An Epidemiological Study on Trigger Factors and Quality of Life in Psoriatic Patients

Abstract

Objective:to evaluate the role of stress, tobacco, drugs, infections, allergies, heredity, alcohol, hormones and skin aggressions as trigger factors and the impact on quality of life in a sample of psoriasis patients.Methods:a transversal study performed in 90 patients affected by psoriasis between January and November 2012 at the “Nene Tereza” University Hospital, Tirane, Albania, based on two scored questionnaires.Results:more than 70 % of patients reported that stressful events caused a flare- up of their psoriasis (p< 0.05). More than 60% of males and 20% of females were smokers (p< 0.05). About 20% of our patients were taking one or more of the medications listed in the questionnaire (p> 0.05). About 20% of patients reported having had recurrent infections (p<0,05). About 80% of males patients consumed alcohol (p<0,05). More than 40% reported a relative with psoriasis. Statistical comparison of the group that reported skin aggressions with the group that did not revealed a significant difference (p<0,05). Only a few of them reported to have allergies (p>0,05). About 36% of females reported that hormonal changes (puberty and menopause) exacerbated their psoriasis (p<0,05). More than 40% of patients reported that psoriasis seriously affects their quality of life.Conclusion:stress, tobacco, infections, heredity, alcohol, hormonal changes and skin aggressions were confirmed as trigger factors for psoriasis in the present sample. Allergies and the investigated drugs seemed not to have any influence in flare-ups. We found that psoriasis had a serious impact in the quality of life in over of 40% of the patients interviewed.

The role of hormones in the pathogenesis of psoriasis vulgaris

“…The onset of psoriasis vulgaris may be at any age, but two peaks were observed, around 20–30 and over 50 years of age [ 9 ]; pediatric psoriasis can reach about 30% of all cases [ 10 ]. The early onset of chronic plaque psoriasis in white population was associated with 36 genetic loci [ 11 ], a finding which supports the assumption that the age of onset is, at least partially, genetically determined [ 12 ].…”

Psychological stress and psoriasis: a systematic review and meta-analysis

“…Thirty‐nine studies, evaluating 32 537 patients, fulfilled the eligibility criteria (19 surveys, seven cross‐sectional studies, 12 case–control studies, one cohort study). The characteristics of the case–control and cohort studies are presented in Table ; the characteristics of the included surveys and cross‐sectional studies are presented in Tables S1 and S2 (see Supporting Information).…”

“…Nineteen studies surveyed 26 099 patients with psoriasis regarding their beliefs in the role of stress in their disease . On average, 46% of patients believed their disease was reactive to stress.…”

“…Nineteen studies surveyed 26 099 patients with psoriasis regarding their beliefs in the role of stress in their disease. 7,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] On average, 46% of patients believed their disease was reactive to stress. Berg et al noted that the percentage of patients believing psoriasis was stress-related was low in studies prior to 1990 but increased thereafter.…”

Providing Guidance for Patients With Moderate-to-Severe Psoriasis Who are Candidates for Biologic Therapy

“…To minimize the risk of nonadherence, NPs and PAs should be proactive in discussing potential life events that could interrupt psoriasis treatment, such as pregnancy, changes in insurance or employment status, and relocation. If patients are experiencing psoriasis flares, it is important to determine whether this is because of nonadherence or other factors, such as increased stress, hormonal changes, or illness (e.g., strep throat or other infection; Gudjonsson, Thorarinsson, Sigurgeirsson, Kristinsson, & Valdimarsson, 2003 ; Xhaja, Shkodrani, Frangaj, Kuneshka, & Vasili, 2014 ). Once these factors have been ruled out, the possibility of treatment failure should be considered, but not assumed, if the patient continues to experience flares.…”