Journal of Psoriasis and Psoriatic Arthritis®

To evaluate and update the evidence for the measurement properties of the Psoriatic Arthritis Impact of Disease (PsAID12) questionnaire to measure health-related quality of life (HRQoL) in psoriatic arthritis (PsA).

The PsAID12 psychometric evidence was gathered in a systematic literature review in PsA (registration number: CRD42016032546). The study quality was appraised using the Consensus-based Standards for the selection of health Measurement Instruments–Outcome Measures in Rheumatology (COSMIN-OMERACT) good methods check-list. Content validity, test–retest reliability, construct validity, longitudinal construct validity, discrimination, and thresholds of meaning were appraised. Additional analyses for construct validity, responsiveness, and sensitivity to change were conducted in available observational data sets after prespecified hypotheses were formulated.

Eight publications (129-474 patients) were analyzed. The PsAID12 fulfilled OMERACT criteria for content validity (patients and physicians endorsed content match with PsA HRQoL domain), feasibility (endorsed by patients and physicians), and test–retest reliability (intraclass correlation coefficient: 0.91-0.95). A priori construct validity hypotheses were mostly met: Psoriatic Arthritis Impact of Disease had high correlation with generic (r = 0.76-0.87) and PsA-specific HRQol measures (0.8), and with measures of physical function (0.66-0.72), work productivity (0.69-0.75), pain (0.83), and fatigue (0.84). Psoriatic Arthritis Impact of Disease had moderate-high correlation with measures of patient global (0.49-0.84) and dermatologic HRQoL (0.36-0.53). Correlations were higher with generic HRQoL measured by short form-36 physical component score (0.47-0.73) versus short form-36 mental component score (0.22-0.60). Three studies confirmed known group validity of PsAID12 according to PsA disease activity. Psoriatic Arthritis Impact of Disease discriminated between change groups in 2 longitudinal studies (standardized response mean: 0.74-0.91, 53 and 105 patients). The minimal clinically important improvement was 3 and 1.4 points.

Psoriatic Arthritis Impact of Disease had evidence for good content and construct validity, reliability, and longitudinal construct validity and is ready to evaluate in clinical trials.

Childhood psoriasis affects 2% of the world pediatric population. An association between psoriasis and geographic tongue (GT) in adults has been suggested, but there are no studies in children.

This study aimed to compare the prevalence of oral lesions in pediatric patients with psoriasis (PP) and healthy controls and investigate the correlation between GT, severity, and age of psoriasis onset.

The participants were 17 PP aged <18 years and 91 HC. The severity of vulgaris psoriasis was determined according to Psoriasis Area and Severity Index (PASI) and all patients underwent an oral examination.

Oral findings were present in 43% of the participants and the most common lesions were candidiasis and GT. There was a mean earlier onset in psoriasis with GT (3 years old) compared to psoriasis without GT (10 years old). The mean PASI scores in psoriasis with GT and psoriasis without GT were 9 and 3, respectively.

Geographic tongue and candidiasis were frequently found in PP. Patients with psoriasis with GT are younger and have earlier onset of the disease, a positive family history of psoriasis, and a severe form of the disease. The present study is the first of its type to demonstrate clinical differences in pediatric PP with and without GT.

There is limited literature on the occurrence and management of psoriasis involving the ear.

To better understand psoriasis of the ear and current approaches for management.

The Medical Board of the National Psoriasis Foundation was surveyed on the frequency and presentation of psoriasis of the ear, the types of examinations performed, and the rationale for choice of treatment.

In this survey, the observed frequency of ear psoriasis was wide (10%-70%). The scalp was the most common concurrent site of extra-auricular psoriasis. Inspection of the ear was commonly reported; however, 75% of respondents report not inspecting the canal. Topical corticosteroids were the most commonly used treatment. Systemic and biologic therapies are infrequently used.

This study is limited by the sample size of respondents. Not every question of the survey was answered by all those surveyed.

Results from our survey suggest that the evaluation of psoriasis of the ear is often not complete. Inspection of the ear, including the canal, is recommended, especially if the scalp is involved. Routine inspection of the ear is recommended both to evaluate treatment response and for potential adverse side effects. In the setting of persistent ear disease, collaboration between dermatologists and otolaryngologists is encouraged.

The Simplified Psoriasis Index (SPI) is a summary measure of psoriasis for current severity (SPI-s), psychosocial impact (SPI-p), and past history and interventions (SPI-i). Two complementary versions are available, differing only in that current severity is either professionally (proSPI-s) or patient self-assessed (saSPI-s). They have been shown to be valid, reliable, and interpretable.

The current study investigated whether the validity, reliability, and interpretability of SPI could be replicated in an independent study in a different population and setting.

A validated translation of SPI into Thai was used to assess the validity and reliability of SPI for assessing psoriasis in 100 Thai patients. The interpretability of proSPI-s and saSPI-s was assessed in 289 Thai patients.

There were close correlations between Psoriasis Area and Severity Index (PASI) and proSPI-s (r = 0.84) and between PASI and saSPI-s (r = 0.78). The SPI-p was closely correlated with the validated Thai version of the Dermatology Life Quality Index (r = 0.78). Excellent intrarater (proSPI-s, saSPI-s, SPI-p, and SPI-i) reliability was demonstrated (all ICC ≥0.88). The PASI-equivalent cutoff scores for mild (PASI < 10) and severe psoriasis (PASI ≥ 20) were <9 and ≥18 for proSPI-s and <11 and ≥20 for saSPI-s.

Our study confirms that SPI retains good validity and reliability in translation. The cutoff points we obtained were very close to those of the original study and confirmed that the originally proposed PASI-equivalent cutoff scores for mild and severe psoriasis of <9 and ≥18 for psoSPI-s and <10 and ≥20 for saSPI-s, respectively, were valid for use in a very different language and setting.