Fatigue in psoriasis - a controlled study

Abstract

Background

Fatigue is associated with various chronic inflammatory diseases, but few studies have focused on its occurrence in psoriasis.

Objectives

To describe fatigue prevalence and degree among patients with chronic plaque psoriasis compared with age- and gender-matched healthy subjects, and to examine how fatigue is influenced by essential clinical and demographic factors.

Methods

In 84 patients and 84 healthy subjects, fatigue severity was assessed using three different generic fatigue instruments: the fatigue Visual Analogue Scale (fVAS), the Fatigue Severity Scale (FSS), and the Short Form 36 (SF-36) vitality scale. Cut-off scores for clinically important fatigue were defined as ≥4 for FSS, ≥50 for fVAS, and ≤35 for SF-36 vitality scale. Disease activity was evaluated using the Psoriasis Area and Severity Index (PASI) and the impact on quality of life (QoL) with the Dermatology Life Quality Index (DLQI).

Results

Patients and healthy control subjects, respectively, showed median fVAS scores of 51 (IQR 46) and 11 (IQR 17), FSS scores of 4 (IQR 2·8) and 1·6 (IQR 1·1), and SF-36 vitality scores of 43 (IQR 85) and 73 (IQR 20). The rates of clinically important fatigue among patients vs. healthy controls, respectively, were 51% vs. 4%, (fVAS), 52% vs. 4% (FSS), and 42% vs. 2% (SF-36 vitality) (P < 0·001 for all differences). Fatigue was associated with DLQI scores, but not PASI scores, in univariate analysis but not in multivariate analysis.

Conclusions

Nearly 50% of psoriasis patients suffered from substantial fatigue. Fatigue severity was associated with smoking, pain, and depression, but not with psoriasis severity.

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