Challenges Psoriasis and Its Impact on Quality of Life: Challenges in Treatment and Management

Małgorzata Ponikowska,1 Ercole Vellone,2,3 Michał Czapla,4– 6 Izabella Uchmanowicz3,7 1Division of Clinical Trials and Registries, University Centre of General Dermatology and Oncodermatology, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland; 2Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; 3Department of Nursing, Faculty of Nursing and Midwifery, Wroclaw Medical University, Wroclaw, Poland; 4Department of Emergency Medical Service, Faculty of Nursing and Midwifery, Wroclaw Medical University, Wroclaw, Poland; 5Institute of Heart Diseases, University Hospital, Wrocław, Poland; 6Group of Research in Care (GRUPAC), Faculty of Health Science, University of La Rioja, Logroño, Spain; 7Centre for Cardiovascular Health, Edinburgh Napier University, Sighthill Campus, Edinburgh, UKCorrespondence: Michał Czapla, Department of Emergency Medical Service, Faculty of Nursing and Midwifery, Wroclaw Medical University, Wrocław, Poland, Tel +48713468275, Email [email protected]: Psoriasis, a chronic inflammatory disease affecting approximately 3% of the global population, presents complex challenges that extend beyond its physical manifestations. This comprehensive review examines the multidimensional impact of psoriasis on patients’ lives, encompassing physical, psychological, and social aspects. We analyze current therapeutic approaches, from traditional systemic treatments to cutting-edge biological therapies and emerging oral medications, evaluating their efficacy, limitations, and accessibility. The review explores how disease severity correlates with quality of life measures and psychological burden, noting the high prevalence of depression (20%), anxiety (21%), and suicidal ideation (0.77%) among affected individuals. However, emerging evidence suggests that clinical severity, as measured by PASI or BSA, does not always correlate with the psychoemotional burden experienced by patients, highlighting the need for a more comprehensive assessment of disease impact. We discuss the evolution of treatment strategies, highlighting recent developments in targeted therapies, including JAK inhibitors, particularly selective TYK2 inhibitors, and PDE4 inhibitors, which offer promising alternatives to traditional treatments. Additionally, we examine the role of various assessment tools and quality of life measures in evaluating treatment outcomes. The analysis emphasizes the need for a holistic approach to patient care that integrates medical interventions with psychological support, addressing both the visible and invisible burdens of the disease. This review underscores the importance of personalized treatment strategies that consider not only clinical efficacy but also patient preferences, accessibility, and long-term safety profiles.Keywords: psoriasis, quality of life, treatment challenges, psychological impact, biologics, systemic treatments, TYK2 inhibitors, PDE4 inhibitors