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MINDFULNESS AND UVB IN THE TREATMENT OF MODERATE PSORIASIS 42 The quality of life varied in terms of the different seasons. During the summer, life quality was described as having improved, while in the winter was more likely to end in relapse. The disease had a relatively big impact on their life at baseline with approximately DLQI= 10, where DLQI> 11 is assumed to be a boundary where topical treatments are not sufficient (Finlay & Khan, 1994). Most informants argued for the big impact the current relapse had on life quality, while others had clear discomfort with their disease, but did not report it as lowering their life quality. One informant had particularly high discomfort with itching on the hands, but only reported DLQI<6. DLQI has one direct question about itching, and the others are indirectly connected to the consequences of the skin disease in behavior from oneself and others. The degree of itching and its impact on the life of psoriasis may be an important aspect to influencing the life quality of psoriasis patients. The VAAS questionnaire has been suggested as good instrument for detecting itch impact on the life of those with psoriasis (Globe, Bayliss, & Harrison, 2009; Prignano, Ricceri, Pescitelli, & Lotti, 2009). The stigma or embarrassment of having visible symptoms seems to have led to the use of clothes as a means to hide psoriasis, for instance by wearing long sleeves whenever going to the store. (Ghorbanibirgani, Fallahi-Khoshknab, Zarea, & Abedi, 2016). The discomfort was often greater when symptoms were in visible areas, such as the face and hands. The choice of hiding the skin symptoms in public may well be a habit, as well as some unconscious processes. The life quality measure of DLQI has multiple questions for detecting discomfort of socially interacting in society, though it did not pursue the subjective meaning as with conducting interviews. The discomfort increased with presence of thick skin, scales and crust, which is suggested by the informants and former research as manifestation of the disease (Prignano et al., 2009). The informants mentioned their concerns about future disease progression. They often compared themselves to worse cases of psoriasis, such as having it on the face, hands, or having thick skin, crust, itching and scaling. The understanding of how psoriasis patientsPDF Image | Combining Mindfulness and Ultraviolet Phototherapy (UVB
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