Psoriatic and psoriatic arthritis patients with and without jet-lag: does it matter for disease severity scores? Insights and implications from a pilot, prospective study

ABSTRACT

Background: Jet-lag may affect air-travelers crossing at least two time-zones and has several health-care implications. It occurs when the human biological rhythms are out of synch with respect to the day-night cycle at the country destination. Its effect in psoriasis is missing. We aimed to evaluate the effect of Jet-lag in psoriatic patients’ management. Methods: This is a prospective observational study that enrolled psoriatic patients that underwent a flight: patients who experienced jet-lag were compared to patients who did not experience jet-lag. Before the flight, a dermatologist recorded clinical and demographical data with particular attention to Psoriasis Area Severity Index (PASI) and Disease Activity in Psoriatic Arthritis (DAPSA). Patients performed Self-Administered Psoriasis Area Severity Index (SAPASI), the Dermatology Life Quality Index (DLQI) and the pruritus Visual Analog Scale (VAS) scores. After the flight, patients completed the SAPASI, DLQI and pruritus-VAS scores. Results: The sample recruited comprised of 70 psoriatic patients aged 42.4 ± 9.7 years (median 42.5 years). Thirty (42.9%) were males, mean BMI was 25.5 ± 2.2 kg/m². Average disease duration was 15.2 ± 7.1 years, and 20 (28.6%) subjects had developed PsA. Average hours of flight were 5.4 ± 3.5 (median 3.5 h), with 34 (48.6%) subjects reporting jet-lag. At the multivariate regression analysis, the change in the SAPASI score resulted correlated with jet-lag (regression coefficient 1.63, p = .0092), as well the change in the DLQI score (regression coefficient = 1.73, p = .0009), but no change on the pruritus VAS scale was found. Conclusions: The present study suggests that jet-lag may influence disease severity and DLQI scores, but not itch in psoriatic patients.

KEYWORDS:

• Psoriasis
• psoriatic arthritis
• circadian rhythm
• human biological clock
• melatonin
• jet-lag
• PASI
• SAPASI
• DAPSA
• pruritus-VAS

Authors Contributions

Conceptualization, G.D., N.L.B., S.G., V.K.C. and C.M.S.; methodology, N.L.B. and G.D.; software, N.L.B.; validation, S.G., V.K.C. and C.M.S.; formal analysis, N.L.B; investigation, G.D., A.P., P.M., P.D.M.P., R.R.Z.C., D.T. and A.W.; resources, S.G., V.K.C., C.M.S., and M.A.; data curation, G.D., S.G., V.K.C., C.M.S., A.P., P.M., P.D.M.P., R.R.Z.C., D.T., A.W. and M.A.; writing—original draft preparation, G.D., N.L.B., G.D., N.L.B., S.G., V.K.C., C.M.S., A.P., P.M., P.D.M.P., R.R.Z.C., D.T., A.W.; writing—review and editing, G.D., N.L.B., S.G., V.K.C., C.M.S., A.P., P.M., P.D.M.P., R.R.Z.C., D.T., A.W. and M.A; visualization, N.L.B.; supervision, S.G., V.K.C., C.M.S., M.A.; project administration, A.P., P.M., P.D.M.P., R.R.Z.C., D.T. and A.W.; funding acquisition, M.A.

Conflicts of Interest

The authors declare no conflict of interest.

Supplementary Materials

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases [P50 AR 070590 01A1].