Patient Psoriasis Severity Affects Caregiver Quality of Life

Psoriasis severity effects the patient’s quality of life – but what about the caregiver’s quality of life?

Caregivers of patients with moderate to severe psoriasis have a total higher score on the Psoriasis Family Index-14 (PFI-14) compared with those of patients with mild psoriasis, investigators reported in a study published in the Journal of the European Academy of Dermatology and Venereology.

The study included 126 adult patients with psoriasis, as well as their caregivers, who were referred to a dermatology service from September 2018 to December 2019. The goal was to relate psoriasis severity according to the Body Surface Area (BSA) and Psoriasis Area and Severity Index (PASI) to the quality of life of patients (Dermatology Life Quality Index, DLQI) and of their caregiver (validated Italian version of the PFI-14).

Patients had a mean (SD) age of 52.4 ± 17.6 years, and 72% were men. Caregivers had a mean (SD) age of 52.6 ± 14.8 years, and 89% were women.

Caregivers’ main concern was their patient’s future (38.9% of caregivers were a lot or very much worried), regardless of patient PASI or BSA score. For patients with moderate to severe psoriasis, 51.7% of caregivers were a lot or very much worried about their patient’s future. Another main concern for caregivers was their time spent in helping their patient with treatment (17.5% of caregivers complained of increased housework). A minority of caregivers stated that psoriasis greatly influences their social life (3.2%) and daily shopping (3.2%), and 5.6% complained a lot or very much about having impairment of night sleeping.

Caregivers of patients with moderate to severe psoriasis had a higher total score than those of patients with mild psoriasis (P < .001) on the PFI-14. A weak and inverse correlation between patient age and PFI-14 total score was observed.

PFI-14 was strongly and significantly correlated with PASI, DLQI, and BSA scores (P < .001). Parents were affected more than any other patient relationship.

A potential study limitation is that the PFI-14 questionnaire asks for responses “at this moment,” which might not be appropriate for psoriasis. Also, the patients and caregivers were diverse in age and relationship.

“In particular, we found a great impact of the disease extension and plaque features on the caregiver,” stated the researchers. “Moreover, there also was a strong correlation between the impacts of the patient quality of life on the caregiver quality of life.”


Bardazzi F, Clarizio G, Marani A, Tengattini V, Sacchelli L. The burden of psoriasis on patient’s caregivers. J Eur Acad Dermatol Venereol. Published online October 27, 2021. doi:10.1111/jdv.17773