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Burden of disease

The impact of psoriasis and burden of disease

Psoriasis is a multifaceted condition with several implications for personal and social lives of affected people, with heavy direct and indirect costs and complex management requirements

Francesca Sampogna Epidemiologist, Rome, Italy

Psoriasis is definitely more than skin deep in its impact on affected patients.1


deeply impairs quality of life, is associated with physical and psychological comorbidities and may have heavy socioeconomic consequences. Psoriasis can have cumulative physical and psychosocial effects preventing sufferers from achieving their full potential in life.2

these aspects is essential for the management of psoriasis.

Impact of psoriasis on quality of life Psoriasis is known to have a strong impact on the quality of life of patients. But what does ‘quality of life’ exactly mean? It is a multidimensional construct, which follows the definition of health by the World Health Organization, where health is understood as the state of complete physical, mental and social well- being, and not merely defined by the absence of disease or infirmity. Quality of life refers to the ‘physical, psychological, and social domains of health, seen as distinct areas that are influenced by a person’s experiences, beliefs, expectations, and perceptions’.3

All of these aspects

may be strongly impaired due to psoriasis. Although it is not a life- threatening condition, the chronic nature of psoriasis and its visibility can cause a great burden on a patient’s life. Therefore,

Being aware of all

30 40 50 60 70 80 90

PF RP BP GH VT SF Figure 1: Quality of life in psoriasis – comparison with SF-36 norm

“Although it is not a life-threatening condition, the chronic nature of psoriasis and its visibility can cause a great burden on a patient’s life”

measuring quality of life (respectively assessing the change in quality of life after an intervention/within a clinical study) is considered essential for a complete evaluation of the status of dermatological patients. (This is also of great value when evaluating outcomes in clinical trials and interventions.) Compared to other non-dermatological conditions, it has been shown that psoriasis can cause as much disability as other major

medical diseases.4 Figure 1 shows the

quality of life scores, as measured by the SF-36 instrument, in a group of patients with psoriasis5

(two lines: all patients, and

patients aged 40 years or more) compared to the health profiles of US patients. Considering that lower scores indicate a worse quality of life, patients with psoriasis had physical health scores similar to those patients with medical conditions (left side of the figure), and RE MH

Hypertension Diabetes t.II Recent acute MI Depression Psoriasis

Psoriasis 40+

PF=Physical functioning RP=Role physical BP=Body pain GH=General health VT=Vitality

SF=Social functioning RE=Role emotional MH=Mental health


SF-36 score (higher score indicates a better status)

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