Comparative assessment of age related clinical and epidemiological characteristics in psoriasis patients

A total number of 374 (54,3% male, 45,7% female) psoriasis patients diagnosed according to the histopathological findings between 2006 – 2016 years, were retrospectively assessed at Ege University Medical Faculty Department of Dermatology and Venereology outpatient clinic. Aim of this study was general and comparative assessment of parameters such as sex, age, duration of disease, family history, clinical types, PASI (Psoriasis Area Severity Index), nail and joint involvement, comorbidities, dermatoses and treatments in four age groups including 0-18, 19-40, 41-65 and above 65. Statistical analyses of study was done using IBM SPSS Statistics 21.0. Analyses were done with 'Pearson's Chi-Square' test. Age of the patients were between 6 and 85 ages (mean 42,17±18,54). Disease onset age ranged between 3 and 70 (mean 25,98±14,56). 16% of the patients were between 0-18 ages, 26,7% were 19-40 ages, 45,5% were 41-65 ages and 11,8% were above 65. 67,9% of patients had plaque, 9,1% had guttate, 6,7% scalp, 4,8% had palmoplantar, 4% had palmoplantar pustular, 3,2% had generalized pustular, 2,7% had erythrodermic and 1,6% had invers psoriasis. Guttate psoriasis and generalized pustular psoriasis observed more frequently in females compared to males (p=0,001). Plaque psoriasis was most observed clinical type in all age groups, while between 0-18 ages guttate psoriasis (31,7%) frequency was statistically significant compared to other age groups (p<0,001). The mean PASI value was 10,45±7,02. Highest PASI values (11,94±6,88) were in 41 – 65 ages, while lowest values (6,28±4,63) were in 0-18 ages. Nail involvement observed in 53,7% of the patients. Nail involvement in 41 – 65 ages were 64,7%, while it was 18,3% in 0-18 age group (p<0,001). Nail involvement were in all patients with generalized pustular (n=12) and erythrodermic psoriasis (n=10) and in 88,9% of palmoplantar psoriasis patients and 57,5% of plaque psoriasis patients. It was not observed in inverse psoriasis patients. Statistically significant relation observed between nail involvement and clinical types (p<0,001). Joint involvement were observed in 24 patients (6,4%). Frequency of joint involvement identified in 1,7% of 0-18 age groups, 4% of 19-40 age groups, 8,8% of 41-65 age groups and 9,1% above 65 ages (p<0,001). Joint involvement were in 50% of patients with generalized pustular and in 40% with erythrodermic psoriasis but not at all in patients with palmoplantar, palmoplantar pustular, scalp and inverse psoriasis (p<0,001). Nail involvement observed in significant frequency (83,3%) in patients with joint involvement compared to patients without (p<0,001). Hypertension (24,3%) and diabetes mellitus (22,5%) were most frequent comorbidities. Frequency of comorbidities significantly increased with age (p<0,001). Tobacco users was 44,7% among patients. It was less frequent (20,6%) in guttate psoriasis, while observed in most of the (93,3%) pustular psoriasis patients (p<0,001). Phototherapy applied to 24,9% of all 374 patients. It was used on 66,7% of palmoplantar, 44,1% of guttate and 22,8% of plaque psoriasis patients (p<0,001). Systemic treatment (methotrexate, cyclosporine, acitretine) was used on 59,8% of patients. Most used systemic agent was methotrexate (44,7%). If to compare systemic agents in different age groups, most used agent in 0-18 age group was acitretine (20%). In other age groups most used systemic agent was methotrexate (p<0,001). Biological treatment was used in 19,2% of patients. Most applied biological agent was adalimumab (9,9%), while etanercet was used in 8,8%, infliximab in 8,6% and ustecinumab in 3,5%. No statistically significant difference observed in use of biological agents in different age groups (p>0,05). In this study, parameters such as family history, clinical types, PASI values, nail and joint involvement, comorbidities, dermatosis and applied treatments compared in different age groups of psoriasis patients. Age defined as a statistically significant factor in distribution of clinical types, nail and joint involvement, comorbidities and selection of treatment modalities. Keywords: Psoriasis, different age groups, comparison.