Factors Associated with Quality of Life among Patients with Chronic Plaque Psoriasis in Southern Sri Lanka

Abstract

Chronic plaque psoriasis (CPP) is an inflammatory skin disease with considerable negative impact on quality of life (QoL). This study investigated the sociodemographic and disease characteristics associated with QoL of patients with CPP. A cross-sectional study was conducted among 297 patients, aged >18 years attending dermatology clinics of Teaching Hospital Karapitiya, General Hospitals Matara and Hambantota. The QoL was assessed by generic and disease specific tools; Sinhala validated versions of Dermatology Life Quality Index (DLQI) and Psoriasis Disability Index (PDI), respectively. Median age (IQR) of study subjects was 55 (42-63) years and 57.6% were males. Nearly 80% had completed secondary school and 46% belonged to the Social class 4. Median psoriasis area severity index (PASI) and the body surface area (BSA) were 4.8 (2.8-10.2) and 9% (4.5-21). According to DLQI, 8% had no impairment of QOL while 57%, 24% and 11% reported mild, moderate and severe impairment of the QoL, respectively. Median PDI score was 6 (3-10) BSA and PASI showed a significant positive correlation with DLQI and PDI (spearman rho BSA_DLQI 0.240, PASI_DLQI 0.183, BSA_PDI 0.32, PASI_PDI 0.31, p<0.01) while age was negatively correlated (spearman rho Age_DLQI -0.26, Age_PDI -0.25, p<0.01) with both DLQI and PDI. Men compared to women, and those with the involvement of head and neck region compared to those without, had greater impairment of QoL. There was no association between the duration of the disease and the QoL. In patients with CPP, greater skin involvement, male gender, head and neck involvement and being young are associated with poor QoL determined by both generic and disease specific tools.