Facial Involvement and the Severity of Psoriasis

Int J Dermatol. 2019 Nov;58(11):1300-1304. doi: 10.1111/ijd.14492. Epub 2019 Jul 26.


Background: Psoriasis is a chronic, inflammatory skin disorder characterized by well-demarcated erythematous-scaly lesions, affecting 0-6.6% of the world population. Facial lesions are neglected in most descriptions in current literature, although some studies indicate that it could be a predictor of psoriasis severity.

Objective: To compare the severity of psoriasis, measured by the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), in patients with and without facial lesions.

Material and methods: This is a cross-sectional study, whose sample size was 63 individuals for each group. Subjects were included in the HUPES Complex Dermatology Service (Salvador/BA - Brazil) from April 2014 to January 2016. Demographic information was obtained using a prestructured form. Assessments of psoriasis severity and quality of life were done using PASI and DLQI, respectively.

Results: Facial lesions were detected on 63 (50.0%) of the 126 patients included. The pinna was the most frequently affected region (63.5%). Mean PASI in the group with facial involvement was 14.0 vs. 6.0, when facial involvement was absent. DLQI means for these groups were, respectively, 7.5 and 4.7.

Conclusions: Facial involvement in a psoriasis patient was a marker of disease severity, and its identification should influence the therapeutic decision.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Brazil
  • Cross-Sectional Studies
  • Facial Dermatoses / complications
  • Facial Dermatoses / diagnosis*
  • Facial Dermatoses / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psoriasis / complications
  • Psoriasis / diagnosis*
  • Psoriasis / pathology
  • Quality of Life*
  • Severity of Illness Index*
  • Skin / pathology