Background: Psoriasis has a great impact on the quality of life of patients, and the ageing population is an important public health issue. Objectives: To investigate whether older patients with psoriasis have a diffe...Background: Psoriasis has a great impact on the quality of life of patients, and the ageing population is an important public health issue. Objectives: To investigate whether older patients with psoriasis have a different impairment in quality of life compared with younger patients, considering level of severity, duration of disease, gender and psychological distress. Methods: The study was performed between February 2000 and February 2002 at the inpatient wards of the Dermatological Institute IDI-IRCCS, Rome, Italy, in the framework of a large project on clinical, epidemiological, emotional and quality of life aspects of psoriasis (IMPROVE study). This is a hospital-based cross-sectional study, with measures of quality of life (Skindex-29, Dermatology Life Quality Index and Psoriasis Disability Index) and of psychological distress, generic (12-item General Health Questionnaire) and psoriasis-related (Psoriasis Life Stress Inventory), all self-asses- sed by patients. We compared the mean scores of each quality of life instrument in patients aged < 65 years and ≥65 years, in subsets of patients based on clinical and sociodemographic characteristics. Results: We analysed 936 patients hospitalized at IDI-IRCCS with a diagnosis of psoriasis. Quality of life was significantly more impaired in the older group for all the Skindex-29 scales, and psychological distress was higher in older patients. In particular, older women suffering from anxiety or depression had the greatest impairment in quality of life. The results were somewhat different using the other quality of life instruments. Conclusions: These results should alert dermatologists that similar levels of clinical severity in psoriasis may be associated with different levels of quality of life and psychological distress of patients. Particular attention should be devoted to older patients, and especially to older women.展开更多
Background: The main dermatology textbooks describe only in passing pruritus in psoriasis and rarely mention other symptoms. A quantification of the presence of symptoms is not available for clinical subgroups of psor...Background: The main dermatology textbooks describe only in passing pruritus in psoriasis and rarely mention other symptoms. A quantification of the presence of symptoms is not available for clinical subgroups of psoriasis. Objectives: T o investigate the prevalence of symptoms experienced by patients with different clinical types of psoriasis. Methods: The study was carried out in patients hosp italized for psoriasis between February 2000 and February 2002 at the inpatient wards of the Istituto Dermopatico dell’Immacolata, Rome, Italy. Symptoms were evaluated using the symptoms scale of Skindex- 29. Clinical severity was assess ed by the dermatologists using the Psoriasis Area and Severity Index (PASI), and by the patients completing the self-administered PASI. Psychiatric morbidity was evaluated using the 12- item General Health Questionnaire. Results: In tota l, 936 eligible patients were analysed. The proportions of patients experiencing symptoms often or always in the 4 weeks before hospitalization were: 63.8% it ching, 59.7% irritation, 46.1% burning/stinging, 39% sensitivity, 26% pa in (from 10% in guttate psoriasis to 50% in arthropathic)- , 25.4% bleedi ng (17% pustular, 19% localized plaque, 36% palmoplantar), and 23.9% bot hered by water (from 8.5% in the guttate form to 68% in palmoplantar). The p revalence of all symptoms was significantly higher in women and tended to increa se with clinical severity. Conclusions: Our study provides evidence of the high frequency of a number of symptoms in different subgroups of psoriasis patients d etermined by their sociodemographic characteristics, clinical type and disease s everity. Symptoms represent a serious disabling factor in patients affected by p soriasis, including those with low levels of psychological distress. Dermatologi sts should include symptoms in the evaluation of disease severity both in clinic al practice and in clinical trials.展开更多
Background: There is a need for reliable, easily measurable laboratory markers that may help dermatologists to predict the course of mycosis fungoides (MF) when they first evaluate their patients. Objectives: Our obje...Background: There is a need for reliable, easily measurable laboratory markers that may help dermatologists to predict the course of mycosis fungoides (MF) when they first evaluate their patients. Objectives: Our objective was to identify clinical, haematological or immunological parameters as predictors of mortality in patients with MF. Methods: We conducted a retrospective study on a prevalent cohort of 124 patients with MF hospitalized at IDI-IRCCS, Rome, Italy, from 1983 to 2001. We calculated the proportion of patients surviving (Kaplan-Meier product-limit estimates) 5 and 10 years after first hospital admission, and hazard ratios (HR) from the Cox proportional hazards model. Results: Patients’survival was linked to age and staging (lower survival in older patients and in patients with staging IIB-IV). Higher numbers of white blood cells (WBC) and neutrophils, lower numbers of CD8+lymphocytes, low haematocrit and lower levels of albumin were significantly associated with a lower survival probability. When simultaneously accounting for age and staging, CD8+[HR = 3.02, 95%confidence interval (CI) 1.01-9.07 for CD8+< 250 vs. ≥600 cells μL-1] and WBC (HR = 2.59, 95%CI 0.96-6.96 for WBC ≥9000 vs. < 6000 cells μL-1) were associated with survival. In addition, we observed an exceedingly high risk of death (HR = 12.40, 95%CI 3.11-49.43) for patients with a combination of WBC ≥9000 and CD8+< 600 cells μL-1 vs. WBC < 9000 and CD8+≥600 cells μL-1). Conclusions: The measurement of CD8+cells and WBC in MF seems to be a promising criterion to predict survival, and possibly to support treatment decisions and inclusion of patients in randomized controlled trials.展开更多
文摘Background: Psoriasis has a great impact on the quality of life of patients, and the ageing population is an important public health issue. Objectives: To investigate whether older patients with psoriasis have a different impairment in quality of life compared with younger patients, considering level of severity, duration of disease, gender and psychological distress. Methods: The study was performed between February 2000 and February 2002 at the inpatient wards of the Dermatological Institute IDI-IRCCS, Rome, Italy, in the framework of a large project on clinical, epidemiological, emotional and quality of life aspects of psoriasis (IMPROVE study). This is a hospital-based cross-sectional study, with measures of quality of life (Skindex-29, Dermatology Life Quality Index and Psoriasis Disability Index) and of psychological distress, generic (12-item General Health Questionnaire) and psoriasis-related (Psoriasis Life Stress Inventory), all self-asses- sed by patients. We compared the mean scores of each quality of life instrument in patients aged < 65 years and ≥65 years, in subsets of patients based on clinical and sociodemographic characteristics. Results: We analysed 936 patients hospitalized at IDI-IRCCS with a diagnosis of psoriasis. Quality of life was significantly more impaired in the older group for all the Skindex-29 scales, and psychological distress was higher in older patients. In particular, older women suffering from anxiety or depression had the greatest impairment in quality of life. The results were somewhat different using the other quality of life instruments. Conclusions: These results should alert dermatologists that similar levels of clinical severity in psoriasis may be associated with different levels of quality of life and psychological distress of patients. Particular attention should be devoted to older patients, and especially to older women.
文摘Background: The main dermatology textbooks describe only in passing pruritus in psoriasis and rarely mention other symptoms. A quantification of the presence of symptoms is not available for clinical subgroups of psoriasis. Objectives: T o investigate the prevalence of symptoms experienced by patients with different clinical types of psoriasis. Methods: The study was carried out in patients hosp italized for psoriasis between February 2000 and February 2002 at the inpatient wards of the Istituto Dermopatico dell’Immacolata, Rome, Italy. Symptoms were evaluated using the symptoms scale of Skindex- 29. Clinical severity was assess ed by the dermatologists using the Psoriasis Area and Severity Index (PASI), and by the patients completing the self-administered PASI. Psychiatric morbidity was evaluated using the 12- item General Health Questionnaire. Results: In tota l, 936 eligible patients were analysed. The proportions of patients experiencing symptoms often or always in the 4 weeks before hospitalization were: 63.8% it ching, 59.7% irritation, 46.1% burning/stinging, 39% sensitivity, 26% pa in (from 10% in guttate psoriasis to 50% in arthropathic)- , 25.4% bleedi ng (17% pustular, 19% localized plaque, 36% palmoplantar), and 23.9% bot hered by water (from 8.5% in the guttate form to 68% in palmoplantar). The p revalence of all symptoms was significantly higher in women and tended to increa se with clinical severity. Conclusions: Our study provides evidence of the high frequency of a number of symptoms in different subgroups of psoriasis patients d etermined by their sociodemographic characteristics, clinical type and disease s everity. Symptoms represent a serious disabling factor in patients affected by p soriasis, including those with low levels of psychological distress. Dermatologi sts should include symptoms in the evaluation of disease severity both in clinic al practice and in clinical trials.
文摘Background: There is a need for reliable, easily measurable laboratory markers that may help dermatologists to predict the course of mycosis fungoides (MF) when they first evaluate their patients. Objectives: Our objective was to identify clinical, haematological or immunological parameters as predictors of mortality in patients with MF. Methods: We conducted a retrospective study on a prevalent cohort of 124 patients with MF hospitalized at IDI-IRCCS, Rome, Italy, from 1983 to 2001. We calculated the proportion of patients surviving (Kaplan-Meier product-limit estimates) 5 and 10 years after first hospital admission, and hazard ratios (HR) from the Cox proportional hazards model. Results: Patients’survival was linked to age and staging (lower survival in older patients and in patients with staging IIB-IV). Higher numbers of white blood cells (WBC) and neutrophils, lower numbers of CD8+lymphocytes, low haematocrit and lower levels of albumin were significantly associated with a lower survival probability. When simultaneously accounting for age and staging, CD8+[HR = 3.02, 95%confidence interval (CI) 1.01-9.07 for CD8+< 250 vs. ≥600 cells μL-1] and WBC (HR = 2.59, 95%CI 0.96-6.96 for WBC ≥9000 vs. < 6000 cells μL-1) were associated with survival. In addition, we observed an exceedingly high risk of death (HR = 12.40, 95%CI 3.11-49.43) for patients with a combination of WBC ≥9000 and CD8+< 600 cells μL-1 vs. WBC < 9000 and CD8+≥600 cells μL-1). Conclusions: The measurement of CD8+cells and WBC in MF seems to be a promising criterion to predict survival, and possibly to support treatment decisions and inclusion of patients in randomized controlled trials.
