Severity of Psoriasis in Tunisia: Cross-Sectional Results From the National PsoTReg Registry

Psoriasis is a chronic, inflammatory disease affecting up to 5% of the population. It significantly impacts patients' quality of life. In Africa, data on disease severity remain limited. The aim of this study was to evaluate the prevalence of severe psoriasis among Tunisian patients and to identify factors associated with disease severity and impairment of quality of life.

A cross-sectional study was conducted using data from the Tunisian National Psoriasis registry (PsoTreg) (ClinicalTrials.gov ID: NCT05258838). A total of 1100 patients with psoriasis were included between July 12, 2022, and November 15, 2024. Disease severity and quality-of-life impairment were assessed using the Simplified Psoriasis Index (SPI). Demographic, clinical, and lifestyle data were analyzed to identify factors associated with disease severity and quality-of-life impairment.

Moderate-to-severe psoriasis affected 31.9% of patients, with 38.3% experiencing quality-of-life impairment. Multivariate analysis confirmed male gender (odds ratio [OR]: 2.057), psoriatic arthritis (OR: 1.693), and substance use (alcohol OR: 2.759; smoking OR: 1.609) as independent severity predictors. There were gender-specific patterns, with smoking significantly associated with severity in men and obesity with quality-of-life impairment in women.

This study, the first multicenter psoriasis registry in North Africa, highlighted the prevalence of moderate-to-severe psoriasis (31.9%). It emphasized a high proportion of patients with quality-of-life impairment (38.3%). Psoriasis severity was associated with smoking in men and obesity in women. These findings suggest a need for gender-tailored lifestyle interventions prioritizing mental health screening in the management of psoriasis patients.