Psoriasis: severity does not determine quality of life

The clinical challenge posed by psoriasis is much greater than just skin manifestations. In addition to the physical burden of the disease and the co-morbidities linked to it, psoriasis is associated with substantial psychological morbidity, including poor self-esteem and an increased prevalence of anxiety and depression. The practical aspects of living with psoriasis can cause stress and significant disruption to patients’ daily routines. Patients often feel stigmatised and report negative reactions from others, including staring and reactions of disgust. Such experiences, along with the anticipation of further stigmatisation, are likely to contribute to the distress faced by patients and may lead to them avoiding social situations. In one study, 84% of psoriasis patients stated that it was difficult for them to establish social relationships. The substantial negative impact of psoriasis on an individual’s quality of life (QoL) is, therefore, comparable to that of other major conditions, including cancer and heart disease.