229 Pityriaris rubra pilaris has a significant psychiatric burden and impact on quality of life

Abstract

Pityriasis rubra pilaris (PRP) is an inflammatory condition that has debilitating complications and is frequently refractory to treatment. Despite this, the psychiatric burden of PRP remains largely uninvestigated. Our aim was to quantify comorbid psychiatric disorders and identify disease factors associated with worsened quality of life in this condition. We conducted an online Qualtrics survey study of PRP patients. We recruited participants through a mailing list from the PRP Alliance. Inclusion criteria were diagnosis of PRP by a dermatologist and age >18 years at survey completion. Univariate analyses comparing mean Dermatology Life Quality Index (DLQI) scores were performed using Kruskal-Wallis tests. In total, 307 patients met inclusion criteria. The mean DLQI score for PRP patients was 11.5 ± 8.4. Overall, 61.9% of patients reported depression, 23.1% anxiety, 69.4% mobility issues, and 58.6% significant impact on their ability to work or attend school. Most (60.9%) patients had a >50% reduction in sleep. Factors associated with a higher DLQI included alopecia, joint pain, photosensitivity, and history of hospitalization (p<0.001). Only 9.1% reported that their dermatologist referred to a psychologist or psychiatrist. Patients referred to psychiatrists or psychologists had mean DLQI scores of 16.4, compared to 11.0 in those without a referral (p=0.0012). Our findings reveal that psychiatric comorbidities and impaired daily living are highly prevalent in PRP patients. Despite this, only a small proportion of patients are referred to psychiatry or psychology, with those who are referred exhibiting higher DLQI scores.