Fatigue and the Impact of Musculoskeletal Pain on Quality of Life in Pediatric Patients With Psoriasis

Abstract

Background and aims

Musculoskeletal pain associated to psoriasis without the presence of psoriatic arthritis is a poor explored issue in pediatric population. The aim of this study was to compare the health-related quality of life (HRQoL) and fatigue scores of pediatric patients with psoriasis and healthy peers and estimate the impact of musculoskeletal pain.

Methods

The pediatric Gait Arms Legs and Spine (pGALS) questions were used to screen for musculoskeletal pain. General HRQoL was measured using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL 4.0) and fatigue was assessed using the PedsQL-Multidimensional Fatigue Scale (PedsQL-MFS).

Results

Fifty psoriatic patients (12.1years old; IQR 9-15) and 50 controls (12.3 years old; IQR 8.8-15.9) were evaluated. Patients with psoriasis had long disease duration of 6.9 years (IQR 3.7-9.5) and predominantly low disease activity (PASI 3.2, IQR 0.8-6; BSA 3.0, IQR 1-8), mainly treated with topical therapy. The PedsQL 4.0 total score of psoriatic patients with musculoskeletal pain was poorer than controls with pain. Fatigue by PedsQL-MFS was also worse in patients with psoriasis and pain. The risk of impaired HRQoL was 7.7 times higher in the presence of musculoskeletal pain (OR = 7.71, 95%CI 1.66-35.78); other variables such as age, sex and severity of psoriasis did not increase the risk of HRQoL impairment.

Conclusions

Musculoskeletal pain and fatigue may provide clues for systemic impairment in pediatric psoriatic disease and calls for effective systemic treatment to reduce disease burden and accumulated damage.