The study investigators measured degree of disease severity and improvement in QOL by analyzing the mean change of CDLQI score per PASI and BSA response, which were divided into four groups: 0 to <50, 50 to <75, 75 to <90, and ≥90. They used the mean CDLQI change in each treatment category to examine which treatment type was associated with the most impact to QOL.
According to the study, patients who achieved PASI ≥90 or BSA ≥90 experienced the greatest improvement to QOL with the estimated marginal mean changes in CDLQI scores of -6.6 (95% CI, -7.5 to -5.7) and -6.8 (95% CI, -7.5 to -6.1), respectively.
These results appear to be in line with previous studies that have examined the relationship between PASI score and improvement to QOL in both adults and pediatric patients2 with psoriasis, according to the study.
The researchers note, however, that the relationship between BSA involvement and QOL appears to be a unique finding.
“To our knowledge, the association between BSA decrease and QOL improvement has never been investigated in children and adults,” they write. Though more research is needed, the authors go on to suggests that, due to these results, dermatologists may want to consider using BSA as a tool to assess psoriasis in practice.
Dermatologists should also keep in mind that pediatric patients with psoriasis may see the greatest benefit to QOL when treated with conventional systemic or biological therapies. In this analysis, researchers found the most improved change in CDLQI score in participants receiving systemic treatments (conventional systemic and biological therapies, EMM change in CDLQI -5.8 [95% CI, -6.7 to -4.9] and -5.8 [95% CI, -7.5 to -4.1], respectively) vs. those receiving topical therapies (topical and dithranol, EMM change in CDLQI -4.3 [95% CI, -4.8 to -3.8] and -4.2 [95% CI, -4.9 to -3.5], respectively).
1. Bruins FM, Bronckers IMGJ, Groenewoud HMM, et al. Association Between Quality of Life and Improvement in Psoriasis Severity and Extent in Pediatric Patients. JAMA Dermatol. 2019;
2. Langley RG, Paller AS, Hebert AA, et al. Patient-reported outcomes in pediatric patients with psoriasis undergoing etanercept treatment: 12-week results from a phase III randomized controlled trial. J Am Acad Dermatol. 2011;64(1):64-70.