Correlation between Dermatology Life Quality Index and Psoriasis Area and Severity Index in Patients with Psoriasis: A Cross-sectional Global Healthcare Study on Psoriasis

Authors

  • Julia-Tatjana Maul Faculty of Medicine, University of Zurich, Zurich, Switzerland; Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
  • Lara V. Maul Faculty of Medicine, University of Zurich, Zurich, Switzerland; Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Department of Dermatology, University Hospital Basel, Basel, Switzerland
  • Johannes A. Didaskalu Faculty of Medicine, University of Zurich, Zurich, Switzerland
  • Fernando Valenzuela Department of Dermatology, University of Chile, Santiago, Chile
  • Ricardo Romiti Department of Dermatology, University of São Paulo, School of Medicine, São Paulo, Brazil
  • Hannah Peterson Loma Linda University School of Medicine, Loma Linda, California, USA
  • Edwin Korouri Rosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, Illinois, USA
  • Farah Novoa Department of Dermatology, Jockey Salud Medical Center, Lima, Peru
  • Hazel H. Oon Department of Dermatology, National Skin Centre, Singapore
  • Min Zheng 10) Dermatology Department, Second Affiliated Hospital, Zhejiang University, School of Medicine, Zhejiang, China
  • Jashin J. Wu Department of Dermatology, University of Miami Miller School of Medicine, Miami, USA
  • Jacob P. Thyssen Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
  • Alexander Egeberg Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
  • April W. Armstrong Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  • Mia-Louise Nielsen Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark

DOI:

https://doi.org/10.2340/actadv.v104.20329

Keywords:

correlation, cross-sectional study, DLQI, GHSP, PASI, psoriasis

Abstract

Quality of life impairment in dermatology patients and severity of psoriasis are quantified by the Dermatology Life Quality Index (DLQI) and the Psoriasis Area and Severity Index (PASI), respectively. The aim of this study is to compare the correlation between PASI and DLQI in patients from different geographical areas and to identify predictors of high DLQI across geographical regions. Correlations between PASI and DLQI were evaluated using Spearman’s rank correlation tests and quantile regression. The study included 1,158 patients with psoriasis, with a median (interquartile range) PASI and DLQI of 6.0 (3.0–12.0) and 8.0 (4.0–15.0), respectively. Correlations were demonstrated between PASI and DLQI, both overall and stratified by geographical region. Quantile (median) regression yielded coefficients of 0.75 (95% confidence interval (95% CI) 0.62, 0.88) for Switzerland, 0.50 (95% CI 0.42, 0.58) for Latin America, 0.34 (95% CI 0.16, 0.51) for Asia, and 0.31 (95% CI 0.08, 0.53) for the USA. Current age, age at diagnosis, sex, body mass index, and psoriasis arthritis affected DLQI in Latin America, while education had an impact among patients treated in Switzerland. Few countries were included within each continent; hence, more data from different countries are necessary for generalizability. The study showed correlations between PASI and DLQI among patients in all included geographical regions. The patients’ characteristics affecting DLQI vary worldwide.

Downloads

Download data is not yet available.

References

Parisi R, Symmons DPM, Griffiths CEM, Ashcroft DM. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol 2013; 133: 377-385.

https://doi.org/10.1038/jid.2012.339 DOI: https://doi.org/10.1038/jid.2012.339

Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM, et al. National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ 2020; 369: m1590-m1590.

https://doi.org/10.1136/bmj.m1590 DOI: https://doi.org/10.1136/bmj.m1590

Alinaghi F, Calov M, Kristensen LE, Gladman DD, Coates LC, Jullien D, et al. Prevalence of psoriatic arthritis in patients with psoriasis: a systematic review and meta-analysis of observational and clinical studies. J Am Acad Dermatol 2019; 80: 251-265.e19.

https://doi.org/10.1016/j.jaad.2018.06.027 DOI: https://doi.org/10.1016/j.jaad.2018.06.027

Iskandar IYK, Ashcroft DM, Warren RB, Yiu ZZN, McElhone K, Lunt M, et al. Demographics and disease characteristics of patients with psoriasis enrolled in the British Association of Dermatologists Biologic Interventions Register. Br J Dermatol 2015; 173: 510-518.

https://doi.org/10.1111/bjd.13908 DOI: https://doi.org/10.1111/bjd.13908

Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial infarction in patients with psoriasis. JAMA 2006; 296: 1735-1741.

https://doi.org/10.1001/jama.296.14.1735 DOI: https://doi.org/10.1001/jama.296.14.1735

Rapp SR, Feldman SR, Exum ML, Fleischer AB, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol 1999; 41: 401-407.

https://doi.org/10.1016/S0190-9622(99)70112-X DOI: https://doi.org/10.1016/S0190-9622(99)70112-X

Maul J-T, Navarini AA, Sommer R, Anzengruber F, Sorbe C, Mrowietz U, et al. Gender and age significantly determine patient needs and treatment goals in psoriasis - a lesson for practice. J Eur Acad Dermatol Venereol 2019; 33: 700-708.

https://doi.org/10.1111/jdv.15324 DOI: https://doi.org/10.1111/jdv.15324

Maul J-T, Augustin M, Sorbe C, Conrad C, Anzengruber F, Mrowietz U, et al. Association of sex and systemic therapy treatment outcomes in psoriasis: a two-country, multicentre, prospective, noninterventional registry study. Br J Dermatol 2021; 185: 1160-1168.

https://doi.org/10.1111/bjd.20387 DOI: https://doi.org/10.1111/bjd.20387

Blome C, Gosau R, Radtke MA, Reich K, Rustenbach SJ, Spehr C, et al. Patient-relevant treatment goals in psoriasis. Arch Dermatol Res 2016; 308: 69-78.

https://doi.org/10.1007/s00403-015-1613-8 DOI: https://doi.org/10.1007/s00403-015-1613-8

de Ruiter CC, Rustemeyer T. Biologics can significantly improve Dermatology Life Quality Index (DLQI) in psoriatic patients: a systematic review. Psoriasis (Auckland, NZ). 2022; 12: 99-112.

https://doi.org/10.2147/PTT.S356568 DOI: https://doi.org/10.2147/PTT.S356568

Nast A, Smith C, Spuls PI, Avila Valle G, Bata-Csörgö Z, Boonen H, et al. EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris - Part 1: treatment and monitoring recommendations. J Eur Acad Dermatol Venereol 2020; 34: 2461-2498.

https://doi.org/10.1111/jdv.16915 DOI: https://doi.org/10.1111/jdv.16915

Nast A, Smith C, Spuls PI, Avila Valle G, Bata-Csörgö Z, Boonen H, et al. EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris - Part 2: specific clinical and comorbid situations. J Eur Acad Dermatol Venereol 2021; 35: 281-317.

https://doi.org/10.1111/jdv.16926 DOI: https://doi.org/10.1111/jdv.16926

Strober B, Ryan C, van de Kerkhof P, van der Walt J, Kimball AB, Barker J, et al. Recategorization of psoriasis severity: Delphi consensus from the International Psoriasis Council. J Am Acad Dermatol 2020; 82: 117-122.

https://doi.org/10.1016/j.jaad.2019.08.026 DOI: https://doi.org/10.1016/j.jaad.2019.08.026

Mattei PL, Corey KC, Kimball AB. Psoriasis Area Severity Index (PASI) and the Dermatology Life Quality Index (DLQI): the correlation between disease severity and psychological burden in patients treated with biological therapies. J Eur Acad Dermatol Venereol 2014; 28: 333-337.

https://doi.org/10.1111/jdv.12106 DOI: https://doi.org/10.1111/jdv.12106

Valenzuela F, De La Cruz C, Lecaros C, Fernández J, Hevia G, Maul LV, et al. Comorbidities in Chilean patients with psoriasis: a Global Healthcare Study on Psoriasis. Clin Exp Dermatol 2022; 47: 2234-2241.

https://doi.org/10.1111/ced.15384 DOI: https://doi.org/10.1111/ced.15384

Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI) - a simple practical measure for routine clinical use. Clin Exp Dermatol 1994; 19: 210-216.

https://doi.org/10.1111/j.1365-2230.1994.tb01167.x DOI: https://doi.org/10.1111/j.1365-2230.1994.tb01167.x

Norris D, Photiou L, Tacey M, Dolianitis C, Varigos G, Foley P, et al. Biologics and dermatology life quality index (DLQI) in the Australasian psoriasis population. J Dermatolog Treat 2017; 28: 731-736.

https://doi.org/10.1080/09546634.2017.1329501 DOI: https://doi.org/10.1080/09546634.2017.1329501

Puig L, Thom H, Mollon P, Tian H, Ramakrishna GS. Clear or almost clear skin improves the quality of life in patients with moderate-to-severe psoriasis: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2017; 31: 213-220.

https://doi.org/10.1111/jdv.14007 DOI: https://doi.org/10.1111/jdv.14007

Muslimani MA, Bolcato V, de Silvestri A, Brazzelli V. Psoriatic patients undergoing long-term therapy with biologics: impact of residual localization of psoriasis on quality of life in an Italian clinical setting. Dermatol Ther 2020; 33: e14337.

https://doi.org/10.1111/dth.14337 DOI: https://doi.org/10.1111/dth.14337

Houghton K, Patil D, Gomez B, Feldman SR. Correlation between change in Psoriasis Area and Severity Index and Dermatology Life Quality Index in patients with psoriasis: pooled analysis from four phase 3 clinical trials of secukinumab. Dermatol Ther (Heidelb) 2021; 11: 1373-1384.

https://doi.org/10.1007/s13555-021-00564-2 DOI: https://doi.org/10.1007/s13555-021-00564-2

Maul J-T, Fröhlich F, Maul LV, Stunnenberg R, Valenzuela F, De La Cruz C, et al. Access to psoriasis treatment in Brazil and Chile: a cross-sectional multicentre Global Healthcare Study on Psoriasis. Br J Dermatol 2023; 188: 533-441.

https://doi.org/10.1093/bjd/ljac128 DOI: https://doi.org/10.1093/bjd/ljac128

Virtanen P, Gommers R, Oliphant TE, Haberland M, Reddy T, Cournapeau D, et al. SciPy 1.0-Fundamental Algorithms for Scientific Computing in Python. CoRR 2019; abs/1907.1. Available from: http://arxiv.org/abs/1907.10121

Seabold S, Perktold J. statsmodels: Econometric and statistical modeling with python. In: 9th Python in Science Conference. 2010.

https://doi.org/10.25080/Majora-92bf1922-011 DOI: https://doi.org/10.25080/Majora-92bf1922-011

Hunter JD. Matplotlib: A 2D Graphics Environment. Comput Sci Eng 2007; 9: 90-95.

https://doi.org/10.1109/MCSE.2007.55 DOI: https://doi.org/10.1109/MCSE.2007.55

Damiani G, Bragazzi NL, Karimkhani Aksut C, Wu D, Alicandro G, McGonagle D, et al. The Global, regional, and national burden of psoriasis: results and insights from the Global Burden of Disease 2019 Study. Front Med 2021; 8: 743180.

https://doi.org/10.3389/fmed.2021.743180 DOI: https://doi.org/10.3389/fmed.2021.743180

Nijsten T, Meads DM, de Korte J, Sampogna F, Gelfand JM, Ongenae K, et al. Cross-cultural inequivalence of dermatology-specific health-related quality of life instruments in psoriasis patients. J Invest Dermatol 2007; 127: 2315-2322.

https://doi.org/10.1038/sj.jid.5700875 DOI: https://doi.org/10.1038/sj.jid.5700875

Chicharro P, Llamas-Velasco M, Armesto S, Herrera-Acosta E, Vidal D, Vilarrasa E, et al. Fast and sustained improvement of patient-reported outcomes in psoriatic patients treated with secukinumab in a daily practice setting. Dermatol Ther 2022; 35: e15653.

https://doi.org/10.1111/dth.15653 DOI: https://doi.org/10.1111/dth.15653

Ruiz-Villaverde R, Vasquez-Chinchay F, Rodriguez-Fernandez-Freire L, C Armario-Hita J, Pérez-Gil A, Galán-Gutiérrez M. Super-responders in moderate-severe psoriasis under guselkumab treatment: myths, realities and future perspectives. Life (Basel) 2022; 12: 1412.

https://doi.org/10.3390/life12091412 DOI: https://doi.org/10.3390/life12091412

Strober B, Papp KA, Lebwohl M, Reich K, Paul C, Blauvelt A, et al. Clinical meaningfulness of complete skin clearance in psoriasis. J Am Acad Dermatol 2016; 75: 77-82.e7.

https://doi.org/10.1016/j.jaad.2016.03.026 DOI: https://doi.org/10.1016/j.jaad.2016.03.026

Loft ND, Egeberg A, Rasmussen MK, Bryld LE, Gniadecki R, Dam TN, et al. Patient-reported outcomes during treatment in patients with moderate-to-severe psoriasis: a Danish nationwide study. Acta Derm Venereol 2019; 99: 1224-1230.

https://doi.org/10.2340/00015555-3331 DOI: https://doi.org/10.2340/00015555-3331

Published

2024-03-12

How to Cite

Maul, J.-T., Maul, L. V., Didaskalu, J. A., Valenzuela, F., Romiti, R., Peterson, H., … Nielsen, M.-L. (2024). Correlation between Dermatology Life Quality Index and Psoriasis Area and Severity Index in Patients with Psoriasis: A Cross-sectional Global Healthcare Study on Psoriasis. Acta Dermato-Venereologica, 104, adv20329. https://doi.org/10.2340/actadv.v104.20329