The Impact of Pruritus on the Quality of Life and Sleep Disturbances in Patients Suffering from Different Clinical Variants of Psoriasis  
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1 Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland 1  
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2 Institute of Physical Culture Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland 2  
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3 Department of Dermatology and Venerology, Faculty of Medicine, Nicolaus Copernicus University in Torut, [PERSON], Collegium Medicium in Bydgoszcz, 85-094 Bydgoszcz, Poland 3  
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4 Department of Dermatology, Gazi University School of Medicine, 06570 Ankara, Turkey 4  
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5 Department of Dermatology, University and Allergology, Wroclaw Medical University, 50-367 Wroclaw, Poland 5  
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6 Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, 92-215 Lodz, Poland 6  
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7 Department and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Faculty of Medicine, Collegium Medicium, University of Warmia and Mazury in Olsztyn, 10-720 Olsztyn, Poland 7  
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4 Department of Dermatology, Gazi University School of Medicine, 06570 Ankara, Turkey 4  
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5 Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, 50-367 Wroclaw, Poland 5  
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6 Department of Dermatology, Pediatric Dermatology and Oncology, Medical University of Lodz, 92-215 Lodz, Poland 6  
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Quality of life (QoL), defined as a complex and multidimensional concept and an index of subjective well-being in the mental, physical, and socioeconomic domains as perceived by individuals, is usually decreased in dermatological patients [1]. Health-related QoL is a term that refers to health status and severity of disease. Many factors such as involvement of visible parts of the body, scaling, or subjective symptoms such as pruritus or pain may have a negative impact on patients' QoL. Emotional stress caused by attempts to hide the skin lesions and lowered self-esteem negatively affect interpersonal relationships. The situation may be of particular relevance if skin lesions are located within the anogenital area, as this may affect sexual activity and relationship with the partner. Social awareness of this disease is still low, therefore, psoriatic patients are often stigmatized and excluded by the social and work environment. All these above-mentioned aspects contribute to sadness, depression, anxiety, and suicidal ideation [2]. Moreover, stress and negative emotions are one of the best known factors that exacerbate psoriasis; thus, patients need to be able to manage these symptoms in order to prevent further disease worsening [3].  
Sleep is undoubtedly an important aspect of general health. An insufficient amount of high-quality sleep may cause fatigue, irritability, emotional liability and, as a consequence, impaired functioning in the society [4]. Many studies reported sleep disturbances in dermatological diseases including psoriasis [5; 6; 7], but data on sleeping problems in different clinical subtypes of psoriasis are limited.  
Here, we aimed to investigate and characterize the differences of QoL and sleeping problems in different clinical variants of psoriasis with a special emphasis put on the role of pruritus, as it is the most frequent and the most bothersome subjective symptom of psoriasis [8; 9; 10].