title: Patient-reported outcomes for psoriasis patients with clear versus almost clear skin in the clinical setting.
abstract: BACKGROUND
  There is little evidence to guide the establishment of treatment goals for moderate to severe psoriasis in the clinical setting.
  
  
  OBJECTIVE
  We sought to compare Dermatology Life Quality Index scores and prescription topical medication use between patients with clear versus almost clear skin.
  
  
  METHODS
  This was a multicenter cross-sectional study of 97 patients with clear skin and 441 patients with almost clear skin receiving current systemic therapy or phototherapy for a primary indication of plaque psoriasis evaluated at 1 of 10 US outpatient dermatology sites participating in the Dermatology Clinical Effectiveness Research Network.
  
  
  RESULTS
  In adjusted analyses, patients with clear versus almost clear skin were more likely to report no impact of psoriasis on quality of life (relative risk 1.60; 95% confidence interval 1.37-1.86). Patients with clear versus almost clear skin were also more likely to report no prescription topical medication use in the preceding week (relative risk 2.08; 95% confidence interval 1.73-2.49).
  
  
  CONCLUSIONS
  Cross-sectional design prohibits longitudinal assessment of outcomes.
  
  
  CONCLUSIONS
  Clinically important differences in quality of life and prescription topical medication use exist between patients with clear versus almost clear skin. Collectively, our results indicate that achievement of clear skin may be an important clinical distinction among patients with moderate to severe psoriasis.
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: Junko.Takeshita@uphs.upenn.edu.
authors.forename: Junko
authors.initials: J
authors.lastname: Takeshita
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; Department of Biostatistics and Epidemiology, 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: Department of Biostatistics and Epidemiology, 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: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gelfand
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010789:Phototherapy / Q000379:methods; D011565:Psoriasis / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D018570:Risk Assessment; D057566:Self Report; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D016896:Treatment Outcome; D014481:United States
chemical_list: D003879:Dermatologic Agents
keywords: Dermatology Life Quality Index; Physician Global Assessment; Psoriasis Area and Severity Index; patient-reported outcome; psoriasis; quality of life