Quality-of-Life Issues and Economic Burden of Psoriasis and Atopic Dermatitis

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Both psoriasis and atopic dermatitis are common skin disorders that have profound social and economic effects on the patients and their families. Surveys of the effects of these diseases have demonstrated their interference with social life, sport, caring for the home, personal and sexual relationships, and the ability to work. These effects are similar across many cultures. Methods of measuring the impact of psoriasis and atopic dermatitis on quality of life include disease-specific indices such as the Psoriasis Disability Index, specialty-specific indices such as the Dermatology Life Quality Index, general health measures such as the UK Sickness Impact Profile, and utility measures. Both diseases score more highly than other skin conditions, and result in handicap levels equivalent to those experienced by patients with nondermatological diseases such as hypertension and angina. The use of these measures in psoriasis and atopic dermatitis has shown an improvement in handicap levels resulting from inpatient admission and from treatment with cyclosporin. These diseases can have an immediate effect on earnings and a long term effect on career choices and employment opportunities. Cost analysis of management strategies highlights the financial advantages of daycare outpatient treatment centres and provides a financial ranking of the different topical and systemic approaches to the treatment of psoriasis. The costs of treatment must be considered in relation to the degree of benefit gained in terms of handicap reduction and restored earning capacity, and not simply in terms of the unit cost of therapy.