Social impact of the burden of psoriasis: effects on patients and practice
Abstract
The raised, scaly, and erythematous plaques associated with psoriasis can be cosmetically disfiguring, which may provoke disgust, fear, and aversion in others. Consequently, the social stigma of psoriasis can be devastating for patients, evoking feelings of shame and anxiety about how they are perceived. In recent years, appreciation of psoriasis as a disease that can cause social distress and impairment has increased. This review discusses the manifold social burdens of psoriasis; different and emerging therapies that may mitigate these burdens by improving outcomes associated with the underlying disease; and psoriasis management in the context of healthcare reform changes focused on assessing the quality and value of patient care. The social impact of psoriasis is substantial (eg, affecting interpersonal relationships, sexual function, intimacy, occupational success). Undertreatment of psoriasis continues, despite evidence that biologic agents may lessen the physical and social burdens and provide greater patient satisfaction than conventional therapy. Changes in healthcare place an even greater emphasis on measurable outcomes, including patient satisfaction. Increased understanding of the social burden of psoriasis may lead to provision of more comprehensive, holistic care that is in concordance with the evolving restructured reimbursement system.