Elsevier

Dermatologic Clinics

Volume 30, Issue 1, January 2012, Pages 61-72
Dermatologic Clinics

A Review of Health Outcomes in Patients with Psoriasis

https://doi.org/10.1016/j.det.2011.08.012Get rights and content

Section snippets

Psoriasis subtypes

Psoriasis varies greatly in clinical presentation and ranges from mild disease with isolated patches to extensive disease with confluent plaques involving multiple areas of the body. Plaque psoriasis is the most common subtype, affecting 80% to 90% of those with psoriasis.2 Plaque psoriasis is characterized by erythematous patches or plaques with silvery scales. Other subtypes of psoriasis include guttate, pustular, inverse, and erythrodermic forms. Guttate psoriasis appears as small,

Impact of Psoriasis on Quality of Life

Psoriasis has a major impact on health-related quality of life that is comparable to other major medical diseases such as cancer, arthritis, hypertension, heart disease, diabetes, and depression.1, 6 In a review of quality-of-life studies from January 1966 to April 2000, investigators found that patients with psoriasis reported physical discomfort, impaired emotional functioning, and negative body image and self-image, as well as limitations in daily activities, social contacts, and work.6 The

Psoriasis comorbidities

Psoriasis is associated with comorbid conditions, including depression, arthritis, diabetes, hypertension, metabolic syndrome, and cardiovascular events. These comorbid conditions may occur concurrently or years after development of psoriasis.19, 20

Treatments

Treatments for psoriasis need to be tailored to patients based on a variety of factors, including type of psoriasis, disease severity, medical coverage, and access to care. Treatments with topical agents, such as topical steroids and topical vitamin D agents, constitute the first line of therapy for mild-to-moderate disease. However, topical therapy alone is often inadequate for moderate-to-severe psoriasis. For patients with moderate-to-severe disease, phototherapy, systemic therapy, or

National Resources

Patients with psoriasis and their families can seek educational resources, along with support and advocacy groups, from a variety of national resource organizations. Online educational resources exist on Web sites from the American Academy of Dermatology (www.aad.org), the National Psoriasis Foundation (www.psoarisis.org), and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (www.niams.nih.gov). Psoriasis Cure Now! is a nonprofit patient advocacy group aimed to increase

Summary

As basic and translational research efforts continue to expand, researchers are developing novel agents to treat psoriasis, especially for those with moderate-to-severe disease. However, access and affordability of current treatments often present a challenge for segments of the patient population, such as those who are uninsured or underinsured. As previously discussed, the average cost of outpatient treatment can range from $1600 to $6000 per year, which can be prohibitively high for patients

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    Funding sources: There were no sources of funding.

    Dr Armstrong is an investigator and consultant for Abbott and Centocor.

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