Psoriasis: snapshots of the unspoken: using novel methods to explore patients' personal models of psoriasis and the impact on well‐being

Bundy, Christine; Borthwick, Molly; McAteer, Helen; Cordingley, Lis; Howells, Laura; Bristow, Paul; McBride, Sandy

doi:10.1111/bjd.13101

Cited by 36 publications

(41 citation statements)

References 26 publications

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“…As scientific consensus to date has not included itch as part of quantifying disease activity, there is a perception that psoriasis is a nonpruritic dermatosis . Patients’ personal experience with the disease counters this, however, some patients have become more aware of itch and have become more assertive that itch is a debilitating symptom . All the new evidence suggests that itch can be a more impactful and intolerable symptom of psoriasis than previously thought.…”

Section: Epidemiology Of Itch In Psoriasismentioning

confidence: 99%

Itch: an under‐recognized problem in psoriasis

Elewski

Alexis

Lebwohl

et al. 2019

Acad Dermatol Venereol

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Psoriasis has historically been considered a nonpruritic dermatosis, in contrast with atopic dermatitis. Thus, itch has often been underappreciated and overlooked in psoriasis. However, increasing evidence over the past decade has shown that itch can be one of the most prevalent and burdensome symptoms associated with psoriasis, affecting almost every patient to some degree. Itch can involve the entire body, although it predominantly affects the legs, hands, back, body and especially the scalp. Uncontrolled itch can significantly impact all aspects of the well‐being and quality of life of the patient. While there has been some progress in trying to better understand the pathophysiology of itch in psoriasis, more research effort and interest are needed. This under‐recognition of itch in psoriasis is clearly reflected in the dearth of treatment options targeting itch despite significant advancement in treating the lesions themselves. Recently, however, clinical studies have begun to include itch as a study outcome. The resulting data have demonstrated concomitant antipruritic benefits and improved Psoriasis Area and Severity Index (PASI) scores with mainstay treatments for psoriasis, such as topical corticosteroids and vitamin D analogs, phototherapies, and various systemics and biologics. This article takes a closer look at this debilitating symptom, reviewing the available epidemiology data for psoriatic itch, presenting the current understanding of psoriatic itch pathophysiology and highlighting important clinical data for various treatment options for itch. Practical considerations for increasing the recognition of itch as well as improving its management in psoriasis are also provided.

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Section: Epidemiology Of Itch In Psoriasismentioning

confidence: 99%

Itch: an under‐recognized problem in psoriasis

Elewski

Alexis

Lebwohl

et al. 2019

Acad Dermatol Venereol

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“…However, this is contrasted by the fact that only a minor proportion of necessitous psoriasis patients actually receive these treatments . While this unsatisfactory fact might be explained partially by economical risk or by the behaviour of treating physicians, recently the personality of psoriasis patients themselves has become the focus of research for compliance and adherence . It is generally accepted that psoriasis is a complex disease and there are several comorbidities associated with it.…”

Section: Introductionmentioning

confidence: 99%

Addiction: an underestimated problem in psoriasis health care

Zink

Herrmann

Fischer

et al. 2017

Acad Dermatol Venereol

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Addictions and gambling are more prevalent in patients with psoriasis compared with the general population. Respective screening measures are recommended in daily practice for doctors treating psoriasis patients, and PeakPASI is suggested as a score to document patients' lifetime highest PASI. Parallel to new drug approvals and even more detailed insights into the pathomechanism of psoriasis, public health strategies and interdisciplinary approaches are essential for a general sustained psoriasis treatment.

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“…Age, sex, education, marital status, a penchant for abusing substances, and susceptibility to addictions were not significant contributors [22]. The study of Bundy et al provided evidence that younger individuals assess their QoL better, regardless of their sex, education, and marital status [16]. In our study, the QoL of psoriatic patients did not depend on their sex, but was determined by their education and marital status.…”

Section: Discussionmentioning

confidence: 44%

“…Very serious pruritus-related complaints were reported by 16.15% (21) of the surveyed, while 10.77% (14) did not have such complaints at all. The median for burning sensation was 5.0 (range: 0-10), with the strongest level being reported by 8.46% (11) of the respondents, and no burning sensation being reported by 18.46% (24).…”

Section: Resultsmentioning

confidence: 95%

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Quality of life of psoriatic patients – modulatory variables

Gawlik¹,

Topczewska²,

Kurpas³

2016

fmpcr

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Background. In recent years, there has been increasing interest in the quality of life (QoL) of patients with dermatological conditions. The problem of the stigma associated with some dermatological conditions has been discerned, as patients suffering from chronic dermatoses tend to perceive themselves in a specific way and to assess their QoL as very low. Objectives. Identification of factors that influence the QoL of patients with psoriasis. Material and methods. This survey-based quantitative research was carried out at the dermatology ward of the Voivodeship Specialist Hospital, Research and Development Centre in Wroclaw, Poland. The study involved 130 adult patients with a diagnosis of psoriasis, of whom 56.92% (74) were women. The research instruments used were the Dermatology Life Quality Index (DLQI), the Hospital Anxiety and Depression Scale (HADS), and a questionnaire of the authors' own design. Results. The median for disappearance of psoriatic patches after hospitalization was 5 (range: 0-10). The median for the remission duration was 3 months (range: 0.25 to 24). 61.54% (80) of those surveyed reported improvement in their psoriasis treatment as a result of regular check-ups at the outpatient dermatology clinic. Disease-related anxiety and QoL were determined by marital status and the level of education. Older patients more often had symptoms of depression, according to HADS. Higher DLQI scores correlated with higher HADS-A and HADS-D scores. Conclusions. Psoriasis has significant effects on patients' mental states and social functioning. The most serious and unpleasant symptoms are pruritus and skin lesions on the uncovered parts of the body. The patients with the highest risk of a lower QoL are the elderly; those living alone (single or widowed); those with secondary, vocational, or no education; and those with symptoms of anxiety or depression.

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Psoriasis: snapshots of the unspoken: using novel methods to explore patients' personal models of psoriasis and the impact on well‐being

Cited by 36 publications

References 26 publications

Itch: an under‐recognized problem in psoriasis

Itch: an under‐recognized problem in psoriasis

Addiction: an underestimated problem in psoriasis health care

Quality of life of psoriatic patients – modulatory variables

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