How Psoriasis Acceptance Impacts Severity, Itch, and Quality of Life

For individuals with psoriasis, higher disease acceptance was associated with better outcomes, highlighting the importance of addressing psychological resilience alongside physical treatment.¹

For individuals with psoriasis, higher disease acceptance was associated with better outcomes. | Andrey Popov - stock.adobe.com

The cross-sectional study is published in the Journal of Clinical Medicine.

“Beyond the development of coping mechanisms, the effective management of psoriasis requires a comprehensive, interdisciplinary approach that integrates psychological support into routine care,” wrote the researchers of the study. “The study highlights the significant psychological burden of psoriasis, including its impact on self-esteem and social interactions, which underscores the importance of addressing the disease beyond its physical symptoms.”

More than 8 million individuals in the US have psoriasis and psoriatic arthritis, of which there is no cure yet, according to the National Psoriasis Foundation.² Psoriasis is not just a cosmetic problem because nearly 60% of individuals with psoriasis report that the disease causes big problems in everyday life.

In the study, the researchers aimed to assess psoriasis disease acceptance among patients and its correlation with disease severity, itch intensity, and quality of life (QoL).¹

The study was conducted on a cohort of 166 patients from Poland. Patients were required to have a confirmed diagnosis of psoriasis vulgaris for at least 1 year, be aged 18 years or older, and proficient in Polish. Those with other chronic dermatologic conditions or who had received systemic or topical treatments within the 4 weeks prior to the study were excluded. All participants were biologically naïve and presented with psoriasis lesions of varying severity at the time of assessment.

Psoriasis severity was evaluated by a dermatologist using the Psoriasis Area and Severity Index (PASI), while demographic and clinical data were collected through a custom questionnaire. Psychological and quality of life assessments included the Acceptance of Illness Scale (AIS) to measure illness acceptance and the Dermatology Life Quality Index (DLQI) to evaluate the impact of psoriasis on quality of life. Itch intensity was quantified using the Numerical Rating Scale (NRS).

In total, participants had a mean (SD) illness acceptance score of 25.1 (8.7) points. Among participants, 44% exhibited moderate acceptance, while 28% demonstrated high acceptance and an equal proportion (28%) showed low acceptance. No significant differences in acceptance levels were observed between male and female patients. The most challenging aspect of acceptance was adjusting to disease limitations, with a mean (SD) score of 2.47 (1.40), while feelings of dependency and being a burden were the least reported concerns, with mean (SD) scores of 3.7 (1.26) and 3.58 (1.41), respectively.

Illness acceptance was negatively correlated with disease severity, as measured by PASI scores (r = −0.256; P < .001), DLQI (r = −0.600; P < .001), and NRS (r = −0.448; P < .001).

“Education and training for health care providers are pivotal in fostering a better understanding of the psychosocial challenges faced by psoriasis patients,” wrote the researchers. “This training should emphasize the integration of psychological and behavioral strategies into clinical practice, enabling clinicians to provide not only medical treatment but also empathetic, patient-centered care. Furthermore, a holistic management plan that includes the collaboration between dermatologists, psychologists, and social workers can help ensure that patients receive tailored support aimed at enhancing their quality of life and illness acceptance.”

References

1. Bień B, Krajewski PK, Szepietowski JC. Patients' acceptance of psoriasis depends on disease severity, itch intensity, and the patients' quality of life: A cross-sectional study. J Clin Med. 2024;13(24):7684. Published 2024 Dec 17. doi:10.3390/jcm13247684

2. Psoriasis statistics. National Psoriasis Foundation. Accessed January 10, 2025. https://www.psoriasis.org/psoriasis-statistics/.