DLQI as a major criterion for introduction of systemic agents in patients with mild psoriasis

BACKGROUND: Psoriasis is a skin inflammatory chronic disease with negative physical, psychological and social repercussions for those affected. However, patients suffering from mild disease also complain about negative impact on their quality of life, making it difficult for physicians to choose the best treatment strategy. OBJECTIVES: Understanding the impact of systemic treatments on Quality of Life (QoL) in patients with mild psoriasis in daily practice. METHODS: This is a monocentric retrospective study analysing patients affected by mild psoriasis [Psoriasis Area and Severity Index (PASI) ≤ 6]. Patients were divided into two groups, depending on the treatment decision taken by the physicians: patients who received local and/or UV light therapies and patients who were treated with systemic therapies as a first choice. PASI and Dermatology Life Quality Index (DLQI) scores were measured at each visit. RESULTS: Patients who received systemic therapies as a first choice reported higher QoL impairment, mainly due to psoriasis lesions localized on visible areas. During Follow-up, this group showed better improvement of PASI score and DLQI compared to patients receiving local and/or UV light treatment. CONCLUSIONS: Our findings highlight the potential benefit of using systemic therapies in patients with mild psoriasis and high QoL impairment. This study will help physicians to make the right therapeutic decision in patients suffering from mild psoriasis.