Clear Skin a Clinical Distinction in QOL with Psoriasis

Significant differences in quality of life (QOL) and use of prescription topical medication exist between patients with clear skin compared to patients with almost clear skin, ultimately suggesting that clear skin is the indicator of the level of psoriasis severity. Junko Takeshita, MD, PhD, and colleagues found there is
little evidence to determine the treatment goals of moderate-to-severe psoriasis. The team conducted a study to determine the Dermatology Life Quality Index scores and prescription topical medication use between patients with clear skin compared to those without clear skin.
 
The multicenter, cross-sectional analysis included 441 patients with almost clear skin and 97 patients with clear skin currently receiving phototherapy or systemic therapy for plaque psoriasis. Patients with clear skin compared to patients with almost clear skin were more likely to note no impact of psoriasis on QOL (relative risk, 1.6; 95% confidence interval [CI], 1.37-1.86). Plaque psoriasis patients with clear skin compared to almost clear skin were more likely to report there was no use of prescription topical medication in the preceding week (relative risk, 2.08; 95% CI, 1.73-2.49). The researchers noted one study limitation. Because the researchers utilized a cross-sectional analysis, it prohibited longitudinal assessment of psoriasis patient outcomes.
 
The differences in QOL and the use of prescribed topical medication of psoriasis patients who reported clear skin compared to patients who reported almost clear skin was significant. The results suggest that a clinical difference between moderate psoriasis and severe psoriasis may be the attainment of clear skin.
 
Takeshita J, Callis Duffin K, Shin DB, et al. Patient-reported outcomes for psoriasis patients with clear versus almost clear skin in the clinical setting. J Am Acad Dermatol. Published online ahead of print June 10, 2014.