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Indicators of health quality in 154 Turkish patients with psoriasis

Dear Editor, Psoriasis is a complex and multidimensional skin disease that imposes a lifelong burden on affected people. The impact of psoriasis on patients’ quality of life has been well documented by using Dermatology Life Quality Index (DLQI). DLQI is a widely used disease-specific life quality assessment method that was developed in 1994 and was shown to be both valid and reliable in various dermatologic diseases as a dermatology-specific life quality index. The purpose of this case-control study was to determine the extent of impact of psoriasis on patients’ quality of life measured by DLQI and to explore the relationship of DLQI scores to clinical and demographic variables in Turkish patients with psoriasis. This study was carried out after obtaining institutional Ethics Committee permission and patients were requested to fill in the Turkish version of the DLQI questionnaire at their clinical visit. Patients with a diagnosis of psoriasis who were older than 16 years of age and attended the outpatient clinic for the first time were included into the study and they signed a written informed consent afterwards. Patients’ demographic and clinical characteristics and response to previous treatment modalities were also recorded. Disease severity was assessed by calculating Psoriasis Area Severity Index (PASI) score for each patient. Physicians also rated severity of psoriasis subjectively as mild, moderate and severe according to severity of clinical findings. All statistical analyses were performed by using SPSS version 13.0 for Windows. A total of 154 patients were recruited into this prospective observational clinical study. Characteristics of patients are shown in Table 1. Mean age of the patients was 42.1 ± 15.45 (18–81) years old while the mean psoriasis starting age was 30.6 ± 16.65 (3–78) years old. Of all patients, 90 (58.4%) were female and 90 (58.4%) had more than 8 years of education. Pruritus was the most common associated symptom in 136 (88.3%) patients (Table 1). Of all patients, 89.0% (n = 137) had a history of previous therapy and this was mostly (85,7%, n = 132) topical steroids. Remission was never achieved in 51.3% (n = 79) of patients. Eighty-two (53.2%) patients found it always difficult to live with psoriasis (Table 1) while social support was observed in 42.9% (n = 66) of the patients. Physicians rated severity of psoriasis as mild in 63.0% (n = 97) of patients. Psoriasis lesions were largely localized (42.9%, n = 66) and located mostly in the scalp (61.7%, n = 95), elbows (52.6%, n = 81) and knees (42.9%, n = 66). The mean PASI score was 8.4 and mean total DLQI score was 9.3 (0–29) (Table 2). DLQI total scores were affected significantly by patients’ age, gender, education, disease starting age, presence and severity of pruritus, presence of other symptoms, presence of stress as a triggering factor, presence of any accompanying illnesses in medical history (especially presence of hypertension) and patients’ self report of ease of living with psoriasis (Table 1). DLQI total scores were not affected significantly (P > 0.05) by marital status, disease total duration, duration of disease symptoms at presentation, tenderness of lesions, presence of triggering symptoms, triggering factors other than stress, presence and type of previous therapy, presence of history of remission, duration of remission, presence of diseases other than hypertension in medical history, presence of family history of psoriasis, psoriasis