A One Year Hospital Based Cross Sectional Study Of Dermatological Life Quality Index (Dlqi) In Psoriasis Patients In Kles Dr Prabhakar Kore Hospital And Medical Research Centre, Belgaum

Abstract

Background and objectives Psoriasis is a chronic disfiguring, inflammatory and proliferative condition of the skin in which both the genetic and environmental factors have a critical role. Psoriasis is linked with social stigma, pain, discomfort, physical disability and psychological stress. Thus the purpose of this study was to assess the impact of psoriasis on quality of life and also to evaluate the psychological distress; anxiety and depression in patients of Psoriasis. Methodology The present one year cross sectional study from January 2014 to December 2014 was done in the Department of Dermatology, Venereology and Leprosy, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum A total of 64 psoriasis patients were examined dermatologically and psychiatrically and then administered the Dermatological Life Quality Index (DLQI), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D). Symptom severity was measured by the Psoriasis Area Severity Index (PASI). Results Majority of patients, 50% were in the age group of 31- 50years. Male to female ratio was 3.1:1. In 17% of patients, the duration of the disease was less than 1year. Stress was initiating or exacerbating factor in 56% of patients. Chronic plaque psoriasis(83%) was the commonest clinical type seen followed by palmoplantar psoriasis. As measured by DLQI scores, psoriasis had small effect on quality of life in 27% of the patients, moderate effect on 20% of patients, very large effect on 33% of patients and extremely large effect on 17% of patients. The mean PASI score was 8.6. Significant correlation was noted between the PASI score and the DLQI. According to Hamilton- anxiety scale, 91% had mild severity and 9% had mild- moderate anxiety. Hamilton-depression scale revealed that, 45% were normal, 33% had mild depression, 14% had moderate, 2% had severe and 6% had very severe depression. With increase in DLQI scores, HAM-A scores were found to increase but it was not statistically significant (P value=0.862).With increase in DLQI scores, Hamilton-D scores were found to increase. The difference was statistically significant (P value- <0.001). Conclusion This study concludes that, psoriasis has a significant negative impact on physical, emotional and psychological wellbeing of the affected patients, thus causing a substantial impact on patient's Quality of life. There is also an association of Psoriasis with psychiatric co-morbidity especially, anxiety and depression.