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Patients with Severe Psoriasis Suffer Daily, Study Finds

Psoriasis significantly reduces quality of life, according to researchers at Wake Forest University Baptist Medical Center.

In a paper published Sept. 1 in the Journal of the American Academy of Dermatology, Stephen Rapp, Ph.D., Steve Feldman, M.D., Ph.D., and others reported that psoriasis patients had the second-poorest physical functioning and the third-poorest mental functioning of 11 health conditions studied, ranging from hypertension, diabetes and depression to cancer, chronic lung disease and congestive heart failure.

The results contradict an earlier study that found the quality of life of psoriasis patients to differ little from the general population.

"Previous studies looked only at patients with mild to moderate psoriasis whose disease was stable," said Rapp, an associate professor of psychiatry and behavioral medicine, and the lead author of the paper. "When we included patients with severe psoriasis in the mix, we found that it is very debilitating, both physically and mentally."

Psoriasis is a chronic disease that leaves the skin red, scaly, uncomfortable and easily irritated. Anyone with psoriasis covering more than 10 percent of his or her body is considered to have a severe case.

The paper noted that psoriasis afflicts about 2 percent of the U.S. population, costs $2 billion to $3 billion a year to treat, and is associated with a higher risk of suicide.

The study looked at 317 psoriasis patients at Wake Forest University Baptist Medical Center who used a standardized form to rate their quality of life in eight areas. The results were compared with quality of life surveys of patients suffering from other diseases, using the same form.

Of 11 other diseases evaluated in the study, the researchers found that only patients with congestive heart failure reported poorer physical functioning than patients with severe psoriasis. Only patients with depression and chronic lung disease reported poorer mental functioning.

"These results indicate that psoriasis can be physically and emotionally debilitating even though it is not life-threatening," Rapp said. "It is not simply a cosmetic nuisance."

Gail M. Zimmerman, president and CEO of the National Psoriasis Foundation, said the paper will help the foundation in its efforts to gain more public attention and support for psoriasis research.

"Psoriasis is a disease that is often misperceived by the public and even the medical community," she said. "This study makes an important contribution in pointing to the debilitating effects of psoriasis."

Although the study population was limited, the authors noted that the distribution of mild, moderate and severe cases within the study group is representative when compared with other surveys of psoriasis patients.

Depending on the case, psoriasis is treated with ointments, light therapy or oral medications. But, Rapp said, the study points out the need for the medical community to develop treatments for psoriasis patients that not only control their disease, but protect their quality of life.

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