Clinical severity and quality of life in patients with psoriasis from India

Psoriasis has a huge socioeconomic impact on patients’ lives [1, 2]. Psoriasis can result in social discomfort and stigmatization due to its impact on aesthetics [3].
This study was conducted to assess the clinical severity, the physical and psychosocial disability and to analyse their interrelationship in psoriasis patients.
Eighty psoriasis patients attending the outpatient department who were aged above 18 years, with duration of the disease for at least 3 months were selected. Written informed consent was obtained from study participants. Approval of the institutional ethical and research committee was obtained (No. G1. 2747/12/ACME dated 25/09/2013). A detailed history with special relevance to known stress factors or any other precipitating factors were noted and physical examination was conducted as per the proforma. Psoriasis Area Severity Index (PASI), Psoriasis Disability Index (PDI) and Psoriasis Life Stress Inventory (PLSI) were assessed and analysed. We used a modified version of the Psoriasis Disability Index (PDI-1990 version) and PLSI based on a study done by Rakhesh et al. to suit the local population [4].
Mean, standard deviation and frequency were calculated and relationships between disease variables and the two quality of life measures were examined using Pearson’s correlation coefficients. Gender, itching, marital status, family history, clinical severity and stress wise comparison were based on t-statistics (for 2 groups) or One Way ANOVA (for more than 2 groups) with a level of significance at 1%, 5% and multiple comparisons were done with post hoc Bonferroni test.
Male to female ratio was 1.9 : 1 and mean age of the study population was 48.96 years. Mean total duration of the disease was 6.76 years. The most common type of psoriasis was chronic plaque psoriasis (n = 75). Males reported a higher amount of physical disability, as shown by a higher mean PDI score, compared to females. This difference assumed significance by independent t-test (p = 0.005).
Family history of psoriasis was noted in 12.5% of patients. Genetic predisposition has a significant role in the etiopathogenesis of psoriasis and familial clustering of the cases has been recorded. The duration of psoriasis ranged from 2 months to 30 years. The duration of the disease had no significant impact on the mean PASI, mean PDI or the mean PLSI. A similar finding had been reported earlier by Fortune et al. and Rakhesh et al. [4, 5]....


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