A Review of Health Outcomes in Patients with Psoriasis




Psoriasis, a chronic inflammatory skin condition, is a complex disease in terms of its significant comorbidities and impact on patients’ quality of life. The objective of this article is to elucidate the health outcomes of the disease, including its economic and psychosocial burden on the patient. Current treatments options and the economic considerations of treatment costs are reviewed. Psoriasis is a multidimensional disease, so patients benefit from having a multidisciplinary team of dermatologists and other physicians for management of it and of associated comorbid conditions.


Psoriasis is a chronic inflammatory skin disorder that affects 2% to 4% of the United States population. Patients with psoriasis present with scaly and erythematous patches and plaques on the skin. Psoriasis is associated with significant comorbidities and affects patients’ quality of life. Successful management of psoriasis patients depends on clinicians’ understanding of the various treatment options as well as their recognition of associated comorbidities.


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. 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, drop-shaped lesions on the trunk, limbs, and scalp, and it is sometimes associated with upper respiratory infections. Pustular psoriasis is characterized by multiple pustules on the skin, whereas inverse psoriasis presents with erythematous patches in the intertriginous areas. Erythrodermic psoriasis is characterized by widespread erythema and scaling of the skin.


Measurement of Disease Severity


In clinical practice, psoriasis disease severity is estimated primarily by using the total body surface area (TBSA) involved. Typically, TBSA involvement of less than 2% is considered mild disease, 2% to 10% is moderate disease, and greater than 10% is severe psoriasis. In clinical trials, researchers often use the Psoriasis Area and Severity Index (PASI) to assess disease severity. PASI is a validated disease-severity instrument that integrates area of involvement with erythema, scaling, and induration of psoriatic plaques. PASI ranges from 0 (no disease) to 72 (maximal disease). About 25% to 30% of patients with psoriasis are classified as having moderate-to-severe disease.


Prevalence and Incidence


The National Institute of Arthritis and Musculoskeletal and Skin Diseases estimates that the prevalence of psoriasis in the United States is approximately 4%, whereas psoriasis has aworldwide prevalence of approximately 2% to 3%. Currently, more than 5 million adults have psoriasis, and 260,000 new cases are diagnosed annually in the United States. Psoriasis appears to affect men and women equally. Although psoriasis can affect all age groups, the onset of psoriasis tends to peak between the ages of 20 and 30 and between ages 50 and 60. Patients with early onset of psoriasis tend to have greater disease severity and a family history of psoriasis.

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Feb 12, 2018 | Posted by in Dermatology | Comments Off on A Review of Health Outcomes in Patients with Psoriasis

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