Article
Voici un extrait qui présente les principales caractéristiques de la section Discussion :
We confirmed the finding that a general instrument (SF-36) reveals a major impact of psoriasis on patients’ lives even though this instrument was not especially designed to detect the burden of skin disease. In this study of quality of life in patients with moderate-to-severe psoriasis, we found more bodily pain and lower social functioning than those reported in a large Dutch reference population. There was no significant correlation between disease severity and disease area, as measured by PASI, and SF-36 scores. However, like Finlay and Coles (1995), we found that psoriasis lesions located on visible parts of the body correlated significantly with aspects of quality of life, in particular, mental health.
This study is limited because most of the patients had quite extensive disease and the study population was relatively homogeneous, which might have had an influence on identifying variations in the burden of the disease. Our study contrasts sharply with earlier investigations in which patients with a wider range of psoriasis severity were examined.
Because patients had a wash-out period of 2 to 4 weeks, we could not completely rule out the possibility that his wash-out period had an impact on disease severity. Therefore, we compared the PASI before and after the wash-out period and found no relevant differences (data not shown).
(…)
Our results do not demonstrate a significant correlation between clinical symptoms and quality of life. It is very likely that cosmetic disfigurement and itching determine the burden of the disease. These are not captured by the disease severity scores or by the generic quality-of-life instruments. To measure these, disease-specific instruments can be used, whereas generic quality-of-life instruments enable comparisons with other groups. We therefore believe that our results support the decision to use disease-specific instruments (to measure the burden of the disease) in combination with a generic instrument (to measure general health-related quality of life) to evaluate the impact of disease severity in psoriasis.