Background Incidence studies of psoriasis are rare, mainly due to lack of established epidemiological criteria and the variable disease course. The objective of this study is to determine time trends ...in incidence and survival of psoriasis patients over three decades. Methods We identified a population-based incidence cohort of 1633 subjects aged ≥18 years first diagnosed with psoriasis between January 1, 1970 and January 1, 2000. The complete medical records for each potential psoriasis subject were reviewed and diagnosis was validated by either a confirmatory diagnosis in the medical record by a dermatologist or medical record review by a dermatologist. Age- and sex-specific incidence rates were calculated and were age- and sex-adjusted to the 2000 US white population. Results The overall age- and sex-adjusted annual incidence of psoriasis was 78.9 per 100,000 (95% confidence interval CI: 75.0-82.9). When psoriasis diagnosis was restricted to dermatologist-confirmed subjects, the incidence was 62.3 per 100,000 (95% CI: 58.8-65.8). Incidence of psoriasis increased significantly over time from 50.8 in the period 1970-1974 to reach 100.5 per 100,000 in the 1995-1999 time period ( P = .001). Although the overall incidence was higher in males than in females ( P = .003), incidence in females was highest in the sixth decade of life (90.7 per 100,000). Survival was similar to that found in the general population ( P = .36). Limitations The study population was mostly white and limited to adult psoriasis patients. Conclusion The annual incidence of psoriasis almost doubled between the 1970s and 2000. The reasons for this increase in incidence are currently unknown, but could include a variety of factors, including a true change in incidence or changes in the diagnosing patterns over time.
Heart disease in psoriasis Kremers, Hilal Maradit, MD, MSc; McEvoy, Marian T., MD; Dann, Frank J., MD ...
Journal of the American Academy of Dermatology,
08/2007, Letnik:
57, Številka:
2
Journal Article
Recenzirano
Psoriasis has been traditionally viewed as an inflammatory skin disorder of unknown origin. Recent advances in the immunopathogenesis and genetics of psoriasis have broadened our understanding of ...psoriasis. Psoriasis is now considered a systemic inflammatory condition analogous to other inflammatory immune disorders. Patients with other immune disorders, such as systemic lupus erythematosus or rheumatoid arthritis, are known to be at increased risk of heart disease. Similarly, patients with psoriasis may carry an excess risk of heart disease, which would represent an important previously unrecognized cause of morbidity and mortality. This review summarizes the current evidence for an increased cardiovascular risk in patients with psoriasis and outlines deficits in our knowledge in this area.
Objective We sought to assess whether patients with psoriasis with moderate or severe disease are being treated with systemic therapy. Methods Participants were identified from a random sample of the ...National Psoriasis Foundation contact database who were 18 years and older, with severe psoriasis (>10% body surface area) and moderate psoriasis (3%-10% body surface area); respondents with psoriatic arthritis were excluded. Results In all, 1657 respondents with psoriasis completed the survey (28% severe, 41% moderate). A total of 39% of respondents with severe psoriasis and 37% with moderate psoriasis were not currently receiving any treatment. Among respondents currently receiving therapy, only 43% of respondents with severe psoriasis received either traditional systemic therapy, biologic therapy, or phototherapy. Limitations Respondents were from the National Psoriasis Foundation contact database and reported their current severity, which may be affected by their treatment. Body surface area as a measure of patient-reported severity has not been validated but has been used in several published studies. Conclusions Almost 40% of respondents with psoriasis were currently not receiving treatment. For respondents with severe psoriasis, 26% were treated with systemic therapy, phototherapy, or both; 39% were not in treatment; and 35% were treated with topical therapy alone.
Objective We sought to examine whether psoriasis severity was associated with patient income and employment. Methods Respondents (>30 years old) to National Psoriasis Foundation surveys (2003-2005) ...were classified by reported body surface area as having mild (<3%), moderate (3%-10%), or severe (>10%) psoriasis. The relationship between severity and household income (<$30,000 vs ≥$30,000) and employment was assessed by logistic regression, adjusting for age, age at onset, sex, race, and drug treatment. Results Probability of low income (<$30,000) was significantly greater among patients with severe disease than those with mild disease ( P = .0002). Patients with severe disease had lower probability of working full time compared with patients with mild psoriasis but it was not statistically significant. Significantly more patients with severe psoriasis (17%) versus mild (6%) reported that psoriasis was the reason for not working ( P = .01). Limitations Household income was self-reported and may be influenced by household composition, which is unknown. Psoriasis severity was patient reported and not physician assessed. Conclusions This study demonstrated that income and employment were negatively impacted among patients with severe psoriasis compared with mild psoriasis.
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