{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:10:24Z","timestamp":1784099424138,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross\u2010sectional study was conducted using data from the Tunisian National Psoriasis registry (PsoTreg) (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      ID: NCT05258838). A total of 1100 patients with psoriasis were included between July 12, 2022, and November 15, 2024. Disease severity and quality\u2010of\u2010life 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\u2010of\u2010life impairment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Moderate\u2010to\u2010severe psoriasis affected 31.9% of patients, with 38.3% experiencing quality\u2010of\u2010life 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\u2010specific patterns, with smoking significantly associated with severity in men and obesity with quality\u2010of\u2010life impairment in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study, the first multicenter psoriasis registry in North Africa, highlighted the prevalence of moderate\u2010to\u2010severe psoriasis (31.9%). It emphasized a high proportion of patients with quality\u2010of\u2010life impairment (38.3%). Psoriasis severity was associated with smoking in men and obesity in women. These findings suggest a need for gender\u2010tailored lifestyle interventions prioritizing mental health screening in the management of psoriasis patients.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/ijd70589-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijd.70589","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:47:37Z","timestamp":1784098057000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severity of Psoriasis in Tunisia: Cross\u2010Sectional Results From the National\n                    <scp>PsoTReg<\/scp>\n                    Registry"],"prefix":"10.1111","author":[{"given":"Noureddine","family":"Litaiem","sequence":"first","affiliation":[{"name":"Department of Dermatology Charles Nicolle Hospital  Tunis Tunisia"},{"name":"Faculty of Medicine of Tunis University of Tunis El Manar  Tunis Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3848-6630","authenticated-orcid":false,"given":"Malek","family":"Akid","sequence":"additional","affiliation":[{"name":"Department of Dermatology Charles Nicolle Hospital  Tunis Tunisia"},{"name":"Faculty of Medicine of Tunis University of Tunis El Manar  Tunis Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Boudaya","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hedi Chaker Hospital  Sfax Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anissa","family":"Zaouak","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis University of Tunis El Manar  Tunis Tunisia"},{"name":"Department of Dermatology Habib Thameur Hospital  Tunis Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0058-0645","authenticated-orcid":false,"given":"Asmahane","family":"Souissi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis University of Tunis El Manar  Tunis Tunisia"},{"name":"Department of Dermatology La Rabta Hospital  Tunis Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nejib","family":"Doss","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis University of Tunis El Manar  Tunis Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4477-9581","authenticated-orcid":false,"given":"Soumaya","family":"Gara","sequence":"additional","affiliation":[{"name":"Department of Dermatology Charles Nicolle Hospital  Tunis Tunisia"},{"name":"Faculty of Medicine of Tunis University of Tunis El Manar  Tunis Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kahena","family":"Jaber","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Tunis University of Tunis El Manar  Tunis Tunisia"},{"name":"Department of Dermatology Military Hospital  Tunis Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina","family":"Aounallah","sequence":"additional","affiliation":[{"name":"Department of Dermatology Farhat Hached Hospital  Sousse 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Tunis University of Tunis El Manar  Tunis Tunisia"},{"name":"Department of Dermatology Habib Thameur Hospital  Tunis Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13854"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen\u20102022\u2010002533"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555\u2010025\u201001631\u20108"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdin.2020.06.002"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555\u2010025\u201001436\u20109"},{"key":"e_1_2_11_7_1","unstructured":"\u201cTunisian National Registry on Psoriasis \u201daccessed April 12 2025 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