[French adaptation of a new score for global assessment of psoriasis severity: The Simplified Psoriasis Index (SPI)]

Contraception, Sexuality and Pregnancy in Women with Psoriasis: Real-Life Experience of 235 Women

Background

Little is known about how women of childbearing age with psoriasis experience contraception, sexuality and pregnancies through the lens of their skin condition.

Objective

To evaluate the experiences and expectations in this group of patients.

Materials and Methods

In total, 235 women aged between 18 and 45 years old completed an online survey. We collected the characteristics of psoriasis, contraception and pregnancy history. Psoriasis severity was measured using the Simplified Psoriasis Index. Patient quality of life was assessed using the Dermatology Life Quality Index (DLQI) and the Short Form-12.

Results

Psoriasis was mild in 78% of cases. The mean DLQI score was 8.8, highlighting a moderate impact of psoriasis. In total, 28% of the women had no current follow-ups, while at least two distinct physicians followed 21% of these patients. In total, 31.5% of the women felt that they could discuss sexuality during their consultations. In addition, 63% of respondents had a contraceptive method, but more than half of the women reported that contraception was rarely or never discussed during the consultations. In total, 63% had at least one pregnancy, and 61.5% reported that the doctor managing their psoriasis did not discuss their pregnancy during consultations. Psoriasis worsened during pregnancy for 21% of the respondents but improved in 34%. Among women who were not pregnant, less than 15% reported that the doctor in charge of their psoriasis discussed family planning and pregnancy possibilities.

Conclusion

Our study shows that the management of women of childbearing age with psoriasis must be improved with respect to sexuality, contraception and pregnancy planning.

Secukinumab efficacy in reducing the severity and the psychosocial impact of moderate-to-severe psoriasis as assessed by the Simplified Psoriasis Index: results from the IPSI-PSO study

Background

The utility of the Simplified Psoriasis Index (SPI), a recently developed multidomain tool for assessing psoriasis, was investigated in a study assessing response to secukinumab.

Methods

In an open‐label, multicentre study involving 17 French centres, patients with moderate‐to‐severe plaque psoriasis received secukinumab 300 mg subcutaneously once weekly from baseline to W4, then every 4 weeks until W48. Dermatologist‐scored SPI psoriasis severity (proSPI‐s) was compared with Psoriasis Area and Severity Index (PASI). Patient self‐assessed severity (saSPI‐s) and psychosocial impact (SPI‐p) were compared with PASI and Dermatology Life Quality Index (DLQI), respectively.

Results

We included 120 patients (69.2% male; mean age 45.9 years; mean duration of psoriasis 21.6 years). Mean baseline scores were as follows: proSPI‐s 24.9, saSPI‐s 23.5, PASI 23.1, SPI‐p 8.2 and DLQI 13.6. Severity scores achieved by 16 weeks (proSPI‐s 2.3, saSPI‐s 2.2 and PASI 2.2) were maintained to W52. Reductions in mean psychosocial impact scores were maintained to W52 (SPI‐p and DLQI, respectively, 2.1 and 1.5 at W16; 1.5 and 1.9 at W52).

Conclusions

Decrease of PASI scores in response to secukinumab was closely correlated with proSPI‐s, supporting the latter's suitability for assessing response to therapy. Although the correlation between PASI and saSPI‐s was slightly weaker, patients were able to complete a valid assessment of their psoriasis independently, and thus potentially remotely. With the added benefit of psychosocial impact assessment (SPI‐p), SPI provides a valid tool enabling patients to assess their own psoriasis, remotely if necessary.