Why do psoriasis patients report better QoL amid COVID-19?

Patients with psoriasis report improved quality of life under the COVID-19 pandemic despite harsh movement restrictions, a recent study has found. Such an effect, however, may suggest that current tools do not completely capture the negative impacts of harsh lockdowns on patients’ wellbeing.

The study included 103 patients who participated in the present retrospective longitudinal assessment. All had moderate-to-severe psoriasis undergoing biologic treatment. Quality of life was measured using the Dermatology Life Quality Index (DLQI), and scores were compared from before vs during the pandemic. Disease severity, as measured by the Psoriasis Area and Severity Index, was also assessed.

Of the participants, 19 had additional psoriatic arthritis. The study sample was predominantly men (74 vs 29) and had a median age of 54 years. The most common biologic treatment was anti-IL-23 antibodies (n=39), followed by anti-IL17A (n=30), anti-IL-12/23 (n=25), and anti-tumour necrosis factor alpha (n=9).

Mean DLQI score shortly before COVID-19 hit was 5.6, which improved to a mean of 2.7 under harsh lockdown restrictions.

However, looking at the DLQI scales individually, the researchers noted that questions regarding social activities, shopping, and leisure, as well as self-perception and personal interactions, were rated as not relevant by patients. This, in turn, may lead to an artificial improvement of quality of life.

“This paradoxical improvement of DLQI during the COVID-19 pandemic suggests that DLQI should be modified when social life is restricted, as these scores evaluated under restrictions do not reflect the true extent of negative impact on life quality,” the researchers said.