Psoriasis severity in PsA 'mostly mild,' still detrimental t
Psoriasis is “mostly mild” in patients with psoriatic arthritis yet still impacts quality of life when measured using a dermatology-specific questionnaire, according to data published in Rheumatology.

year of follow-up and analyze whether its impact on health-related quality of life can be measured with a dermatology-specific questionnaire, researchers studied data from the Dutch Southwest Early Psoriatic Arthritis (DEPAR) cohort. According to the researchers, DEPAR includes newly diagnosed patients with PsA who receive usual care. Focusing on data between July 2013 and March 2020, the researchers included a total of 644 patients from the cohort.

For their study, researchers measured psoriasis severity using the Psoriasis Area and Severity Index (PASI), with dermatology-specific HRQoL assessed with the Skindex-17 questionnaire. According to the researchers, this questionnaire includes 17 questions that patients answer on a 5-point Likert scale. To illustrate psoriasis severity throughout the first year of follow-up, the researchers used a Sankey diagram.

In addition, the researchers performed a linear regression analysis, with hierarchical variable selection, and a zero-inflated negative binominal regression analysis to assess the association between psoriasis severity and the symptoms, as well as the psychosocial subscale of the Skindex-17, respectively.

According to the researchers, 17% of the included patients demonstrated no psoriasis (PASI = 0), while 71% had mild cases (PASI less than 7), 9% were moderate (PASI =7-12) and 4% were severe (PASI more than 12). Psoriasis severity remained largely stable during the first year of follow-up, they added. Lastly, PASI was “significantly associated” with both subscales of the Skindex-17 questionnaire at baseline and 1 year, the researchers wrote.

“Psoriasis severity in PsA patients is mostly mild but impacts HRQoL when measured using a dermatology-specific HRQoL questionnaire,” researchers wrote. “For optimal management of PsA patients, we therefore recommend rheumatologists to additionally acquire information on the degree of psoriatic involvement and not merely ask patients about their general well-being. In our opinion, this information is valuable for the adequate assessment of HRQoL.”