DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20214211

A clinical study to assess disability and stigma associated with psoriasis

Ayesha Khalid, Savita Chaudhary, Kshitij Saxena, Gaurav Paliwal, Chandni Jain, Aliza zaidi

Abstract


Background: Psoriasis relatively common, chronic, inflammatory and hyper-proliferative skin disease that affects 1.4% to 2.0 % of the population. Pateints with psoriasis have to face severe problems with stigmatization, discrimination and negative attitudes in general among the public, and often bear the brunt of public rejection.

Methods: A cross-sectional observational study was carried out on psoriasis patients attending dermatology outpatient department of Era’s Lucknow medical college and hospital between November 2018 and November 2020. Patients with pustular psoriasis, mycosis fungoides, pityriasis rubra pilaris, and other severe medical conditions like heart failure, liver cirrhosis were excluded from the study.

Results: Present study included 170 (aged 16 to 76 years; mean age 37.74±13.70 years; 62.4% males) clinically diagnosed patients of Psoriasis. P-score was observed with increase in Body Surface area, maximum for cases with BSA ≥25%. There was a strong positive significant linear correlation between stigmatization scores and disability scores (r=0.746; p<0.001), thus indicating that with increase in p scores there was a significant increase in PDI scores and vice versa.

Conclusions: Present study showed that feeling of stigmatization and disability was highly prevalent in psoriasis patients. It was seen that stigmatization and disability showed a strong correlation. The findings of study showed that there is need to create awareness regarding psoriasis as a non-communicable disease in order to increase the acceptance of psoriasis patients in society and to reduce their stigmatization.

 


Keywords


Participation scale, Psoriasis disability index, Psoriasis area severity index

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References


Kim N, Thrash B, Menter A. Comorbidities in Psoriasis Patients. Seminars in Cutaneous Medicine and Surgery. 2010;29:10-5.

Ragab HM, El Maksoud NA, Roaiah MMF. Biochemical Significance of Proinflammatory Cytokines in Pso-riasis vulgaris among Egyptian Patients. Journal of American Science. 2010;6(11):374-80.

International Federation of Psoriasis Associations (IFPA). Psoriasis is a Serious Disease Deserving Global At-tention. IFPA. 2012;3.

Zaher HAEM, Amin ME, Rakhawy MY. Coping with Depression and Anxiety In Patients with Psoriasis. Egypt. J. Psychiatry. 2010;31(2):57-63.

Menter A, Gottlieb A, Feldman SR. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;58:826-50.

Gelfand JM, Dommasch E, Shin DB. The Risk of Stroke in Patients with Psoriasis. The Journal of investigative dermatology. 2009;129(10):2411-8.

Gelfand JM. Psoriasis, diabetes, and obesity: weighing the evidence. JAMA dermatology. 2016;152(7):753-4.

Alderson MR, Clarke JA. Cancer incidence in patients with psoriasis. British Journal of Cancer. 1983;47(6):857-9.

Prizment AE, Alonso A, Folsom AR. Association between psoriasis and incident cancer: the Iowa’s Women’s Health Study. Cancer causes & control. 2011;22(7):1003-10.

National Psoriasis Federation (NPF). Psoriasis and Mental Health Issue Brief. NPF Mental Health. 2012;1.

Richards HL, Fortune DG, Griffiths CE, Main CJ. The contribution of perceptions of stigmatisation to disabil-ity in patients with psoriasis. J Psychosomatic Res. 2001;50(1):11-5.

Zachariae R, Zachariae H, Blomqvist K. Quality of life in 6497 Nordic patients with psoriasis. The British Journal of Dermatology. 2002;146(6):1006-16.

Gupta MA, Gupta AK. Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol. 2003;4(12):833-42.

Ayala F, Sampogna F, Romano GV. The impact of psoriasis on work-related problems: a multicenter cross-sectional survey. J Eur Acad Dermatol Venereol. 2014;28:1623-32.

Kimball A, Gieler U, Linder D. Psoriasis: is the impairment to a patient’s life cumulative? J Eur Acad Dermatol Venereol. 2010;24:989-1004.

Warren RB, Kleyn CE, Gulliver WP. Cumulative life course impairment in psoriasis: patient perception of dis-ease-related impairment throughout the life course. Br J Dermatol. 2011;164(1):S1-14.

Da Silva JDT, Müller MC, Bonamigo RR. Coping strategies and stress levels in patients with psoriasis. Anais Brasileiros De Dermatologia. 2006;81(2):143-9.

Jankowiak B, Kowalewska B, Krajewska-Kulak E, Khvorik DF. Stigmatization and Quality of Life in Patients with Psoriasis. Dermatology and Therapy. 2020;10:285-96.

Mahapatro NK, Sampath H, Mishra A. The impact of stress, stigmatization, and psychological morbidity on the quality of life in psoriasis. Ann Indian Psychiatry. 2019;3:161-4.

Łakuta P, Marcinkiewicz K, Bergler-Czop B, Brzezińska-Wcisło L. How does stigma affect people with psori-asis?. Postepy Dermatol Alergol. 2017;34(1):36-41.

Feldman SR, Krueger GG. Psoriasis assessment tools in clinical trials. Ann Rheum Dis. 2005;64(2):ii65-8.

Feldman SR, Malakouti M, Koo JY. Social impact of the burden of psoriasis: effects on patients and practice. Dermatol Online J. 2014;20(8).

Manjula V D, Sreekiran S, Saril P S, Sreekanth M P. A study of psoriasis and quality of life in tertiary care teaching hospital of kottayam, Kerala. Indian J Dermatol. 2011;56:403-6.

Ghorbanibirgani A, Fallahi-Khoshknab M, Zarea K, Abedi H. The Lived Experience of Psoriasis Patients from So-cial Stigma and Rejection: A Qualitative Study. Iran Red Crescent Med J. 2016;18(7):e27893.

Łakuta P, Marcinkiewicz K, Bergler-Czop B, Brzezińska-Wcisło L. How does stigma affect people with psoria-sis?. Postepy Dermatol Alergol. 2017;34(1):36-41.

Kashyap S, Kumar A, Kumar R, Shanker V. Psychiatric morbidity in psoriasis: a study in Himachal Pradesh, India. Int J Res Med Sci. 2016;4:2524-7.

Dimitrov D, Matusiak Ł, Szepietowski JC. Stigmatization in Arabic psoriatic patients in the United Arab Emirates - a cross sectional study. Postepy Dermatol Alergol. 2019;36(4):425-30.

Pichaimuthu R, Ramaswamy P, Bikash K, Joseph R. A measurement of the stigma among vitiligo and psoriasis patients in India. Indian J Dermatol Venereol Leprol. 2011;77:300-6.