Study Examines Touch Avoidance in Psoriasis

Vancouver, Canada—Severity of psoriasis has a significant impact on patient quality of life. In a new study, researchers conducted a cross-sectional survey among patients with psoriasis and included questions to assess the avoidance of interpersonal touch and its link with disease severity and quality of life. The results were presented at the WCD meeting during a session titled Association of Touch Avoidance with Disease Severity and Quality of Life in Psoriasis Patients.

From October 2013 to November 2013, the investigators conducted an online survey consisting of various patient-reported outcome instruments including the Dermatology Quality of Life Index (DLQI) and the Quick Inventory of Depressive Symptomology. A total of 1109 psoriasis patients were asked to rate over the past 2 weeks whether they had avoided touching others or others touching them because of the way their skin looks or feels on a scale of 1 (not at all) to 10 (very much). The patients were divided into 2 groups: (1) “no touch avoidance” or (2) “touch avoidance.” Disease severity was assessed according to the patients’ estimated body surface area (BSA) affected by psoriasis and a patient-related global assessment of disease severity that ranged from 0 (clear) to 5 (severe). Associations between touch avoidance and other outcomes measures were tested using unadjusted Cochran–Mantel–Haenszel chi-square tests and logistic model after adjusting for age, gender, presence of psoriatic arthritis, duration of disease, and BSA, if applicable.

The study showed that nearly half (48.2%) of the patients reported touch avoidance. Gender and marital status had no major impact on touch avoidance. Younger participants expressed significantly more touch avoidance compared with older patients (P<.05). Patients experiencing itch due to psoriasis reported avoiding touch more than those patients without itching (P<.05). Using both the BSA and the 0 to 5 disease severity scales, the researchers found that touch avoidance was significantly associated with disease severity (P<.05). Further, patients with psoriasis on their hands, neck, feet, or nails were more prone to avoid touch compared with those without psoriasis in these 4 locations. The patients reporting touch avoidance were significantly more likely to have worse quality of life as measured by the DLQI (P<.05), and more likely to have depression compared to those with no touch avoidance (P<.05).

“These data indicate that for patients with psoriasis, touch avoidance is associated with disease severity, location of psoriasis on the body, and worsened quality of life, including depression,” concluded the researchers.—Eileen Koutnik-Fotopoulos