The burden of psoriasis in patients with early psoriatic arthritis. (24th July 2021)

• Record Type: Journal Article
• Authors: Kasiem, Fazira R; Kok, Marc R; Luime, Jolanda J; Tchetverikov, Ilja; Wervers, Kim; Korswagen, Lindy-Anne; Denissen, Nastasja H A M; Goekoop-Ruiterman, Yvonne P M; van Oosterhout, Maikel; Fodili, Faouzia; Hazes, Johanna M W; Vis, Marijn
• Is Part Of: Rheumatology. Volume 61:Number 4(2022)
• Page Start: 1570
• Page End: 1578
• Publication Date: 2021-07-24
• Subjects: PsA -- health-related quality of life -- psoriasis; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/keab606
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objectives: Psoriasis impacts health-related quality of life (HRQoL) in PsA patients. However, this is not adequately measured with a general HRQoL questionnaire. The aim of this study was to quantify the degree of psoriasis evolution in PsA patients over the first year of follow-up and to evaluate whether the impact of psoriasis on HRQoL can be adequately measured with a dermatology-specific HRQoL questionnaire. Methods: Data were used from PsA patients in the Dutch south west Early Psoriatic Arthritis cohort. Psoriasis severity was measured with the Psoriasis Area and Severity Index (PASI). Dermatology-specific HRQoL was assessed with the Skindex-17 questionnaire. We used a Sankey diagram to illustrate the evolution of psoriasis severity during the first year of follow-up. To assess the association between psoriasis severity and the symptoms and psychosocial subscale of the Skindex-17, a linear regression analysis with hierarchical variable selection and zero-inflated negative binominal regression analysis were performed, respectively. Results: We included 644 patients; 109 (17%) patients had no psoriasis (PASI = 0), 456 (71%) had mild psoriasis (PASI < 7), 56 (9%) had moderate psoriasis (PASI 7–12) and 23 (4%) had severe psoriasis (PASI > 12). Psoriasis severity did not fluctuate much during the first year. PASI was significantly associated with both subscales of the Skindex-17 at baseline and 12 months. Conclusion: Psoriasis severity in PsA patients is mostly mild but impacts HRQoL when measured using a dermatology-specific HRQoL questionnaire. For optimal management of PsA patients, we recommend rheumatologists acquire information on skin burden by using a dermatology-specific HRQoL questionnaire.