Experience with interleukin-23 inhibitor guselkumab using in patients with severe psoriasis and the impact of the disease on the psycho-emotional background

Abstract

Psoriasis is a chronic immune-mediated disease that leads not only to damage to the skin and its appendages, but is also associated with concomitant systemic diseases, including damage to the musculoskeletal system, cardiovascular pathologies, kidney disease, metabolic syndrome and changes in the nervous system. Not long ago, a term was introduced to unite psoriasis and concomitant comorbid diseases – psoriatic disease. Recently, special attention has been paid to assessing the psychoemotional state and quality of life of patients with psoriasis who bear the burden of a chronic disease. It is no secret that any skin disease significantly worsens the quality and standard of life of the patient and can lead to social and professional stigma and discrimination, and a number of restrictions. Psoriatic disease is recognized as a multisystem inflammatory disease and a holistic approach to treatment is recommended, focusing on comorbidities, including mental health, psychosocial well-being and quality of life. The Dermatological Life Quality Index (DLQI) is one of the most convenient indices that allows you to assess the severity of the burden of chronic skin diseases, including psoriasis, on a person’s daily activities; a correlation was found between the severity of psoriasis, the presence of concomitant diseases, especially psoriatic arthritis and the DLQI level. DLQI is higher in patients with moderate to severe psoriasis, in patients with mild psoriasis (low PASI index), but with damage to socially significant areas of the skin (face, hands and feet, scalp, genitals, nail plates), in patients with active manifestations of psoriatic disease in the form of concomitant diseases, which complicates the choice of drug for treatment. The availability, effectiveness, and treatment regimens of modern drugs play an important role in the psycho-emotional state of patients. Today the biological drugs have been actively used in the treatment of psoriasis, which have a number of advantages compared to drugs of basic anti-inflammatory therapy and phototherapy, and, accordingly, are more effective and are of value for patients who experience emotional discomfort from a chronic skin disease in everyday life. The purpose of this article was to study the prevalence and nature of mental and psychiatric pathologies in patients with psoriasis, the possible improvement of DLQI in patients with psoriasis using a biological drug from the group of interleukin-23 inhibitors guselkumab.