title: The psychosocial burden of psoriasis.
abstract: BACKGROUND
  Skin diseases such as psoriasis can profoundly influence a patient's self-image, self-esteem, and sense of well-being. Psoriasis is a multifactorial inflammatory condition with a disease burden that extends beyond the physical symptoms experienced by patients. Psoriasis affects all aspects of quality of life, including physical, psychologic, social, sexual, and occupational elements.
  
  
  OBJECTIVE
  The goal of this article was to review the published literature on the impact of psoriasis on quality of life.
  
  
  METHODS
  Relevant studies were identified through a comprehensive search of MEDLINE, EMBASE, and the Derwent Drug File databases of English-language articles published between 1993 and 2005 using the terms psoriasis in combination with quality of life, cost, cost-benefit analysis, economic, employment, days lost, healthcare, hospitalization, managed care, outcomes research, occupation, payers, and psychosocial. The reference lists of identified articles were checked for additional studies that might have been missed in the original searches.
  
  
  RESULTS
  Data suggest that social stigmatization, high stress levels, physical limitations, depression, employment problems and other psychosocial co-morbidities experienced by patients with psoriasis are not always proportional to, or predicted by, other measurements of disease severity such as body surface area involvement or plaque severity.
  
  
  CONCLUSIONS
  It is essential to include measures of psychosocial morbidity when assessing psoriasis severity and treatment efficacy because of the substantial role that psychosocial burden plays in patient perception of disease severity, quality of life, and disease course.
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA. harvardskinstudies@partners.org
authors.forename: Alexa B
authors.initials: AB
authors.lastname: Kimball
authors.forename: Christine
authors.initials: C
authors.lastname: Jacobson
authors.forename: Stefan
authors.initials: S
authors.lastname: Weiss
authors.forename: Mary G
authors.initials: MG
authors.lastname: Vreeland
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
mesh_terms: D000223:Adaptation, Psychological; D000437:Alcoholism / Q000523:psychology; D003863:Depression / Q000523:psychology; D004651:Employment; D006801:Humans; D011565:Psoriasis / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D013240:Stereotyping; D013315:Stress, Psychological / Q000523:psychology; D013405:Suicide / Q000523:psychology