title: Self-reported psoriasis severity and quality of life assessment at Comano spa.
abstract: The relationship between quality of life (QoL) and skin lesion improvement due to psoriasis treatment has been recently underlined. Our objective was to study the self-reported disease severity reduction and QoL during spa treatments and identify predictors of psoriasis improvement. Patients were assessed before and after spa treatment with a disease-specific QoL questionnaire (Skindex-17) and self-administered psoriasis area and severity index (SAPASI). Their correlations were tested. Factors predicting a reduction in Skindex-17 or in SAPASI score were evaluated through regression analysis. Significant mean overall reductions in SAPASI (27%) and Skindex-17 scores (psychosocial: 6%; symptoms: 2%) were achieved. However, 51% of patients reporting SAPASI improvement also reported a worsened QoL. Pearson's correlation between the SAPASI and Skindex-17 scores was poor (r=0.26 for SAPASI-symptoms and r=0.40 for SAPASI-psychosocial). Logistic regression analysis identified the age of psoriasis onset before 30 years (OR=3.81, 95% CI 1.22-11.95, p=0.02) and a basal Skindex-17 symptoms value greater than 5 (OR=3.37, 95% CI 1.12-10.08, p=0.03) as predictive of both SAPASI and Skindex-17 score reductions. Age-of-onset-based stratification identifies the subset most likely to respond to spa treatment. Combining the Skindex-17 with SAPASI provides a more comprehensive patient-centered assessment. We recommend this assessment for psoriasis patients undergoing spa treatment.
authors: Health Services Research Unit, IRCCS, Via Monti di Creta 104, 00167 Rome, Italy. calogero.pagliarello@libero.it
authors: Calogero
authors: C
authors: Pagliarello
authors: Anna
authors: A
authors: Calza
authors: Cristina
authors: C
authors: Di Pietro
authors: Stefano
authors: S
authors: Tabolli
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D001452:Balneology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011565:Psoriasis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology*; D057566:Self Report; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014467:Ultraviolet Therapy