Psoriasis Severity

The Dermatology Life Quality Index (DLQI) may underestimate disease severity in patients with psoriasis who respond “not relevant” to one or more items, according to a research letter published online April 10 in JAMA Dermatology. John S. Barbieri, M.D., and Joel M. Gelfand, M.D., from the University of Pennsylvania Perelman School of Medicine in Philadelphia, compared disease severity between psoriasis patients who responded “not relevant” or “not at all” for items 3 through 10 on the DLQI.

Psoriasis can appear on any location

Psoriasis typically affects the outside of the elbows, knees or scalp, though it can appear on any location. Some people report that psoriasis is itchy, burns and stings. Psoriasis is associate with other serious health conditions, such as diabetes, heart disease and depression. If you develop a rash that doesn’t go away with an over-the-counter medication, you should consider contacting your doctor.

While scientists do not know what exactly causes psoriasis, they do know that the immune system and genetics play major roles in its development. Usually, something triggers psoriasis to flare. The skin cells in people with psoriasis grow at an abnormally fast rate, which causes the buildup of psoriasis lesions.

Men and women develop psoriasis at equal rates. Psoriasis also occurs in all racial groups, but at varying rates. About 1.9% of African-Americans have psoriasis, compare to 3.6% of Caucasians. Psoriasis often develops between the ages of 15 and 35, but it can develop at any age. About 10 to 15% of those with psoriasis get it before age 10. Some infants have psoriasis, although this is consider rare.

Psoriasis lesions are not infectious

Psoriasis is not contagious. It is not something you can “catch” or that others can catch from you. Psoriasis lesions are not infectious. The researchers find that 24% of 1,733 respondents had at least one “not relevant” response, with items 6 and 9 (sport and sexual relationships) being the most frequent to have “not relevant” responses. Among 532 patients with DLQI scores greater than 5, 37% of respondents had at least one “not relevant” response; across all items, the frequency of “not relevant” responses was increase.
Those who respond “not relevant” had worse objective disease severity than those who respond “not at all” as reflect by higher Psoriasis Area Severity Index scores; they also had worse subjective disease severity as reflect by higher DLQI scores and lower EuroQoL Health-Relate Quality of Life 5-Dimension 3-Level index values and visual analogue scale scores.
“Given the importance of quality of life as a clinical and research outcome, continuing psychometric research is need to develop and refine the most appropriate instruments to measure this outcome in dermatology,” the authors write. One author disclose financial ties to the pharmaceutical industry.