Psychiatric comorbidities and impaired daily living in Pityriasis Rubra Pilaris

Objective: To investigate the impact of Pityriasis Rubra Pilaris (PRP) on psychosocial health and daily life. Methods: Members of the PRP Facebook support group and an email listing (approximately 1979 patients) were invited to complete the study. Results: Of 625 responses, 307 patients met inclusion criteria. The mean Dermatology Life Quality Index (DLQI) score for PRP patients was 11.5 ± 8.4. 23.1% of patients reported anxiety, and 61.9% of patients reported depression. 58.6% of patients reported that their disease significantly impacted their ability to work or attend school, and 69.4% reported mobility issues. 60.9% of patients had a > 50% reduction in sleep. Only 9.1% reported that their dermatologist referred to a psychologist or psychiatrist. Mean DLQI scores were higher for patients who reported anxiety, depression, or had work/school, mobility, and sleep issues compared to those who did not. Patients referred to psychiatrists or psychologists had mean DLQI scores of 16.4, compared to 11.0 in those who were not (P=0.0012). Conclusion: Psychiatric comorbidities and impairment of daily life are highly prevalent in PRP patients, and contribute to poor Quality of Life (QOL). In spite of this, few patients are referred to psychiatry or psychology, and those who are score significantly higher on the DLQI.