Оценка качества жизни детей, страдающих псориазом

Abstract

An increase of psoriasis in childhood, a more severe course of this disease, the presence of a cosmetic defect, which causes a negative impact on the quality of life of such patients, determine the relevance of this problem of modern dermatology. Psoriasis is characterized by a psoriatic rash, which is based on hyperkeratosis caused by uncontrollable mitosis of keratinocytes. Despite the recent studies of a large number of various mechanisms that can contribute to the psoriasis development, there is still no clear answer which of them is the main one, and this makes it impossible to achieve in most cases the desired clinical result of treatment, in particular, ensuring stable clinical remission or complete recovery of patients. The purpose of our study was to assess the impact of psoriatic manifestations on the quality of life among children. The object of observation was 106 children aged 4 to 17 years suffering from psoriasis. The average age of the children was 13 years. The measurement was carried out using the “Dermatological Quality of Life Index” (DLQI) (age 16–17 years), and the “Pediatric Dermatological Quality of Life Index” (CDLQI) (age 4–15 years). In addition, we analyze the severity indices of psoriasis in children: BSA, PASI and PGA. As a result of the study, the following was found: in general, psoriasis has a small impact on the quality of life in children – DLQI in children with psoriasis is 5 points; the value of the DLQI index is statistically significantly higher in girls than in boys, and with age the effect on the quality of life in children with psoriasis increases; skin lesions with psoriatic plaques of open areas in children has a significant impact on the quality of life: with scalp psoriasis, the DLQI level is the highest; statistically significant relationships between DLQI and psoriasis severity indices are established: between DLQI and BSA (r = 0.378; p < 0.001), between PASI and DLQI (r = 0.38; p < 0.001). With an increase in the intensity of manifestations of the pathological process assessed by the PGA index, the influence of psoriasis on the quality of life among children also increases (p = 0.011). According to the results of the study, methodological recommendations on medical and social support for children with psoriasis were drawn up and provided to specialized medical organizations.