Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis

J Am Acad Dermatol. 2014 Oct;71(4):623-32. doi: 10.1016/j.jaad.2014.04.063. Epub 2014 Jun 2.


Background: The impact of palmoplantar psoriasis on health-related quality of life (QoL) is largely unknown.

Objective: We sought to compare clinical characteristics and patient-reported outcomes between patients with palmoplantar psoriasis and moderate to severe plaque psoriasis.

Methods: We conducted a cross-sectional study of patients with plaque psoriasis (N=1153) and palmoplantar psoriasis (N=66) currently receiving systemic or light treatment for psoriasis.

Results: Patients with palmoplantar psoriasis were more likely to report Dermatology Life Quality Index scores that correspond to at least a moderate impact on QoL (odds ratio [OR] 2.08; 95% confidence interval [CI] 1.20-3.61); problems with mobility (OR 1.98; 95% CI 1.10-3.58), self-care (OR 3.12; 95% CI 1.24-7.86), and usual activities (OR 2.47; 95% CI 1.44-4.22) on the European Quality of Life-5 Dimensions questionnaire; and heavy topical prescription use of at least twice daily in the preceding week (OR 2.81; 95% CI 1.63-4.85) than those with plaque psoriasis.

Limitations: Our assessment tools may not account for all dimensions of health-related QoL affected by palmoplantar disease, and these results may not be generalizable to patients with milder forms of psoriasis.

Conclusion: Patients with palmoplantar psoriasis experience greater health-related QoL impairment and are more likely to report heavy use of topical prescriptions than those with moderate to severe plaque psoriasis.

Keywords: epidemiology; health-related quality of life; palmoplantar psoriasis; patient-reported outcomes; plaque psoriasis; psoriasis.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Age Factors
  • Combined Modality Therapy
  • Confidence Intervals
  • Cross-Sectional Studies
  • Female
  • Foot
  • Hand
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Patient Satisfaction / statistics & numerical data
  • Psoriasis / classification
  • Psoriasis / pathology*
  • Psoriasis / psychology*
  • Psoriasis / therapy
  • Quality of Life*
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Sickness Impact Profile
  • Treatment Outcome