Title: Comparison of PASI and DLQI among Out-Patients Andin-Patients with Psoriasis in a Tertiary Care Centre

Authors: Karpagavalli.R, Prasad P.V.S, Kaviarasan.P.K, Dr Asokkumar, Kannambal.K

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.130

Abstract

Psoriasis is a chronic condition strongly affecting social stigmatization, comfort, physical disability and psychological distress.  It is important to define the severity of psoriasis, but it is also important to identify psoriasis, that severely affects the quality of life. Psoriasis causes great physical, emotional and social burden.1

Aim: To compare the DLQI at the time of presentation and follow up the inpatients and outpatients of the tertiary care centre.

Materials and Methods: This study consisted of 60 patients (30 out-patients and 30 in-patients) with psoriasis. In all patients, clinical severity and quality of life were assessed using PASI and DLQI questionnaire respectively. Psychiatric status was assessed for all patients individually with the help of psychiatric (MHC) department using Hamilton scoring systems. The quality of life was assessed in all patients using DLQI questionnaire again, after one week.

Results: On comparison, the DLQI of in-patients was decreased from the mean of 15.5 to 10.63 with a ‘p’ value of 0.005, and in patients attending outpatient department there was no significant improvement with DLQI after one week of follow up. It shows that, hospitalization had improved the quality of life in psoriatic patients due to adequate treatment care, psychiatric intervention (counselling), Physical medicine and rehabilitation (Yoga therapy) and absence of precipitating factors like alcohol, smoking and stress affecting the quality of life during the stay.

Keywords: Psoriasis, PASI, DLQI, Psychiatric morbidity.

References

  1. Finally AY. Quality of life measurement in dermatology: A practical guide Br J Dermatol 1997; 136:305-4.
  2. Finlay AY. Quality of life indices. Indian J Dermatol Venereol Leprol 2004; 70:143-8. 43.
  3. Gupta MA, Schork NJ, Gupta AK, Kirkby S, Ellis CN: Suicidal ideation in psoriasis. Int J Dermatol 1993, 32: 188–190.
  4. Henseler, T. and E. Christophers (1985). "Psoriasis of early and late onset: characterization of two types of psoriasis vulgaris." J Am Acad Dermatol 13(3): 450-6.
  5. Ashcroft, D. M., A. L. Wan Po, et al. (1999). "Clinical measures of disease severity and outcome in psoriasis: a critical appraisal of their quality." Br J Dermatol 141(2): 18591 20.
  6. Lewis V, Finlay ten years of experience of dermatology life quality index (DLQ1). J Invest Dermatolsympproc 2004;9:169-80.1
  7. Susana Coimbra1, Hugo Oliveira, Américo Figueiredo, Petronila Rocha-Pereira1, and Alice Santos-Silva1,. Psoriasis: Epidemiology, Clinical and Histological Features, Triggering Factors, Assessment of Severity and Psychosocial Aspects. intechopen.com.
  8. Lewis V, Finlay AY 20 years’ experience of psoriasis disability index under (po1) J Dermatol 2004; 151 (suppl 68): 50-1
  9. Stern, R. S., T. Nijsten, et al. (2004). "Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction." J Investig Dermatol Symp Proc 9(2): 136-9.
  10. Burns, Tony, Breathnach, Stephen; Cox, Neil, Griffiths, Christopher, Rook Text Book of Dermatology, 8th Edition.
  11. Nevitt, G. J. and P. E. Hutchinson (1996). "Psoriasis in the community: prevalence, severity and patients' beliefs and attitudes towards the disease." Br J Dermatol 135(4): 533-7.
  12. Dogra S, Yadav. S, Psoriasis in India: Prevalence and Pattern. Indian J Dermatol Venerol Leprol. 2010; 76: 595-601.
  13. Gaikwad R, Deshpande S, Raje S, Dhamdhere DV, Ghate MR. Evaluation of functional impairment in psoriasis. Indian J Dermatol Venereol Leprol 2006;72:37-40.
  14. Bedi TR. Psoriasis in north India. Geographical variations. Dermatologica 1977; 155:310-4.
  15. Kimball AB, Jacobson C, Weiss S, et al. The psychosocial burden of psoriasis. Am J Clin Dermatol 2005; 6 (6): 383–92
  16. Vensel E, Hilley T, Trent J, Taylor JR, Kirsner RS, Kerdel FA, et al. Sustained improvement of quality of life of patients with psoriasis after hospitalization. J Am Acad Dermatol 2000;43:858-60.

Corresponding Author

Karpagavalli.R

Post Graduate, Department of Dermatology Venereology and Leprosy,

Rajah Muthiah Medical College & Hospital,

Annamalai University, Chidambaram, India – 608002