Correlation between clinical severity and quality of life in moderate to severe psoriasis patients: Real-world evidence

Abstract

Background/Aim. Psoriasis is a chronic multisystem, inflammatory and immune-mediated dermatological disease of a relapsing nature. It does not only affect objective parameters such as skin and joint, with different intensity involvement with changes and the degree of changes but also significantly affects the health-related quality of life. The aim of the study was to determine the clinical severity and quality of life of patients with moderate to severe psoriasis and to examine the association between those parameters before and after the treatment. Methods. This cross-sectional study included 183 patients diagnosed with moderate to severe psoriasis. The severity of the clinical picture was determined by calculating Psoriasis Area and Severity Index (PASI) by a dermatologist, while the quality of life was assessed using Dermatology Life Quality Index (DLQI) questionnaire and the Psoriasis Life Stress Inventory (PLSI). Disease severity and quality of life were measured at the baseline visit and after 16th week of therapy. Results. The average PASI score at the beginning of therapy was 23.1?6.5, while after the 16 weeks, this value was 4.36?4.86. The DLQI score was 20.8?5.0 at the start of therapy and 6.20?6.16 after 16 weeks. The PLSI score was 35.37?8.84 initially and 12.75?12.82 after the 16 weeks of therapy. On the assessment of the correlation between the PASI and PLSI, the PASI score was found to be in a high positive correlation with the PLSI (r=0.702, ?<0.001) in the 16th week of therapy, but the correlation is moderate between the DLQI and PASI (r=0.683, ?<0.001). We failed to find any significant differences between PASI and DLQI scores (r=0.080, ?=0.284) and between PASI and PLSI scores (r=0.109, ?=0.140) in the baseline. Conclusion. Patients with severe psoriasis experience a significant reduction in their quality of life, accompanied by a high level of psychosocial stress. Observed improvements in quality of life have shown a moderate correlation, while lower levels of psychosocial stress have strongly correlated with the severity of the clinical presentation. This may indicate a complex interaction between psychological factors and physical health in patients with psoriasis.