Psoriasis Disability Index Research Articles

Health-Related Quality of Life in Psoriasis: Literature Review.

The assessment of quality of life (QoL) in patients with psoriasis plays a crucial role in understanding the impact of the disease and evaluating treatment outcomes. We provide an overview of the key measures used to assess QoL in psoriasis patients, including both generic and psoriasis-specific instruments. The limitations and strengths of instruments such as the Dermatology Life Quality Index (DLQI), Skindex, and Psoriasis Disability Index (PDI) are discussed, highlighting their psychometric properties and areas for improvement. Furthermore, this review examines the potential of disease-specific QoL measures in providing greater sensitivity to disease-related burden and change compared to generic instruments. However, most of the available psoriasis-specific patient-reported outcome measures need further validation. We aim to provide valuable insights into the importance of using validated QoL measures in clinical practice and research, ultimately contributing to a more comprehensive assessment of the impact of psoriasis on patients' lives and enhancing the evaluation of treatment interventions.

P168 The impact of psoriatic arthritis on quality of life and lifestyle: a systematic review

Abstract Background/Aims Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects adults of all ages. It is common for patients to experience a wide variety of physical and psychological problems. The objective of this systematic review was to determine how PsA impacts a person's quality of life (QoL). Methods A systematic literature search of CENTRAL, CINAHL, AMED, EMBASE, Global Health, MEDLINE and PsycINFO databases was conducted on 28th May 2021. Title, abstract and whole text screening, and data extraction were completed by two independent authors. The primary outcomes of this study were PsA activity and severity, impact of PsA on lifestyle and QoL. As per the protocol (PROSPERO CRD42021257395), studies which reported at least one of these primary outcomes were included. The quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal criteria. Results Of the 20,316 papers identified by the search strategy, 42 papers which reported on at least one of the study primary outcomes were included in the review. 38 studies reported on PsA activity and severity, 26 on impact of PsA on lifestyle and 23 on QoL. 7 different measures were used to assess impact of PsA on lifestyle, including Health Assessment Questionnaire (HAQ) (n = 13), modified HAQs (n = 10), PsA impact of disease measure (n = 2), functional capacity ACR (n = 1), functional assessment of chronic illness therapy (n = 1), Bath ankylosing spondylitis functional index (n = 1) and a patient-directed question (n = 1). 13 papers reported an average HAQ score between 0.13 and 1.3 for PsA participants. Two studies which reported HAQ disability index compared PsA participants to other groups. Thus, the impact of disease on lifestyle is worse for PsA compared to psoriasis, rheumatoid arthritis and healthy controls, psoriasis. DAPSA and PASI were the most used disease activity scores in addition to various patient-reported outcomes. The average DAPSA was 15.5, suggesting that the majority of PsA patients have moderate disease activity. Although the average PASI (skin) score showed mild disease among the PsA (3.82) group, a high PASI score was associated with late/never minimal disease activity and obesity. 8 different measures were used to assess QoL, including Psoriatic Arthritis Quality of Life (n = 6, average), EQ-5D (n = 4), EQ-3D (n = 1), DLQI (n = 7), SF-36 (n = 3), SF-12 (n = 1), WHOQOL-BREF (n = 2), PSQI (n = 1), Rosenberg Self-Esteem Scale (n = 1) and Psoriasis disability index (n = 1). Except for QoL for skin (DLQI), PsA was associated with worse outcomes in all these measures, in comparison with spondylarthritis, healthy control and psoriasis only groups. Conclusion PsA significantly affects a patient's life and health-related QoL. The degree of activity and severity of the disease have a substantial impact. Therefore, for patients with high disease activity, specific management plans should be discussed and facilitated to maintain their mobility and functional abilities. Disclosure L. James: None. R. Suribhatla: None. L.H. Hailey: None. R. Amarnani: None. C. Bundy: None. D. McGagh: None. S. Kirtley: None. D. O'Sullivan: None. I. Steinkoenig: None. L.C. Coates: None.

Ayurvedic management of Plaque Psoriasis - A Case Study

Psoriasis is a chronic inflammatory disease affecting mainly in skin and joint. In Ayurveda, under the umbrella of Kushtha all skin diseases are described. In management of Psoriasis Ayurvedic system of medicine is giving good results. The main line of treatment of skin diseases in Ayurveda is repeated Samshodhana (purificatory therapies) along with Samshamana (palliative therapies). Three assessments were done before and after treatment on scoring of Dermatology Life Quality Index (DLQI), Psoriasis Disability Index (PDI) and PASI score. Score of the patient was 83% before treatment and 16% after treatment and 10% after follow up on Dermatology Life Quality Index (DLQI), 86% before treatment and 65% after treatment and 41% after follow up on Psoriasis Disability Index (PDI) and 35.5% before treatment, 10.2% after treatment and 8% after follow up in PASI (Psoriasis Area and Severity Index). This case study wants to substantiate the effectiveness of Ayurvedic treatment in the management of Plaque psoriasis.

Efficacy and safety of piclidenoson in plaque psoriasis: Results from a randomized phase 3 clinical trial (COMFORT-1).

A3 adenosine receptor (A3AR) is overexpressed in the skin and peripheral blood mononuclear cells of psoriasis patients. We investigated the efficacy/safety of piclidenoson (CF101), an orally bioavailable A3AR agonist that inhibits IL-17 and IL-23 production in keratinocytes, in moderate-to-severe plaque psoriasis. The randomized, placebo- and active-controlled, double-blind phase 3 COMFORT-1 trial randomized patients (3:3:3:2) to piclidenoson 2 mg BID, piclidenoson 3 mg BID, apremilast 30 mg BID or placebo. At Week 16, patients in the placebo arm were re-randomized (1:1:1) to piclidenoson 2 mg BID, piclidenoson 3 mg BID or apremilast 30 mg BID. The primary end point was the proportion of patients achieving ≥75% improvement in Psoriasis Area and Severity Index (PASI) from baseline (PASI-75) at Week 16 versus placebo. A total of 529 patients were randomized and received ≥1 dose of study medication (safety population). The efficacy analysis population for the primary end point included 426 patients (piclidenoson 2 mg BID, 127; piclidenoson 3 mg BID, 103; apremilast, 118; placebo, 78). Piclidenoson at 2 and 3 mg BID exhibited similar efficacy. The primary end point was met with the 3 mg BID dose: PASI 75 rate of 9.7% versus 2.6% for piclidenoson versus placebo, p = 0.037. The PASI responses with piclidenoson continued to increase throughout the study period in a linear manner. At week 32, analysis in the per-protocol population showed that a greater proportion of patients in the piclidenoson 3 mg BID arm (51/88, 58.0%) achieved improvement from baseline in Psoriasis Disability Index (PDI) compared to apremilast (59/108, 55.1%), and the test for noninferiority trended towards significance (p = 0.072). The safety/tolerability profile of piclidenoson was excellent and superior to apremilast. Piclidenoson demonstrated efficacy responses that increased over time alongside a favourable safety profile. These findings support its continued clinical development as a psoriasis treatment (ClinicalTrials.gov identifier: NCT03168256).

Evaluation of sleep quality and pruritus severity in psoriatic patients and their impact on quality of life: a cross section correlational study

Psoriasis is a chronic inflammatory condition associated with genetic and immunological susceptibility. The objective of the study was to evaluate pruritus and sleep quality in correlation (r) to psoriasis severity and to detect their impact on quality of life. Two hundred (200) patients with psoriasis were included. Psoriasis severity was determined using the psoriasis area severity index (PASI), the quality of life (QoL) was assessed by the psoriasis disability index (PDI) questionnaire, and the sleep quality was evaluated by the Pittsburgh sleep quality index (PSQI). Finally, the severity of itching was evaluated using a 12-item pruritus severity scale (PSS). Poor sleep quality was found in 16.0% of patients in this study. Poor sleep was detected among 50.0% of cases with severe psoriasis. PASI scores correlated significantly with sleep quality, duration and sleep disturbances (p < 0.001). The global PSQI and PASI were also significantly correlated (p = 0.004). In conclusion patients complaining of psoriasis exacerbated by pruritus and sleep problems demonstrated lower quality of life in all domains. Sleep disturbances and depressive symptoms impairing quality of life should be taken into consideration when screening patients suffering from psoriasis.

EVALUATION OF EFFICACY AND SAFETY OF ORAL VITAMIN D3 AND VITAMIN E AS AN ADD-ON-THERAPY TO METHOTREXATE IN PATIENTS OF MODERATE CHRONIC PLAQUE PSORIASIS

Objective: This study was conducted with the aim to evaluate the efficacy and safety of oral Vitamin D3 and Vitamin E as an add-on-therapy to methotrexate (MTX) in patients of moderate chronic plaque psoriasis. Methods: In this prospective, open-labeled, randomized, and comparative clinical study, a total of 120 patients of age 20–60 years with moderate chronic plaque psoriasis attending the dermatology outpatient department were randomly allocated into three groups of 40 each, i.e., Group M, Group D, and Group E. Group M received MTX (7.5 mg) tablet orally weekly, Group D received MTX (7.5 mg) and Vitamin D3 (60,000 IU) sachet orally weekly, and Group E received MTX (7.5 mg) weekly and Vitamin E (400 mg) daily. Efficacy assessment was done through the following primary parameters-psoriasis area and severity index (PASI) score, dermatology life quality index (DLQI), and psoriasis disability index (PDI), and secondary parameters such as Vitamin D deficiency and insufficiency among the study participants and improvement of serum 25(OH)D concentration. Adverse events were monitored. Results: PASI and DLQI were calculated at the time of recruitment (baseline), 1 month, 2 months, 3 months, and 4 months, and PDI and serum Vitamin D were calculated at baseline and 4 months. On intergroup comparison of PASI score and PDI, statistically significant results were seen at 4 months. DLQI showed significant results at 2, 3, and 4 months. Significant results were found in Group D which signifies improvement in serum Vitamin D levels. Mild side effects were seen at the end of 4 months. Conclusion: The present study suggested that Vitamin D as an add-on therapy was found to cause a significant reduction in psoriatic lesions. It could be a promising drug in patients with psoriasis to improve the psoriatic lesions, when combined can reduce the dose of MTX, thereby minimizing the side effects.

The Psoriasis Disability Index in Romanian Psoriasis Patients during COVID-19 Pandemic: Contribution of Clinical and Psychological Variables.

Psoriasis is one of the most frequent chronic inflammatory skin diseases and has a negative impact on the interpersonal relationship and psychosocial well-being. The aims of this study were to examine the effects of intensity of pruritus on quality of life and depression, to investigate the relationship between anger, self-esteem, and depression, and to compare patients with early and late onset of psoriasis. As our study was carried out during the COVID-19 pandemic, we aimed also to investigate the safety concerns and anxiety related to COVID-19 in psoriasis patients. This cross-sectional study included 137 patients diagnosed with plaque psoriasis. The patients were classified as early-onset (age < 30 years) and late-onset psoriasis (age ≥ 30 years). Duration of disease, pruritus scores, and socio-demographic characteristics were recorded. Measures included the State-Trait Anger Expression Inventory (STAXI), Rosenberg Self-Esteem Scale, Beck Depression Inventory (BDI-II), Psoriasis Disability Index (PDI), and Fear and anxiety in relationship with COVID-19 Scale were used for determining anger, anger expression style, self-esteem, depression, anxiety, and quality of life. The psoriasis patients had a lower score for self-esteem than the normative data from the Romanian general population. The average scores for state anger and trait anger are similar to the normative data from the Romanian general population, but the scores for anger-in and anger-out are higher. Patients with early onset had higher depression scores and lower quality of life. Self-esteem correlates negatively with depression, anger, severity of disability due to psoriasis, number of affected areas, and duration of disease. Lower level of self-esteem led to increased anger. Reduced self-esteem, increased anger levels, and depression are present in psoriasis patients. The effective treatment of psoriasis must, therefore, consist of a multidisciplinary approach, in which the personalized treatment of the skin condition is as important as the adjuvant therapies that reduce the patients' stress level.

Homoeopathy in Psoriasis Vulgaris with Special Emphasis on Modified Naranjo Criteria for Homeopathy: An Evidence-Based Case Report

Abstract Background Psoriasis is a chronic multisystem inflammatory disease with predominantly skin and joint involvement. Ample evidences suggest that psoriasis patients improve under homoeopathic treatment. The main objective of this documentation is to find out whether such improvement can be attributable to the homoeopathic treatment. Method A case of psoriasis vulgaris with the complaint of dry, scaly itching eruption on the extensor surface of both legs is presented here. Outcome-related to impact on daily living (ORIDL) was used to evaluate the patient-reported outcome related to his daily living, disease severity in the involved area was assessed by PASI (Psoriasis Area and Severity Index) scale and PDI (Psoriasis Disability Index) scale was used to assess the disease-specific quality of life. Photographs were taken as objective evidence after obtaining consent from the patient. The Modified Naranjo Criteria for Homeopathy (MONARCH) was used to find out the possible causal attribution of the treatment provided. Result The ORIDL score of (+4) showed the major improvement from patient and physician's perspective. PASI score reduced from ‘11.2 to 0’ (documented in photographs) within a plausible timeframe. The duration of remission of the skin lesion continued for six months. Each domain of PDI score reduced (from ‘25 to 3′) imparting improved quality of life. The high total score (+9 in ‘−6 to 13’ scale) of MONARCH suggested the likelihood of improvement was attributable to the homoeopathic intervention. This case has evidently shown its marked improvement with validated outcome measures.

Psoriasis Disability Index in Psoriasis Patients in a Tertiary Care Hospital: A Cross Sectional Study

Psoriasis Disability Index in Psoriasis Patients in a Tertiary Care Hospital: A Cross Sectional Study

Individualized Homeopathic Medicines in the Treatment of Psoriasis Vulgaris: Double-Blind, Randomized, Placebo-Controlled Trial

Introduction: Psoriasis is a chronic inflammatory skin disorder, affecting the trunk and extensor surfaces of the limbs and scalp predominantly. Worldwide prevalence ranges between 0.1 and 11.4%, and in India between 0.4 and 2.8%; this creates a serious health burden. Psoriasis remains a frequently encountered condition in homeopathy practice, but there is a dearth of conclusive efficacy data supporting its use. Methods: This 6-month, double-blind, randomized trial was conducted on 51 patients suffering from psoriasis at the National Institute of Homoeopathy, India. Patients were randomized to receive either individualized homeopathic medicines (IHMs; n = 25) in LM potencies or identical-looking placebos (n = 26). Psoriasis area and severity index (PASI; primary), psoriasis disability index (PDI), and dermatological life quality index (DLQI; secondary) were measured at baseline and every 2 months, up to 6 months. The intention-to-treat sample was analyzed using a two-way repeated measure analysis of variance. Results: Although intragroup changes were significant in both groups in the outcome measures, improvements were significantly higher in the IHMs group than in placebos in PASI scores after 6 months of intervention (F1, 49 = 10.448, p = 0.002). DLQI daily activity subscale scores also yielded similar significant results favoring IHMs against placebos after 6 months (F1, 49 = 5.480, p = 0.023). Improvement in PDI total (F1, 49 = 0.063, p = 0.803), DLQI total (F1, 49 = 1.371, p = 0.247), and all remaining subscales were higher in the IHMs group than placebos after 6 months, but nonsignificant statistically. Calcarea carbonica, Mercurius solubilis, Arsenicum album, and Petroleum were the most frequently prescribed medicines. Conclusions: IHMs exhibited better results than placebos in the treatment of psoriasis. Further research is warranted.

Efficacy and Safety of Topical Botanical Cream in the Treatment of Psoriasis: A Randomized Controlled Study

This study evaluated the efficacy and safety of a topical botanical cream containing a combination of herbs for the treatment of psoriasis, a chronic inflammatory skin disease that can considerably diminish the quality of life of a patient. Although numerous topical therapies are available, the majority rely on potentially dangerous steroid creams or coal tar ointments that require a doctor's prescription. In this setting, safe and effective alternative treatments are required. The purpose of this study was to evaluate the efficacy and safety of a topical botanical cream containing a combination of herbs for the treatment of psoriasis.A randomized controlled trial including 51 patients with plaque psoriasis was done. Patients were administered the topical cream for eight consecutive weeks, with the dosage decided by the afflicted skin area. Patients' quality of life was measured using the Psoriasis Disability Index (PDI) and Dermatology Life Quality Index (DLQI).The patients in the therapy group reported a significant reduction in psoriasis severity, as judged by the PASI, according to the study results. The symptoms began to ease as early as the second week of cream use. In addition, as measured by the PDI and DLQI, the patients' quality of life increased. By the sixth week, the DLQI score reduced from a high impact to a moderate impact, while the PDI improved in all categories.The topical botanical cream was proven to be safe and effective in treating psoriasis, hence improving the quality of life of patients. The herbal mixture is a viable alternative to steroid creams and coal tar ointments, which can be used as a substitute or supplement to other standard treatments for psoriasis. To corroborate the outcomes of this trial and determine the long-term safety and efficacy of the botanical cream, however, additional studies with bigger sample sizes are required. This study gives crucial insights into the possible use of herbal formulations in the treatment of psoriasis and highlights the need for additional research in this area.

Cross-cultural adaptation and validation of the Bangla version of the Psoriasis Disability Index.

The Psoriasis Disability Index (PDI) is used for the quality-of-life assessment of psoriasis patients. However, a locally adapted Bangla version of the PDI (B-PDI) instrument is currently lacking in Bangladesh. To translate the instrument, adapt, and validate it among psoriatic patients of the country was the objective of the study. Translation, adaptation, and back-to-back translation to Bangla were made from the original English PDI. The final Bangla instrument was applied among 83 psoriasis patients twice at 10 days intervals. The psychometric property of the instrument was evaluated. Item-level content-validity index (CVI) was used to check the content validity of the instrument. Convergent validity was tested by comparing the B-PDI with the validated Bangla version of Short Form 36(SF-36) and the Psoriasis Area Disability Index (PASI) score. Necessary testing was used to assess internal consistency and test-retest reliability. The B-PDI was well-accepted by the patients. It showed good internal consistency (Cronbach's alpha = 0.76) and very high test-retest reliability (Pearson r = 0.92, p < 0.001). The scale demonstrated excellent content validity (Content Valid Index [CVI] = 1). The instrument had satisfactory convergent validity with four components of SF-36. Pearson correlation coefficient for physical, emotional, social, and pain domains of SF-36 was 0.663, 0.644, 0.808, and 0.862, respectively, and for PASI score was 0.812. Factor exploration using Principal Component Analysis revealed four factors reflecting working disabilities, social, and hygienic disabilities, lifestyle difficulties, and leisure-associated disabilities. This study supports the reliability and validity of the B-PDI instrument for measuring health-related quality-of-life for Bangla-speaking psoriasis patients.

Assessment of Cutaneous Parameters and Sympathetic Skin Response as a Non-Invasive Complementary Diagnostic Tool in Psoriasis: An Exploratory Study.

Various diagnostic tools are used to assess cutaneous psoriasis, but most of it were subjective. Sympathetic skin response (SSR), skin PH and temperature objectively measure the skin barrier functions that could aid clinicians to evaluate accurately and predict skin disease incidence even before the onset of clinical symptoms. The study's objective was to assess the utility of cutaneous parameters (skin temperature and pH) and SSRs influencing psoriatic patients' diagnosis management and treatment compared to controls. A total of 40 healthy participants and 40 psoriasis patients aged 18 to 65 years were recruited for this study. SSR, skin temperature and pH were assessed. The psoriasis disability index (PDI) was recorded from all the patients. Data analysis was carried out using SPSS version 20.0. The results shows significantly increased skin temperature, prolonged SSR latency (bilaterally) and decreased SSR amplitude (bilaterally) among patients affected with psoriasis compared to control subjects. There is a positive correlation between SSR latency with PDI and a negative correlation between SSR amplitude and PDI in psoriasis patients. SSR reveals sympathetic sudomotor dysfunction and increased skin temperature in psoriasis. Furthermore, there is a link between increased SSR latency and PDI, which shows that local nervous system impairment significantly contributes to the inflammatory process in psoriasis. Thus, SSR can be used as a complementary tool for the early identification and assessment of epidermal barrier integrity in psoriasis patients, along with the clinician's standard protocols.

Open-Label Study to Evaluate the Response to Homeopathic Treatment of Psoriasis

Patients with psoriasis commonly opt for homeopathic treatment. However, no study has assessed the response to homeopathic treatment by using standardized disease-specific scales, and the findings are based on clinical assessments only. The objective of this study was to evaluate the response to the individualized homeopathic treatment of psoriasis with respect to changes in disease severity and quality of life based on Psoriasis Area and Severity Index (PASI) and Psoriasis Disability Index (PDI) scales, respectively. A multicentric study was conducted using a pragmatic model. The study participants were regularly followed up for 1 year. Subsequently, participants completing the 1-year follow-up were included in a long-term assessment for further 2 years. Three monthly assessments were made by using PASI, PDI, and Visual Analog scales for patient and physician general assessment. Data were analyzed to identify treatment effects and variables affecting treatment. In total, 384 patients were enrolled, out of whom 254 participants completed 1 year of treatment. Of these, 84 participants continued treatment for an additional 12 months. A significant reduction was observed in the scores of PASI (10.96 ± 10.67 at baseline to 4.24 ± 5.10 at 12 months, p = 0.000), PDI (10.19 ± 9.11 to 3.91 ± 4.44, p = 0.000), and patient and physician global assessment scales. Regarding PASI response at 12 and 24 months, PASI 75–89 was reported in 66 and 14 participants, whereas PASI 90–100 was reported in 29 and 17 participants, respectively. Baseline severity of psoriasis considerably affected treatment response, whereas age, gender, and duration of psoriasis did not. Furthermore, the severity of psoriasis and quality of life improved considerably with regular homeopathic treatment.

Indian Traditional Treatments for Psoriasis: A Critical Appraisal of Available Evidence Supporting Efficacy.

To examine data from studies supporting the clinical efficacy of medical approaches from India traditional systems of medicines like Ayurveda, Unani, Siddha, and Homeopathy for psoriasis using outcome indicators employed in clinical practice and research. Searches were conducted between December 2019 and September 2020 in databases PubMed, Scopus, Web of Science and Ovid Medline using search terms including traditional, complementary, psoriasis, Kushtha, Ayurveda, Siddha, Unani, Homeopathy and clinical. Controlled trials, case series and case reports published from India were included. Data of 17 selected studies were extracted. Treatment efficacy in terms of improvement in Psoriasis Area and Severity Index (PASI) score or/and percentage reduction in score (PASI 50, PASI 75 and PASI 90) or/and patient-reported outcomes using instruments like Dermatology Life Quality Index and Psoriasis Disability Index were noted. All studies reported good improvement as per the study specific outcome. However, study characteristics, including study design, sample size, follow-up period, inclusion and exclusion criteria were heterogeneous, and the choice of outcome measures was not adequate to conclude the effectiveness of intervention. The use of some herbs as common ingredients in several formulations across different systems of medicines were noted in analyzing individual formulation. Future studies must incorporate a comprehensive study design with specific outcome measures like PASI, PASI 75, PASI 90, quality of life parameters, compliance to medications, adverse reactions, remission period, relapse rate and cost-effectiveness with long term follow-up. The currently available evidence on the roles of these herbs at molecular level in psoriasis is preliminary.

PS10 (P37): Correlation of Psoriasis Disability Index and Psoriasis Area and Severity Index

PS10 (P37): Correlation of Psoriasis Disability Index and Psoriasis Area and Severity Index

P37: Correlation of Psoriasis Disability Index and Psoriasis Area and Severity Index

P37: Correlation of Psoriasis Disability Index and Psoriasis Area and Severity Index

Influences of methotrexate iontophoresis on functional lifestyle disabilities, functional capacity, and pain in patients with plantar psoriasis.

Objectives This study was aimed to evaluating the influences of methotrexate iontophoresis on functional lifestyle disabilities, functional capacity, and pain after a 6-min walking distance (6MWD) test in patients with plantar psoriasis (PP). Patients and methods Forty‑five patients (29 females, 16 males; mean age 33.9±6.6 years; range, 20 to 45 years) with hyperkeratotic PP were enrolled in the randomized, placebo-controlled, parallel-groups, double-blinded study. They were assigned randomly into the active methotrexate iontophoresis (MI) group (n=23) and the placebo iontophoresis group (n=22). The patients in both groups were assessed before starting the treatment intervention and after completing eight sessions of the treatment intervention through functional lifestyle disabilities measured on the Arabic version of psoriasis disability index, functional capacity using the 6MWD test, and pain after the 6MWD test. Results The pre-treatment measurements of the three variables among the two groups did not reveal statistically significant differences (p>0.05). However, there were statistically significant differences in the post-treatment results between the two groups (p<0.05). Additionally, the pre-and post-treatment values of the three outcome measures revealed statistically significant differences within the MI group (p<0.05). In contrast, there were no significant differences within the placebo group (p>0.05). Conclusion Methotrexate iontophoresis is effective in improving functional lifestyle disabilities, enhancing functional capacity, and decreasing pain in patients with PP.

Quality of life of psoriatic patients in Ouagadougou, Burkina Faso

Background: Psoriasis is a chronic, displaying inflammatory dermatosis. The evaluation of the psychosocial impact of chronic dermatoses on the quality of life of patients may help to orientate the objectives of management in order to improve their daily life, hence the interest of our study with the objective to evaluate the impact of psoriasis on the quality of life of patients followed in the dermatology, venereology, and rheumatology departments of the city of Ouagadougou, Burkina Faso. Patients and Method: This was a descriptive, cross-sectional study that took place from March 1 to June 28, 2019, in six public hospitals in the city of Ouagadougou. The Dermatology Life Quality Index (DLQI) and Psoriasis Disability Index (PDI) were the quality of life tools employed for this study. Results: Forty-eight (48) patients with psoriasis met the inclusion criteria. The mean age of the patients was 46.20 years, ranging from 22 to 79 years. There were 18 females and 30 males, with a sex ratio of 1.6. The measurement of the patients’ QoL by the DLQI reported a mean score of 9.14 out of 30. There was a low impact of the disease on the QoL for seventeen patients. The evaluation of the QOL with the PDI noted an alteration of daily activities (3.95/15) and alteration of the patients’ psychosocial relationships (2.66/18). The analysis of the QoL according to sociodemographic and clinical variables noted an alteration significantly related to age, level of education, and severity of the disease. An alteration in professional relationships was significant in female patients. An alteration in the different dimensions of the QoL was more significant in patients with a low level of education. The duration of the disease seemed to have no impact on the patients’ quality of life. Daily activities were significantly altered for patients with a PASI between 7 and 10. The DLQI did not correlate with disease severity (PASI) (r = 0.228; p = 0.120), unlike the PDI (r = 0.371; p = 0.009). Conclusion: The QoL of psoriatic patients in Ouagadougou seemed to be slightly altered. This alteration was more significant for females. Professional relationships were altered for young subjects while daily activities were altered for those older.

Correlation of Psoriasis Disability Index and Psoriasis Area and Severity Index: A Study from Afghanistan.

BackgroundPsoriasis is a common skin disease that affects physical, psychological, and social well-being of patients. Several studies have assessed health-related quality of life of patients with psoriasis in different populations with large variations.ObjectiveTo investigate, for the first time, the impact of psoriasis on quality of life of Afghan patients with psoriasis.MethodsThis is a prospective observational study conducted at the dermatology department of Maiwand Teaching hospital in Kabul City during April 2018 to May 2019. Patients with plaque psoriasis with age ≥16 years were included in the study. Psoriasis Disability Index was used for the assessment of health-related quality of life. Psoriasis Area and Severity Index was used to define the severity of disease. Appropriate tests were performed using Statistical Package for Social Science.ResultsA total of 174 patients with psoriasis were included in the study, 89 of them were male (51.1%) and 85 of them were female (48.9%). The mean age of the patients was 27.7 years with 13.2 years SD, and the average duration of the disease was 3.2 years with 4.7 years SD. The mean of PASI score was 13.3 with 7.8 SD, while the mean of total PDI was 9.6 with 3.7 SD; there was a strong correlation between total PDI and PASI score (r=0.751, p<0.001). The mean of total PDI was higher among moderate-to-severe psoriasis, female patients, younger age, and those who were single.ConclusionOur study highlighted that psoriasis disability index was highly correlated with psoriasis area and severity index. Furthermore, the quality of life was more affected among female patients, patients younger than 40 years, and those patients who were single.