title: Low-dose cyclosporin improves the health-related quality of life in Japanese psoriasis patients dissatisfied with topical corticosteroid monotherapy.
abstract: Psoriasis greatly impacts the health-related quality of life of patients, including any dermatological conditions that are listed in the dermatology life quality index (DLQI). We investigated the relationships between DLQI and the degree of patient satisfaction using questionnaires among psoriasis patients treated only with topical corticosteroids. Patients who were dissatisfied with topical corticosteroids alone and agreed to receive cyclosporin were given low-dose oral cyclosporin. We assessed changes of the DLQI and the psoriasis area and severity index (PASI) scores in patients dissatisfied with treatment during the period of cyclosporin addition. Of 32 enrolled patients, 17 reported dissatisfaction with the current treatment of topical corticosteroids alone. There was a significantly positive correlation between the degree of patient satisfaction questionnaires and the DLQI of these 32 patients. Among the 17 dissatisfied patients, 12 patients agreed to receive additional cyclosporin therapy and five did not. The 12 patients who started on cyclosporin had a significantly lower PASI after 12 weeks than they did at baseline. The DLQI improved significantly after 12 weeks in the cyclosporin-treated patients. The 12 patients who agreed to receive cyclosporin showed a significantly lower DLQI at 12 weeks compared to the five patients who declined the addition of cyclosporin to their treatment. Assessing the degree of patient satisfaction with therapy using a questionnaire could be useful for improving clinical interventions in psoriasis patients. Low-dose oral cyclosporin could be effective in patients who are dissatisfied with topical corticosteroid treatment alone.
authors.affiliation: Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, 67 Asahimachi, Fukuoka, Japan. hashimot@med.kurume-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Tamihiro
authors.initials: T
authors.lastname: Kawakami
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tsuruta
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hamada
authors.forename: Yohei
authors.initials: Y
authors.lastname: Natsuaki
authors.forename: Shunpei
authors.initials: S
authors.lastname: Fukuda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koga
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Sogame
authors.forename: Bungo
authors.initials: B
authors.lastname: Ohyama
authors.forename: Fumitake
authors.initials: F
authors.lastname: Ono
authors.forename: Tadashi
authors.initials: T
authors.lastname: Karashima
authors.forename: Takekuni
authors.initials: T
authors.lastname: Nakama
authors.forename: Teruki
authors.initials: T
authors.lastname: Dainichi
authors.forename: Norito
authors.initials: N
authors.lastname: Ishii
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yasumoto
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007564:Japan; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011565:Psoriasis / Q000188:drug therapy*; D011788:Quality of Life; D012720:Severity of Illness Index
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D016572:Cyclosporine