Understanding Patients’ Perception of Symptoms with Psoriasis and Psoriatic Arthritis
Sinead Maguire; Una Martin; Paula Dreelan; Mary Dunphy; Michael O'Connell; Claire Sheehy
Departments of Rheumatology & Dermatology University Hospital Waterford Waterford
Psoriatic disease includes both psoriasis (PS) and psoriatic arthritis (PsA), which typically affect both the skin and joints in addition to systemic features. These diseases are managed jointly between Rheumatology and Dermatology departments using a myriad of treatment options. Due to the wide range of symptoms affecting these diseases, it can be a challenge for the clinician to understand the importance of certain symptoms from a patient perspective, which can have implications in terms of treatment priorities and disease severity.
To improve understanding of patients’ perception of their symptoms to aid assessment of disease severity, ongoing level of disease activity and need for further treatment in the setting of PS and PsA.
This was an opt-in cross sectional study of patients with PS and PsA attending the Rheumatology and Dermatology outpatient departments at University Hospital Waterford. A survey was designed to gather patient perception of their symptoms. The focus of the surveys was on symptoms commonly associated with both PS and PsA. Symptoms were ranked from most to least problematic in terms of overall skin and joint features.
Fifty-four patients completed the surveys, of which 29 patients had PsA and 25 had PS. The average duration of disease was 16.4 years with most patients currently taking a combination of biologic and topical treatments. Of the patients with PsA, joint pain was considered the most problematic while flaking of skin the least problematic. Of the PsA patients with skin disease, they tended to have more severe redness and nail problems than PS patients. For PS pruritis was ranked as the most problematic while painful skin was the least troublesome. Very few PS patients reported eye symptoms(8%) while over 70% reported fatigue. The PsA patients rarely encountered difficulty at work due to their disease, however a large proportion had difficulty with social encounters and sleep.
This study provides insight into symptoms which patients consider of high importance. Improved awareness and screening for these symptoms would aid clinician assessment of disease severity and the functional impact on activities of daily living thus guiding the need for further treatment.