title: The economic impact of psoriasis increases with psoriasis severity.
abstract: BACKGROUND
  Psoriasis treatments are known to be costly, but little is known about the financial impact of psoriasis and the way in which it relates to the severity of the disease.
  
  
  OBJECTIVE
  This study was performed to obtain an estimate of the treatment costs faced by patients with psoriasis.
  
  
  METHODS
  A total of 578 anonymous mail surveys were distributed to patients with psoriasis; 318 surveys were returned (55%). Psoriasis severity was assessed with the previously validated Self-Administered Psoriasis Area Severity Index (SAPASI).
  
  
  RESULTS
  The total and out-of-pocket expenses to care for psoriasis were correlated with psoriasis severity (r = 0.26, p = 0.0001). There were no sex (p = 0.9) or racial (p = 0.4) differences in total expenditures. Severity was correlated with how bothersome to the patient was the cost of treatment (r = 0.30, p = 0.0001), the time required for treatment (r = 0.38, p = 0.0001), and the time lost from work (r = 0.23, p = 0.0001). Lower quality of life at work and in money matters also correlated with severity of psoriasis. Higher family income was associated with less time spent caring for psoriasis and less interference with work around the home.
  
  
  CONCLUSIONS
  As expected, the expenses caring for psoriasis are greater for patients with more severe disease. These costs and other financial implications are associated with lower quality of life for patients with more severe psoriasis.
authors.affiliation: Department of Dermatology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Feldman
authors.forename: A B
authors.initials: AB
authors.lastname: Fleischer
authors.forename: D M
authors.initials: DM
authors.lastname: Reboussin
authors.forename: S R
authors.initials: SR
authors.lastname: Rapp
authors.forename: D D
authors.initials: DD
authors.lastname: Bradham
authors.forename: M L
authors.initials: ML
authors.lastname: Exum
authors.forename: A R
authors.initials: AR
authors.lastname: Clark
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living; D001294:Attitude to Health; D044383:Black People; D017281:Cost of Illness; D005260:Female; D005382:Financing, Personal; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D007182:Income; D008297:Male; D011565:Psoriasis / Q000191:economics* / Q000503:physiopathology; D011788:Quality of Life; D012648:Self Care; D012647:Self-Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D044465:White People; D014937:Work