Psoriasis in old age: impact of aesthetical and functional damage on the quality of life in a study on 120 patients

Background. Psoriasis is associated with skin and/or joint lesions that cause aesthetical damage and limit movements. These can determine psychosocial troubles in subjects with low social engagement, as old patients. Objective. To describe the assessment tools, to appraise the damage and the psychosocial impact of psoriasis in old subjects. Methods. 60 men and 60 women, aged 65-82 years were enrolled in this study. The following assessment tools were used: skin damage by the Psoriasis Area and Severity Index (PASI); joints damage by the ultrasound test (US); functional damage by the Range of Motion (ROM); psychosocial troubles by the synthetic Italian inventory of personality (ITAPI-S) and the questionnaire on the quality of the life (DLQI). Results. Skin lesions were present in 105 patients (87,5%), arthritis in 46 patients (38,3%), psychosocial troubles in 97 cases (84,9%). The clinical importance has been described in the four progressive stages. There was a statistically significant correlation among the US, ROM, ITAPI-S and DLQI scores. Discussion. The "visible" lesions and the reduction in articular "movement" can produce uneasiness and difficulty of relationship (socialization). These psychosocial troubles can impact on the quality of life and produce a "psoriatic" personality. Conclusions. The tools described can help to define the diagnosis, evaluate the treatment and appraise the skin or aesthetical, articular or functional and psychosocial damages.