Quality of Life of Patients with Psoriasis Seeking Care from Out Patient Department (OPD) of a Tertiary Care Centre of South India Assessed by Dermatology Life Quality Index (DLQI) and its Correlation

Introduction: Psoriasis causes considerable psychosocial disability and has a major impact on patients' quality of life. A proper assessment of the quality of life may help the doctor to individualize the treatment plan to suit the patient's needs for a better outcome. Objectives: To assess the Dermatological Life Quality Index (DLQI) of patients with psoriasis and to find out the correlation between Psoriasis Area Severity Index (PASI) and DLQI and any other factor affecting the DLQI of patients with psoriasis. Materials and Methods: A cross sectional study was conducted between August 1 and September 30, 2017 by enrolling new, clinically diagnosed consecutive psoriasis patients attending the outpatient department of Dermatology in Sree Gokulam Medical College, Venjaramoodu, Thiruvananthapuram. Assessment of the severity of disease was carried out by using PASI. Malayalam version of DLQI questionnaire was administered to the patients to assess the quality of life. Results: Thirty three patients who were clinically diagnosed with psoriasis were included in the study and their mean age was 50.9 years. About one third of the patients had either hypertension, diabetes mellitus or dyslipidemia. Majority (72.7%) of patients in the study had chronic plaque psoriasis. Itching was a major symptom in 31(93.9%) patients. Joint pain and nail changes were present in 12.1% patients each. The mean score of PASI was 10.23 with range of 1 to 35 and the mean score of DLQI was 8.67. Visual Analogue Scale Score (VASS) for itching had a significant, moderately strong positive correlation to DLQI. PASI had a strong correlation to DLQI. The presence of skin lesions on the forearms and upper chest and nail changes were found to be significantly associated with higher DLQI score. However on multiple linear regression analysis, PASI was found to be the only significant predictor of DLQI. Conclusion: PASI remains the single most important predictor of the dermatology quality of life of patients with psoriasis. But other factors like presence of pruritus, nail changes and presence of skin lesions in emotionally charged body regions may also be taken into account while assessing the quality of life.