ABSTRACT
Patients with psoriasis suffer from the effects of a chronic illness. One of the most bothersome aspects of the disease is a sense of loss of 'control.' 'Perceived control' is an important and well-studied psychological concept. The literature on perceived control offers guidance to help improve the physician-patient relationship and outcomes in chronic diseases such as psoriasis. Practical suggestions include the use of materials and other resources offered by patient advocacy groups (such as those from the National Psoriasis Foundation) and the development of a physician-patient relationship that gives the patient a sense of control of their disease.
Subject(s)
Internal-External Control , Physician-Patient Relations , Psoriasis/psychology , Psoriasis/therapy , Self Care , HumansABSTRACT
Alpha hydroxy acids are used extensively by patients and consumers for restorative cutaneous purposes. The current study of 32 patients evaluated the clinical and psychosocial effects of this cosmetic therapy. After 12 weeks, significant clinical improvements were found for facial skin tone and fine wrinkling, as well as for patient-reported satisfaction with physical appearance and with marital or relationship quality.
Subject(s)
Body Image , Cosmetics/therapeutic use , Hydroxy Acids/therapeutic use , Quality of Life , Skin/drug effects , Adult , Cosmetics/pharmacology , Face , Female , Humans , Hydroxy Acids/pharmacology , Male , Middle Aged , Personal Satisfaction , Skin Aging/drug effectsABSTRACT
BACKGROUND: Psoriasis remains a chronic disease with lesions that are often extensive and disfiguring. While the potential for psychosocial morbidity and impairment are recognized, the literature remains equivocal with regard to the prevalence and degree of this impairment. METHODS: The present study utilized a new questionnaire designed to assess the type and degree of psychosocial impairment present among psoriasis patients. The questionnaire was designed to assess major areas of psychosocial functioning and was completed by 64 patients undergoing outpatient treatment. RESULTS: Approximately half the patients were found to have moderate to extreme levels of anxiety, depression, and anger. Patients reported experiencing these negative emotional sequelae both during their disease flares and during periods of remission. Patients were also found to have moderate to extreme levels of pruritus associated with their flares. Psychologic morbidity was positively associated with length of disease flare. Significant levels of social embarrassment, life disruption, and social withdrawal were found as well. CONCLUSIONS: Psoriasis does appear to cause significant psychosocial morbidity. Greater awareness by physicians and more comprehensive treatment addressing these psychosocial components may avert, or at least minimize, some of these negative sequelae.
Subject(s)
Psoriasis/physiopathology , Psoriasis/psychology , Anger , Anxiety , Depression , Disease Progression , Humans , Life Change Events , Morbidity , Psoriasis/epidemiology , Risk Factors , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
Psychogenic pruritus and self-excoriation are diagnoses of exclusion. Elimination of traditional organic causes often leads the clinician to label a symptom as psychogenic in origin and limits treatment options. This article examines the organic and psychologic causes and concomitants of dermatologic conditions associated with pruritus and self-excoriation. An organized cognitive framework is presented to guide the clinician in the evaluation and treatment of these patients. Specific treatment options are offered and relevant psychopharmacologic agents are reviewed.
