Domain-specific Skindex-29 response under biologics, conventional systemics, and phototherapy: a four-time-point...

Skindex-29 provides a domain-specific assessment of quality-of-life (QoL) burden in psoriasis, but real-world comparisons across treatment modalities and clinically relevant time points remain limited. We prospectively followed 183 adults with psoriasis (Psoriasis Area Severity Index [PASI]>10) treated with phototherapy, conventional systemic agents, or biologics in a tertiary center. Skindex-29 total and domain scores were assessed at weeks 0, 4, 12, and 16. Total scores decreased significantly within all modalities (all p<0.001), with earlier and larger observed reductions among patients receiving biologics. After Benjamini-Hochberg adjustment, between-group differences remained significant for total scores at weeks 0, 4, and 16; for Emotions and Functioning at weeks 0, 4, and 16; and for Symptoms at week 4. PASI was strongly correlated with all domains (r=0.692-0.795; all p<0.001). Skindex-29 may complement PASI in domain-aware monitoring, although the non-randomized design precludes causal interpretation.