Incidence and Risk Factors for Psoriasis in the General Population

Spanish Centre for Pharmacoepidemiologic Research.
Archives of dermatology (Impact Factor: 4.79). 01/2008; 143(12):1559-65. DOI: 10.1001/archderm.143.12.1559
Source: PubMed


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.

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Available from: Luis Alberto Garcia-Rodriguez,
    • "Psoriasis is a multifactorial papulosquamous disorder common in pediatrics. It has been estimated that psoriasis affects 1-3% of the population [1] and even if the true prevalence of pediatric patients may vary in different regions worldwide, it represents about 4% of all skin diseases in patients aged less than 16 years in Europe and North America [2] [3]. Since children differ from adults, specific guidelines underlining triggers, clinical pictures, management and psychosocial effect of pediatric psoriasis are needed. "
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    ABSTRACT: Psoriasis is a chronic, immune-mediated, inflammatory systemic disease which target primarily the skin. It presents a genetic basis, affecting 1 to 3% of the white population. Nevertheless, the existence of two psoriasis incidence peaks has been suggested (one in adolescence before 20 years of age and another in adulthood) onset may occur at any age, including childhood and adolescence, in which its prevalence ranges between 0.7% and 1.2%. As for adult psoriasis, pediatric psoriasis has recently been associated with obesity, metabolic syndrome, increased waist circumference percentiles, and metabolic laboratory abnormalities, warranting early monitoring and lifestyle modifications. In addition, due to psoriasis chronic nature and frequently occurring relapses, psoriatic patients tend to have an impaired quality of life, often requiring long-term treatment. Therefore, education of both pediatric patients and their parents is essential to successful and safe disease management. However, systemic treatment of children is challenging as the absence of standardized guidelines and the fact that evidence-based data form randomized controlled trials are very limited. This review shows an overview of the current understanding of the pathogenesis, comorbidities, differential diagnosis, treatment and prevention of pediatric psoriasis, also presenting with an emphasis on the necessity of an integrated treatment approach involving different specialists such as dermatologist, pediatricians, rheumatologists, etc.
    04/2015; 11(999). DOI:10.2174/1573400511666150504125456
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    • "In our study, 5.3% of patients have pointed out stress presence. However, Huerta et al. [13] stated that there was no connection between psoriasis occurrence risk and stress histories. The three severe skin forms of psoriasis have been observed in our study and are the erythrodermic psoriasis (60.7%), the universal psoriasis (37.5%), and pustular psoriasis (1.8%). "
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    ABSTRACT: Bacground. Psoriasis is an erythematosquamous dermatosis of chronic development. In sub-Saharan Africa, few studies have been focused on complicated forms of psoriasis. Objective. The aim is to describe epidemiological, clinical, and histological features of severe skin forms of psoriasis in Cote d'Ivoire. Material and Methods. The study was both cross-sectional and descriptive, that focused on patient admitted to the dermatology unit for complicated psoriasis, from January 1st, 1986, to December 31th, 2007. Results. Fifty-six patients admitted to hospital for severe skin forms of psoriasis were recorded and included in our study over 7.503 patients hospitalized during the study period. They represented 0.75% of cases. The average age was 39.6 ± 3.3 years. There were 49 male (87.5%) and 7 female patients (12.5%) with a sex ratio of 7. At socioprofessional level, 48 patients (87.5%) were from category 1. Patients' history was dominated by the psoriasis vulgaris. Physical and general signs were dominated by itching (58.9%). The three severe skin forms were observed with predominant erythrodermic psoriasis (60.7%). Fifteen patients (34.9%) were HIV positive. Conclusion. Severe skin forms of psoriasis are rare in our setting. But in the quarter of HIV-positive patients, they are dominated by the erythrodermic psoriasis.
    12/2013; 2013:561032. DOI:10.1155/2013/561032
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    • "However, data on psoriasis treatment patterns in primary care, especially for patients who are referred to specialist care, is lacking. Additionally, the most current estimates for the incidence of psoriasis in the UK utilized data for patients diagnosed about 15 years ago, in 1996–1997 [13]. It is important to understand the proportion and characteristics of patients who are currently being referred for specialist care to determine an updated disease burden on the UK health system. "
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    ABSTRACT: In the UK, referrals to specialists are initiated by general practitioners (GPs). Study objectives were to estimate the incidence of diagnosed psoriasis in the UK and identify factors associated with GP referrals to dermatologists. Newly diagnosed patients with psoriasis were identified in The Health Improvement Network (THIN) database between 01July2007-31Oct2009. Incidence of diagnosed psoriasis was calculated using the number of new psoriasis patients in 2008 and the mid-year total patient count for THIN in 2008. A nested case--control design and conditional logistic regression were used to identify factors associated with referral. Incidence rate of diagnosed adult psoriasis in 2008 was 28/10,000 person-years. Referral rate to dermatologists was 18.1 (17.3-18.9) per 100 person-years. In the referred cohort (N=1,950), 61% were referred within 30 days of diagnosis and their median time to referral was 0 days from diagnosis. For those referred after 30 days (39%, median time to referral: 5.6 months), an increase in the number of GP visits prior to referral increased the likelihood of referral (OR=1.87 95%CI:1.73-2.01). A prescription of topical agents such as vitamin D3 analogues 30 days before referral increased the likelihood of being referred (OR=4.67 95%CI: 2.78-7.84), as did corticosteroids (OR=2.45 95% CI: 1.45-4.07) and tar products (OR=1.95 95%CI: 1.02-3.75). Estimates of the incidence of diagnosed adult psoriasis, referral rates to dermatologists, and characteristics of referred patients may assist in understanding the burden on the UK healthcare system and managing this population in primary and secondary care.
    BMC Dermatology 08/2013; 13(1):9. DOI:10.1186/1471-5945-13-9
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