Incidence and risk factors for psoriasis in the general population.

Spanish Centre for Pharmacoepidemiologic Research.
Archives of dermatology (Impact Factor: 4.76). 01/2008; 143(12):1559-65. DOI: 10.1001/archderm.143.12.1559
Source: PubMed

ABSTRACT To study the clinical spectrum of psoriasis and the incidence in the general population and to identify risk factors associated with the occurrence of psoriasis.
Prospective cohort study with nested case-control analysis.
The data source was the United Kingdom General Practice Research Database containing computerized clinical information entered by general practitioners (GPs).
The study population comprised patients receiving a first-ever diagnosis of psoriasis between January 1, 1996, and December 31, 1997, and free of cancer.
Diagnosis of psoriasis was validated in a random sample of 14% of all ascertained cases requesting confirmation by the GPs. Nested case-control analysis included 3994 cases of psoriasis and a random sample of 10 000 controls frequency matched to cases by age, sex, and calendar year.
Incidence rate of psoriasis and estimates of the odds ratio (OR) and 95% confidence interval (CI) for psoriasis as associated with selected risk factors.
The incidence rate of psoriasis was 14 per 10 000 person-years. Patients with antecedents of skin disorders and skin infection within the last year carried the highest risk of developing psoriasis (OR, 3.6 [95% CI, 3.2-4.1], and OR, 2.1 [95% CI, 1.8-2.4], respectively). Also, smoking was found to be an independent risk factors for psoriasis (OR, 1.4 [95% CI, 1.3-1.6]). We did not find an association between risk of psoriasis and antecedents of stress, diabetes, hypertension, hyperlipidemia, cardiovascular disease, or rheumatoid arthritis.
The incidence rate in our study was higher than those published in other studies, probably owing to our case definition that considered cases recorded by the GPs independently of a specialist confirmation. Our results confirm the association between psoriasis, skin disorders, and smoking.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Psoriasis (Pso) is a common chronic cutaneous inflammatory disease involving the skin that is associated with serious comorbidities. Comorbidities in Pso include psoriatic arthritis (PsA), reduced quality of life, malignancy, depression, but also a constellation of associated conditions that enhance the cardiovascular (CV) risk. Indeed, obesity is common in patients with Pso or PsA and is considered to be a risk factor for the onset of these diseases. Patients with Pso and PsA share common obesity-related complications such as metabolic syndrome (MetS), dyslipidemia, diabetes or insulin resistance, and CV diseases. Chronic inflammation in Pso and PsA partially explains the development of atherosclerosis and CV diseases. In parallel, body composition is disturbed in patients with Pso or PsA, as suggested by anthropometric measurements, while an excess of abdominal adiposity is observed in PsA, enhancing the risk of MetS and CV diseases. Adipokines may link the adipose tissue to the obesity-related complications of Pso and PsA. Indeed, altered circulating levels of the adipokines leptin, adiponectin, visfatine, and resistin have been found in patients with Pso or PsA. In addition, an excess of adipose tissue may compromise the therapeutic response to traditional drugs or biological agents in Pso and PsA. This paper reviews the comorbidities that contribute to enhanced CV risk, the body composition results, and the potential role of adipokines in systemic inflammation and energetic balance in Pso and PsA.
    Frontiers in Immunology 01/2014; 5:368.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Psoriasis is a chronic, immune-mediated inflammatory skin disease that is associated with multiple comorbidities including psoriatic arthritis, cardiometabolic diseases, malignancies, nonalcoholic fatty liver disease, autoimmune diseases, inflammatory-bowel disease, obstructive sleep apnea and chronic obstructive pulmonary disease. Cardiovascular disease including myocardial infarction, stroke and subclinical atherosclerosis as well as obesity, metabolic syndrome, diabetes, hypertension and hyperlipidemia, are associated with psoriasis. Shared inflammatory pathways may be the basis for these disease associations, especially in the case of cardiovascular disease and its risk factors. Reduced quality of life, depression, anxiety, smoking and alcoholism are also seen in psoriasis patients. Awareness and understanding of the relationships between psoriasis and its comorbidities is important in managing patients with psoriasis. The multiple comorbidities associated with psoriasis will be discussed here, focusing on presenting available data pertaining to each disease, its relationship to psoriasis pathology and the implications for physicians and psoriatic patients.
    Expert Review of Dermatology 01/2014; 8(3).
  • [Show abstract] [Hide abstract]
    ABSTRACT: Psoriasis is a chronic, immune-mediated inflammatory skin disease, affecting approximately 2–4% of the population in western countries. Patients with a more severe form of the disease are typically considered for systemic therapy, including biologics. In spite of the overall superiority of biologic agents, the treatment response may differ substantially among individual patients. As with other medical conditions, a range of factors contribute to response heterogeneity observed in psoriasis. Proper identification of these factors can significantly improve the therapeutic decisions. This review focuses on potential genetic and nongenetic factors that may affect the treatment response and outcomes in patients with psoriasis.
    Dermatologic Therapy 08/2014; · 1.48 Impact Factor

Full-text (2 Sources)

Available from
May 21, 2014