title: Fatigue in psoriasis: a phenomenon to be explored.
abstract: Fatigue is a prevalent and substantial phenomenon in many patients with chronic inflammatory diseases, often rated by patients as the most troublesome symptom and aspect of their disease. It frequently interferes with physical and social functions and may lead to social withdrawal, long-standing sick leave and disability. Although psychological and somatic factors such as depression, sleep disorders, pain and anaemia influence fatigue, the underlying pathophysiological mechanisms by which fatigue is generated and regulated are largely unknown. Increasing evidence points towards a genetic and molecular basis for fatigue as part of the innate immune system and cellular stress responses. Few studies have focused on fatigue in dermatological diseases. Most of these studies describe fatigue as a phenomenon related to psoriatic arthritis and describe the beneficial effects of biological agents on fatigue observed in clinical studies. It is therefore possible that this problem has been underestimated and deserves more attention in the dermatological community. In this review, we provide a definition and explanation for chronic fatigue, describe some commonly used instruments for measuring fatigue, and present hypothetical biological mechanisms with an emphasis on activation of the innate immune system and oxidative stress. An overview of relevant clinical studies covering the theme 'psoriasis and fatigue' is given.
authors.affiliation: Department of Dermatology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: I M
authors.initials: IM
authors.lastname: Skoie
authors.affiliation: Department of Dermatology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Ternowitz
authors.affiliation: Department of Medical Biochemistry, Stavanger University Hospital, Stavanger, Norway.
authors.forename: G
authors.initials: G
authors.lastname: Jonsson
authors.affiliation: Clinical Immunology Unit, Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Norheim
authors.affiliation: Clinical Immunology Unit, Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway.|Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
authors.forename: R
authors.initials: R
authors.lastname: Omdal
mesh_terms: D001685:Biological Factors / Q000627:therapeutic use; D002908:Chronic Disease; D003863:Depression / Q000150:complications; D005221:Fatigue / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D015673:Fatigue Syndrome, Chronic / Q000209:etiology; D006801:Humans; D011565:Psoriasis / Q000150:complications*; D012893:Sleep Wake Disorders / Q000150:complications
chemical_list: D001685:Biological Factors