Quality of life of psoriasis and family participation, Vachira phuket hospital.

Abstract

Background: Psoriasis is a common inflammatory skin disease. The present study of severity, knowledge of the psoriasis patient and quality of life of psoriasis among Thai patients with psoriasis is limited. There are many problems that arise from both patient and family’s misunderstanding about the psoriatic disease and lack of continuing care system. Objective: To study clinical data, disease severity, quality of life and to evaluate the problems of the psoriasis patients found in the treatment therapy. Methods: A cross sectional-study was conducted by interviewing 128 psoriasis patients, filled out the questionnaires within six-months period and followed up the severity after the educational of psoriasis had been given to the patients and care givers for three months. Results: The common comorbidities included; dyslipidemia (67.2%), Obesity (53.9%) hypertension (43.8%), metabolic syndrome (42.2%) and diabetes (20.3%). The average BMI of male and female patients were 25.77 kg/m2 and 27.63 kg/m2, waist circumference were 93.72 cm. and 95.71 cm. respectively. Those are higher than the Thai standard. Average age of onset in psoriatic patients was 11.07 years (range 4 to 76 years). The most common type was chronic plaque (94.5%). Parts of the body were scalp (98.4%), arm / legs (88.3%) and trunk (87.5%). The association symptoms were pruritus (84.4%), malaise (29.7%), burning sensation (20.3%) fever (13.3%) and stress (0.8%). Psoriatic arthritis was found 15.6% of the patients and the finger joint was the most common area. 76.6% of thepatients had psoriatic nail consisted of onycholysis (76.5%) and pitting nail (63.3%). 43.8% of the patients were treated with methotrexate (MTX). The most common indication of MTX prescribed was area involvement of psoriasis >10% of BSA. Almost one-fourth of the patients had ever used herbal remedies containing steroid. There was 59.4% of the psoriasis patients had never known how to control the symptoms, 40.6% uneducated about the treatment medications and 33.6% had got the side effect caused from inappropriate use of steroids. Mean of PASI among the psoriasis patients before attended health education was12.78 graded from severity 35.7%, mild 33.3% and moderate 31.0%. After attended health education the mean of PASI had decreased to 6.4 graded in mild 63.3% moderate 21.1% and severe 14.1% in associated with improvement of quality of life (DLQI) and psoriasis disability index (PDI), significantly (p-value <0.001). There were 50% of the psoriasis patients had 3-4 family members. 67.2% of the patients had caregivers mostly are wives. After health education had been given to the psoriasis patients and caregivers mean of PASI decreased in this group compared to the non-caregivers group. The average scores of patients and caregivers concerning to the knowledge of psoriasis disease had increased significantly (p-value <0.001). Conclusions: The level of the disease knowledge in the patients with psoriasis influences their quality of live. Therefore it is indicated for the patients and their families to be involved in the proper educational program.