Challenges of Working with Psoriasis
Do you feel like your quality of life is slipping as you continue to manage your psoriasis? Maybe you find some additional challenges getting to work, dealing with certain work situations, or staying productive once you get there? If you feel like any of these represent you, know that you are not alone. While it may be obvious that life with psoriasis has these challenges, a recent study has verified that these feelings are pervasive among people with psoriasis and psoriatic arthritis.
What does the research tell us?
Psoriasis and decreased quality of life have been shown in previous studies to be correlated. Examining this relationship more closely when flare-ups or periods of remission are encountered, however, has not been given the same attention in the research. What's more, research on psoriasis and the impact of work has rarely taken into account differences in the level of symptom severity.
A team of researchers recently published a paper in Dermatology Online Journal that quantifies and uncovers the relationship between psoriasis severity, the impact of psoriasis on daily life, and work life as well. Specifically, the study examined nearly 700 people with varying psoriasis severity levels, and also linked their data to information from 200 dermatologists. All of the individuals with psoriasis represented similar demographics, however, they differed in their status or severity of the condition. About one-quarter (24%) of the patients were reported as being in remission, 62% were reported as having active psoriasis that was not currently flaring (and characterized as a moderate level of severity), and the final 15% were reported as having both active and flaring psoriasis (the most severe).
The individuals’ health-related quality of life (HRQoL), as well as their work productivity, were measured using the EuroQOL 5-D Health Questionnaire and the Dermatology Life Quality Index (for HRQoL), and the Work Productivity Activity Index (for work productivity). The Work Productivity Activity Index (WPAI) evaluated levels of job performance including time impaired while at work, overall work impairment, work time missed, and activity impairment. 49% of the individuals surveyed reported missing work specifically due to psoriasis or psoriatic arthritis symptoms.
The study participant scores on the quality of life and work impact were analyzed and the observed relationship between psoriasis severity and impact on work were confirmed regardless of other factors in the model. It may come as no surprised to hear that lower HRQoL levels were associated with increasing psoriasis severity. This means that those who had active and flaring psoriasis reported a lower quality of life than those who had active psoriasis but were not flaring. Also, not surprisingly people with active psoriasis or psoriatic arthritis, regardless of whether they had active flares, had lower quality of life scores than those who were in remission. This same trend was found for the work impact scores as well, indicating that work productivity decreased with increasing psoriasis severity.
What's it mean for you?
This may seem intuitive, especially knowing how frustrating and challenging life with psoriasis can be. However, there is one thing that the researchers note that has important clinical implications. Currently, the goal of psoriasis treatment is often reducing the number of symptoms, the overall severity of symptoms, or reducing the frequency of flare-ups. Very few clinical trials have been conducted where the goal of treatment is complete remission of psoriasis or psoriatic arthritis. While psoriasis treatment options have advanced significantly, and people have been able to reach high levels of clearance of skin lesions, complete remission for people with psoriasis and psoriatic arthritis remains elusive.
Clearly, most patients would prefer complete remission, but it is rarely possible for most people to achieve remission long-term. Remission is particularly challenging for people with moderate to severe psoriasis. Because psoriasis is an autoimmune condition, chronic inflammation means that flare-ups will continue to be a treatment challenge. Substantial reduction of skin symptoms does not always reduce inflammation that causes other damage to your body. Moreover, reducing visible symptoms may not help with fatigue caused by chronic inflammation.
In this study, even those who were classified as "in remission" did have residual symptoms. These symptoms also decreased quality of life and had a negative impact on work, even if they had less of an impact than for people that were not in remission.
Let us know in comments if psoriasis has a negative impact on your ability to work. How does it impact your work? Do you feel like your quality of life decreases when you have flare-ups? What symptoms do you think most affect your quality of life?
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