Quality of Life of a Cohort of Children with Pustular Psoriasis in Singapore

Abstract Introduction: Pustular psoriasis is a rare variant of psoriasis, occurring in only 1%–5.4% of children with psoriasis. The impact of pustular psoriasis on the quality of life (QoL) of affected children and their families remains poorly reported. Methods: A cross-sectional study was conducted at KK Women’s and Children’s Hospital, a tertiary hospital in Singapore. Various validated QoL questionnaires, including SF-36, age-appropriate Dermatology Life Quality Indices (DLQIs), and Family DLQI, were administered to children and/or their caregivers. A Pediatric Dermatology Socioeconomic Survey was used to evaluate the monetary and time costs associated with pustular psoriasis. Interviews were conducted to gather qualitative insights regarding QoL in pustular psoriasis. Results: Six children aged 1–17 years with pustular psoriasis were recruited from KK Women’s and Children’s Hospital between 2022 and 2023. Overall, the study revealed a lower QoL of affected teenagers than their younger counterparts. Qualitative interviews unveiled difficulties arising from limited public awareness of and stigma against pustular psoriasis. In addition, financial strain and inadequate support were reported. Conclusion: The study findings emphasize the importance of proactive mental health screening and timely support programs for teenagers with pustular psoriasis, and aggressive early treatment to improve disease control from young, to improve overall QoL. Enhancing public awareness of rare skin conditions such as pustular psoriasis and implementing policies to financially support these individuals is also essential. Given its rarity, we advocate future collaborative research on larger populations, incorporating longitudinal assessments and interventions to enhance the QoL for children with pustular psoriasis.