Información de la revista
Vol. 114. Núm. 1.
Páginas 33-38 (Enero 2023)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Visitas
...
Vol. 114. Núm. 1.
Páginas 33-38 (Enero 2023)
Review
Open Access
Quality of Life and Body Region Affected by Psoriasis: A Systematic Review
Calidad de vida y región corporal afectada por la psoriasis: una revisión sistemática
Visitas
...
K. Nabievaa, R. Venderb,
Autor para correspondencia
ron.vender@me.com

Corresponding author.
a University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
b Dermatrials Research Inc., Hamilton, Canada
Contenido relaccionado
K. Nabieva, R. Vender
Información del artículo
Resumen
Texto completo
Bibliografía
Descargar PDF
Estadísticas
Figuras (3)
Mostrar másMostrar menos
Material adicional (1)
Abstract
Purpose

Psoriasis is a chronic skin condition that affects approximately 1–3% of the world's population and is known to decrease patients’ quality of life. However, it is yet to be ascertained whether the specific location of psoriatic lesions on the body influences one's quality of life.

Methods

A systematic review was conducted with a search of MEDLINE, EMBASE, and Web of Science databases. Only non-case report and non-review studies with explicitly stated body regions affected by psoriasis were included in the review.

Findings

Psoriatic patches and plaques in different areas of the body were not found to influence patients’ quality of life to differing extents.

Conclusions

While the body of evidence is limited and presents unstandardized results, the results of this review point to the fact that all psoriatic patches and plaques decrease patients’ quality of life, with neither one region doing so to a significantly greater extent than another.

Keywords:
Quality of life
Psoriasis
Psoriasis localization
Resumen
Objetivo

La psoriasis es una afección crónica de la piel que afecta aproximadamente el 1-3% de la población mundial con gran impacto negativo en la calidad de vida de los pacientes. Sin embargo, aún no se ha determinado en qué medida la ubicación específica en el cuerpo de las lesiones psoriasis influye en la calidad de vida.

Método

Se realizó una revisión sistemática con una búsqueda en las bases de datos Medline, Embase y Web of Science. En la revisión se descartaron los artículos referidos a casos clínicos y revisiones, incluyéndose solo aquellos en los que se indicó de forma explícita la evaluación por regiones corporales afectadas por psoriasis.

Resultados

No pudo identificarse una relación entre la presencia de placas de psoriasis en diferentes áreas del cuerpo y la calidad de vida de los pacientes.

Conclusiones

Si bien la evidencia es limitada y presenta resultados no estandarizados, los resultados de esta revisión permiten sugerir que la presencia de placas de psoriasis disminuyen la calidad de vida de los pacientes, sin diferencias en función de la región afectada.

Palabras clave:
Calidad de vida
Psoriasis
Localización de la psoriasis
Texto completo
Introduction

Psoriasis vulgaris is a chronic immune-mediated systemic inflammatory disease that affects 1–3% of the world's population.1 It is often associated with scaly papules, patches, and plaques that may appear anywhere on the body.2 While it is known that psoriasis negatively affects the quality of life of patients, little is known about the relationship between the region(s) of the body affected by psoriasis and the quality of life.3 This systematic review strives to ascertain whether the body region affected with psoriasis can predict one's quality of life. It is hypothesized that psoriatic areas that are more visible or sensitive (face, neck, genitals) will be associated with a lower quality of life compared to psoriatic areas that are less visible, such as thighs or trunk.

Methods

A literature search using the MEDLINE, EMBASE, and Web of Science literature database was conducted using the terms (“psoriasis” AND (face OR facial OR scalp OR ear OR cheek* OR lips OR lip OR earlobe* OR forehead OR eyelid* OR nose OR chin OR jaw OR neck OR Shoulder* OR chest OR breast* OR underarm* OR axilla OR axillae OR arm OR forearm* OR elbow* OR wrist* OR hand* OR finger* OR nail* OR abdomen OR stomach OR hip OR hips OR back OR trunk OR buttock* OR leg OR legs OR thigh* OR knee* OR kneecap* OR ankle* OR shin* OR calf* OR calves OR toe OR toes OR plantar OR foot OR feet OR limb* OR Genital* OR vulv* OR labia* OR groin OR vagina* OR folds OR penile OR penis OR scrotum OR pubis OR “inverse psoriasis”) AND (“Dermatology Life Quality Index” OR “DLQI” OR “Skindex 29” OR “Skindex 17” OR “Dermatology Quality of life Scale” OR “DQOLS” OR “Psoriasis Disability Index” OR “PDI” OR “Impact of Psoriasis Questionnaire” OR “IPSO” OR “Psoriasis Index of Quality of Life” OR “quality of life scale” OR “QOLS” OR “PSORIQoL” OR “SF36” OR “EQ5D” OR MQOL OR “McGill Quality of Life scale” OR HRQOL OR “Health-related quality of life” OR WHOQOL-BREF OR “Global Quality of Life Scale” OR GQOL) AND adult).

Articles identified for inclusion met the following criteria: there was mention of the specific body part(s) affected by psoriasis; the quality of life of psoriasis patients was reported; the articles were published prior to February 14, 2021. Studies were excluded if patients’ quality of life scores accounted for more than one location of psoriasis on the body, for instance, if the patients had multiple areas of the body affected by psoriasis and their quality of life score reflected all of those areas. Additionally, articles were excluded if the studies were conference proceedings, if they did not mention where on the body patients experienced psoriasis, if they were reviews or meta-analyses, and if they were case reports.

Quality of life scales

Despite having a search strategy that accounted for a wide array of quality of life scales, the most common one reported in the included studies were the DLQI.4–6

The Dermatology Life Quality Index (DLQI) is a 10-item questionnaire used to evaluate quality of life impact and disability associated with skin disease. This questionnaire deals with many aspects of one's life, including the impact of skin disease on symptoms, one's self-perception, activities, relationships, and treatment. Patients indicate how much their skin disease affects their life for each item, with possible answers being: “very much,” “a lot,” “a little,” and “not at all.” Each response is scored on a scale from 0 to 3 and summed to get a total score out of a maximum 30 points. Thus, a higher DLQI score indicates a greater impairment of one's quality of life.

Results

A total of 663 relevant citations were identified from the literature search (Fig. 1).7 Of these, 251 were excluded based on the title and abstract, and 301 were selected for further examination. A total of 50 articles were included in this review.8-57 See Table 1 (Supplementary material) for a summary of the included studies.

Figure 1.

PRISMA flow chart of the selection of studies examining the relationship between psoriasis and quality of life.

(0,1MB).
Evidence synthesis

Given that studies used different quality of life scales, it was not possible to compile and average results from all studies. Hence, we compiled results from studies which used the same quality of life scale. For instance, studies whose results were based on DLQI were included with similar studies, and studies whose results were based on EQ-5D were similarly grouped together.

For graphical representation and statistical analysis, every psoriatic body region had to correspond to at least two studies to be included in the analysis, so as to prevent one study's results biasing the analysis. Keeping this methodology in mind, the most commonly-reported quality of life scale was the DLQI, followed by the EQ-5D, as shown in Figs. 2 and 3.

Figure 2.

DLQI mean scores stratified by location of psoriasis on the body.

(0,19MB).
Figure 3.

EQ-5D mean scores stratified by location of psoriasis on the body.

(0,1MB).

For other quality of life scales, such as Modified Finlay-Kahn questionnaire or the PDI, there were insufficient studies for compilation into a graphical format and for statistical analysis. Nevertheless, these studies’ results are reported in Table 1, Supplementary material.

At first glance, Fig. 2 appears to demonstrate that psoriasis localization on the neck/décolleté is associated with a higher DLQI score (decreased quality of life) compared to psoriasis localized to the palms, for instance. To deduce whether the differences in the quality of life between the psoriatic body regions are truly significant, the One-way ANOVA test was used. The ANOVA test results pointed to the fact that the mean DLQI scores between all of the body regions affected by psoriasis are not significantly different.

To deduce whether the results in Fig. 3 are significantly different, a T-test was used. The result of the T-test pointed to the fact that the mean EQ-5D scores of nail and palmoplantar psoriasis are also not significantly different.

Discussion

While it was hypothesized that more visible and/or sensitive psoriatic areas such as the face, neck, and genitals would be associated with a significantly impaired quality of life compared to less visible and/or sensitive ones, this was not the case. In fact, there was not one region of the body affected by psoriasis which was associated with a significantly worsened quality of life compared to another region. This review specifically analyzed the baseline quality of life scores of patients with various psoriatic body region involvements rather than the improvement of quality of life due to a treatment. This was done to avoid confounding the results.

The results of the study could have been affected by the limitations of the systematic review. For one, certain studies reported the quality of life associated with the involvement of specific body regions, rather than associated with those body regions in isolation. This made it difficult to deduce to what extent the impairment in quality of life was to the specific psoriatic region alone. Furthermore, studies included in this review used different quality of life scales, making it difficult to compare the results across the studies and to pool the studies’ results for analysis. This greatly reduced the maximum possible number of studies used in the analyses and hence may have biased the results. Thus, future studies are encouraged to report multiple scales if possible, especially accounting for the more conventionally-used scales. Furthermore, the inherent limitation of quality of life scales is that they may be subjective. A methodological limitation of this review was that data abstraction and review was completed by only one reviewer, thereby limiting the inter-rater reliability of study screening. Finally, this review is limited by the fact that the included studies were both observational studies and controlled trials, meaning there were varying degrees of variable and bias control. However, without this methodological limitation, the body of evidence would be insufficient to lend itself to a statistical analysis, meaning that this was a necessary limitation.

Some of the strengths of this study include the fact there was a broad search conducted, with a thorough review of studies, as well as the use of multiple databases for the search. Additionally, the statistical analysis allows for more robust conclusions to be reached.

Future studies are encouraged to be performed with a greater sample size, with each patient experiencing only one localization of psoriasis (for instance, on the scalp alone) in order to truly delineate whether there is a relationship between the body region affected by psoriasis and the quality of life. Additionally, future studies should use more common quality of life scales, such as DLQI, in order to allow for better comparison among studies. Lastly, further research can also explore to what extent treatment improves the quality of life in specific body regions and whether certain body regions’ associated quality of life improves significantly more compared to other regions affected by psoriasis. Further research may also benefit from including more parameters, such as skin area affected by psoriasis and the corresponding quality of life scores, to determine whether larger areas of skin also play a role in affecting the patients’ quality of life. Perhaps the area of skin affected by psoriasis is another confounding variable in the relationship between psoriatic sites and quality of life.

Conclusions

To the best of our knowledge, this systematic review is the first to use worldwide data in an attempt to deduce whether specific psoriatic areas of the body affect patients’ quality of life to differing extents. The results of this review point to the fact that all psoriatic involvement arguably decrease a patient's quality of life, with neither one region doing so to a significantly greater extent than another.

Despite not arriving at the predetermined hypotheses, the results of this review are still useful in shedding light on the fact that patients with psoriasis have a decreased quality of life no matter where they have skin involvement. This can help inform importance of additional care for patients with psoriasis, including anticipation of a decreased quality of life and proactive management, such as referral for psychotherapy or patient support groups.

This review can also help patients to appreciate that no one region affected by psoriasis is predicts a significantly “better” or “worse” quality of life than another; all psoriatic regions predict a decreased quality of life.

Conflict of interest

Dr. Vender has received.

  • Grants/Research Support: Abbvie, Amgen, Bausch Health, Centocor, Dermira, Dermavant, Galderma, GSK, Leo, Lilly, Takeda, Novartis, Merck, Pfizer, Regeneron, UCB.

  • Participated in Speakers Bureau and received Honoraria: Abbvie, Amgen, Janssen, Galderma, GSK, Leo, Lilly, Merck, Novartis, Pfizer, Bausch-Health, Actelion, Celgene, Cipher, UCB.

  • Has received Consulting Fees: Abbvie, Amgen, BMS, Janssen, Galderma, GSK, Leo, Lilly, Merck, Novartis, Palladin, Pfizer, Bausch-Health, Actelion, Celgene, Cipher, UCB.

Appendix A
Supplementary data

The following are the supplementary data to this article:

References
[1]
T. Lahousen, J. Kupfer, U. Gieler, A. Hofer, M.D. Linder, C. Schut.
Differences between psoriasis patients and skin-healthy controls concerning appraisal of touching, shame and disgust.
Acta Derm Venereol, 96 (2016), pp. 78-82
[2]
M.J. Bhosle, A. Kulkarni, S.R. Feldman, R. Balkrishnan.
Quality of life in patients with psoriasis.
Health Qual Life Outcomes, 4 (2006), pp. 35
[3]
M.J. Bhosle, A. Kulkarni, S.R. Feldman, R. Balkrishnan.
Quality of life in patients with psoriasis.
[4]
A.Y. Finlay, G. Khan.
Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use.
[5]
A.Y. Finlay, S.E. Kelly.
Psoriasis—an index of disability.
Clin Exp Dermatol, 12 (1987), pp. 8-11
[6]
M. Herdman, C. Gudex, A. Lloyd, M.F. Janssen, P. Kind, D. Parkin, et al.
Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L).
Qual Life Res, 20 (2011), pp. 1727-1736
[7]
E. Stovold, D. Beecher, R. Foxlee, A. Noel-Storr.
Study flow diagrams in Cochrane systematic review updates: an adapted PRISMA flow diagram.
[8]
L. Andreassi, A. Giannetti, M. Milani, Scale Investigators Group.
Efficacy of betamethasone valerate mousse in comparison with standard therapies on scalp psoriasis: an open, multicentre, randomized, controlled, cross-over study on 241 patients.
Br J Dermatol, 148 (2003), pp. 134-138
[9]
M. Augustin, R. Sommer, N. Kirsten, A. Danckworth, M.A. Radtke, K. Reich, et al.
Topology of psoriasis in routine care: results from high-resolution analysis of 2009 patients.
Br J Dermatol, 181 (2019), pp. 358-365
[10]
P. Bahraini, M. Rajabi, P. Mansouri, G. Sarafian, R. Chalangari, Z. Azizian.
Turmeric tonic as a treatment in scalp psoriasis: a randomized placebo-control clinical trial.
J Cosmet Dermatol, 17 (2018), pp. 461-466
[11]
R. Bissonnette, R. Haydey, L.A. Rosoph, C.W. Lynde, M. Bukhalo, J.F. Fowler, et al.
Apremilast for the treatment of moderate-to-severe palmoplantar psoriasis: results from a double-blind, placebo-controlled, randomized study.
J Eur Acad Dermatol Venereol, 32 (2018), pp. 403-410
[12]
K.C. Duffin, M.A. Mason, K. Gordon, R.W. Harrison, M.M. Crabtree, A. Guana, et al.
Characterization of patients with psoriasis in challenging-to-treat body areas in the corrona psoriasis registry.
Dermatology, 237 (2021), pp. 46-55
[13]
J. Chung, K.C. Duffin, J. Takeshita, D.B. Shin, G.G. Krueger, A.D. Robertson, et al.
Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis.
J Am Acad Dermatol, 71 (2014), pp. 623-632
[14]
J.M. Cohen, K. Halim, C.J. Joyce, M. Patel, A.A. Qureshi, J.F. Merola.
Shedding light on the “hidden psoriasis”: a pilot study of the inverse psoriasis burden of disease (IPBOD) questionnaire.
JDD, 15 (2016), pp. 1011-1016
[15]
N. Da Silva, C. von Stülpnagel, A. Langenbruch, A. Danckworth, M. Augustin, R. Sommer.
Disease burden and patient needs and benefits in anogenital psoriasis: developmental specificities for person-centred healthcare of emerging adults and adults.
J Eur Acad Dermatol Venereol, 34 (2020), pp. 1010-1018
[16]
N.D. Silva, M. Augustin, A. Langenbruch, U. Mrowietz, K. Reich, D. Thaçi, et al.
Sex-related impairment and patient needs/benefits in anogenital psoriasis: difficult-to-communicate topics and their impact on patient-centred care.
PLOS ONE, 15 (2020), pp. 1-3
[17]
C. de Belilovsky, J.M. Bohbot.
Effects of a topical ointment on responses to treatments used for common genital diseases and on quality of life.
Cogent Med, 7 (2020), pp. 1795964
[18]
A. Egeberg, K. See, A. Garrelts, R. Burge.
Epidemiology of psoriasis in hard-to-treat body locations: data from the Danish skin cohort.
BMC Dermatol, 20 (2020), pp. 1-8
[19]
M. Ghajarzadeh, S. Kheirkhah, M. Ghiasi, N. Hoseini.
Depression and quality of life in psoriasis and psoriatic arthritis patients.
Iran J Dermatol, 14 (2011), pp. 123-128
[20]
A. Gottlieb, J. Sullivan, M. van Doorn, A. Kubanov, R. You, A. Parneix, et al.
Secukinumab shows significant efficacy in palmoplantar psoriasis: results from GESTURE, a randomized controlled trial.
J Am Acad Dermatol, 76 (2017), pp. 70-80
[21]
A. Gual, I. Pau-Charles, S. Molin.
Topical treatment for scalp psoriasis: comparison of patient preference, quality of life and efficacy for non-alcoholic mometasone emulsion versus calcipotriol/betamethasone gel in daily clinical practice.
J Dermatol Treat, 27 (2016), pp. 228-234
[22]
E. Herédi, F. Rencz, O. Balogh, L. Gulácsi, K. Herszényi, P. Holló, et al.
Exploring the relationship between EQ-5D DLQI and PASI, and mapping EQ-5D utilities: a cross-sectional study in psoriasis from Hungary.
Eur J Health Econ, 15 (2014), pp. 111-119
[23]
Imafuku S, Kanai Y, Murotani K, Nomura T, Ito K, Ohata C, et al. Utility of the Dermatology Life Quality Index at initiation or switching of biologics in real-life Japanese patients with plaque psoriasis: results from the ProLOGUE study. J Dermatol Sci.
[24]
S. Jung, S.M. Lee, D. Suh, H.T. Shin, D.C. Suh.
The association of socioeconomic and clinical characteristics with health-related quality of life in patients with psoriasis: a cross-sectional study.
Health Qual Life Outcomes, 16 (2018), pp. 1-9
[25]
K. Khobzey, I. Liskova, A. Szegedi, L. Pavlovsky, T. Lunder, K. Kingo, et al.
Effectiveness of adalimumab in the treatment of scalp and nail affection in patients with moderate to severe plaque psoriasis in routine clinical practice.
Acta Dermatovenerol Alp Pannonica Adriat, 26 (2017), pp. 11-14
[26]
K.M. Klaassen, P.C. Van De Kerkhof, M.C. Pasch.
Nail psoriasis, the unknown burden of disease.
J Eur Acad Dermatol Venereol, 28 (2014), pp. 1690-1695
[27]
Kokolakis G, Bachmann F, Wolk K, Sabat R, Philipp S. Efficacy of adalimumab for nail psoriasis during 24 months of continuous therapy. Acta Dermato-venereol.
[28]
A. Kyriakou, A. Patsatsi, D. Sotiriadis.
Quality of life and severity of skin and nail involvement in patients with plaque psoriasis.
Eur J Dermatol, 24 (2014), pp. 623-625
[29]
C. Lanna, G.M. Cesaroni, S. Mazzilli, L. Vollono, R. Gaziano, D. Marino, et al.
Apremilast as a target therapy for nail psoriasis: a real-life observational study proving its efficacy in restoring the nail unit.
J Dermatol Treat, 31 (2020), pp. 1-5
[30]
M. Larsabal, S. Ly, E. Sbidian, M. Moyal-Barracco, J.N. Dauendorffer, N. Dupin, et al.
GENIPSO: a French prospective study assessing instantaneous prevalence, clinical features and impact on quality of life of genital psoriasis among patients consulting for psoriasis.
Br J Dermatol, 180 (2019), pp. 647-656
[31]
T.A. Luger, J. Barker, J. Lambert, S. Yang, D. Robertson, J. Foehl, et al.
Sustained improvement in joint pain and nail symptoms with etanercept therapy in patients with moderate-to-severe psoriasis.
J Eur Acad Dermatol Venereol, 23 (2009), pp. 896-904
[32]
J.M. Martínez-Ortega, P. Nogueras, J.E. Muñoz-Negro, L. Gutiérrez-Rojas, P. González-Domenech, M. Gurpegui.
Quality of life, anxiety and depressive symptoms in patients with psoriasis: a case–control study.
J Psychosom Res, 124 (2019), pp. 109780
[33]
M. Abe, T. Syuto, Y. Yokoyama, O. Ishikawa.
Improvement of quality of life and clinical usefulness of cyclosporin administration in patients with nail psoriasis.
J Dermatol, 38 (2011), pp. 916-918
[34]
K.A. Meeuwis, J.A. De Hullu, H.P. Van de Nieuwenhof, A.W. Evers, L.F. Massuger, P.C. Van de Kerkhof, et al.
Quality of life and sexual health in patients with genital psoriasis.
Br J Dermatol, 164 (2011), pp. 1247-1255
[35]
M. Moradi, F. Rencz.
A comparative cross-sectional study on health-related quality of life in psoriasis from Hungary and Iran.
Value Health, 17 (2014), pp. A612
[36]
C. Ohata, B. Ohyama, F. Kuwahara, E. Katayama, T. Nakama.
Fingernail involvement is a bigger burden than face and scalp involvement in patients with psoriasis.
J Psoriasis Psoriatic Arthritis, 4 (2019), pp. 28-30
[37]
J.P. Ortonne, R. Baran, M. Corvest, C. Schmitt, J.J. Voisard, C. Taieb.
Development and validation of nail psoriasis quality of life scale (NPQ10).
J Eur Acad Dermatol Venereol, 24 (2010), pp. 22-27
[38]
A.N. Passos, d.A.V.R. Rêgo, G.V. Duarte, R.C. Santos e Miranda, d.O.B. Rocha, d.F.S.P.M. de Oliveira.
Facial involvement and the severity of psoriasis.
Int J Dermatol, 58 (2019), pp. 1300-1304
[39]
C. Paul, L. Guenther, H. Torii, H. Sofen, R. Burge, C.Y. Lin, et al.
Impact of ixekizumab on facial psoriasis and related quality of life measures in moderate-to-severe psoriasis patients: 12-week results from two phase III trials.
J Eur Acad Dermatol Venereol, 32 (2018), pp. 68-72
[40]
J. Peruzzo, G.C. Garbin, G. Maldonado, T.F. Cestari.
Nail psoriasis treated with pulsed dye laser.
Anais brasileiros de dermatologia, 92 (2017), pp. 885-887
[41]
A.A. Pettey, R. Balkrishnan, S.R. Rapp, A.B. Fleischer, S.R. Feldman.
Patients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: implications for clinical practice.
J Am Acad Dermatol, 49 (2003 1), pp. 271-275
[42]
Y. Poulin, J.J. Crowley, R.G. Langley, K. Unnebrink, O.M. Goldblum, W.C. Valdecantos.
Efficacy of adalimumab across subgroups of patients with moderate-to-severe chronic plaque psoriasis of the hands and/or feet: post hoc analysis of REACH.
J Eur Acad Dermatol Venereol, 28 (2014), pp. 882-890
[43]
M. Augustin, M. Radtke, J. Schneider, A. Pinter, D. Wilsmann Theis, R.U. Peter.
Real-world experience with apremilast: analysis of 250 patients from the APPRECIATE study with psoriasis in difficult-to-treat areas.
AAD Annual Meeting, (2019), pp. 1-5
[44]
K. Reich, J. Sullivan, P. Arenberger, U. Mrowietz, S. Jazayeri, M. Augustin, et al.
Effect of secukinumab on the clinical activity and disease burden of nail psoriasis: 32-week results from the randomized placebo-controlled TRANSFIGURE trial.
Br J Dermatol, 18 (2019), pp. 954-966
[45]
K. Reich, J.P. Ortonne, U. Kerkmann, Y. Wang, J.H. Saurat, K. Papp, et al.
Skin and nail responses after 1 year of infliximab therapy in patients with moderate-to-severe psoriasis: a retrospective analysis of the EXPRESS Trial.
Dermatology, 221 (2010), pp. 172-178
[46]
F. Rencz, P. Hollo, S. Karpati, M. Pentek, E. Remenyik, A. Szegedi, et al.
Moderate to severe psoriasis patients’ subjective future expectations regarding health-related quality of life and longevity.
J Eur Acad Dermatol Venereol, 29 (2015), pp. 1398-1405
[47]
A.G. Richetta, C. Mattozzi, S. Giancristoforo, S. D’Epiro, C. Cantisani, L. Macaluso, et al.
Safety and efficacy of Adalimumab in the treatment of moderate to severe palmo-plantar psoriasis: an open label study.
Clin Ter, 163 (2012), pp. e61-e66
[48]
C. Ryan, M. Sadlier, E. De Vol, M. Patel, A.A. Lloyd, A. Day, et al.
Genital psoriasis is associated with significant impairment in quality of life and sexual functioning.
J Am Acad Dermatol, 72 (2015), pp. 978-983
[49]
S.R. Syed Nong Chek, S. Robinson, A. Mohd Affandi, N. Baharum.
Clinical characteristics of patients with facial psoriasis in Malaysia.
Int J Dermatol, 55 (2016), pp. 1092-1095
[50]
N.H. Shear, M. Hartmann, M.E. Toledo-Bahena, M. Gilbert, A. Katsambas, R. Yao, et al.
Health-related quality-of-life improvements during 98 weeks of infliximab therapy in patients with plaque-type psoriasis in real-world practice.
Qual Life Res, 25 (2016), pp. 2031-2040
[51]
Z. Sojević Timotijević, S. Janković, G. Trajković, P. Majcan, S. Perišić, N. Dostanić, et al.
Identification of psoriatic patients at risk of high quality of life impairment.
J Dermatol, 40 (2013), pp. 797-804
[52]
D. Thaci, K. Unnebrink, M. Sundaram, S. Sood, Y. Yamaguchi.
Adalimumab for the treatment of moderate to severe psoriasis: subanalysis of effects on scalp and nails in the BELIEVE study.
J Eur Acad Dermatol Venereol, 29 (2015), pp. 353-360
[53]
A. Tsentemeidou, T.A. Vyzantiadis, A. Kyriakou, D. Sotiriadis, A. Patsatsi.
Prevalence of onychomycosis among patients with nail psoriasis who are not receiving immunosuppressive agents: results of a pilot study.
Mycoses, 60 (2017), pp. 830-835
[54]
A.S. Van Voorhees, L.S. Gold, M. Lebwohl, B. Strober, C. Lynde, S. Tyring, et al.
Efficacy and safety of apremilast in patients with moderate to severe plaque psoriasis of the scalp: results of a phase 3b, multicenter, randomized, placebo-controlled, double-blind study.
J Am Acad Dermatol, 83 (2020), pp. 96-103
[55]
S.S. Zaghloul, M.J. Goodfield.
Objective assessment of compliance with psoriasis treatment.
Arch Dermatol, 140 (2004), pp. 408-414
[56]
J. Zhou, X. Yi, Y. Li, Y. Ding.
Efficacy assessment of UVA1 and narrowband UVB for treatment of scalp psoriasis.
Lasers Med Sci, 33 (2018), pp. 1979-1982
[57]
O.A. Vaughn, D. Amato, C. Lin, L. Renda, G.K. ordon.
592 impact of scalp psoriasis on quality of life measurements at baseline and following treatment with ixekizumab.
J Investig Dermatol, 139 (2019), pp. S102
Copyright © 2022. AEDV
Actas Dermo-Sifiliográficas

Suscríbase a la newsletter

Opciones de artículo
Herramientas
Material suplementario

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?