The evaluation of the clinical and demographic features of patients diagnosed with psoriasis

The prevalence of psoriasis, a chronic and inflammatory skin disease, ranges from 0.2% to 4.8%. Psoriasis vulgaris is the most common type of psoriasis that can appear in different clinical forms. The fact that many comorbidities accompany psoriasis that can be seen at any age and negatively affect the quality of life further increases the importance of the disease. In our study, the clinical and demographic characteristics of patients with psoriasis were prospectively investigated. This study included 277 patients with psoriasis who applied to the Department of Dermatology, Faculty of Medicine, Dicle University, between December 2018 and February 2020. Detailed anamnesis of all patients were taken, and parameters such as age, gender, height, weight, occupation, marital status, place of residence, duration of disease, age of onset of disease, triggering factors, joint involvement, nail involvement, systemic disease history, alcohol history, smoking history, family histories, topical and systemic treatments received were prospectively examined. To evaluate the disease severity, Psoriasis area severity index (PASI), body surface area (BSA) and dermatology life quality index (DLQI) were used. Data were evaluated with SPSS 24 program and analyzed with x² (ChiSquare) statistical method. The ages of 277 patients included into the study ranged between 8 and 81. The mean age of the patients was 37.1 ± 15.9. The mean age of onset of illness was 21.0 ± 14.1 in females and 25.3 ± 14.4 in males. Age and onset age were lower in female gender on admission, and this difference was statistically significant (p values <0.001 and 0.012, respectively). Male gender constituted 54.9% of our patients and the male / female ratio was 1.21. In 85.2% of our patients, it was found that the disease started before the age of 40 (type 1), and 14.8% of the patients started after the age of 40 (type 2). Family history of psoriasis was present in 29.6% of our patients, and the family history was higher in patients with type 1 psoriasis (p: 0.023). When the patients were evaluated in terms of clinical subtype, the most common type with a rate of 82.3% was the classical plaque type, while the least common was the localized pustular type with a rate of 0.4%. While 31 patients with pediatric psoriasis had mostly the common plaque type (58%), similar to adults, the least common types were guttate (3.2%) and erythrodermic (3.2%), whereas localized pustular psoriasis was not detected in this group. Different triggering factors were present in 74% of patients. Stress was the most common triggering factor in both the adult and child populations, while the second was food in adults and infections in the pediatric group. There were accompanying comorbid diseases in 17% of the patients, and the most common comorbidity was hypertension. Of the patients, 44% had nail involvement. The most common nail change was pitting (75.9%). Psoriatic arthritis (PsA) was detected in 25 of 277 patients. Female gender dominance was detected in patients with PsA (p: 0.016) and the most common type was asymmetric oligoartricular type with a rate of 64%. When the patients were evaluated according to the treatment they received, 17.3% were treated only with topical treatment, 1.1% with phototherapy, 37.5% with conventional therapy, 42.2% with biological therapy, 1.8% with conventional + biological therapy. There are many studies examining the clinical and demographic characteristics of psoriasis patients. The clinical and demographic data of our study were similar to those reported in previous studies. We believe that performing similar studies involving more extensive patient groups will contribute to the diagnosis and treatment of the disease. Keywords: Clinical, demographic, psoriasis, clinical type, triggering factor