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      Psoriasis in special localizations

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          Abstract

          Psoriasis is a chronic inflammatory dermatosis affecting 1–3% of the general population. Patients with psoriasis represent a heterogeneous population with individual disease expression – different degrees and severity of skin involvement. Psoriatic lesions in particular localizations such as the face, scalp, intertriginous or palmoplantar areas significantly reduce quality of life. Patients often feel ashamed, embarrassed, or self-conscious about their symptoms. Furthermore, genital psoriasis significantly affects sexual health. Among patients with psoriasis, the prevalence of special localizations is estimated to be 23–27% on the nails, 49% on the face, 12–16% on the palms and soles, and up to 36% in intertriginous regions. Due to peculiar features of skin in these areas, adequate and specific management is required, which is discussed in this review.

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          Most cited references 43

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          A systematic review of worldwide epidemiology of psoriasis

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            European patient perspectives on the impact of psoriasis: the EUROPSO patient membership survey.

             ,  T Lotti,  S. Chimenti (2006)
            EUROPSO (European Federation of Psoriasis Patient Associations) undertook a Europe-wide survey examining quality of life and patients' perspectives on treatment and their disease. To explore patients' perspectives of psoriasis on their lifestyle and well-being and to gain insight into the effectiveness of and satisfaction with currently available therapies for psoriasis. Self-administered questionnaires (n = 50,500) were mailed to members of psoriasis patient associations in Belgium, the Czech Republic, Finland, France, Germany, Italy and the Netherlands. Responses were received from 18,386 patients (36%), of whom 17,990 had psoriasis. Mean age at onset of psoriasis was 30.5 years, 59% of respondents had self-reported moderate to severe psoriasis (3% or greater body surface area involvement) and 30% had been diagnosed with psoriatic arthritis. The mean Psoriasis Disability Index score was 12.2 (25% of the maximum score), increasing to 21 (44%) in patients with more than 10% body surface area involvement. The greatest impact was on activities of daily living, especially affecting clothing choice, bathing routine and sporting activities. Overall, 77% replied that psoriasis was a problem or a significant problem. While patients were satisfied with the information and care from their dermatologist (40% highly satisfied), available treatment options were less satisfactory, with over 70% reporting only low to moderate satisfaction. This is the largest survey of people with psoriasis in Europe and shows that psoriasis has a profound impact on quality of life.
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              How patients experience psoriasis: results from a European survey.

               L Adjadj,  S Fouéré,  H Pawin (2005)
              Most of the psoriasis that affects the European population is treated with topical preparations. Compliance rates, however, are known to be quite low. To provide an update on how psoriasis is experienced by patients and how well these patients comply with prescribed topical treatment. This was an observational and transversal survey conducted in 1281 patients with psoriasis. Patient input alone formed the basis of the study. Participants were contacted through the national psoriasis patient associations in France, the United Kingdom, Belgium, Germany and the Netherlands. The study showed that 32% of the patients suffer currently from psoriasis in the face, skin folds and genital areas--areas very sensitive to topical treatments. Most of the patients (74%) considered their psoriasis as at least moderately severe, and 73% stated not to comply with their current treatment. Lack of efficacy and messiness of the treatment were the main reasons for non-compliance, an element that is especially important for the use in sensitive areas such as the face, skin folds and genitalia. The present survey confirmed that cosmetic acceptability is, together with efficacy and safety, a very important aspect of a successful treatment of psoriasis.
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                Author and article information

                Journal
                Reumatologia
                Reumatologia
                RU
                Reumatologia
                Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie
                0034-6233
                2084-9834
                23 December 2018
                2018
                : 56
                : 6
                : 392-398
                80718
                10.5114/reum.2018.80718
                6330687
                Copyright: © 2018 Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

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