Quality of life issues
       Quality of life issues (QoL) in psoriasis

        While planning treatment of psoriasis, the treatment providers often forget the impact of psoriasis in the life of an individual patient . Some may consider a single lesion is psychologically devastating while very extensive psoriasis may not be a concern in a few. That is why it as always stated that “Each person has his/ her own psoriasis”. So care should be given to look into various other aspects of the disease than the physical disability . This thought has led to the development of the concept of Quality of Life. Now a days , there are a member of specific tools to measure the QoL in each diseases and also the strategies to tackle the disease. This has led to the introduction of “ Third Dimension in treatment of psoriasis”. With this concept , the treatment of psoriasis includes not only the use of drugs alone but also the modification of psychological aspect of he patient. This has led to the near total care of patient with psoriasis. With the knowledge of metabolic arrangement of psoriasis another dimension has added to treatment of psoriasis is the “fourth dimension”. With this concept the treatment of psoriasis has reached ‘the total care’. Various studies by various agencies has confirmed that the about 80% patients had lowered QoL.
QoL impairment may be due to the physical as well as psychological impact of the disease in the life of the patient. The physical impairment of psoriasis is comparable with that of cancer, heart disease, hypertension , diabetes , arthritis and depression. The physical impact is mostly seen in patients with moderate to severe psoriasis. The physical impairment may have greatest impact in elderly psoriatics. This is more so in patients psoriatic arthritis. In the work place , the physical impact will lead to decreased work productively which in turn results in psychological impairment.
It is well established fact that psoriasis is associated with significant psychological distress. There is more depression and suicidal tendencies than the general population among psoriatics. Many studies have found higher levels of anxiety and excessive worry in patients with psoriasis . It has also been found out that anticipation and avoidant coping behaviors to be significantly associated with psoriasis. These factors not only causes distress but also reduces the efficacy of treatment.
A large number of patients have a perceptive of stigmatization . This will lead to a great disability in patient . So psychological distress negatively impacts a patients quality of life.
The major aim of treatment of psoriasis is to improve the quality of life. Since psoriasis can have such a profound impact on physical and psychological aspects of patients’ lives, the physician must integrate QoL assessments with physical examination in order to make appropriate treatment discussions.

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Kerala, India
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Web: www.amalapsoriasisfoundation.com

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