| Abstract | Uvod: Psorijaza je kronično recidivirajuća upalna bolest kože karakterizirana eritematoznim plakovima prekrivenim srebrnkasto-bijelim ljuskama te započinje u djetinjstvu u gotovo trećini slučajeva. Stope prevalencije psorijaze u djetinjstvu i adolescenciji iznose od 0,2% do 5%. Djeca oboljela od psorijaze imaju veću prevalenciju komorbiditeta, uključujući dijabetes melitus, hipertenziju, hiperlipidemiju, psorijatični artritis, Chronovu bolest, pretilost te psihijatrijske poremećaje. Od iznimne važnosti je rano dijagnosticiranje psorijaze te primjena odgovarajućeg liječenja kako bi se spriječio utjecaj bolesti na kvalitetu života oboljele djece i adolescenata.
Cilj: Utvrditi utjecaj psorijaze na kvalitetu života oboljele djece i adolescenata.
Ispitanici i metode: U istraživanju je sudjelovalo 35 ispitanika koji se liječe od psorijaze u Ambulanti za Dječju i adolescentnu dermatologiju i venerologiju u Klinici za dječje bolesti Zagreb. Podatci su prikupljeni za period od 1.5.2018. do 1.5.2022. godine pomoću validiranog indeksa za procjenu kvalitete života DLQI/CDLQI (Dermatology Life Quality Indeks/ Children Dermatology Life Indeks). Upitnik se sastoji od deset pitanja putem kojeg se ispituje utjecaj bolesti na svakodnevni fizički, socijalni i psihički život oboljele djece i adolescenata. Također, u svrhu istraživanja korišten je on-line PASI kalkulator pomoću kojeg se procjenjuje težina bolesti i učinkovitost liječenja te BSA (Body Surface Area), metoda kojom se iskazuje postotak zahvaćenosti površine kože tijela obuhvaćene psorijazom. Vrijednosti DLQI, CDLQI, PASI Indeksa i BSA navedene su u nalazima preuzetim iz bolničkog informatičkog sustava prema dijagnozi Psoriasis. Istraživanje je odobrilo Etičko povjerenstvo Klinike za dječje bolesti Zagreb. Za analizu rezultata korištene su deskriptivne metode i inferencijalne metode.
Rezultati: U istraživanju je sudjelovalo 35 ispitanika, od toga 16 (45,7%) muških ispitanika i 19 (54,3%) ženskih ispitanika. Lakše simptome psorijaze ima 18 ispitanika (51,4%), dok njih 17 (45,6%) ima nešto teže simptome. Prema težini psorijaze, blagu psorijazu ima 12 ispitanika (34,3%), umjereno tešku 14 ispitanika (40%), dok tešku psorijazu ima 9 ispitanika (25,7%). Sistemsku terapiju koristi 2,9% ispitanika, 74,3% ispitanika liječeno je lokalnom terapijom, dok je 20% ispitanika bilo liječeno kombinacijom sistemske i lokalne terapije. Utvrđena je statistički pozitivna povezanost (p>0,01) između kvalitete života djece i adolescenata oboljelih od psorijaze i stupnja psorijaze. Što osoba ima teže simptome psorijaze, to ima lošiju kvalitetu života. Također, utvrđena je statistički značajna razlike između muških i ženskih ispitanika u kvaliteti života (p<0,05). Kvalitetniji život imaju ženske ispitanice oboljele od psorijaze (M=8) od muških ispitanika (M=5,63).
Zaključak: 1.Istraživanjem je potvrđeno da psorijaza značajno narušava kvalitetu života oboljele djece i adolescenata. Što osoba ima teže simptome psorijaze to ima lošiju kvalitetu života.
2. Djeca i adolescenti oboljeli od psorijaze nemaju povećanu učestalost psorijatičnog artritisa.
3. Pokazalo se kako djeca i adolescenti koji imaju jače simptome psorijaze imaju veći postotak zahvaćenosti površine kože tijela obuhvaćene promjenama izazvanim psorijazom.
4. Iz rezultata ovog istraživa može se zaključiti kako većina ispitanika koji imaju lakše simptome bolesti koriste jednu vrstu terapije, nasuprot onima koji imaju teži oblik bolesti i koji su većinom na kombinirajoj terapiji.
Iz rezultata ovog istraživa se može zaključiti kako ispitanici koji imaju lakše simptome bolesti u većoj mjeri primaju jednu vrstu terapije, njih 16 dok dvoje ispitanika s lakšim simptomima prima kombiniranu terapiju. Ispitanici s težim simptomima bolesti, njih 11 prima jednu vrstu terapije, dok 6 ispitanika prima kombiniranu terapiju.
5. Istraživanje je potvrdilo kako veću kvalitetu života imaju ženske ispitanice oboljele od psorijaze u odnosu na muške ispitanike. |
| Abstract (english) | Background: Psoriasis is a chronic relapsing inflammatory skin disease characterized by erythematous plaques covered with silvery-white scales. It begins in childhood in almost a third of cases. Prevalence rates of psoriasis in childhood and adolescence range from 0.2% to 5%. Children suffering from psoriasis have a higher prevalence of comorbidities, including diabetes mellitus, hypertension, hyperlipidemia, psoriatic arthritis, Crohn's disease, obesity and psychiatric disorders. It is extremely important to diagnose psoriasis early and apply appropriate treatment in order to prevent the impact of the disease on the quality of life of affected children and adolescents.
Aim: To determine the impact of psoriasis on the quality of life of affected children and adolescents.
Subjects and methods: 35 subjects participated in this study. All of them have been receiving treatment for psoriasis in the Children's and Adolescent Dermatology and Venereology Department at the Children's Hospital Zagreb. The data have been collected by using a validity index for assessing the quality of life DLQI/CDLQI (Dermatology Life Quality Index/Children Dermatology Life Index). The questionnaire consisted of ten questions that evaluate the impact of the disease on the daily physical, social and psychological life of affected children and adolescents. Also, for the purpose of this research, an online PASI calculator was used to assess severity of the disease and the effectiveness of the treatment and the BSA (Body Surface Area) method was used to calculate the percentage of body surface area affected by psoriasis. The values of DLQI, CDLQI, PASI Index and BSA were obtained from patients' medical records downloaded from the hospital information system according to the diagnosis of Psoriasis. The research was approved by the Ethics Committee of the Children's Hospital Zagreb. Descriptive methods and inferential methods have been used to analyze the results.
Results: 35 subjects have participated in this research, of which 16 (45.7%) male and 19 (54.3%) female. 18 (51.4%) subjects had mild psoriasis symptoms, while 17 (45.6%) had moderate symptoms. According to the severity of psoriasis, 12 (34.3%) subjects had mild psoriasis, 14 (40%) had moderate psoriasis, while 9 (25.7%) had severe psoriasis. Systemic therapy was used in 2.9% of subjects, 74.3% subjects were treated with topical therapy, while 20% of subjects were treated with a combination of systemic and topical therapy. A statistically positive correlation (p>0.01) has been determined between the quality of life of children and adolescents suffering from psoriasis and the severity of psoriasis. Subjects with more severe psoriasis symptoms had worse quality of life. Also, a statistically significant difference has been determined between male and female subjects in the quality of life (p<0.05). Female subjects suffering from psoriasis had a better quality of life (M=8) than male subjects (M=5.63).
Conclusion:
1. Research has confirmed that psoriasis significantly impairs the quality of life of affected children and adolescents. Patients with severe psoriasis symptoms had more impaired quality of life.
2. Children and adolescents suffering from psoriasis do not have an increased incidence of psoriatic arthritis.
3. It has been shown that children and adolescents who have more severe symptoms of psoriasis have a higher percentage of body surface area covered by psoriasis skin lesions.
4. From the results of this research, it can be concluded that the majority of participants who had mild symptoms of the disease used only monotherapy, in contrast to those who had a more severe from of the disease and who were mostly on combined therapy.
5. The research has confirmed that female patients suffering from psoriasis had better quality of life compared to male patients. |
