Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Quality of Life Among Patients with Psoriasis, PsA

Arch Dermatol Res; ePub 2019 Mar 13; Duvetorp, et al

According to a recent survey, the impact of psoriasis on the respondents’ health-related quality of life (HRQoL) was profound and was greater for psoriatic arthritis (PsA) than for psoriasis, as was absence due to sickness. Sleeping disorders and depression were also common. In order to describe the impact of psoriasis on HRQoL and patients’ contact with the healthcare system, they survey was administered to 22,050 randomly selected adults, inquiring if they had psoriasis. 1,264 individuals who reported physician-diagnosed psoriasis/PsA were administered the full survey; 1,221 responded (74.6% diagnosed with psoriasis alone; 25.4% with PsA ± psoriasis). Researchers found:

  • Respondents with psoriasis alone most frequently consulted a general practitioner and 10.7% had never seen a dermatologist (although those with severe symptoms visited dermatologists more often).
  • Negative impacts on HRQoL were reported by 38.1% of respondents with psoriasis (mostly limitations on clothing [22.6%], sleep disorders [16%], and depression/anxiety [16%]) and by 73% of respondents with PsA (mostly limitations on clothing [41.8%], sports/leisure [44.0%], or daily routine [45.1%] and sleeping disorders).
  • Absence from work/education was more common with PsA ± psoriasis (51.9%) than psoriasis alone (15.1%).

Duvetorp A, Østergaard L, Skov O, et al. Quality of life and contact with healthcare systems among patients with psoriasis and psoriatic arthritis: Results from the NORdic PAtient survey of Psoriasis and Psoriatic arthritis (NORPAPP). [Published online ahead of print March 13, 2019]. Arch Dermatol Res. doi:10.1007/s00403-019-01906-z.


This survey based out of Sweden, Denmark, and Norway demonstrates that the presence of both psoriasis and psoriatic arthritis have a significant impact on the health-related quality of life. This detrimental effect underscores the importance of appropriate monitoring of patients to ensure timely diagnosis and treatment of psoriatic arthritis. In addition, sleep disorders and depression were found to affect the quality of life with both conditions. Better training and education may be needed to help dermatologists, rheumatologists, and other health care providers who diagnose and manage these diseases to understand the psychological impacts in individuals who have concomitant psoriasis and psoriatic arthritis. —Paul S. Yamauchi, MD, PhD; Clinical Assistant Professor of Dermatology David Geffen School of Medicine at UCLA; Harbor-UCLA Medical Center Division of Dermatology; Adjunct Associate Professor John Wayne Cancer Institute.