MedWire News: Researchers have called for the development of new scoring systems for evaluating psoriasis severity that incorporate the symptoms of the disease.
“[The] Psoriasis Area and Severity Index (PASI), the most commonly used measure of severity of psoriasis, does not take symptoms into account,” note Aylin Türel Ermertcan and colleagues.
“This could have been based on the assumption that a perfect correlation exists between PASI scores and the presence and frequency of symptoms.”
To investigate the prevalence of psoriasis symptoms and their relationship with patient characteristics, the team interviewed 87 patients with psoriasis, aged between 16 and 81 years, of whom 51.7% were female.
Pruritus was the most common symptom, affecting 96.6% of patients, followed by burning (56.3%), exudation (56.3%), and bleeding (49.4%). The rarest symptom was “botheration by contact with water” (11.1%).
Aside from pruritus, burning was the most frequent symptom in women, while exudation was the most frequent symptom in men.
Hurting, pain, exudation, and weakness were more often observed in older patients, with the exception of weakness, which was absent in those aged 41–50 years.
Other than pruritus, exudation and bleeding were particularly frequent in patients with localized plaque type psoriasis, affecting 50.0% and 45.8% of patients. Burning (56.0%) was particularly frequent in those with generalized plaque type, and exudation (68.0%) and burning (64.0%) in those with guttate and other types of psoriasis.
The researchers note in the Indian Journal of Dermatology, Venereology and Leprology that “weakness” was the only symptom that was found to be significantly higher in patients with high PASI scores of at least 10.
The frequency of other symptoms were higher (hurting, burning, pruritus, sensitiveness, sleeplessness), equal (bothering by contact with water) or less (pain, bleeding, exudation) in patients with PASI scores of 10 or above compared with those with lower scores.
All symptoms were more frequent in patients with poor quality of life, as measured on the Dermatology Life Quality Index, and all symptoms, except for weakness, were more common in psoriasis patients with than without depression.
“We suggest that dermatologists should be alert to the presence, frequency, and relevance of symptoms experienced by their patients with psoriasis on the evaluation of disease severity both in clinical practice and in clinical trials,” the team concludes.
“It is also important to interrogate these associated symptoms before deciding therapeutic approaches and evaluating their efficacies.”
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