dermatology, Institute of Psoriasis, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Luyang Kong
- Department of Dermatology, Institute of Psoriasis, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yangfeng Ding
- Department of Dermatology, Institute of Psoriasis, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xinling Bi
- Department of Dermatology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Hui Deng
- Department of Dermatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jianhua Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Research Center for Mental Health, Shanghai, China
| | - Jun Gu
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jiajing Lu
- Department of Dermatology, Institute of Psoriasis, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.
| | - Yuling Shi
- Department of Dermatology, Institute of Psoriasis, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.
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Orbai AM, Chakravarty SD, You Y, Shawi M, Yang YW, Merola JF. Efficacy of Guselkumab in Treating Nails, Scalp, Hands, and Feet in Patients with Psoriasis and Self-reported Psoriatic Arthritis. Dermatol Ther (Heidelb) 2023; 13:2859-2868. [PMID: 37713133 PMCID: PMC10613182 DOI: 10.1007/s13555-023-01012-z] [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: 07/18/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION The aim of this study was to evaluate guselkumab efficacy on regional psoriasis in a subset of psoriasis patients with a self-reported psoriatic arthritis (PsA) diagnosis. METHODS In the phase 3 VOYAGE-1 and -2 studies, at week (W)0, patients with moderate-to-severe psoriasis were randomized to guselkumab 100 mg, placebo → guselkumab 100 mg at W16 through W44, or adalimumab 80 mg then 40 mg at W1 through W48 (VOYAGE-1) or W24 (VOYAGE-2). Pooled efficacy outcomes, including scalp-specific Investigator's Global Assessment (ss-IGA), hands and/or feet Physician's Global Assessment (hf-PGA), fingernail PGA (f-PGA), Nail Psoriasis Area and Severity Index (NAPSI), and Dermatology Life Quality Index (DLQI), were compared (nominal p-values) through W24 in patients with self-reported PsA diagnosis. Response rates/percentage improvement from baseline were determined, employing treatment failure rules and non-response/no improvement data imputation. RESULTS A total of 76, 153, and 106 psoriasis patients with self-reported PsA were randomized to the placebo, guselkumab, or adalimumab groups, respectively; the baseline characteristics of patients in all three arms were comparable. At W16, a greater proportion of guselkumab- versus placebo-treated patients achieved ss-IGA 0/1 (80.6% vs. 22.7%, p < 0.001), hf-PGA 0/1 (68.9% vs. 14.8%, p < 0.001), f-PGA 0/1 (47.6% vs. 17.0%, p < 0.001), and DLQI 0/1 (45.6% vs. 2.7%, p < 0.001) responses; mean percentage NAPSI improvement was also greater with guselkumab (39.5% vs. 6.5%, p < 0.001). At W24, patients receiving guselkumab had higher ss-IGA 0/1 (77.5% vs. 58.5%, p = 0.003) and DLQI 0/1 (47.7% vs. 34.3%, p = 0.024) response rates versus those receiving adalimumab. Response rates/mean percentage improvements at W48 (VOYAGE-1) were numerically greater with guselkumab than adalimumab (e.g., NAPSI improvement: 75.6% vs. 60.9%). CONCLUSIONS Guselkumab-treated patients with psoriasis and self-reported PsA showed meaningful improvements in nail, scalp, and palmoplantar psoriasis. TRIAL REGISTRATION VOYAGE-1 (ClinicalTrials.gov Identifier: NCT02207231) and VOYAGE-2 (ClinicalTrials.gov Identifier: NCT02207244).
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Affiliation(s)
- Ana-Maria Orbai
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Soumya D Chakravarty
- Janssen Scientific Affairs, LLC, Horsham, PA, USA
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Yin You
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - May Shawi
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Ya-Wen Yang
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Joseph F Merola
- Brigham and Women's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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Jankowiak B, Krajewska-Kułak E, Jakoniuk M, Khvorik DF. Stigmatization among Patients with Plaque Psoriasis. J Clin Med 2023; 12:6425. [PMID: 37835068 PMCID: PMC10573936 DOI: 10.3390/jcm12196425] [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: 08/21/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023] Open
Abstract
The aim of the study was to analyze the level of stigmatization among patients with plaque psoriasis according to their demographic and clinical characteristics. The study included 122 patients who completed the 6-item and 33-item Feelings of Stigmatization Questionnaire and a sociodemographic survey. The analysis of the 6-item Stigmatization Scale showed a mean stigmatization score of 6.4 points. (Me = 6; s = 3.7); the mean score for the 33-item scale was 81.3 points (Me = 79.5; s = 19.9). Female patients felt stigmatized more often than males. Respondents living in the countryside had a stronger sense of stigmatization in the Sensitivity to Others' Attitudes (p = 0.0238) and Secretiveness (p = 0.0234) domains. The presence of psoriatic lesions across the entire body was the only explanatory variable significantly determining the level of stigmatization in the Positive Attitudes domain, either through the main effect or through the interaction with the patient sex. A highly significant difference was found for the feeling of being flawed domain (p = 0.044), with a mean score of 13.4 points. The issue of stigmatization in psoriasis deserves more attention, as the analysis of this problem may provide a better insight into the effect of the disease on the patient's condition, not merely in the context of its clinical manifestation.
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Affiliation(s)
- Barbara Jankowiak
- Department of Integrated Medical Care, Medical University of Bialystok, 15-096 Białystok, Poland;
| | - Elżbieta Krajewska-Kułak
- Department of Integrated Medical Care, Medical University of Bialystok, 15-096 Białystok, Poland;
| | - Marta Jakoniuk
- Department of Invasive Neurology, Medical University of Białystok, 15-096 Białystok, Poland;
| | - Dzmitry F. Khvorik
- Department of Dermatovenerology, Medical University of Grodno, 230009 Grodno, Belarus;
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Michalski P, Palazzo-Michalska V, Buda P, Michalska-Bańkowska A, Bańkowski M, Strojny D, Grabarek BO. A crossroads between dietary habits, alcohol consumption, and smoking in the clinical course of psoriasis: a narrative review. Postepy Dermatol Alergol 2023; 40:599-605. [PMID: 38028418 PMCID: PMC10646720 DOI: 10.5114/ada.2023.129308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 12/01/2023] Open
Abstract
Psoriasis is a chronic autoimmune disease that affects 1-3% of the population. The pathomechanism of psoriasis development is complex, but genetic (non-modifiable) factors play a key role. However, the importance of environmental factors and lifestyle choices, such as the diet, alcohol consumption, and smoking, is increasing. The objective of this review was to analyse the influence of dietary habits, alcohol consumption, and smoking on the clinical course of psoriasis. Stress, a poor diet, alcohol abuse, and smoking can trigger psoriasis or cause its exacerbation. Therefore, in addition to the correct selection of therapy, it is extremely important to educate patients about the impact of these factors on the onset and progression of psoriasis. This literature review confirms that a holistic and multidisciplinary approach is required for patients with psoriasis, further emphasizing Hippocrates' thesis, "Let food be thy medicine, and medicine be thy food".
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Affiliation(s)
- Piotr Michalski
- Department of Dermatology, Center for Child and Family Health, Sosnowiec, Poland
| | | | - Paulina Buda
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, Academy of Silesia in Katowice, Poland
| | | | - Mirosław Bańkowski
- Department of Dermatology, Center for Child and Family Health, Sosnowiec, Poland
| | - Damian Strojny
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, Academy of Silesia in Katowice, Poland
| | - Beniamin Oskar Grabarek
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, Academy of Silesia in Katowice, Poland
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Munz J, Kupfer J, Schepko M, Weisshaar E, Schut C. [Stigmatization and social anxiety in patients with skin diseases]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:799-808. [PMID: 37721562 DOI: 10.1007/s00105-023-05219-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/19/2023]
Abstract
Stigmatization of patients with skin diseases has only recently attracted more attention in research. However, both external stigmatization by society and self-stigmatization by the affected patients are widespread in patients with skin diseases. Many studies show that in this group of patients, the experience of both kinds of stigmatization is associated with psychosocial burden, such as social anxiety. This is often independent of the visibility of skin lesions. The psychosocial burden of affected individuals may lead to psychological comorbidities, such as depression or anxiety disorders, making it important to screen patients in dermatologic settings for the presence of these conditions. Interventions to reduce external and self-stigmatization have been developed, but more randomized controlled trials are needed to test the effects of such interventions.
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Affiliation(s)
- J Munz
- Institut für Medizinische Psychologie, Justus-Liebig-Universität Gießen, Gießen, Deutschland.
| | - J Kupfer
- Institut für Medizinische Psychologie, Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - M Schepko
- Institut für Medizinische Psychologie, Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - E Weisshaar
- Sektion Berufsdermatologie, Zentrum Hautklinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Schut
- Institut für Medizinische Psychologie, Justus-Liebig-Universität Gießen, Gießen, Deutschland
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Vata D, Tarcau BM, Popescu IA, Halip IA, Patrascu AI, Gheuca Solovastru DF, Mocanu M, Chiriac PC, Gheuca Solovastru L. Update on Obesity in Psoriasis Patients. Life (Basel) 2023; 13:1947. [PMID: 37895330 PMCID: PMC10608303 DOI: 10.3390/life13101947] [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: 08/21/2023] [Revised: 09/09/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
Psoriasis is a chronic inflammatory skin condition, with genetic, epigenetic, environmental, and lifestyle factors contributing to its onset and recurrence. Severe psoriasis has a great impact on quality of life, which is similar to that of insulin-dependent diabetes, depression, and ischemic heart disease, but with a lower mortality. There is an overlap between the rising incidences of autoimmune diseases and obesity. In recent years, research has shown that there is an association between psoriasis and obesity. Psoriasis is linked to obesity in a two-way manner, as each can precipitate the development of the other. Several adipose tissue-secreted adipokines were shown to be elevated in obese psoriasis patients, exhibiting similar mechanisms of action to those underlying the pathogenesis of psoriasis. Excess body weight can influence not only the treatment response in psoriasis, but also the adverse events, leading to decreased patient compliance. Specific human microbiome patterns have been identified for obesity and psoriasis and could represent a future therapeutic target in selected individuals.
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Affiliation(s)
- Dan Vata
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Bogdan Marian Tarcau
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ioana Adriana Popescu
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Ioana Alina Halip
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | - Adriana Ionela Patrascu
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | | | - Madalina Mocanu
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
| | | | - Laura Gheuca Solovastru
- Department of Dermatology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.V.); (I.A.H.); (A.I.P.); (M.M.); (L.G.S.)
- Dermatology Clinic, “St. Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania
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Ding W, Yao M, Wang Y, Wang M, Zhu Y, Li Y, Li Z, Li L, Ma W, Liu M, Zhou N. Patient Needs in Psoriasis Treatment and their Influencing Factors: A Nationwide Multicentre Cross-Sectional Study in China. Indian J Dermatol 2023; 68:587. [PMID: 38099128 PMCID: PMC10718237 DOI: 10.4103/ijd.ijd_611_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Background The management and treatment of psoriasis has rarely considered patient needs, which are numerous, multi-dimensional and are of great importance to improving treatment outcomes. Objectives This study aimed to evaluate and compare the patients' needs for psoriasis treatment and identify factors predicting the need to make patient-centred decisions about treatment. Materials and Methods This nationwide multicentre cross-sectional study included subjects between October 2020 and August 2021. The status quo of the needs in psoriasis treatment and their influencing factors were analysed mainly using the Chi-square test and binary logistic regression. Results Information on sociodemographic and clinical characteristics were obtained. Factor analysis of a specially designed questionnaire showed that rapid skin clearance, reduced treatment expense and fewer hospital visits or treatment time were the first three patient needs in psoriasis treatment. Several influencing factors were important including the sociodemographic characteristics of gender, marital status, education level and family history, special location of skin lesions, dermatology life quality index (DLQI), Investigator's Global Assessment modified 2011 (IGA mod 2011), condition of the episode, clinical type of psoriasis, seasonal exacerbation and therapy. Conclusions Patients with psoriasis pursued a wide range of treatment goals, with the most desired being rapid skin clearance, reduced treatment expense and time-saving. Paying attention to sex, marital status, education level, the special location of skin lesions and the DLQI will help dermatologists develop patient-centred treatment, meet the patient's needs and eventually improve the treatment outcomes.
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Affiliation(s)
- Wei Ding
- From the Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- National Clinical Research Center for Skin and Immune Diseases
| | - Manxue Yao
- From the Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- National Clinical Research Center for Skin and Immune Diseases
| | - Yuting Wang
- From the Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- National Clinical Research Center for Skin and Immune Diseases
| | - Miaomiao Wang
- From the Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- National Clinical Research Center for Skin and Immune Diseases
| | - Yueqian Zhu
- From the Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- National Clinical Research Center for Skin and Immune Diseases
| | - Yan Li
- From the Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- National Clinical Research Center for Skin and Immune Diseases
| | - Zonghui Li
- From the Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- National Clinical Research Center for Skin and Immune Diseases
| | - Ling Li
- From the Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- National Clinical Research Center for Skin and Immune Diseases
| | - Wenxia Ma
- Department Quality Management, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Ming Liu
- From the Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- National Clinical Research Center for Skin and Immune Diseases
| | - Naihui Zhou
- From the Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
- National Clinical Research Center for Skin and Immune Diseases
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Tang TR, Wang M, Li H, Yang SC, Zhang CC, Lin WR, Ke XC, Zhang HY, Su J, Zhu SL. Untreated depression and anxiety in patients with common skin diseases: a cross-sectional study in China. Front Psychol 2023; 14:1150998. [PMID: 37260960 PMCID: PMC10227509 DOI: 10.3389/fpsyg.2023.1150998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/26/2023] [Indexed: 06/02/2023] Open
Abstract
Objective The study aimed to analyze the current status and reasons for the neglect of the psychological need of patients with common skin diseases. Methods This cross-sectional study was conducted in China using an online self-assessment questionnaire distributed via social media. Demographic, clinical and psychological data were collected, and the main outcomes, i.e., depression (evaluated using the 9-item Patient Health Questionnaire, PHQ-9) and anxiety (evaluated using Generalized Anxiety Disorder-7, GAD-7). Multivariate regression analysis was used for the prediction of variates of mental health service seeking behaviors. Results A total of 1,010 patients participated in the survey, and 273 (27.0%) patients met the "with need" criteria, i.e., having the need for mental health intervention but not being treated. In the multivariate regression model, income (OR = 0.80, 95%CI: 0.65-0.99), duration of disease (OR = 0.68, 95%CI: 0.49-0.95) and suicide ideation (OR = 2.10, 95%CI: 1.14-3.87) were significant factors. For patients who did not receive mental health care, the lack of knowledge about the availability of mental health services, lack of knowledge of where to seek help, concerns about the side effects of treatment, failure to seek treatment for severe skin diseases, and absence of current psychological distress were associated with their need for psychological intervention. Conclusion This study examined the current status of the need for psychological intervention and the reasons why the need was unmet in patients with skin diseases. Due to the confusion and a lack of knowledge about their mental health issues, mental health services are often underutilized.
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Affiliation(s)
- Tao-Ran Tang
- School of Nursing, Hunan University of Chinese Medicine, Hunan, Changsha, China
- Department of Nursing, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Hunan, Changsha, China
| | - Mi Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Hong Li
- School of Nursing, Hunan University of Chinese Medicine, Hunan, Changsha, China
| | - Song-Chun Yang
- Department of Dermatology, Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Cheng-Cheng Zhang
- Department of Social Medicine and Health Management, School of Public Health, Central South University, Hunan, Changsha, China
| | - Wen-Rui Lin
- Department of Dermatology, Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Xin-Chen Ke
- Department of Dermatology, Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Han-Yi Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Hunan, Changsha, China
| | - Shi-Lin Zhu
- Department of Nursing, The Second Affiliated Hospital of Hunan University of Chinese Medicine, Hunan, Changsha, China
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Nicolescu AC, Ionescu MA, Constantin MM, Ancuta I, Ionescu S, Niculet E, Tatu AL, Zirpel H, Thaçi D. Psoriasis Management Challenges Regarding Difficult-to-Treat Areas: Therapeutic Decision and Effectiveness. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122050. [PMID: 36556415 PMCID: PMC9785802 DOI: 10.3390/life12122050] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/19/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
Psoriasis is not optimally controlled in spite of newly developed treatments, possibly due to the difficulty of objectively quantifying the disease's severity, considering the limitations of the clinical scores used in clinical practice. A major challenge addresses difficult-to-treat areas, especially in the absence of significant body surface involvement. It is controversial whether the severity evaluation of patients with several affected areas (having at least one difficult-to-treat area) should be done differently from current methods. Scores used for special areas (PSSI, NAPSI and ESIF) allow an accurate assessment of disease severity in difficult-to-treat areas, but the issue of whether to integrate these scores into PASI, BSA or DLQI remains. The review's purpose resides in providing an overview of the main current issues in determining psoriasis severity in patients with psoriasis in difficult-to-treat areas and suggesting possible solutions for the optimal integration of the area assessment in current scores: severity can be either established according to the highest calculated score (PASI or PSSI or NAPSI or ESIF) or by adding a correction factor in the calculation of PASI for special areas.
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Affiliation(s)
| | - Marius-Anton Ionescu
- Dermatology Department, University Hospital “Saint Louis”, University of Paris, 75014 Paris, France
| | - Maria Magdalena Constantin
- Department of Dermatology II, “Carol Davila” University of Medicine and Pharmacy, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Ioan Ancuta
- Department of Rheumatology, “Carol Davila” University of Medicine and Pharmacy, “Dr. I. Cantacuzino” Clinical Hospital, 011437 Bucharest, Romania
- Department of Dermatology III, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: (I.A.); (E.N.); Tel.: +40-728267435 (I.A.); +40-741398895 (E.N.)
| | - Sinziana Ionescu
- General Surgery and Surgical Oncology Clinic I of the Bucharest Oncology Institute, “Carol Davila” University of Medicine and Pharmacy, 022328 Bucharest, Romania
- “Prof Dr. Al Trestioreanu” Bucharest Oncology Institute, 022328 București, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Medicine and Pharmacy, 800008 Galati, Romania
- Pathology Department, “Sfantul Apostol Andrei” Emergency Clinical Hospital, 800578 Galati, Romania
- Correspondence: (I.A.); (E.N.); Tel.: +40-728267435 (I.A.); +40-741398895 (E.N.)
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Medicine and Pharmacy, 800008 Galati, Romania
- Dermatology Department, “Sfanta Cuvioasa Parascheva” Hospital of Infectious Diseases, 800179 Galati, Romania
| | - Henner Zirpel
- Research Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, 23538 Lübeck, Germany
| | - Diamant Thaçi
- Comprehensive Center for Inflammation Medicine, University of Lübeck, 23538 Lübeck, Germany
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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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Ahmad Fuat MS, Mat Yudin Z, Muhammad J, Mohd Zin F. Quality of Life and Its Associated Factors among Patients with Psoriasis in a Semi-Urban Northeast Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11578. [PMID: 36141851 PMCID: PMC9517003 DOI: 10.3390/ijerph191811578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
Psoriasis is a chronic relapsing dermatological disorder that significantly affects the patients' psychosocial well-being and quality of life (QOL). This study aimed to determine the proportion of severely impaired QOL, the factors associated with severely impaired QOL, and its correlation with depression among semi-urban populations on the Northeast Coast of the Peninsular Malaysia. A cross-sectional study was conducted among 257 patients with psoriasis at the Dermatology Clinic of Hospital Sultanah Bahiyah via a self-administered questionnaire that included sociodemographic profiles, the validated Malay version of the Dermatology Life Quality Index (DLQI), and the Malay version of the Beck depression scale. The data were analysed using logistic and linear regression models. About 20.5% of the patients had severely impaired QOL quality of life, while 79.5% of the patients had non-impaired QOL. Multiple logistic regression analysis showed that the psoriatic severity [Adjusted OR = 1.91, 95% CI: 1.76, 9.93; p < 0.001] and exposed area [Adjusted OR 2.93, 95% CI: 0.38, 2.29; p = 0.050] had a significant association with severely impaired QOL. Among the patients, 18.7% had a positive result in the screening for depression, which revealed a significant association between QOL and depression scores [r = 0.47, 95% CI: 0.35, 0.56, p < 0.001]. Psoriasis can impair QOL and have a relation with mental health. Regular screening for depression among patients with psoriasis is a beneficial strategy for the early detection of depression, especially in semi-urban areas.
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Affiliation(s)
- Mohd Shahriman Ahmad Fuat
- Department of Family Medicine, School of Medical Science, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Zainab Mat Yudin
- School of Dental Science, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Juliawati Muhammad
- Department of Family Medicine, School of Medical Science, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Faridah Mohd Zin
- MSU Medical Centre, Jalan Boling Padang 13/64, Seksyen 13, Shah Alam 40100, Selangor, Malaysia
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13
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Neurological Complications of Biological Treatment of Psoriasis. Life (Basel) 2022; 12:life12010118. [PMID: 35054511 PMCID: PMC8777957 DOI: 10.3390/life12010118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 12/16/2022] Open
Abstract
In the available literature, little attention has been paid to the assessment of psoriasis and the biological therapy used for it and the nervous system. The purpose of this article is to discuss the relationship between psoriasis and the nervous system as well as to analyze the mechanisms that lead to neurological complications during anticytokine therapies in psoriasis. However, this connection requires further analysis. The use of biological drugs in psoriasis, although it yields positive therapeutic results, is not without numerous side effects. Serious neurological side effects of the therapy are most often visible with the use of anti-TNF-alpha, which is why patients should be monitored for their potential occurrence. Early detection of complications and rapid discontinuation of treatment with the drug may potentially increase the patient’s chances of a full recovery or improvement of his/her neurological condition. It also seems reasonable that, in the case of complications occurring during anti-TNF-alpha therapy, some of the drugs from other groups should be included in the therapy.
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14
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Zhang H, Yang Z, Tang K, Sun Q, Jin H. Stigmatization in Patients With Psoriasis: A Mini Review. Front Immunol 2021; 12:715839. [PMID: 34867945 PMCID: PMC8634029 DOI: 10.3389/fimmu.2021.715839] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/12/2021] [Indexed: 11/13/2022] Open
Abstract
Psoriasis is a chronic and recurrent immune-related skin disease that often causes disfigurement and disability. Due to the visibility of lesions in patients and inadequate understanding of dermatology knowledge in the general public, patients with psoriasis often suffer from stigma in their daily lives, which has adverse effects on their mental health, quality of life, and therapeutic responses. This review summarized the frequently used questionnaires and scales to evaluate stigmatization in patients with psoriasis, and recent advances on this topic. Feelings of Stigmatization Questionnaire, Questionnaire on Experience with Skin Complaints, and 6-item Stigmatization Scale have been commonly used. The relationship between sociodemographic characteristics, disease-related variables, psychiatric disorders, quality of life, and stigmatization in patients with psoriasis has been thoroughly investigated with these questionnaires. Managing the stigmatization in patients with psoriasis needs cooperation among policymakers, dermatologists, psychologists, psychiatrists, researchers, and patients. Further studies can concentrate more on these existing topics, as well as other topics, including predictors of perceived stigmatization, stigmatization from non-patient groups, influence of biologics on stigmatization, and methods of coping with stigmatization.
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Affiliation(s)
- Hanlin Zhang
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zihan Yang
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Keyun Tang
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiuning Sun
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongzhong Jin
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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15
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Fino E, Russo PM, Tengattini V, Bardazzi F, Patrizi A, Martoni M. Individual Differences in Emotion Dysregulation and Social Anxiety Discriminate between High vs. Low Quality of Life in Patients with Mild Psoriasis. J Pers Med 2021; 11:1236. [PMID: 34834589 PMCID: PMC8624212 DOI: 10.3390/jpm11111236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 12/18/2022] Open
Abstract
A deeper understanding of how health-related quality of life relates to the clinical and individual characteristics of patients is essential for the delivery of patient-centered dermatological care. The current study aimed to examine the role of individual differences in emotion dysregulation and social anxiety in modulating quality of life in psoriatic patients. A total of 130 patients affected by psoriasis were consecutively enrolled in the study as they approached the Dermatology Unit of Sant'Orsola-Malpighi Hospital of Bologna. Clinical information gathered included illness severity, assessed with the Psoriasis Area and Severity Index (PASI) and the Body Surface Area (BSA); illness onset; familiarity; and prescribed treatment. The patient-reported outcome measures were the Dermatology Life Quality Index (DLQI), measuring the patient's quality of life; the Psoriasis Skin Appearance Bothersomeness scale (PSAB), measuring patient's perception of illness severity; the Difficulties in Emotion Regulation Scale (DERS), assessing emotion dysregulation traits; and the Social Interaction Anxiety Scale (SIAS), measuring anxiety about social interactions. Patients with moderate-to-severe psoriasis reported significantly lower quality of life compared to mildly affected patients. In addition, of the patients affected by mild psoriasis, those characterized by emotion dysregulation and social anxiety traits showed significantly lower levels of quality of life. Our findings suggest that individual differences in emotion dysregulation and social anxiety contribute to health-related quality of life in addition to illness severity. Therapeutic approaches that combine dermatological care with psychological support, especially focused on emotional regulation skills, may be useful to improve clinical outcomes in patients with psoriasis.
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Affiliation(s)
- Edita Fino
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum Università di Bologna, St. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; (P.M.R.); (M.M.)
| | - Paolo Maria Russo
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum Università di Bologna, St. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; (P.M.R.); (M.M.)
| | - Vera Tengattini
- Dermatology Unit, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; (V.T.); (F.B.)
| | - Federico Bardazzi
- Dermatology Unit, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; (V.T.); (F.B.)
| | - Annalisa Patrizi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum Università di Bologna, St. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; (P.M.R.); (M.M.)
- Dermatology Unit, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; (V.T.); (F.B.)
| | - Monica Martoni
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum Università di Bologna, St. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; (P.M.R.); (M.M.)
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16
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Bakar RS, Jaapar SZ, Azmi AF, Aun YC. Depression and anxiety among patients with psoriasis: A correlation with quality of life and associated factors. J Taibah Univ Med Sci 2021; 16:491-496. [PMID: 34408605 PMCID: PMC8348547 DOI: 10.1016/j.jtumed.2021.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/04/2021] [Accepted: 02/16/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Psoriasis is a chronic, immune-mediated illness that primarily affects the skin, nails and joints. This illness may predispose people to mental disorders such as depression and anxiety. This study aims to determine the prevalence of depression and anxiety in patients with psoriasis and their correlation with quality of life and associated factors. METHODS This cross-sectional study involved 174 patients with psoriasis at the dermatology clinic of Hospital Sultanah Bahiyah, Alor Setar. All patients were instructed to complete four sets of questionnaires relating to: sociodemographic profile, clinical characteristics of illness, the validated Malay version of Hospital Anxiety and Depression Scale (HADS) and the Malay validated version of Dermatology Life Quality Index (DLQI). Data were analysed using a descriptive analysis and correlational and multiple logistic regression analyses. RESULTS We have found that 8.5% patients had depressive and 16.9% had anxiety symptoms. Multiple logistic regression analysis showed that higher DLQI scores, presence of lower limbs' lesions and dyslipidaemia were associated with depression in the sampled population. CONCLUSION This study has shown that the cohort with psoriasis exhibited notable symptoms of depression and anxiety. This emphasises the need for the assessment of anxiety and depression among patients with psoriasis as these symptoms predict poor quality of life. Such correlation of psoriasis with anxiety and depression essentially leads to psychological sequelae. Affected psoriasis patients need appropriate intervention. Our study paves the way for further research by involving other underlying constructs such as perceived body image and stigma.
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Affiliation(s)
- Raishan S. Bakar
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Sharifah Z.S. Jaapar
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Afiq F. Azmi
- Department of Psychiatry Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
| | - Yeoh C. Aun
- Dermatology Department, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
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17
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Germain N, Augustin M, François C, Legau K, Bogoeva N, Desroches M, Toumi M, Sommer R. Stigma in visible skin diseases - a literature review and development of a conceptual model. J Eur Acad Dermatol Venereol 2021; 35:1493-1504. [PMID: 33428316 DOI: 10.1111/jdv.17110] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/11/2020] [Indexed: 11/26/2022]
Abstract
The burden of visible skin diseases (VSDs) includes not only physical symptoms but also psychosocial consequences such as depression, anxiety, impaired quality of life and low self-esteem. Stigmatization was shown to play a major role in people with skin diseases. The aim of the study was to review the evidence for the components, drivers and impacts of (self-)stigma, and to organize the data into a series of conceptual models. A targeted literature search was conducted to identify studies on (self-)stigma in relation to VSD. Conceptual models of stigma in VSDs were developed from existing generic conceptual models for VSD and of generic conceptual models of stigma and were refined after discussion with a board of experts, patient advocacy groups, clinicians and researchers. A total of 580 references were identified, of which 56 references were analysed and summarized. Two conceptual models of stigma were identified: one with external stigma and self-stigma dimensions, the other for self-stigma in mental health. These models were adapted to allow a complete description of stigma in VSDs. For this, a distinction was made between 'discrimination' and 'impact'. Finally, five models were developed: macro-overview; stigma, impact and socio-demographics; stigma, impact and disease characteristics; stigma, impact and quality of life; and stigma, impact and coping. Gaps were identified in available quantitative evidence. To our knowledge, this is the first conceptual model of stigma in VSDs. The model will help to standardize evaluation of stigma and to enhance empirical evaluation of anti-stigma interventions in VSDs. Further research should be conducted to develop a more complete model in stigma due to significant gaps in existing evidence, particularly including the stigma in others (external stigma) and also to cover a broader range of VSDs as their impact on particular dimensions of stigma differs.
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Affiliation(s)
- N Germain
- HEOR, Creativ-Ceutical, Paris, France
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - K Legau
- LEO Pharma, Kopenhagen, Denmark
| | - N Bogoeva
- HEOR, Creativ-Ceutical, Sofia, Bulgaria
| | | | - M Toumi
- Public Health Department, Aix-Marseille University, Marseilles, France
| | - R Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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18
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Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations. Dermatol Ther (Heidelb) 2021; 11:235-252. [PMID: 33426634 PMCID: PMC7859133 DOI: 10.1007/s13555-020-00475-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/02/2020] [Indexed: 01/14/2023] Open
Abstract
Introduction Treat-to-target strategies are used in several chronic diseases to improve outcomes. Treatment goals have also been suggested for psoriasis, but there is currently no consensus on targets, and guidance is needed to implement this strategy in clinical practice. The project ‘Treat to Target Italia’ was launched by a scientific board (SB) of 10 psoriasis experts to generate expert consensus recommendations. Methods On the basis of the published literature, their clinical experience, and the results of a survey among Italian dermatologists, the SB identified four relevant topics: (1) clinical remission; (2) quality of life; (3) abrogation of systemic inflammation; (4) safety. They drafted 20 statements addressing these four topics and submitted them to a panel of 28 dermatologists, in a Delphi process, to achieve consensus (greater than 80% agreement). Results Consensus was reached on all statements. Treatment goals defining clinical remission should include a 90% improvement from baseline in the Psoriasis Area and Severity Index (PASI90 response) or an absolute PASI score of less than or equal to 3. Patient’s quality of life and satisfaction are important targets. If PASI targets are achieved, there should be no or very low impact of psoriasis on quality of life [Dermatology Life Quality Index (DLQI) score less than or equal to 3]. If PASI or DLQI goals are not achieved within 3–4 months, treatment should be changed. Abrogation of systemic inflammation may be crucial for preventing or delaying inflammatory comorbidities. Safety is an equally important target as efficacy. Conclusion These 20 consensus statements define the parameters of a treat-to-target strategy for psoriasis in Italy. It is hoped that use of these in the management of patients with psoriasis will improve treatment outcomes and patient health-related quality of life.
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19
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Kowalewska B, Jankowiak B, Krajewska-Kułak E, Khvorik DF, Niczyporuk W. Quality of life in skin diseases as perceived by patients and nurses. Postepy Dermatol Alergol 2020; 37:956-961. [PMID: 33603616 PMCID: PMC7874861 DOI: 10.5114/ada.2019.86182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 05/24/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The appearance of the skin and its appendages not only reflects the general body condition, but also exerts an effect on one's self-esteem and self-image, and the way he/she is perceived by the others. AIM To analyse the quality of life (QOL) in dermatological diseases, assessed by the patients themselves and the nurses being their caregivers. MATERIAL AND METHODS The survey was completed by 300 patients diagnosed with various dermatological conditions; however, only the data from 281 surveys were considered during the analysis. All patients completed an anonymous questionnaire designed specifically for the purpose of the study. The survey included 32 questions. Moreover, the study patients were surveyed with the Dermatology Life Quality Index (DLQI). Moreover, the study included 1713 nurses employed in various healthcare institutions and providing care to patients with dermatological diseases. The survey for the nurses consisted of 32 questions. RESULTS Mean DLQI score for the study patients was 12.4 ±8.1 points. Based on the median, lower and upper quartile values, every fourth person presented with DLQI scores > 18 points, half of the respondents had DLQI scores no greater than 12 points, and every fourth respondent experienced good QOL (DLQI score no higher than 5 points). CONCLUSIONS According to the majority of patients and nurses, individuals with skin conditions are not fully able to cope with their disease and show a negative attitude towards it. The QOL of patients with skin diseases is determined by the type of the dermatological condition.
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Affiliation(s)
- Beata Kowalewska
- Department of Integrated Medical Care, Medical University in Bialystok, Bialystok, Poland
| | - Barbara Jankowiak
- Department of Integrated Medical Care, Medical University in Bialystok, Bialystok, Poland
| | | | | | - Wiaczesław Niczyporuk
- Faculty of Health Sciences, Lomza State University of Applied Sciences, Lomza, Poland
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20
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Theodoridis X, Grammatikopoulou MG, Stamouli EM, Talimtzi P, Pagkalidou E, Zafiriou E, Haidich AB, Bogdanos DP. Effectiveness of oral vitamin D supplementation in lessening disease severity among patients with psoriasis: A systematic review and meta-analysis of randomized controlled trials. Nutrition 2020; 82:111024. [PMID: 33183899 DOI: 10.1016/j.nut.2020.111024] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/01/2020] [Accepted: 09/09/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Many treatment modalities have been used to manage psoriasis; however, there is, to our knowledge, no pooled estimate for the effectiveness of oral vitamin D supplements in patients with psoriasis. Hence, the aim of the present study was to systematically review and meta-analyze the efficacy of oral vitamin D supplementation in lessening disease severity of patients with psoriasis. METHODS A systematic literature review was performed on the electronic databases PubMed, Embase, and Cochrane Central and the gray literature for retrieving randomized controlled trials comparing oral vitamin D supplementation with placebo. The primary outcome was the change of Psoriasis Area and Severity Index (PASI) score. We used the random effects model for synthesizing the evidence. RESULTS Of the total 5018 search results, 4 studies were included in the qualitative and 3 studies in quantitative analysis. Vitamin D supplementation was effective in ameliorating the PASI score after 6 mo of intervention (mean difference [MD] = -0.92, 95% confidence interval [CI] = -1.72 to -0.11). However, after the Hartung-Knapp adjustment, the results became non-significant (MD = -0.92, 95% CI = -2.21 to 0.38). CONCLUSIONS A favorable effect of oral vitamin D supplementation in patients with psoriasis could not be verified. More randomized controlled trials with larger sample sizes are needed to produce robust results.
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Affiliation(s)
- Xenophon Theodoridis
- Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
| | - Maria G Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Eleni-Maria Stamouli
- Department of Biological Sciences, University of Edinburgh, Medical School, Edinburgh, UK
| | - Persefoni Talimtzi
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eirini Pagkalidou
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efterpi Zafiriou
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Anna-Bettina Haidich
- Laboratory of Hygiene, Social and Preventive Medicine and Medical Statistics, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios P Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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21
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Menter MA, Murakawa GJ, Glover H, Mendelsohn AM, Parno J, Rozzo SJ, Davidson D, Gupta AK. Clearance of head and neck involvement in plaque psoriasis with tildrakizumab treatment in the phase 3 reSURFACE 1 study. J Eur Acad Dermatol Venereol 2020; 34:e803-e805. [PMID: 32432798 PMCID: PMC7953895 DOI: 10.1111/jdv.16648] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 11/30/2022]
Affiliation(s)
- M A Menter
- Division of Dermatology, Baylor Scott & White, and Texas A&M College of Medicine, Dallas, TX, USA
| | | | - H Glover
- Dermatology and Skin Cancer Surgery Center, McKinney, TX, USA
| | | | - J Parno
- Sun Pharmaceutical Industries, Inc, Princeton, NJ, USA
| | - S J Rozzo
- Sun Pharmaceutical Industries, Inc, Princeton, NJ, USA
| | - D Davidson
- Sun Pharmaceutical Industries, Inc, Princeton, NJ, USA
| | - A K Gupta
- Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, Toronto, ON, Canada.,Mediprobe Research, Inc, London, ON, Canada
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22
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Ehrenthal JC, Woeste S, Mrowietz U, Gerdes S, Graetz C. Profiles of psychosocial variables and dental status in patients with psoriasis. J Eur Acad Dermatol Venereol 2020; 34:e586-e587. [PMID: 32277503 DOI: 10.1111/jdv.16452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J C Ehrenthal
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - S Woeste
- Clinic of Conservative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - U Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - S Gerdes
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - C Graetz
- Clinic of Conservative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Kiel, Germany
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23
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Founta O, Adamzik K, Tobin AM, Kirby B, Hevey D. Psychological Distress, Alexithymia and Alcohol Misuse in Patients with Psoriasis: A Cross-Sectional Study. J Clin Psychol Med Settings 2020; 26:200-219. [PMID: 30206746 DOI: 10.1007/s10880-018-9580-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study investigates (a) the prevalence of psychological distress, alexithymia and alcohol misuse in psoriasis patients; and (b) the relationship between psoriasis severity, alexithymia, alcohol and psychological distress in patients with psoriasis. A cross-sectional study was conducted. Outpatients (n = 184) with moderate to severe psoriasis completed a psychological screening battery. Measures included the Hospital Anxiety and Depression Scale, the Penn State Worry Questionnaire, the twenty-item Toronto Alexithymia Scale, the Dermatology Life Quality Index, the Psoriasis Area and Severity Index, the Self-Administered Psoriasis Area and Severity Index, and the Alcohol Use Disorders Identification Test. Demographic, clinical details and information on knowledge of psychosocial issues, alcohol and confidence on coping with distress and talking to others about psoriasis was also gathered. Alexithymia was associated with anxiety, depression and worry; subjective psoriasis severity was associated with worry. Alcohol misuse was related to anxiety and worry, but not to depression. Appropriate identification and treatment of alcohol difficulties and psychological distress of patients with psoriasis is needed.
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Affiliation(s)
- Ourania Founta
- Research Centre for Psychological Health, School of Psychology, Trinity College Dublin, Dublin 2, Ireland.
| | - Karoline Adamzik
- Dermatology Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Anne-Marie Tobin
- Dermatology Department, The Adelaide & Meath Hospital, Tallaght, Dublin 24, Ireland
| | - Brian Kirby
- Dermatology Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.,Charles Department of Dermatology, St Vincent's University Hospital and School of Health Sciences, UCD, Dublin 4, Ireland
| | - David Hevey
- Research Centre for Psychological Health, School of Psychology, Trinity College Dublin, Dublin 2, Ireland
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24
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Tonarelli L. Translating Knowledge of IL-23 Targeting into New Solutions for Psoriasis Treatment. EUROPEAN MEDICAL JOURNAL 2019. [DOI: 10.33590/emj/10314579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Following a brief introduction by Prof Lambert, the symposium started with an in-depth review of the current unmet needs in the clinical management of psoriasis, provided by Prof Radtke, who also reported on the multiple and cumulative negative effects of the condition on patients’ health, activity engagement, family relationships, and overall quality of life (QoL). Prof Radtke went on to describe the factors contributing to the burden of psoriasis, other than disease severity, and highlighted the importance of taking a holistic approach to the management of the condition that takes into consideration the individual patient’s expectations and needs. Prof Lambert continued the symposium with an overview of the core pathways involved in disease pathogenesis in relation to the development of novel targeted immunotherapies.
Prof Lambert reviewed the current clinical paradigms for the treatment of psoriasis, including targeted biological therapies, such as TNF-α inhibitors and newer agents acting on IL-17 and IL-23, which research shows may represent a more effective approach to the treatment of psoriasis and other autoimmune inflammatory disorders. The latest Phase III clinical trial data on therapies selectively targeting the upstream cytokine IL-23 were then presented by Dr Piaserico, with a focus on the monoclonal antibodies guselkumab, risankizumab, and tildrakizumab, and their potential to achieve consistent rates of skin clearance long-term, with the added benefit of prolonged dose intervals and intermittent treatment in some patients.
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25
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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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26
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Zhang XJ, Wang AP, Shi TY, Zhang J, Xu H, Wang DQ, Feng L. The psychosocial adaptation of patients with skin disease: a scoping review. BMC Public Health 2019; 19:1404. [PMID: 31664970 PMCID: PMC6819547 DOI: 10.1186/s12889-019-7775-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 10/14/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Skin disease is a global public health problem that often has physiological, psychological and social impacts. However, it is not very clear how to adapt to these impacts, especially psychosocial adaptation of patients with skin disease. METHODS We searched EMBASE, PubMed, CINAHL and PsycINFO from 2009 to 2018. The following themes were extracted from the included articles: the concepts, related factors, and interventions for psychosocial adaptation of patients with skin disease. Two reviewers independently screened and analyzed. RESULTS From 2261 initial records, 69 studies were identified and analyzed. The concept of psychosocial adaptation in patients with skin disease was referred to under an assortment of descriptions. The related factors for psychosocial adaptation in patients with skin disease included the following: demographic factors (sex, age, education level, ethnicity, BMI, sleep quality, marital status, exercise amount, family history, the use of topical treatment only, personality and history of smoking); disease-related factors (disease severity, clinical symptoms, localization and duration); psychological factors (anxiety/depression, self-esteem, body image, stigma and suicidal ideation); and social factors (social support, social interaction, sexual life, economic burden and social acceptance). Despite being limited in quantity, several studies have clarified the benefits of adjuvant care in the form of cognitive behavioral training, educational training and self-help programs, all of which have become common methods for dealing with the psychosocial impacts. CONCLUSIONS Based on the previous literatures, we constructed a protocol of care model for psychosocial adaptation in patients with skin disease. It not only provided the direction for developing new instruments that could assess psychosocial adaptation statue, but also a basis for helping patients adjust to changes in skin disease.
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Affiliation(s)
- Xiu-jie Zhang
- Department of Nursing, The First affiliated Hospital of China Medical University, Shenyang, Liaoning Province China
- Department of dermatology, The First affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province China
| | - Ai-ping Wang
- Department of Nursing, The First affiliated Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Tie-ying Shi
- Department of dermatology, The First affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province China
| | - Jun Zhang
- Department of Nursing, The First affiliated Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Hui Xu
- Department of Nursing, The First affiliated Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Da-qiu Wang
- Department of Nursing, The First affiliated Hospital of China Medical University, Shenyang, Liaoning Province China
| | - Li Feng
- Department of Nursing, The First affiliated Hospital of China Medical University, Shenyang, Liaoning Province China
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27
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Hu S, Yuan S, Chen G, Tu H. Increased incidence of ischaemic heart disease and cerebrovascular disease in psoriasis patients with depression: a nationwide retrospective cohort study. J Eur Acad Dermatol Venereol 2019; 33:1547-1554. [DOI: 10.1111/jdv.15616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 04/01/2019] [Indexed: 12/14/2022]
Affiliation(s)
- S.C.‐S. Hu
- Department of Dermatology Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Department of Dermatology College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
- Department of Medical Research Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
- Translational Research Center Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
| | - S.‐S.F. Yuan
- Department of Medical Research Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
- Translational Research Center Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
- Graduate Institute of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
- Department of Obstetrics and Gynecology Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan
| | - G.‐S. Chen
- Department of Dermatology Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Department of Dermatology College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
| | - H.‐P. Tu
- Department of Public Health and Environmental Medicine School of Medicine College of Medicine Kaohsiung Medical University Kaohsiung Taiwan
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28
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Gisondi P. Recognizing the differential impact of site of involvement on quality of life in dermatology. Br J Dermatol 2019; 181:229-230. [DOI: 10.1111/bjd.17788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- P. Gisondi
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
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29
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Ermis E, Celik SK, Solak N, Genc GC, Dursun A. The role of GNLY gene polymorphisms in psoriasis pathogenesis. An Bras Dermatol 2019; 94:198-203. [PMID: 31090825 PMCID: PMC6486070 DOI: 10.1590/abd1806-4841.20198188] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 08/01/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Psoriasis is a systemic inflammatory disorder that involves complex pathogenic interactions between the innate and adaptive immune systems. The most accepted mechanism in the etiopathogenesis of psoriasis is the induction of inflammation with keratinocyte hyperproliferation. Granulysin (GNLY) is a cytolytic antimicrobial peptide (AMP) that is secreted together with granzyme and perforin from the granules of human cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells. It has been immunohistochemically proven that the expression of granulysin is increased in lesions of psoriasis. OBJECTIVE This study aimed to investigate the relationship between psoriasis disease and granulysin gene polymorphisms. METHODS GNLY rs7908 and rs10180391 polymorphisms were studied by PCR-RFLP in 100 psoriasis patients under treatment in the Dermatology Polyclinic of Bulent Ecevit University. In addition, 100 healthy individuals with similar age and sex distribution were used as a control group. RESULTS In the control group, GNLY rs7908 CC genotype was significantly higher than in psoriasis patients (P= 0.031; OR= 0.305; Cl= 0.305 (0.121 - 0.773). In our study, the genotype distributions in patients and control groups were GNLY rs7908 (SNP) GG (51%, 37%), GC (41%, 44%), CC (8%, 19%); GNLY rs10180391 (SNP) from the CC (41%, 44%), CT (42%, % 41), TT (17%, 15%). STUDY LIMITATIONS The study only included Turkish patients. CONCLUSION Our findings showed that GNLY rs7908 CC genotype and C allele had a protective effect against psoriasis and decreased the disease severity (according to PASI score), whereas rs10180391 SNP did not show any effective role in psoriasis pathogenesis.
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Affiliation(s)
- Esra Ermis
- Department of Molecular Biology and Genetics, Faculty of
Sciences and Arts, Bulent Ecevit University, Zonguldak, Turkey
| | - Sevim Karakas Celik
- Department of Molecular Biology and Genetics, Faculty of
Sciences and Arts, Bulent Ecevit University, Zonguldak, Turkey
| | - Nilgun Solak
- Department of Dermatology, Faculty of Medicine, Bulent
Ecevit University, Zonguldak, Turkey
| | - Gunes Cakmak Genc
- Department of Medical Genetics, Faculty of Medicine,
Bulent Ecevit University, Zonguldak, Turkey
| | - Ahmet Dursun
- Department of Medical Genetics, Faculty of Medicine,
Bulent Ecevit University, Zonguldak, Turkey
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30
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Augustin M, Sommer R, Kirsten N, Danckworth A, Radtke M, Reich K, Thaci D, Boehncke W, Langenbruch A, Mrowietz U. Topology of psoriasis in routine care: results from high‐resolution analysis of 2009 patients. Br J Dermatol 2019; 181:358-365. [DOI: 10.1111/bjd.17403] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2018] [Indexed: 01/08/2023]
Affiliation(s)
- M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - R. Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - N. Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - A. Danckworth
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - M.A. Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - K. Reich
- Dermatologikum Berlin and SCIderm Research Institute Hamburg Germany
| | - D. Thaci
- Comprehensive Center for Inflammation Medicine University Hospital Schleswig‐Holstein Campus Lübeck Lübeck Germany
| | - W.H. Boehncke
- Department of Dermatology and Venereology Geneva University Hospitals Geneva Switzerland
| | - A. Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - U. Mrowietz
- Department of Dermatology University Medical Center Schleswig‐Holstein Campus Kiel Kiel Germany
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