Psoriatic patients undergoing long-term therapy with biologics: Impact of residual localization of psoriasis on quality of life in an Italian clinical setting

Residual psoriasis characterizes body sites resistant to biologic drugs. Some affected body sites exert disproportionate impact on patients' quality of life. The aim was to localize residual psoriasis in patients treated with biologics for at least 6 months, and to study the correlation between lesional localization and patients' quality of life. Current Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) were assessed. Quality of life was obtained by measuring Dermatology Life Quality Index (DLQI). An observational retrospective study was designed. Seventy-five psoriatic patients were included (59 males, 78.67%, mean age 52.45 ± 11.83 years). The overall median current PASI was 0 (Interquartile Range IQR 0-4). The overall median current NAPSI was 0 (IQR 0-0) and DLQI was 0 (IQR 0-1). The commonest sites of residual psoriasis were elbows (41.33%; 95% confidence interval [CI]: 2.502-38.9), followed by anterior lower legs (33.33%; 95% CI 2.097-23.8) and forearms (29.33%; 95% CI 1.019-10.1). Statistical significance between DLQI and forearm, dorsal hand and abdomen was observed. Sites traditionally regarded as difficult-to-treat were rarely affected by residual lesions and showed relatively limited impact on quality of life.