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From skin clearance to psychological wellbeing: real-world outcomes of biologic therapy in psoriasis

Title: From skin clearance to psychological wellbeing: real-world outcomes of biologic therapy in psoriasis
Authors: Cuniberti, Francesco; Miniotti, Marco; Bailon, Mariagiulia; Mastorino, Luca; Ortoncelli, Michela; Picardi, Angelo; Ribero, Simone; Leombruni, Paolo
Source: Frontiers in Psychology ; volume 17 ; ISSN 1664-1078
Publisher Information: Frontiers Media SA
Publication Year: 2026
Collection: Frontiers (Publisher - via CrossRef)
Description: Background Psoriasis impacts psychological and quality-of-life (QoL). While biologic therapies demonstrated robust efficacy in reducing skin lesions, their broader psychosocial impact remains underexplored in real-world settings. This ambispective observational cohort study evaluated clinical, psychological, and health-related QoL (HRQoL) outcomes of biologic therapy in patients with moderate-to-severe plaque psoriasis treated in routine dermatological practice. Methods A total of 133 patients undergoing biologic therapy at a referral center in Northern Italy were assessed. Baseline data (T0) were retrospectively extracted from medical records, while 6-month follow-up assessments (T1) were conducted prospectively. Clinical severity (PASI), depression (PHQ-9, BSI-18), anxiety and somatization (BSI-18), perceived stress (PSS), dermatology-specific QoL (DLQI), and general HRQoL (WHOQOL-BREF) were evaluated. Regression models identified baseline predictors of T1 psychological and QoL outcomes. Results At follow-up, patients reported significant improvements in psychological wellbeing and QoL. PHQ-9 scores decreased markedly ( p < 0.001), with the prevalence of moderate-to-severe depressive symptoms dropping from 28.6% to 5.3%. Substantial perceived stress (PSS ≥ 27) declined from 15.0% to 1.5%. DLQI scores showed a large effect size ( p < 0.001), with 89.5% reporting minimal impact (DLQI 0–1) at follow-up. Regression analyses identified baseline psychological symptoms as the strongest predictors of follow-up psychological and QoL outcomes. Additional predictors included PASI, female sex, psychiatric comorbidity, and previous biologic therapy. At T1, 77.4% achieved complete skin clearance (PASI 100). Conclusion Biologic therapies confer multidimensional benefits in moderate-to-severe psoriasis, extending beyond skin clearance to substantial reductions in psychological distress and improvements in QoL. These findings support a patient-centered model integrating dermatologic and mental health care.
Document Type: article in journal/newspaper
Language: unknown
DOI: 10.3389/fpsyg.2026.1735777
DOI: 10.3389/fpsyg.2026.1735777/full
Availability: https://doi.org/10.3389/fpsyg.2026.1735777; https://www.frontiersin.org/articles/10.3389/fpsyg.2026.1735777/full
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.3999F408
Database: BASE