Quality of Life in Patients with Psoriasis Seen in the Department of Dermatology, Antananarivo, Madagascar

BACKGROUND: Psoriasis is a chronic, inflammatory, and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision-making along with the effectiveness and the harmlessness of the treatments. OBJECTIVE: To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales. METHODS: A cross-sectional study from January to June 2018 was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, including patients more than 18 years old with mild to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales. RESULTS: 80 patients were included, their mean age was 36.5 years, and the male to female was 1.5 : 1. The mean DLQI score was 13.8. Symptoms, feelings, and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p = 0.36). Furthermore, the clinical presentation of psoriasis did not influence the patient's QoL (p = 0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p = 0.2). The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p = 0.002). Furthermore, the higher the PASI, the more QoL is altered (p = 0.002). CONCLUSION: Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.