title: Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis.
abstract: BACKGROUND
  The impact of palmoplantar psoriasis on health-related quality of life (QoL) is largely unknown.
  
  
  OBJECTIVE
  We sought to compare clinical characteristics and patient-reported outcomes between patients with palmoplantar psoriasis and moderate to severe plaque psoriasis.
  
  
  METHODS
  We conducted a cross-sectional study of patients with plaque psoriasis (N=1153) and palmoplantar psoriasis (N=66) currently receiving systemic or light treatment for psoriasis.
  
  
  RESULTS
  Patients with palmoplantar psoriasis were more likely to report Dermatology Life Quality Index scores that correspond to at least a moderate impact on QoL (odds ratio [OR] 2.08; 95% confidence interval [CI] 1.20-3.61); problems with mobility (OR 1.98; 95% CI 1.10-3.58), self-care (OR 3.12; 95% CI 1.24-7.86), and usual activities (OR 2.47; 95% CI 1.44-4.22) on the European Quality of Life-5 Dimensions questionnaire; and heavy topical prescription use of at least twice daily in the preceding week (OR 2.81; 95% CI 1.63-4.85) than those with plaque psoriasis.
  
  
  CONCLUSIONS
  Our assessment tools may not account for all dimensions of health-related QoL affected by palmoplantar disease, and these results may not be generalizable to patients with milder forms of psoriasis.
  
  
  CONCLUSIONS
  Patients with palmoplantar psoriasis experience greater health-related QoL impairment and are more likely to report heavy use of topical prescriptions than those with moderate to severe plaque psoriasis.
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Jina
authors.initials: J
authors.lastname: Chung
authors.affiliation: Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Kristina
authors.initials: K
authors.lastname: Callis Duffin
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Junko
authors.initials: J
authors.lastname: Takeshita
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Shin
authors.affiliation: Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Gerald G
authors.initials: GG
authors.lastname: Krueger
authors.affiliation: National Psoriasis Foundation, Portland, Oregon.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Robertson
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Troxel
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Abby S
authors.initials: AS
authors.lastname: Van Voorhees
authors.affiliation: Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana.
authors.forename: Emily
authors.initials: E
authors.lastname: Edson-Heredia
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: joel.gelfand@uphs.upenn.edu.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gelfand
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005528:Foot; D006225:Hand; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011565:Psoriasis / Q000145:classification / Q000473:pathology* / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018434:Sickness Impact Profile; D016896:Treatment Outcome
keywords: epidemiology; health-related quality of life; palmoplantar psoriasis; patient-reported outcomes; plaque psoriasis; psoriasis