Comparison of clinical and psychosocial characteristics of patients with early and late onset psoriasis

Psoriasis is a common, chronic inflammatory disease and one of the dermatological diagnoses with high psychosocial morbidity. When psoriasis is grouped according to the age of onset, it is divided into two groups as early-onset (type 1, <40 years) and late-onset (type 2, >40 years). The aim of our study was to compare the clinical and psychosocial characteristics of our patients with the diagnosis of psoriasis, according to the age at onset of psoriasis. A total of 190 patients who met the inclusion criteria were included in our study. A Sociodemographic Data Form, Hospital Anxiety and Depression (HAD) Scale, Psoriasis Internalized Stigma Scale (PISS), Dermatology Life Quality Index (DQLI) and Pictorial Representation of Illness and Self Measure Revised II (PRISM-RII) scale were applied to the patients. A total of 135 patients (71%) were included in the early-onset psoriasis group, and 55 (29%) in the late-onset psoriasis group. Chronic plaque psoriasis was most common in both groups, and pustular psoriasis clinical variants were more common in the late-onset group than in the early-onset group (P=0.006). In our study, family history (P=0.000) and sensitivity to stress (P=0.025) were more common in early-onset psoriasis, whereas trauma history associated with disease onset was more common in the late-onset group (P=0.001). A positive correlation was found between the age of onset of the disease and BMI. There was no difference between the two groups in terms of joint involvement, nail involvement and PASI. Parameters that correlated positively with PASI were DLQI, PISS- Stereotype endorsement subscale, and SIS. HAD-Anxiety in 23.1% of our patients and HAD-Depression in 36.3% of our patients were above the threshold values, but no significant difference was observed between the two groups in terms of HAD scores. The agents with the highest treatment satisfaction are biological treatments, and a negative correlation was found between treatment satisfaction and DLQI and HAD-Anxiety. A positive correlation was found between PISS and most of its subscales, and DLQI and HAD. A negative correlation was found between the PRISM-RII-SIS subscale and the DLQI, HAD and PISS scores. Our study is one of the few studies evaluating clinical and psychosocial characteristics in patients with early and late onset psoriasis. The fact that some features such as psoriasis clinical variants, susceptibility to stress, trauma history, and high BMI vary according to the age of onset of the disease shows that the age of onset is a parameter that should be considered when evaluating patients. In addition, it has been shown that there is a relationship between patients' quality of life and stigma, depression, anxiety, perception of illness and clinical severity of psoriasis. These multifaceted interactions reveal the importance of dermatologists' holistic approach to patients, considering the psychological effects of the disease. Keywords: psoriasis, age at onset of disease, psychosocial morbidity