Psoriasis - The Life Course Approach.
Over the last decades, Life Course Research (LCR), predominantly the domain of sociology, has been increasingly applied in health research, as Life Course Epidemiology (LCE). The latter is concerned with disease patterns over time, accumulation of exposures over time, critical time periods and patterns of risk. We argue that concepts from LCR and LCE could be widely applied in dermatology, in general, and, more precisely, in the study of chronic inflammatory skin diseases, e.g. atopic eczema and psoriasis. The life course approach can generally be applied in two different ways. It may be used in the more traditional manner, in which the disease and its patterns over time are examined as the outcome vari-able. Conversely, it can examine life course as the outcome variable, which is dependent on the disease course, the treatments administered, and other physical or psychosocial environmental exposures. In dermatology, this second application of the LCR concepts is both promising and relevant because of the notable impact of chronic skin diseases on the patients' quality of life. In particular, we argue how LCR may be conducive to a better understanding of the concept of 'Cumulative Life Course Impairment', which is increasingly gaining acceptance. This approach helps identifying not only individuals at risk and particularly vulnerable patients but also critical periods for optimising interventions in order to avoid life course impairment. It also may facilitate more appropriate treatment decisions in clinical practice.
Department of Dermatology, University of Padua, IT-35122 Padua, Italy. michael.dennis.linder@gmail.com.
Michael Dennis
MD
Linder
Stefano
S
Piaserico
Matthias
M
Augustin
Anna Belloni
AB
Fortina
Arnon D
AD
Cohen
Uwe
U
Gieler
Gregor B E
GB
Jemec
Alexa Boer
AB
Kimball
Andrea
A
Peserico
Francesca
F
Sampogna
Richard B
RB
Warren
John
J
de Korte
D000223:Adaptation, Psychological; D002908:Chronic Disease; D017281:Cost of Illness; D006801:Humans; D008016:Life Change Events; D011565:Psoriasis / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life