Associated Factors and Quality of Life in Self-Reported Psoriasis Among Adults in Saudi Arabia: An Exploratory Cross-Sectional Study

Abstract

Background 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.