Patients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: implications for clinical practice

doi:10.1067/S0190-9622(03)01479-8

Journal of the American Academy of Dermatology

Volume 49, Issue 2, August 2003, Pages 271-275

https://doi.org/10.1067/S0190-9622(03)01479-8 Get rights and content

Abstract

Background

Psoriasis is a chronic, unpredictable, and incurable disease that has a negative impact on patients’ quality of life. Palm and sole psoriasis can add to this negative impact as it directly affects activities of daily living.

Objective

We sought to estimate the prevalence of palmoplantar psoriasis in a patient population and to explore associations with patient outcomes.

Methods

In all, 317 individuals with psoriasis completed a comprehensive assessment battery. Patients with palmoplantar psoriasis (n = 124, 39%) were compared with patients without palmoplantar involvement with respect to functional disability, psychiatric symptoms, physical and social discomfort, self-reported psoriasis severity, and health-related quality of life.

Results

Patients with palmoplantar involvement reported significantly greater physical disability and physical discomfort than patients without palmoplantar involvement (both P < .01). There were no differences between the 2 groups with respect to psychosocial outcomes.

Conclusion

Patients with palmoplantar psoriasis are affected to a greater degree by the physical aspects of the disease than patients without palmoplantar involvement.

Section snippets

Sample

Data were obtained from a survey of patients with psoraisis seen at our institution. Details on survey conduct and study population are described in detail elsewhere.2 Briefly, a survey was mailed to 579 patients with a previous diagnosis of psoriasis. A total of 317 usable questionnaires were returned, yielding a rate of 54.7% (317/579). The survey included questions about their age, sex, race, marital status, education level, income, length of time with psoriasis, and the locations of their

Respondent characteristics

Group comparisons are presented in Table I. The participants included 136 (43%) men and 181 (57%) women with a mean age of 49 years. The study population was primarily white, married, and well educated. At the time of the survey, patients had psoriasis for an average of 14 years. See Fleischer et al13 for additional information about the study sample.

Palm/sole involvement

In all, 124 respondents reported lesions on the palm, sole, or both (39%) and 193 reported no involvement (Table I). There were no significant

Discussion

The importance of skin disease and the negative impact on individuals is often underestimated by society and by health care professionals. Several studies have demonstrated the negative effect of psoriasis on physical, psychologic, and social functioning.2, 3, 6, 7, 8, 19 This study adds to our understanding of the impact of psoriasis by revealing that palm and sole involvement affects a substantial portion of patients. The data further show that persons with palm and/or sole involvement

References (19)

S.R. Rapp et al.
Psoriasis causes as much disability as other major medical diseases
J Am Acad Dermatol
(1999)
I.H. Ginsburg et al.
Feelings of stigmatization in patients with psoriasis
J Am Acad Dermatol
(1989)
S.R. Feldman et al.
The economic impact of psoriasis increases with psoriasis severity
J Am Acad Dermatol
(1997)
A.B. Fleischer et al.
Disease severity measures in a population of psoriasis patients; the symptoms of psoriasis correlate with self-administered psoriasis area severity index scores
J Invest Dermatol
(1996)
A.B. Fleischer et al.
Patient measurement of psoriasis disease severity with a structured instrument
J Invest Dermatol
(1994)
S.R. Feldman et al.
The self-administered psoriasis area and severity index is valid and reliable
J Invest Dermatol
(1996)
S.C. Weiss et al.
Quantifying the harmful effect of psoriasis on health-related quality of life
J Am Acad Dermatol
(2002)
C. Camisa
Psoriasis
(1994)
S.R. Rapp et al.
Health-related quality of life in psoriasisa biopsychosocial model and measures

There are more references available in the full text version of this article.

Cited by (134)

Quality of Life and Body Region Affected by Psoriasis: A Systematic Review
2023, Actas Dermo-Sifiliograficas
Psoriasis is a chronic skin condition that affects approximately 1–3% of the world's population and is known to decrease patients’ quality of life. However, it is yet to be ascertained whether the specific location of psoriatic lesions on the body influences one's quality of life.
A systematic review was conducted with a search of MEDLINE, EMBASE, and Web of Science databases. Only non-case report and non-review studies with explicitly stated body regions affected by psoriasis were included in the review.
Psoriatic patches and plaques in different areas of the body were not found to influence patients’ quality of life to differing extents.
While the body of evidence is limited and presents unstandardized results, the results of this review point to the fact that all psoriatic patches and plaques decrease patients’ quality of life, with neither one region doing so to a significantly greater extent than another.
La psoriasis es una afección crónica de la piel que afecta aproximadamente el 1-3% de la población mundial con gran impacto negativo en la calidad de vida de los pacientes. Sin embargo, aún no se ha determinado en qué medida la ubicación específica en el cuerpo de las lesiones psoriasis influye en la calidad de vida.
Se realizó una revisión sistemática con una búsqueda en las bases de datos Medline, Embase y Web of Science. En la revisión se descartaron los artículos referidos a casos clínicos y revisiones, incluyéndose solo aquellos en los que se indicó de forma explícita la evaluación por regiones corporales afectadas por psoriasis.
No pudo identificarse una relación entre la presencia de placas de psoriasis en diferentes áreas del cuerpo y la calidad de vida de los pacientes.
Si bien la evidencia es limitada y presenta resultados no estandarizados, los resultados de esta revisión permiten sugerir que la presencia de placas de psoriasis disminuyen la calidad de vida de los pacientes, sin diferencias en función de la región afectada.
Dysregulation of the gut-brain-skin axis and key overlapping inflammatory and immune mechanisms of psoriasis and depression
2021, Biomedicine and Pharmacotherapy
The occurrence, progression and recurrence of psoriasis are thought to be related to mood and psychological disorders such as depression. Psoriasis can lead to depression, and depression, in turn, exacerbates psoriasis. No specific mechanism can explain the association between psoriasis and depression. The gut-brain-skin axis has been used to explain correlations among the gut microbiota, emotional states and systemic and skin inflammation, and this axis may be associated with overlapping mechanisms between psoriasis and depression. Therefore, in the context of the gut-brain-skin axis, we systematically summarized and comparatively analysed the inflammatory and immune mechanisms of psoriasis and depression and illustrated the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and the gut microbiota. This review provides a theoretical basis and new targets for the treatment of psoriasis and depression.
Acquired diffuse palmoplantar erythema with keratoderma in Chinese patients with pustular psoriasis: A predictor for IL36 receptor antagonist c.115+6T>C mutation?
2024, Experimental Dermatology
Palmoplantar psoriasis: A clinico-epidemiological study with special reference to its impact on quality of life
2024, Journal of Pakistan Association of Dermatologists
Effectiveness of Ixekizumab in Chinese Patients with Moderate-Severe Plaque Psoriasis with Special Area Involvement: Subanalysis of a Prospective, Multicenter, Observational Real-World Study
2024, Dermatology and Therapy
Drug survival of biologics and non-biologics in patients affected by palmoplantar psoriasis: a “real-world”, mono-center experience
2024, International Journal of Dermatology

View all citing articles on Scopus

^☆

Supported by the National Institute of Mental Health grant No. MH-51552.

Conflicts of interest: None identified.

View full text

ReportPatients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: implications for clinical practice☆

Abstract

Background

Objective

Methods

Results

Conclusion

Section snippets

Sample

Respondent characteristics

Palm/sole involvement

Discussion

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

J Invest Dermatol

J Invest Dermatol

J Invest Dermatol

J Am Acad Dermatol

Psoriasis

Health-related quality of life in psoriasisa biopsychosocial model and measures

Report
Patients with palmoplantar psoriasis have more physical disability and discomfort than patients with other forms of psoriasis: implications for clinical practice☆