Associated Factors and Quality of Life in Self-Reported Psoriasis Among Adults in Saudi Arabia: An Exploratory Cross-Sectional Study
Rena H. Alharbi, Mohammad A. Jareebi, Khlood K. Alattas, Shatha H. Moharaq, Alia A. Alruwished, Ghufran A. Almowalad, Sarah H. Bahakeem, Amal A. Badri, Saja A. Almraysi, Rauf M. Mawkili, Nuha H. Abutalib, Amany Mashi, Farjah H. Algahtani, Abdulwahab A. Aqeeli, Alaa H. HakamiBackground and Objectives: Psoriasis is a chronic immune-mediated inflammatory disease whose burden extends beyond the skin. Community-based data from Saudi Arabia are scarce, as most local studies recruit from dermatology clinics and miss people who never reach specialist care. This study examined its frequency in a multi-regional sample of adults in Saudi Arabia, described its clinical profile, identified factors associated with it, and examined its association with quality of life. Methods: An exploratory cross-sectional study recruited 1619 adults residing in Saudi Arabia by online convenience sampling, using a self-administered online questionnaire covering sociodemographic and health characteristics, psoriasis status and clinical features, lifestyle factors, and the Arabic WHOQOL-BREF. Groups were compared using the chi-square, Fisher’s exact and Mann–Whitney U tests. Multivariable logistic regression, with Firth-penalized and parsimonious sensitivity models, examined factors associated with psoriasis, and five linear models were fitted for the overall quality of life facet and each domain. Results: Psoriasis was reported by 3.3% of participants (95% CI 2.5 to 4.3), and by 2.7% (95% CI 2.0 to 3.6) when restricted to physician-diagnosed cases. Onset occurred before age 35 in 84.6% of cases, psychological stress was the commonest trigger (69.2%), and herbal remedies had been used more often (34.6%) than oral systemic agents (25.0%), phototherapy (15.4%) or biologics (7.7%). Current smoking was associated with higher odds of reporting psoriasis (aOR 4.23, 95% CI 1.97 to 9.08, p < 0.001) and male sex with lower odds (aOR 0.41, 95% CI 0.19 to 0.90), and this was consistent across sensitivity models; middle income and university education were also associated with higher odds, although these may reflect differences in who receives a diagnosis rather than differences in risk. Psoriasis was independently associated with a lower overall quality of life and general health score (β = −6.73, 95% CI −12.75 to −0.71, p = 0.028); all four domain coefficients were negative but non-significant. Conclusions: Psoriasis was reported by roughly one in thirty participants and was associated with poorer self-rated quality of life. Smoking was the most consistent modifiable correlate, and treatment patterns suggest reliance on remedies outside established care.