Łuszczyca
Epidemiologia
Łuszczyca (psoriasis) to przewlekła, immunologicznie uwarunkowana choroba zapalna skóry o złożonej etiologii, dotykająca około 2-3% populacji światowej, co odpowiada około 125 milionom osób. Występowanie choroby wykazuje zróżnicowanie geograficzne i etniczne, z wyższą częstością w krajach rozwiniętych i chłodniejszych klimatach (do 4,6%), a niższą w regionach tropikalnych i wśród osób o ciemniejszym fototypie skóry (np. 0,14-0,17% w Azji Wschodniej). Zachorowalność waha się od 30,3 do 321,0 przypadków na 100 000 osobolat, z wyższą częstością u dorosłych. Łuszczyca ma dwumodalny rozkład wieku zachorowania (15-25 lat i 55-60 lat), a około 10-15% przypadków dotyczy dzieci poniżej 10 roku życia. Czynniki ryzyka obejmują predyspozycje genetyczne (35% pacjentów z rodzinnym występowaniem), palenie tytoniu, otyłość, spożycie alkoholu, infekcje paciorkowcowe, urazy skóry, stres psychiczny oraz niektóre leki (beta-blokery, lit, inhibitory ACE). Łuszczycowe zapalenie stawów (PsA) występuje u 10-41% pacjentów z łuszczycą, z roczną zapadalnością 3,0-23,1 przypadków na 100 000 osobolat, a narzędzie przesiewowe PEST (wynik ≥3) wykazuje wysoką czułość (93-97%) i swoistość (79-89%) w wykrywaniu PsA.
- Epidemiologia łuszczycy
- Rozpowszechnienie łuszczycy na świecie
- Zachorowalność i trendy czasowe
- Różnice etniczne i rasowe
- Wiek i płeć
- Czynniki ryzyka i czynniki wyzwalające
- Łuszczyca stawowa
- Choroby współistniejące
- Choroby sercowo-naczyniowe i metaboliczne
- Zaburzenia psychiczne i neurologiczne
- Inne choroby współistniejące
- Wpływ łuszczycy na jakość życia
- Obciążenie ekonomiczne
- Wyzwania epidemiologiczne i przyszłe kierunki
Epidemiologia łuszczycy
Łuszczyca (psoriasis) to przewlekła, immunologicznie mediowana choroba zapalna skóry o złożonej etiologii, która dotyka znaczącej części populacji na całym świecie. Badania epidemiologiczne dostarczają istotnych informacji na temat rozpowszechnienia choroby, czynników ryzyka oraz współwystępujących schorzeń, co jest niezbędne dla prawidłowego planowania opieki zdrowotnej i wdrażania skutecznych strategii profilaktycznych i terapeutycznych12.
Rozpowszechnienie łuszczycy na świecie
Częstość występowania łuszczycy na świecie szacuje się na około 2-3% populacji ogólnej, co odpowiada około 125 milionom osób dotkniętych tą chorobą12. Dane z Global Psoriasis Atlas wskazują, że około 60 milionów ludzi na całym świecie cierpi na łuszczycę1. Występowanie choroby wykazuje znaczne zróżnicowanie geograficzne i etniczne:
- Wyższe wskaźniki występowania obserwuje się w krajach rozwiniętych i regionach o chłodniejszym klimacie, gdzie może dotykać 4,6% populacji12
- W Stanach Zjednoczonych łuszczyca dotyka około 7,5-8 milionów osób (około 2,2% populacji według National Institutes of Health)12
- W Europie Zachodniej rozpowszechnienie łuszczycy sięga 1,92% (95% przedział ufności: 1,07% do 3,46%), a w Europie Środkowej 1,83% (0,62% do 5,32%)1
- Najniższe wskaźniki występowania odnotowuje się w regionach tropikalnych i cieplejszych oraz wśród osób o ciemniejszym fototypie skóry1
- W Azji Wschodniej częstość występowania łuszczycy jest znacznie niższa i wynosi około 0,14-0,17%12
Badania wykazały, że częstość występowania łuszczycy wzrasta wraz z oddalaniem się od równika, co może być związane z różnicami klimatycznymi, tłem genetycznym i czynnikami środowiskowymi12.
Zachorowalność i trendy czasowe
Zachorowalność na łuszczycę (liczba nowych przypadków) wykazuje również zróżnicowanie geograficzne. Według danych badań systematycznych, wskaźniki te wahają się od 30,3 przypadków na 100 000 osobolat (95% przedział ufności: 26,6 do 34,1) na Tajwanie do 321,0 przypadków na 100 000 osobolat we Włoszech1. Zachorowalność jest wyższa wśród dorosłych niż wśród dzieci2.
Analiza trendów czasowych wskazuje na względną stabilność zachorowalności w ostatnich latach, przy jednoczesnym systematycznym wzroście rozpowszechnienia choroby1. Globalne badanie epidemiologiczne opublikowane w International Journal of Dermatology wykazało, że w latach 1990-2017 rozpowszechnienie łuszczycy wzrosło z 758 przypadków na 100 000 osób do 812 przypadków na 100 000 osób1.
Różnice etniczne i rasowe
Łuszczyca wykazuje zróżnicowanie w zależności od pochodzenia etnicznego i rasowego:
- W Stanach Zjednoczonych częstość występowania łuszczycy jest wyższa wśród osób rasy białej (3,6%) w porównaniu z Azjatami (2,5%), Latynosami (1,9%) i osobami rasy czarnej (1,5%)1
- Częstość występowania łuszczycy wśród Afroamerykanów szacuje się na 1,3-1,5% w porównaniu do 2,5-3,6% wśród osób rasy białej12
- Choroba jest rzadka lub niemal nieobecna wśród rdzennych mieszkańców Australii, Indian z Ameryki Południowej czy Samoa12
Różnice te mogą być częściowo związane z podłożem genetycznym oraz czynnikami środowiskowymi, ale również z niedodiagnozowaniem łuszczycy wśród osób o ciemniejszym fototypie skóry ze względu na odmienną prezentację kliniczną1.
Wiek i płeć
Epidemiologia łuszczycy wykazuje charakterystyczny rozkład wiekowy i związek z płcią:
- Choroba może pojawić się w każdym wieku, jednak badania wskazują na dwumodalny rozkład wieku zachorowania12
- Pierwszy szczyt zachorowań przypada na 15-25 rok życia (typ I łuszczycy), a drugi na 55-60 rok życia (typ II łuszczycy)12
- Typ I stanowi ponad 75% wszystkich przypadków1
- Średni wiek zachorowania wynosi około 28 lat1
- Około 10-15% nowych przypadków pojawia się u dzieci poniżej 10 roku życia1
Dane dotyczące różnic między płciami są niejednoznaczne. Niektóre badania wskazują na nieznacznie wyższą częstość występowania łuszczycy wśród mężczyzn1, podczas gdy inne sugerują równy rozkład między płciami12. U kobiet obserwuje się wcześniejszy wiek zachorowania niż u mężczyzn1.
Czynniki ryzyka i czynniki wyzwalające
Badania epidemiologiczne zidentyfikowały szereg modyfikowalnych czynników ryzyka, które mogą predysponować do rozwoju łuszczycy lub zaostrzać przebieg istniejącej choroby1:
- Czynniki genetyczne – dziedziczenie jest wielogenowe, około 35% pacjentów wykazuje rodzinne występowanie choroby12
- Palenie tytoniu – stanowi uznany czynnik ryzyka rozwoju i zaostrzenia łuszczycy1
- Otyłość – wykazuje silny związek z łuszczycą, zwłaszcza z cięższym przebiegiem choroby1
- Spożywanie alkoholu – może zwiększać ryzyko rozwoju i zaostrzeń łuszczycy1
- Infekcje – szczególnie paciorkowcowe, mogą wyzwalać pierwsze wystąpienie lub zaostrzenie łuszczycy1
- Urazy skóry – mogą prowadzić do rozwoju łuszczycy w miejscu urazu (zjawisko Koebnera)1
- Stres psychiczny – jest uznanym czynnikiem wyzwalającym zaostrzenia u wielu pacjentów12
- Niektóre leki – w tym beta-blokery, lit, inhibitory ACE, niesteroidowe leki przeciwzapalne i leki przeciwmalaryczne mogą wyzwalać lub zaostrzać łuszczycę1
Zrozumienie czynników ryzyka ma kluczowe znaczenie dla profilaktyki i odpowiedniego zarządzania chorobą1.
Łuszczyca stawowa
Łuszczyca stawowa (łuszczycowe zapalenie stawów, PsA) stanowi istotne powikłanie łuszczycy i ważny aspekt epidemiologii tej choroby1.
Rozpowszechnienie łuszczycy stawowej
Szacuje się, że łuszczycowe zapalenie stawów występuje u znaczącego odsetka pacjentów z łuszczycą:
- Według różnych badań, od 10% do 41% pacjentów z łuszczycą rozwinie łuszczycowe zapalenie stawów12
- Najczęściej przytaczany wskaźnik wynosi około 30%12
- W przeglądzie systematycznym Prey i wsp. wykazali, że łuszczycowe zapalenie stawów może dotyczyć do 24% pacjentów z łuszczycą1
- Roczna zapadalność i chorobowość łuszczycowego zapalenia stawów wynoszą odpowiednio 3,0-23,1 przypadków/100 000 osobolat i 14-20 przypadków/100 000 osób, z podobnymi wynikami w krajach zachodnich i w Chinach1
Co istotne, około 16% pacjentów z łuszczycą może mieć niezdiagnozowane łuszczycowe zapalenie stawów1, co podkreśla znaczenie odpowiednich narzędzi przesiewowych i systematycznej oceny pacjentów z łuszczycą pod kątem zajęcia stawów.
Narzędzia przesiewowe – PEST
Psoriasis Epidemiology Screening Tool (PEST) to walidowane narzędzie przesiewowe opracowane specjalnie do wykrywania łuszczycowego zapalenia stawów u pacjentów z łuszczycą12. PEST wyróżnia się prostotą i łatwością użycia, co czyni go przydatnym zarówno dla lekarzy podstawowej opieki zdrowotnej, jak i dermatologów, którzy mogą mieć trudności z rozpoznaniem łuszczycowego zapalenia stawów1.
Główne cechy kwestionariusza PEST:
- Składa się z pięciu prostych pytań dotyczących objawów stawowych12
- Wynik 3 lub więcej punktów wskazuje na ryzyko łuszczycowego zapalenia stawów12
- Wykazuje wysoką czułość (93-97%) i dobrą swoistość (79-89%) w wykrywaniu łuszczycowego zapalenia stawów12
- Wartość predykcyjna dodatnia wynosi około 65%, a wartość predykcyjna ujemna 99%1
- Jest zalecany do stosowania co 6 miesięcy u wszystkich pacjentów z łuszczycą1
PEST został zwalidowany w różnych populacjach, w tym japońskiej1 i tureckiej1, wykazując dobre właściwości psychometryczne. Badania sugerują również jego użyteczność w populacji pediatrycznej1. Systematyczne stosowanie tego narzędzia może przyczynić się do wcześniejszego rozpoznania łuszczycowego zapalenia stawów i poprawy wyników leczenia1.
Choroby współistniejące
Łuszczyca jest obecnie uznawana za chorobę ogólnoustrojową związaną z licznymi chorobami współistniejącymi, co ma istotne implikacje dla diagnostyki, leczenia i prowadzenia pacjentów12.
Choroby sercowo-naczyniowe i metaboliczne
Dane epidemiologiczne wskazują na zwiększone ryzyko chorób sercowo-naczyniowych i metabolicznych u pacjentów z łuszczycą1:
- Choroby układu krążenia – w jednej z największych metaanaliz wykazano, że łuszczyca jest związana z chorobami układu krążenia i ich czynnikami ryzyka1
- Zespół metaboliczny – występuje częściej u pacjentów z łuszczycą1
- Otyłość – jest częstym schorzeniem współistniejącym, które może nasilać przebieg łuszczycy1
- Cukrzyca typu 2 – wykazuje zwiększone występowanie u pacjentów z łuszczycą1
- Zaburzenia lipidowe – stanowią jedno z najczęstszych schorzeń współistniejących (35,87% pacjentów)1
- Nadciśnienie tętnicze – dotyka około 35,50% pacjentów z łuszczycą1
Związek między łuszczycą a chorobami sercowo-naczyniowymi jest silniejszy u pacjentów z łuszczycowym zapaleniem stawów w porównaniu do pacjentów z samą łuszczycą1.
Zaburzenia psychiczne i neurologiczne
Łuszczyca wpływa znacząco na stan psychiczny pacjentów1:
- Depresja – występuje częściej u osób z łuszczycą1
- Zaburzenia lękowe – stanowią istotny problem u pacjentów z łuszczycą1
- Zwiększone ryzyko samobójstwa – obserwowane u pacjentów z cięższymi postaciami choroby1
Łuszczyca nie tylko wywołuje negatywny wpływ na zdrowie psychiczne, ale również może powodować istotne zmiany patologiczne w układzie nerwowym poprzez zapalenie mediowane dysregulacją immunologiczną1.
Inne choroby współistniejące
W ostatnich latach zidentyfikowano lub potwierdzono związek łuszczycy z wieloma innymi schorzeniami1:
- Przewlekła choroba nerek (CKD) – pacjenci z łuszczycą mają zwiększone ryzyko CKD1
- Poważne infekcje – łuszczyca wiąże się z nieznacznym zwiększeniem ryzyka poważnych infekcji, a ciężkość łuszczycy jest predyktorem tego ryzyka1
- Choroby zapalne jelit – szczególnie choroba Crohna, występują częściej u pacjentów z łuszczycą1
- Gruźlica i mukowiscydoza – wykazano silny związek tych chorób z łuszczycą (iloraz szans odpowiednio 2,36 i 2,15)1
- Celiakia i bielactwo – wykazano dwukierunkowe związki między tymi chorobami a łuszczycą1
Badania wykazały, że pacjenci z łuszczycą często borykają się z wielochorobowością – prawie trzech na czterech pacjentów prezentuje wiele chorób i objawów o różnym pochodzeniu1.
Wpływ łuszczycy na jakość życia
Łuszczyca, mimo że zazwyczaj nie zagraża życiu, ma znaczący negatywny wpływ na jakość życia pacjentów12.
Mierzenie wpływu na jakość życia
Do oceny wpływu łuszczycy na jakość życia stosuje się różne narzędzia, w tym Dermatology Life Quality Index (DLQI). Badania pokazują, że1:
- Pacjenci z łuszczycą doświadczają obniżenia jakości życia porównywalnego lub gorszego niż pacjenci z innymi chorobami przewlekłymi, takimi jak choroba niedokrwienna serca czy cukrzyca1
- Średni wynik DLQI w badaniach pacjentów z łuszczycą wynosi około 14, co wskazuje na bardzo duży wpływ choroby na życie pacjenta1
- Wpływ na jakość życia nie zawsze koreluje z klinicznym nasileniem choroby – nawet łagodna łuszczyca może znacząco obniżać jakość życia, jeśli zajmuje widoczne obszary ciała1
Czynniki wpływające na jakość życia
Badania zidentyfikowały szereg czynników, które wpływają na stopień obniżenia jakości życia u pacjentów z łuszczycą1:
- Płeć – łuszczyca ma większy wpływ na jakość życia kobiet i młodszych pacjentów1, choć w niektórych badaniach, np. z Chile, mężczyźni zgłaszali większy wpływ choroby na jakość życia1
- Wiek zachorowania – młodszy wiek zachorowania wiąże się z większym wpływem na jakość życia1
- Czas trwania choroby – niedawno zdiagnozowana choroba często ma większy wpływ na jakość życia1
- Lokalizacja zmian – zajęcie twarzy i widocznych obszarów ciała znacząco obniża jakość życia1
- Rozległość choroby – bardziej rozległa łuszczyca zazwyczaj wiąże się z większym obniżeniem jakości życia1
- Obecność chorób współistniejących – szczególnie łuszczycowego zapalenia stawów1
Interwencje psychologiczne, szczególnie w formie poznawczo-behawioralnych technik zarządzania stresem, mogą odgrywać istotną rolę w leczeniu łuszczycy1. Jest to szczególnie ważne, biorąc pod uwagę, że do 60% pacjentów opisuje stres jako kluczowy czynnik wyzwalający lub zaostrzający chorobę1.
Obciążenie ekonomiczne
Łuszczyca stanowi znaczące obciążenie ekonomiczne zarówno dla systemu opieki zdrowotnej, jak i dla poszczególnych pacjentów1.
Koszty leczenia
Koszty związane z leczeniem łuszczycy są znaczne1:
- Pacjenci z łuszczycą ponoszą roczne koszty opieki zdrowotnej znacznie wyższe niż populacja ogólna1
- W Stanach Zjednoczonych całkowite koszty opieki zdrowotnej związane z łuszczycą szacuje się na około 135 miliardów dolarów rocznie (dane z 2013 roku)12
- Ekonomiczne obciążenie łuszczycą jest znaczne ze względu na przewlekły charakter choroby oraz związane z nią negatywne konsekwencje fizyczne, psychiczne i społeczne1
Nasilenie choroby a koszty
Nasilenie łuszczycy ma istotny wpływ na koszty leczenia1:
- Około 60% pacjentów ma łagodną łuszczycę, 30% umiarkowaną, a 10% ciężką1
- Prawie jedna czwarta pacjentów z łuszczycą (24%) ma postać umiarkowaną do ciężkiej1
- Pacjenci z cięższymi postaciami choroby generują proporcjonalnie wyższe koszty leczenia ze względu na potrzebę stosowania bardziej zaawansowanych terapii (np. leki biologiczne)1
Ocena nasilenia łuszczycy opiera się głównie na miarach jakości życia oraz na odsetku zajętej powierzchni ciała. Na podstawie aktualnych dowodów, wskaźnik PASI (Psoriasis Area Severity Index) wydaje się najbardziej wiarygodnym i powtarzalnym klinicznym wskaźnikiem nasilenia w postępowaniu z dorosłymi pacjentami z łuszczycą plackowatą1.
Wyzwania epidemiologiczne i przyszłe kierunki
Pomimo znacznego postępu w badaniach epidemiologicznych dotyczących łuszczycy, nadal istnieją istotne wyzwania i luki w wiedzy12.
Luki w danych epidemiologicznych
Istnieją znaczące luki w dostępnych danych epidemiologicznych1:
- Tylko 19% krajów na świecie posiada dane epidemiologiczne dotyczące łuszczycy1
- 81% krajów świata nie ma informacji na temat epidemiologii łuszczycy12
- Dane dotyczące zapadalności i chorobowości łuszczycy są szczególnie ograniczone w krajach o niskim i średnim dochodzie1
- W Indiach, kraju o dużej różnorodności, częstość występowania łuszczycy może się różnić w zależności od regionu ze względu na zmienne czynniki środowiskowe i genetyczne1
Zaleca się przeprowadzenie dużych badań epidemiologicznych opartych na populacji w różnych częściach świata w celu oszacowania rzeczywistej częstości występowania łuszczycy w populacji ogólnej1.
Przyszłe kierunki
Przyszłe kierunki badań epidemiologicznych nad łuszczycą powinny obejmować1:
- Lepsze zrozumienie przyczyn wzrostu rozpowszechnienia łuszczycy w czasie1
- Badanie wpływu zmian klimatycznych, zanieczyszczenia środowiska i zmian stylu życia na epidemiologię łuszczycy1
- Identyfikację biomarkerów, które mogą pomóc w lepszej stratyfikacji, diagnostyce i personalizacji leczenia w łuszczycy1
- Badanie dwukierunkowych związków między łuszczycą a chorobami współistniejącymi1
- Opracowanie lepszych pytań ankietowych i włączenie ich do krajowych badań w celu lepszej charakterystyki łuszczycy z perspektywy zdrowia publicznego1
- Kampanie zwiększające świadomość, wcześniejszą diagnostykę w podstawowej opiece zdrowotnej, terminowe leczenie i odpowiednie skierowania do specjalistów1
Dane epidemiologiczne dotyczące łuszczycy są niezbędne do podejmowania decyzji dotyczących zdrowia publicznego w zakresie odpowiedniego zarządzania chorobą i oceny jej naturalnej historii w czasie1.
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Materiały źródłowe
- #1 Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC9226890/
Psoriasis is a chronic autoimmune inflammatory disease that remains active for a long period, even for life in most patients. […] With the understanding of the biological nature of psoriasis, it has been recognized as an autoimmune disease with significant impacts on health implications extending beyond the skin. […] In the past 5 years, increasing epidemiologic evidence supports that more systemic diseases are identified as extracutaneous comorbidities of psoriasis. […] This review summarizes the epidemiological evidence supporting the association between psoriasis and important and/or newly reported systemic diseases in the past 5 years, and may help to comprehensively recognize the comorbidity burden related to psoriasis, further to improve the management of people with psoriasis.
- #1 Psoriasis Statisticshttps://www.psoriasis.org/psoriasis-statistics/
Millions of people in the U.S. and around the world experience psoriasis and psoriatic arthritis, and there is no cure, yet. […] 125 million people worldwide 2 to 3 percent of the total population have psoriasis, according to the World Psoriasis Day consortium. […] According to current studies, more than 8 million Americans have psoriasis. […] An estimated 30 percent of people with psoriasis also develop psoriatic arthritis. […] Psoriasis prevalence in African Americans is 1.5 percent compared to 3.6 percent of Caucasians. […] Psoriasis is likely to be underdiagnosed among African-Americans and other individuals with skin of color due to differences in clinical presentation. […] Psoriasis has a greater impact on the quality of life in women and younger patients. […] Individuals with psoriasis experience higher rates of many comorbidities, including cardiovascular disease, heart attack, stroke, metabolic syndrome, and depression, among others.
- #1https://www.globalpsoriasisatlas.org/en/explore
The prevalence (number of cases) of psoriasis appears to vary depending on genetic background and geographic location. Learn about the prevalence of psoriasis here. […] An estimated 60 million people have psoriasis worldwide. […] Only 19% of countries have epidemiological data on psoriasis. […] The prevalence of psoriasis in children is below 1% in every country. In adults, the prevalence of psoriasis varies between 0.17% in East Asia to 2.50% in Western Europe. […] Psoriasis prevalence varies depending on geographic location. […] Our data indicates a prevalence estimate of 0.06% in Taiwan compared to a prevalence estimate of 1.91% in Denmark. […] Studies worldwide suggested a stable or slightly decreasing trend in psoriasis incidence, while an increasing trend in psoriasis prevalence has been consistently reported.
- #1 Azthena logo with the word Azthenahttps://www.news-medical.net/health/Psoriasis-Epidemiology.aspx
The epidemiology of psoriasis is relatively well studied, and there is a comprehensive research about the prevalence of the disease, severity of symptoms, and health care costs. […] Psoriasis affects approximately 125 million people globally, which is about 2.2% of the worldwide population. The prevalence varies in different areas of the world; however, higher rates are reported in developed countries accounting for 4.6% of the population. […] Psoriasis is the most common autoimmune disease in the United States, with an estimated 7.5 million Americans who suffer from the condition. […] The incidence of psoriasis is most common between the ages of 15 and 25; however, it may affect individuals of any age. […] Psoriatic arthritis is a successive condition of psoriasis that affects between 10-30% of patients with psoriasis.
- #1 National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study | The BMJhttps://www.bmj.com/content/369/bmj.m1590
Objective To systematically review and provide information on the incidence of psoriasis and quantify global, regional, and country specific estimates of its prevalence. […] In adults, the incidence of psoriasis varied from 30.3 per 100000 person years (95% confidence interval 26.6 to 34.1) in Taiwan to 321.0 per 100000 person years in Italy. The prevalence of psoriasis varied from 0.14% (95% uncertainty interval 0.05% to 0.40%) in east Asia to 1.99% (0.64% to 6.60%) in Australasia. The prevalence of psoriasis was also high in western Europe (1.92%, 1.07% to 3.46%), central Europe (1.83%, 0.62% to 5.32%), North America (1.50%, 0.63% to 3.60%), and high income southern Latin America (1.10%, 0.36% to 2.96%). […] Eighty one per cent of the countries of the world lack information on the epidemiology of psoriasis. The disease occurs more frequently in adults than in children. Psoriasis is unequally distributed across geographical regions; it is more frequent in high income countries and in regions with older populations. The estimates provided can help guide countries and the international community when making public health decisions on the appropriate management of psoriasis and assessing its natural history over time.
- #1 Plaque Psoriasis: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/1108072-overview
Plaque psoriasis first appears during 2 peak age ranges. The first peak occurs in persons aged 16-22 years, and the second occurs in persons aged 57-60 years. Females develop plaque psoriasis earlier than males, and patients with a positive family history for psoriasis also tend to have an earlier age of onset. […] Psoriasis can affect persons of any race; however, epidemiologic studies have shown a higher prevalence in western European and Scandinavian populations. In these groups, 1.5-3% of the population is affected by the disease. […] The highest documented disease prevalence is in Arctic Kasach’ye, with 12% of the population affected, followed by Norway, where 4.8% of the population has psoriasis. Lower prevalence rates for psoriasis have been reported among Japanese and Inuit populations. […] Psoriasis is thought to be rare in West Africans and African Americans and is nearly absent in North American Indians. Psoriasis was undetected in the Samoan population and in a study that examined 26,000 South American Indians.
- #1 Who Gets Psoriasis? Sex, Age, Race, and Ethnicityhttps://www.webmd.com/skin-problems-and-treatments/psoriasis/who-gets-psoriasis
What Is Psoriasis Epidemiology? […] The field of epidemiology can help us answer these questions. Its a branch of science that looks at how often diseases affect different groups of people and why. Medical experts can then use the information to plan and assess ways to prevent or manage diseases. […] Psoriasis affects an estimated 7.5 million to 8 million people in the United States and about 125 million worldwide. […] In the U.S., more white people tend to get diagnosed with the condition than people of color. […] A 2021 study looked at the rate of psoriasis in certain racial and ethnic groups. The percentages of adults 20 years and older whod been diagnosed with psoriasis in each group were: White: 3.6%, Asian: 2.5%, Hispanic: 1.9%, Black: 1.5%. […] The rate of psoriasis hasnt changed much in the U.S. since 2003, the researchers said. […] Genes may be part of the reason that the condition is more common in white people. […] The condition tends to become more common the farther away from the equator you live. Its not clear why this is, but one study says it may be tied to differences in climate, genetic background, and environment.
- #1 National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study | The BMJhttps://www.bmj.com/content/369/bmj.m1590
The incidence of psoriasis was higher in adults than in children, varying from 30.3 per 100000 person years (95% confidence interval 26.6 to 34.1) in Taiwan to 321.0 per 100000 person years in Italy. […] The prevalence of psoriasis in children varied from 0.02% (95% uncertainty interval 0.01% to 0.04%) in east Asia to 0.22% (0.06% to 0.81%) in Australasia and 0.21% (0.11% to 0.41%) in western Europe. In adults, the disease varied from 0.14% (0.05% to 0.40%) in east Asia to 1.99% (0.64% to 6.60%) in Australasia. Other regions with an occurrence of the disease above 1% were western Europe (1.92%, 1.07% to 3.46%), central Europe (1.83%, 0.62% to 5.32%), high income North America (1.50%, 0.63% to 3.60%), and high income southern Latin America (1.10%, 0.36% to 2.96%). […] Data on the incidence and prevalence of psoriasis have increased in recent years. However, considerable gaps exist in the geographical areas that report this information, particularly from low and middle income countries.
- #1 Global Burden of Psoriasis Has Risen for 3 Decadeshttps://www.ajmc.com/view/global-burden-of-psoriasis-has-risen-for-3-decades
From 1990 to 2017, the global prevalence of psoriasis increased from 758 cases per 100,000 to 812 cases per 100,000. […] Globally, the incidence of psoriasis increased from 92.3 individuals per 100,000 to 99.5 individuals. […] YLDs, which indicate burden of suffering, increased globally from 65.2 per 100,000 to 70. […] Finally, DALYs, which combines YLDs with years of life lost to premature deaths and reflects overall suffering, increased from 65.1 per 100,000 to 70, globally. […] The public health implications of these findings include the need for awareness campaigns, early diagnosis in primary care, timely treatment, and appropriate referrals, the authors concluded.
- #1 Psoriasis: epidemiology, clinical features, and quality of life | Annals of the Rheumatic Diseaseshttps://ard.bmj.com/content/64/suppl_2/ii18
Psoriasis is a common chronic, recurrent, immune mediated disease of the skin and joints. It can have a significant negative impact on the physical, emotional, and psychosocial wellbeing of affected patients. […] The epidemiology, clinical features, and impact on quality of life of psoriasis are reviewed. […] This paper reviews the epidemiology and clinical features of psoriasis and its impact of patients quality of life. […] Although psoriasis occurs worldwide, its prevalence varies considerably. In the USA, approximately 2% of the population is affected. High rates of psoriasis have been reported in people of the Faroe islands, where one study found 2.8% of the population to be affected. […] The prevalence of psoriasis is low in certain ethnic groups such as the Japanese, and may be absent in aboriginal Australians and Indians from South America.
- #1 Psoriasis: epidemiology, clinical features, and quality of life | Annals of the Rheumatic Diseaseshttps://ard.bmj.com/content/64/suppl_2/ii18
A bimodal age of onset has been recognised in several large studies. The mean age of onset for the first presentation of psoriasis can range from 15 to 20 years of age, with a second peak occurring at 55-60 years. […] Type I disease accounts for more than 75% of cases. […] The course and progress of psoriasis is unpredictable. […] The molecular genetic basis of psoriasis is complex with evidence that multiple genes are involved. […] The strength of associations between such genes and susceptibility to psoriasis, apart from PSORS1, is variable as replication of these findings has been incomplete. […] Psoriasis is a papulosquamous disease with variable morphology, distribution, severity, and course. […] Psoriasis may also develop at the site of trauma or injury, known as Koebners phenomenon.
- #1 Psoriasis: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/1943419-overview
According to the National Institutes of Health (NIH), approximately 2.2% of the United States population has psoriasis. Internationally, the incidence of psoriasis varies dramatically. A study of 26,000 South American Indians did not reveal a single case of psoriasis, whereas in the Faeroe Islands, an incidence of 2.8% was observed. Overall, approximately 2-3% of people are affected by psoriasis worldwide. Psoriasis can begin at any age, yet there is a bimodal peak between age 20-30 years and 50-60 years. Approximately 10-15% of new cases begin in children younger than 10 years. The median age at onset is 28 years. […] Psoriasis appears to be slightly more prevalent among women than among men; however, men are thought to be more likely to experience the ocular disease. […] The incidence of psoriasis is dependent on the climate and genetic heritage of the population. It is less common in the tropics and in persons with dark skin. Psoriasis prevalence in African Americans is 1.3% compared with 2.5% in Whites.
- #1 Psoriasis: Epidemiology, clinical features, co-morbidities, and clinical scoringhttps://pmc.ncbi.nlm.nih.gov/articles/PMC5134160/
On the basis of current evidence derived from hospital-based studies, mostly from North India, the prevalence of psoriasis in adults varies from 0.44 to 2.8%, with a much lower prevalence in children. […] It is recommended that population-based large epidemiologic studies should be undertaken in different parts of the country for estimating the correct prevalence of psoriasis in general population. […] The worldwide prevalence of psoriasis is estimated to be approximately 23%. […] In a diverse country such as India, the prevalence of psoriasis may vary from region to region due to variable environmental and genetic factors. […] A higher prevalence in males has been reported with a peak age at onset is in the third and fourth decade of life. […] The yearly estimated incidence and prevalence of psoriatic arthritis are, respectively, 3.0-23.1 cases/100,000 and 14-20 cases/100,000 people, with similar results in Western countries and in China.
- #1 Epidemiology of psoriasis â GPnotebookhttps://gpnotebook.com/en-GB/pages/dermatology/psoriasis/epidemiology-of-psoriasis
Psoriasis is universal in occurrence, affecting males and females equally. […] Prevalence varies with race and geography; it is greatest in regions with older populations and lowest in those with younger populations. […] Around 2% of the population in the UK is affected by psoriasis with the highest prevalence in white adults. […] There is a clear genetic link established by HLA, family and twin studies, especially in those whose disease had an early onset and in patients with a positive family history. […] According to a number of large studies, a bimodal age of onset has been documented with the first peak from 15-20 years and the second at 55-60 years. […] Onset is most common between 15-40 years of age. It is rare under 10 years. The mean is 28 years. […] Several studies have also reported that people with psoriasis, particularly those with severe disease, may be at increased risk of cardiovascular disease, lymphoma and non-melanoma skin cancer.
- #1 Psoriasis: epidemiology, natural history, and differential diagnosis | PTThttps://www.dovepress.com/psoriasis-epidemiology-natural-history-and-differential-diagnosis-peer-reviewed-fulltext-article-PTT
Psoriasis is a chronic, immune-mediated, inflammatory disease which affects primarily the skin and joints. It occurs worldwide, but its prevalence varies considerably between different regions of the world. […] Epidemiological studies identified several modifiable risk factors that may predispose individuals to developing psoriasis or exacerbate pre-existing disease. These include smoking, obesity, alcohol consumption, diet, infections, medications and stressful life events. […] The natural history of psoriasis varies depending on the clinical subtype as well as special circumstances, including pregnancy and HIV infection. In general, psoriasis is a chronic disease with intermittent remissions and exacerbations.
- #1 Psoriasis â Epidemiology, pathophysiology and presentation | Clinical Gatehttps://clinicalgate.com/psoriasis-epidemiology-pathophysiology-and-presentation/
Psoriasis affects 1.53% of the population in Europe and North America, but is less common in Africa, China and Japan. The condition may start at any age, even in the elderly. The two peaks of onset are the second to third and the sixth decades. It is unusual in children under 8 years old. […] Inheritance is polygenic: 35% have a family history. […] Peaks of onset are in the second to third and the sixth decades. […] Precipitating factors include streptococcal infection, drugs, sunlight, alcohol, smoking and psychological stress. […] Psoriasis affects 1.53% of western populations. […] Geneticists have identified loci for possible psoriasis genes, e.g. PSOR1 on chromosome locus 6p. […] The number of proliferating keratinocytes is increased seven-fold, but the epidermal cell cycle time is not shortened. […] Presentation is variable: the chronic plague form affecting the elbows, knees and scalp is the commonest. […] Nail involvement is found in 2550% of cases and is difficult to treat.
- #1 Psoriasis: Epidemiology, Potential Triggers, Disease Course | SpringerLinkhttps://link.springer.com/chapter/10.1007/978-3-030-54859-9_4
Worldwide prevalence rates of psoriasis range from 0.6 to 4.8%. […] Psychological distress is a causative or maintaining factor in disease expression for many patients with psoriasis. […] Other well-documented triggers for flares include trauma, alcohol and smoking, as well as obesity. […] Plaque psoriasis is usually chronic with intermittent remissions. […] Christophers E. Psoriasis epidemiology and clinical spectrum. Clin Exp Dermatol. 2001;26(4):31420.
- #1 Multimorbidity of Psoriasis: A Large-Scale Population Study of Its Associated Comorbiditieshttps://www.mdpi.com/2077-0383/13/2/492
The prevalence of psoriasis obtained in our population (2.84%) is similar to that found in other studies carried out in Spain (2.90%). […] Our study supports previous research, revealing that patients with psoriasis are frequently plagued by multimorbidity, with almost three in four presenting with multiple diseases and symptoms of different origins. […] The association between obesity and psoriasis has been demonstrated in several studies. […] One of the most common comorbidities associated with psoriasis is type 2 diabetes. […] Additionally, psoriasis is also associated with an increased risk of CVD, such as heart attacks and strokes. […] The relationship between psoriasis and neoplasms has been the subject of much research in recent years. […] Our findings have the potential to improve the comprehension of psoriasis comorbidities and enhance its management for better patient outcomes.
- #1 Psoriasis: epidemiology, clinical features, and quality of life | Annals of the Rheumatic Diseaseshttps://ard.bmj.com/content/64/suppl_2/ii18
Psoriasis can be highly variable in morphology, distribution, and severity. […] Although psoriasis generally does not affect survival, it certainly has a number of major negative effects on patients, demonstrable by a significant detriment to quality of life. […] Patients with psoriasis have a reduction in their quality of life similar to or worse than patients with other chronic diseases, such as ischaemic heart disease and diabetes. […] Psychological intervention may play a role in the management of psoriasis, particularly in the form of cognitive behavioural stress management. […] Up to 60% of patients describe stress as being a key exacerbator or trigger of their disease.
- #1 Psoriasis: Epidemiology, clinical manifestations, and diagnosis – UpToDatehttps://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-diagnosis-of-psoriasis
Psoriasis: Epidemiology, clinical manifestations, and diagnosis […] The epidemiology, clinical manifestations, and diagnosis of psoriatic skin disease will be reviewed here. […] Psoriasis has also been identified as a multisystem chronic inflammatory disorder associated with multiple comorbidities. Psoriatic arthritis is a common comorbidity that should be screened for in all patients. Examples of other comorbidities that are more common in individuals with psoriasis and may warrant intervention include obesity, metabolic syndrome, hypertension, diabetes, and atherosclerotic disease.
- #1 Psoriasis: Epidemiology, clinical features, co-morbidities, and clinical scoringhttps://pmc.ncbi.nlm.nih.gov/articles/PMC5134160/
Prey et al. in their systematic review of literature concluded that psoriatic arthritis may affect up to 24% of patients with psoriasis. […] In one of the largest and well-conducted meta-analysis, it was concluded that, based on information, mostly from hospital-based studies, psoriasis is associated with cardiovascular disease and its risk factors, and not with cerebrovascular disease. […] The association is stronger with psoriatic arthritis compared to psoriasis. […] However, Prey et al. in their systematic review of epidemiologic studies studying the cardiovascular risk factors in chronic plaque psoriasis concluded that there is an increased risk of obesity and metabolic syndrome in psoriasis, although no consistent results were found with hypertension, diabetes, and dyslipidemia.
- #1 Retrospective Analysis of the Impact of Screening for Psoriatic Arthritis (PsA) with the Psoriasis Epidemiology Screening Tool (PEST) in Clinical Dermatology Practice | SKIN The Journal of Cutaneous Medicinehttps://skin.dermsquared.com/skin/article/view/3056
Patients with plaque psoriasis (PSO) have an increased risk of developing PsA as the disease severity progresses. […] While it is estimated that 30% of patients with PSO have PsA, nearly 16% of patients with PSO may have undiagnosed PsA. […] This observational study aimed to assess the proportion of patients with PSO and no previous PsA diagnosis who screened positive on the PEST and were then diagnosed with PsA by a healthcare provider in the PEST deployment period within the Advanced Dermatology and Cosmetic Surgery (ADCS) specialty dermatology network. […] These results suggest that a meaningful proportion of patients with PsA may be underdiagnosed in the dermatology setting. Deployment of the PEST in the clinical dermatologic workflow may provide an opportunity to diagnose PsA earlier and improve patient outcomes.
- #1 Psoriasis Epidemiology Screening Tool (PEST): A Report from the GRAPPA 2009 Annual Meeting | The Journal of Rheumatologyhttps://www.jrheum.org/content/38/3/551
Patients with psoriasis attending general practitioner and dermatology clinics may complain about their joints, but it may be difficult for the nonrheumatologist to distinguish psoriatic arthritis (PsA) from other forms of arthritis. A screening tool for PsA would therefore be useful to both general practitioners and dermatologists and help identify patients for further evaluation by a rheumatologist. […] Although several screening tools have been developed, the Psoriasis Epidemiology Screening Tool (PEST) has the advantage of simplicity and ease of use. […] The PEST screening questionnaire for psoriatic arthritis (in people with psoriasis). Score 1 point for each question answered in the affirmative. A total score of 3 or more indicates psoriatic arthritis (sensetivity 0.97, specificity 0.79, positive predictive value 0.65, negative predictive value 0.99). […] The PEST questionnaire is a useful tool for screening for PsA in patients with psoriasis, but further validation and comparison with other tools is required. A study based in secondary care and comparing the PEST, ToPAS, and PASE tools is under way in the UK.
- #1 Psoriasis epidemiology screening tool (PEST) is useful for the detection of psoriatic arthritis in the Japanese population | Scientific Reportshttps://www.nature.com/articles/s41598-021-95620-4
Psoriasis is a chronic inflammatory skin disease that involves various systemic organs and tissues and is characterized by scaly erythematous skin. […] In this study, we investigated the utility of a representative tool, the psoriasis epidemiology screening tool (PEST) questionnaire, to identify PsA among Japanese patients with psoriasis. […] Taken together, our study suggests that the PEST questionnaire is a useful tool to identify PsA among Japanese patients with psoriasis. […] To address these problems, the psoriasis epidemiology screening tool (PEST) questionnaire was developed as a modified version of the PsA questionnaire. […] Although the usefulness of the PEST questionnaire to detect PsA has been validated in some Asian countries, it remains unclear whether it can be used for the Japanese population.
- #1 Screen for PsAhttps://www.psoriasis.org/psoriatic-arthritis-screening-test/
One in three individuals with psoriasis have PsA. […] The Psoriasis Epidemiology Screening Tool (PEST) is a validated screening tool for psoriatic arthritis. […] It is recommended that individuals with psoriasis complete the PEST every six months. […] Forty-one percent of those who screened positive for PsA using the PEST had not previously been diagnosed with PsA.
- #1 Validity and reliability of the Turkish version of Psoriasis Epidemiology Screening Tool for the detection of psoriatic arthritis in patients with psoriasis | Volume 37 – Issue 4 – December 2022 | Archives of Rheumatologyhttps://www.tjr.org.tr/full-text/1415
The Psoriasis Epidemiology Screening Tool (PEST) is a simple and useful questionnaire designed to screen arthritis in patients with psoriasis. This study aims to evaluate the validity and reliability of the PEST questionnaire in Turkish patients with psoriasis. […] The Turkish version of PEST is a reliable and valid tool for screening PsA in Turkish patients with psoriasis. […] The PEST scale provides a significant advantage in PsA screening due to its properties such as being an easy questionnaire consisting of only five questions, which takes a very short time to complete without a physical examination component. […] The sensitivity and specificity for the diagnosis of PsA were 93% and 89%, respectively, with a cut-off value of 3 in our study. […] These results demonstrated the validity and reliability of the Turkish version of the PEST for screening PsA.
- #1https://link.springer.com/article/10.1007/s10067-021-06009-7
Juvenile psoriatic arthritis (JPsA) is a severe inflammatory arthritis, which is associated with psoriasis in most cases. While there are few validated screening tools for diagnosis of arthritis for adult patients with psoriasis, those screening tools were never evaluated in children. The aims of this study were to evaluate two screening tools among pediatric patients with psoriasis. […] Thirty-nine patients with the diagnosis of psoriasis completed two screening questionnaires: The Psoriasis Epidemiology Screening Tool (PEST) questionnaire and the new Early Arthritis for Psoriatic Patients (EARP) questionnaire. All patients were evaluated by a rheumatologist for the diagnosis of JPsA, and the accuracy of the two questionnaires was compared. […] Both the PEST and EARP questionnaires were easy to use and had high sensitivity for the diagnosis of JPsA in the pediatric population with psoriasis. The PEST questionnaire had a higher specificity than the EARP. […] EARP and PEST are good screening tools for diagnosis of arthritis in pediatric population with psoriasis.
- #1 Multimorbidity of Psoriasis: A Large-Scale Population Study of Its Associated Comorbiditieshttps://www.mdpi.com/2077-0383/13/2/492
The prevalence of psoriasis was 2.84%, and it was more prevalent in men (3.31% vs. 2.43%). […] The most frequent chronic comorbidities were disorders of lipid metabolism (35.87%), hypertension (35.50%), and other nutritional-endocrine-metabolic disorders (21.79%). […] The conditions most associated with psoriasis were (odds ratio; 95% confidence interval) tuberculosis (2.36; 1.24â4.49), cystic fibrosis (2.15; 1.25â3.69), amongst others. […] We did not find a significant association between psoriasis and hypertension or neoplasms (0.90; 0.86â0.95). […] This study revealed significant associations between psoriasis and cardiac, psychological, and musculoskeletal comorbidities. […] The objective of this study is to determine the prevalence of psoriasis in a large-scale, population-based cohort in the Spanish region of Aragon, to exhaustively describe its comorbidities, and to analyze which diseases are systematically associated with the presence of psoriasis.
- #1 Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC9226890/
Psoriasis has a significantly increased risk of CKD, and is weakly associated with CKD stages 3-5. […] The cumulative incidence of psoriasis was higher in CKD patients with anemia than those without, and low hemoglobin levels were significantly related to the risk of psoriasis in CKD patients. […] Psoriasis is associated with an unremarkable increase in the risk of serious infection, and psoriasis severity is a predictor of serious infection risk. […] Psoriasis not only causes a negative impact on psychological health in patients, which leads to a range of psycho-emotional consequences, but also causes substantial pathological changes of the nervous system by immune dysregulation-mediated inflammation. […] Bidirectional associations are proved between psoriasis and extracutaneous comorbidities, such as depression, CKD, celiac disease, and vitiligo, and it provides epidemiological evidence that psoriasis treatment benefits comorbidities.
- #1 Epidemiology of Psoriasis: Comorbidities Frequency and Healthcare Services: A Descriptive Study of 122 189 Patients in Mexicohttps://www.scitechnol.com/peer-review/epidemiology-of-psoriasis-comorbidities-frequency-and-healthcare-services-a-descriptive-study-of-122-189-patients-in-mexico-2L9i.php?article_id=11438
Objective: The purpose of this pilot study was to describe the clinical and epidemiological behavior related to psoriasis in adult patients, older than 18 years in a period of 5 years in Mexico is used the database System of Analysis of Noncommunicable Diseases (SANENT) in the IMSS. […] The study included from 2013 to 2017, psoriasis patients had an average age of 48.2 years. It was identified that 0.8% (n=1,007) recorded hospital discharges during the mentioned period. In 12% of hospitalized patients, the presence of some comorbidity added to psoriasis was documented, the most frequent being the presence of systemic heart disease (41%) and psoriatic arthritis (34%). […] The prevalence in health services found in adults with psoriasis was 0.38%. In hospitalized patients they had a mortality of 5.79%.
- #1 Psoriasis: Epidemiology, Diagnosis and Management Strategies â Nova Science Publishershttps://novapublishers.com/shop/psoriasis-epidemiology-diagnosis-and-management-strategies/
Psoriasis is a common, non-infectious, chronic inflammatory skin disease characterised by distinctive erythematous plaques that multiply and scale over with silvery patches. […] This book discusses the epidemiology, diagnosis and management strategies of psoriasis. […] Chapter One provides an overview of the challenging medical condition. […] Chapter Two discusses the possible factors raised by literature as main contributors to sleep disturbances and its correlation to psoriasis. […] Chapter Three gives an overview of the current results where blood plasma thermal changes have been detected by Differential Scanning Calorimetry (DSC) technique on psoriatic patients with different clinical stages, and monitored patients with no symptoms to patients with serious symptoms. […] Chapter Four discusses psoriasis treatment that targets the IL-23/Th17 axis. […] Chapter Five reviews natural health products for managing psoriasis.
- #1 Epidemiology and Quality of Life of Patients With Psoriasis in Chile | Actas Dermo-Sifiliográficashttps://www.actasdermo.org/es-epidemiology-quality-life-patients-with-articulo-S1578219012000212
The purpose of this study was to determine epidemiological features and the impact on QoL of psoriasis in patients seen in a Chilean hospital. […] The mean age at onset of psoriasis in our sample was 27.5 years (range, 468 years), without significant differences between sexes in the sample as a whole; however, in the late-onset group there was a slight but significantly larger proportion of men. […] High blood pressure and diabetes mellitus were present as comorbidities in 20.3% and 11.1% of our sample, respectively. […] Psoriatic arthritis (PsA) has been defined as a chronic inflammatory arthropathy of the peripheral joints and axial skeleton, usually seronegative and associated with psoriasis, which is estimated to occur in 1% to 3% of the general population but in 4.7% to 42% of patients with psoriasis.
- #1 Psoriasis: Epidemiology, clinical features, co-morbidities, and clinical scoringhttps://pmc.ncbi.nlm.nih.gov/articles/PMC5134160/
The Medical Advisory Board of the National Psoriasis Foundation has defined mild, moderate, and severe psoriasis based largely on quality-of-life (QOL) measures, with consideration also given to proportion of body surface area affected. […] Based on the current evidence, the psoriasis area severity index appears to be the most valid and reproducible clinical severity score in the management of adult patients with plaque-type psoriasis.
- #1 Epidemiology and Quality of Life of Patients With Psoriasis in Chile | Actas Dermo-Sifiliográficashttps://www.actasdermo.org/es-epidemiology-quality-life-patients-with-articulo-S1578219012000212
Epidemiology and Quality of Life of Patients With Psoriasis in Chile […] Clinical characteristics of psoriasis vary between different races and climates. There are few data on Latin American and even fewer on Chilean patients with psoriasis. […] To assess that clinical characteristics and quality of life (QoL) of a group of Chilean patients with psoriasis. […] A cross-sectional, observational and analytic study was conducted at the Dermatology Department of the Clinical Hospital of the University of Chile between July 2006 and December 2008 applying an epidemiological and QoL-related survey to psoriatic patients. […] The mean Dermatology Life Quality Index was 14. Greater impact of the disease on QoL was associated with male sex, young age of onset, newly diagnosed disease, facial involvement, and widespread disease.
- #1 Epidemiology and Quality of Life of Patients With Psoriasis in Chile | Actas Dermo-Sifiliográficashttps://www.actasdermo.org/es-epidemiology-quality-life-patients-with-articulo-S1578219012000212
Health professionals tend to underscore the impact of skin diseases because most of them are not life threatening and have a chronic course. […] Psoriasis fulfills these characteristics and many physicians underestimate patients feelings about their condition; nevertheless, it is well known that psoriasis has a major impact on patient QoL. […] Mean DLQI in our patients was 14 (very large effect on patient’s life). This value is similar to or higher than that reported in the international literature. […] Another particular issue in QoL on Chilean patients with psoriasis was the difference in DLQI between men and women. Men were consistently more affected in almost all areas of the questionnaire. […] In conclusion, this study verifies that clinical features in Chilean psoriatic patients are comparable to international patterns and that the disease has a negative impact on patient QoL.
- #1 Psoriasis Statisticshttps://www.psoriasis.org/psoriasis-statistics/
Nearly one-quarter of people with psoriasis have cases that are considered moderate to severe. […] Patients with psoriasis incur annual health care costs that are significantly greater than those of the general population and may amount to $135 billion annually (2013, U.S. $). […] In the United States, the economic burden of psoriasis is substantial because this disease results in considerable negative physical, psychiatric, and social consequences.
- #1 Azthena logo with the word Azthenahttps://www.news-medical.net/health/Psoriasis-Epidemiology.aspx
The severity of psoriasis symptoms can vary significantly between different patients; however, for the majority of patients, it presents a large problem for their everyday life. […] Nearly 1 in 4 of psoriasis patients have severe symptoms, which is more likely to have an impact on their quality of life. […] The total healthcare costs attributable to the management and treatment of psoriasis in the United States are estimated to be more than $135 billion each year.
- #1 Psoriasis: Symptoms, Treatment, Images and More – DermNethttps://dermnetnz.org/topics/psoriasis
Psoriasis affects 24% of males and females. It can start at any age including childhood, with onset peaks at 15-25 years and 50-60 years. It tends to persist lifelong, fluctuating in extent and severity. […] Patients with psoriasis are more likely than others to have associated health conditions such as are listed here. […] The severity of psoriasis is classified as mild in 60% of patients, moderate in 30% and severe in 10%. […] Evaluation of comorbidities may include: Psoriatic Arthritis Screening Evaluation (PASE) or Psoriasis Epidemiology Screening Tool (PEST).
- #1https://www.globalpsoriasisatlas.org/en/explore
Further research is required to determine the reasons driving the increase in psoriasis prevalence over time. […] Eighty one per cent of the countries of the world lack information on the epidemiology of psoriasis. […] Considerable gaps still exist in the geographical areas reporting data on incidence and prevalence of psoriasis. […] Prevalence data are presented for 196 countries of the world. Countries are nested into regions which are nested into super-regions. […] Prevalence data are presented for 21 regions of the world (which contain 196 countries). Regions are nested into super-regions. […] Prevalence data are presented for 7 super-regions of the world (which contain 21 regions in which are nested 196 countries). […] Uncertainty intervals have been produced by the statistical models to quantify the uncertainty around prevalence estimates. These intervals thus reflect the uncertainty levels around the psoriasis prevalence estimates.
- #1 Focus on Psoriasis: A Report from the 2024 IPC Think Tank Symposium â Psoriasis: The Multiple Facets of a Global Disease | International Psoriasis Councilhttps://psoriasiscouncil.org/disease-severity/2024-think-tank/
Epidemiology and Comorbidities of Psoriasis Across the AgesLuigi Naldi, MD, IPC CouncilorPsoriasis affects 2â3% of the global population, with higher prevalence in Western countries and bimodal peaks in incidence at ages 35â44 and 65â74. Early-onset psoriasis (Type 1) is linked to HLA-C*06:02, while late-onset psoriasis involves other factors. Environmental influences like air pollution and nutrition may also impact disease risk. Comorbidities such as obesity, cardiovascular disease, and diabetes are prevalent, including children, emphasizing the need for holistic management. […] The symposium, Psoriasis: The Multiple Facets of a Global Disease, included nine lectures covering epidemiology, clinical features, genetics of psoriasis and related diseases, mechanistic scenarios, and treatment advances.
- #1 Focus on Psoriasis: A Report from the 2024 IPC Think Tank Symposium â Psoriasis: The Multiple Facets of a Global Disease | International Psoriasis Councilhttps://psoriasiscouncil.org/disease-severity/2024-think-tank/
Biomarkers offer potential for better stratification, diagnosis, and personalized treatment in psoriasis. Transcriptomic studies highlight differences between psoriasis subtypes and provide insights into immune pathways like IL-1 and IL-36. These findings pave the way for precision medicine and targeted interventions.
- #1 Prevalence of Psoriasis Among Adults in the U.Shttps://stacks.cdc.gov/view/cdc/36674
Background A 2010 CDC-sponsored consultation of psoriasis, psoriatic arthritis, and public health experts developed a public health agenda for psoriasis and psoriatic arthritis indicating that additional population-based research is needed to better characterize psoriasis in the population. […] Purpose To better characterize the burden of psoriasis in the U.S. using recent population-based, cross-sectional data in this 2012 analysis. […] Results The overall prevalence of psoriasis was 3.1% (95% CI=2.6, 3.6); extrapolating to older adults suggests that 6.7 million adults aged 20 years are affected. […] Psoriasis is a large public health problem. Further characterizing psoriasis from a public health perspective will require better survey questions and inclusion of these questions in national surveys.
- #2 Epidemiology of Psoriasishttps://benthamscience.com/public/article/35924
The prevalence of psoriasis is relatively high in the general population, ranging between 0.6% and 4.8%, mainly as a result of chronicity and the absence of a cure. […] Risk factors, which have been documented in epidemiological studies include smoking, alcohol consumption, diet, infection, drugs, and stressful life events. […] Apart from a few cross-sectional surveys of large series of psoriatic patients, there have been no formal studies of the natural history and prognosis of established psoriasis. […] By imposing methodologic control and a numerate approach, epidemiology can offer a major contribution to understand psoriasis.
- #2 Azthena logo with the word Azthenahttps://www.news-medical.net/health/Psoriasis-Epidemiology.aspx
The epidemiology of psoriasis is relatively well studied, and there is a comprehensive research about the prevalence of the disease, severity of symptoms, and health care costs. […] Psoriasis affects approximately 125 million people globally, which is about 2.2% of the worldwide population. The prevalence varies in different areas of the world; however, higher rates are reported in developed countries accounting for 4.6% of the population. […] Psoriasis is the most common autoimmune disease in the United States, with an estimated 7.5 million Americans who suffer from the condition. […] The incidence of psoriasis is most common between the ages of 15 and 25; however, it may affect individuals of any age. […] Psoriatic arthritis is a successive condition of psoriasis that affects between 10-30% of patients with psoriasis.
- #2 EpiCast Report: Psoriasis – Epidemiology Forecast to 2022https://www.prnewswire.com/news-releases/epicast-report-psoriasis—epidemiology-forecast-to-2022-203226801.html
Psoriasis is an immune-mediated chronic disorder of the skin characterized by redness and irritation. It affects people of both sexes and of all ages and races/ethnicities. The global prevalence of psoriasis varies geographically, with the disease being more prevalent in the colder areas of the north, and less prevalent in the tropics and warmer regions of the world (Weller et al., 2008). […] In European countries, psoriasis is more prevalent in residents of the colder central regions and less prevalent in residents of the southern regions. […] In some Asian countries, such as India, the prevalence of psoriasis is highest in the northern parts of the country. In contrast to India, China shows no difference in prevalence between the northern and southern regions (Bedi, 1995; Ding et al., 2012; Kawada et al., 2003; Naldi et al., 2004; Saraceno et al., 2006).
- #2 Psoriasis: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/1943419-overview
According to the National Institutes of Health (NIH), approximately 2.2% of the United States population has psoriasis. Internationally, the incidence of psoriasis varies dramatically. A study of 26,000 South American Indians did not reveal a single case of psoriasis, whereas in the Faeroe Islands, an incidence of 2.8% was observed. Overall, approximately 2-3% of people are affected by psoriasis worldwide. Psoriasis can begin at any age, yet there is a bimodal peak between age 20-30 years and 50-60 years. Approximately 10-15% of new cases begin in children younger than 10 years. The median age at onset is 28 years. […] Psoriasis appears to be slightly more prevalent among women than among men; however, men are thought to be more likely to experience the ocular disease. […] The incidence of psoriasis is dependent on the climate and genetic heritage of the population. It is less common in the tropics and in persons with dark skin. Psoriasis prevalence in African Americans is 1.3% compared with 2.5% in Whites.
- #2https://www.globalpsoriasisatlas.org/en/explore
The prevalence (number of cases) of psoriasis appears to vary depending on genetic background and geographic location. Learn about the prevalence of psoriasis here. […] An estimated 60 million people have psoriasis worldwide. […] Only 19% of countries have epidemiological data on psoriasis. […] The prevalence of psoriasis in children is below 1% in every country. In adults, the prevalence of psoriasis varies between 0.17% in East Asia to 2.50% in Western Europe. […] Psoriasis prevalence varies depending on geographic location. […] Our data indicates a prevalence estimate of 0.06% in Taiwan compared to a prevalence estimate of 1.91% in Denmark. […] Studies worldwide suggested a stable or slightly decreasing trend in psoriasis incidence, while an increasing trend in psoriasis prevalence has been consistently reported.
- #2 Epidemiology and Quality of Life of Patients With Psoriasis in Chile | Actas Dermo-Sifiliográficashttps://www.actasdermo.org/es-epidemiology-quality-life-patients-with-articulo-S1578219012000212
Chilean patients with psoriasis have clinical characteristics and QoL comparable to patients in other countries. A notable difference, however, was the greater impact of psoriasis on the QoL of Chilean men compared to women. […] Psoriasis is almost universally present in the human population. […] The prevalence of the disease varies widely from 0% in American Samoa and South American indigenous peoples to 11.8% in Northern Russia. […] Moreover, it has been reported that the prevalence of psoriasis varies with climatic conditions and is more common in colder climates than in tropical regions. […] In Chile, psoriasis accounts for 2.03% of dermatological consultations, with higher rates (around 2.6%) in the cooler southern area and 1.8% in the warmer north; in addition, a difference has been observed between urban and rural areas (2.3% versus 1.9%).
- #2 National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study | The BMJhttps://www.bmj.com/content/369/bmj.m1590
The incidence of psoriasis was higher in adults than in children, varying from 30.3 per 100000 person years (95% confidence interval 26.6 to 34.1) in Taiwan to 321.0 per 100000 person years in Italy. […] The prevalence of psoriasis in children varied from 0.02% (95% uncertainty interval 0.01% to 0.04%) in east Asia to 0.22% (0.06% to 0.81%) in Australasia and 0.21% (0.11% to 0.41%) in western Europe. In adults, the disease varied from 0.14% (0.05% to 0.40%) in east Asia to 1.99% (0.64% to 6.60%) in Australasia. Other regions with an occurrence of the disease above 1% were western Europe (1.92%, 1.07% to 3.46%), central Europe (1.83%, 0.62% to 5.32%), high income North America (1.50%, 0.63% to 3.60%), and high income southern Latin America (1.10%, 0.36% to 2.96%). […] Data on the incidence and prevalence of psoriasis have increased in recent years. However, considerable gaps exist in the geographical areas that report this information, particularly from low and middle income countries.
- #2 Plaque Psoriasis: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/1108072-overview
Plaque psoriasis first appears during 2 peak age ranges. The first peak occurs in persons aged 16-22 years, and the second occurs in persons aged 57-60 years. Females develop plaque psoriasis earlier than males, and patients with a positive family history for psoriasis also tend to have an earlier age of onset. […] Psoriasis can affect persons of any race; however, epidemiologic studies have shown a higher prevalence in western European and Scandinavian populations. In these groups, 1.5-3% of the population is affected by the disease. […] The highest documented disease prevalence is in Arctic Kasach’ye, with 12% of the population affected, followed by Norway, where 4.8% of the population has psoriasis. Lower prevalence rates for psoriasis have been reported among Japanese and Inuit populations. […] Psoriasis is thought to be rare in West Africans and African Americans and is nearly absent in North American Indians. Psoriasis was undetected in the Samoan population and in a study that examined 26,000 South American Indians.
- #2 Psoriasis â Epidemiology, pathophysiology and presentation | Clinical Gatehttps://clinicalgate.com/psoriasis-epidemiology-pathophysiology-and-presentation/
Psoriasis affects 1.53% of the population in Europe and North America, but is less common in Africa, China and Japan. The condition may start at any age, even in the elderly. The two peaks of onset are the second to third and the sixth decades. It is unusual in children under 8 years old. […] Inheritance is polygenic: 35% have a family history. […] Peaks of onset are in the second to third and the sixth decades. […] Precipitating factors include streptococcal infection, drugs, sunlight, alcohol, smoking and psychological stress. […] Psoriasis affects 1.53% of western populations. […] Geneticists have identified loci for possible psoriasis genes, e.g. PSOR1 on chromosome locus 6p. […] The number of proliferating keratinocytes is increased seven-fold, but the epidermal cell cycle time is not shortened. […] Presentation is variable: the chronic plague form affecting the elbows, knees and scalp is the commonest. […] Nail involvement is found in 2550% of cases and is difficult to treat.
- #2 Epidemiology of psoriasis â GPnotebookhttps://gpnotebook.com/en-GB/pages/dermatology/psoriasis/epidemiology-of-psoriasis
Psoriasis is universal in occurrence, affecting males and females equally. […] Prevalence varies with race and geography; it is greatest in regions with older populations and lowest in those with younger populations. […] Around 2% of the population in the UK is affected by psoriasis with the highest prevalence in white adults. […] There is a clear genetic link established by HLA, family and twin studies, especially in those whose disease had an early onset and in patients with a positive family history. […] According to a number of large studies, a bimodal age of onset has been documented with the first peak from 15-20 years and the second at 55-60 years. […] Onset is most common between 15-40 years of age. It is rare under 10 years. The mean is 28 years. […] Several studies have also reported that people with psoriasis, particularly those with severe disease, may be at increased risk of cardiovascular disease, lymphoma and non-melanoma skin cancer.
- #2 Psoriasis â Epidemiology, pathophysiology and presentation | Plastic Surgery Keyhttps://plasticsurgerykey.com/psoriasis-epidemiology-pathophysiology-and-presentation/
Psoriasis affects 1.53% of the population in Europe and North America, but is less common in Africa, China and Japan. The sex incidence is equal. The condition may start at any age, even in the elderly. The two peaks of onset are the second to third and the sixth decades. It is unusual in children under 8 years old. […] Inherited factors predispose to the development of psoriasis: genetic factors appear to be polygenic. About 35% of patients show a family history, and identical twin studies show a concordance of 64%. There is a 14% probability that a child with one parent who has psoriasis will be affected, but this increases to 41% if both parents have psoriasis. There are strong correlations with the human leucocyte antigens (HLAs), e.g. HLA-Cw6. Environmental factors are thought to trigger the disease in susceptible individuals.
- #2 Psoriasis: Epidemiology, Potential Triggers, Disease Course | SpringerLinkhttps://link.springer.com/chapter/10.1007/978-3-030-54859-9_4
Worldwide prevalence rates of psoriasis range from 0.6 to 4.8%. […] Psychological distress is a causative or maintaining factor in disease expression for many patients with psoriasis. […] Other well-documented triggers for flares include trauma, alcohol and smoking, as well as obesity. […] Plaque psoriasis is usually chronic with intermittent remissions. […] Christophers E. Psoriasis epidemiology and clinical spectrum. Clin Exp Dermatol. 2001;26(4):31420.
- #2https://aseestant.ceon.rs/index.php/scriptamed/user/setLocale/en_US?source=%2Findex.php%2Fscriptamed%2Farticle%2Fview%2F51703
Psoriatic arthritis (PsA) is chronic inflammatory disease with estimated prevalence of 6 % to 41 % in patients with psoriasis. […] The aim of this study was to determine the prevalence of PsA in Bosnian patients with psoriasis in everyday dermatological practice by using psoriasis epidemiology screening tool (PEST) screening test for detection of PsA. […] The risk of having PsA was evaluated by PEST (scores 3 indicate risk of PsA). […] Of 79 included psoriatic patients, 22.8 % had a PEST 3. […] In the present study, using PEST questionnaire, one fifth of Bosnian patients were suspected of having PsA, highlighting a need for improved screening for PsA in daily dermatological practice.
- #2 Screen for PsAhttps://www.psoriasis.org/psoriatic-arthritis-screening-test/
One in three individuals with psoriasis have PsA. […] The Psoriasis Epidemiology Screening Tool (PEST) is a validated screening tool for psoriatic arthritis. […] It is recommended that individuals with psoriasis complete the PEST every six months. […] Forty-one percent of those who screened positive for PsA using the PEST had not previously been diagnosed with PsA.
- #2 Psoriasis epidemiology screening tool (PEST) is useful for the detection of psoriatic arthritis in the Japanese population | Scientific Reportshttps://www.nature.com/articles/s41598-021-95620-4
Psoriasis is a chronic inflammatory skin disease that involves various systemic organs and tissues and is characterized by scaly erythematous skin. […] In this study, we investigated the utility of a representative tool, the psoriasis epidemiology screening tool (PEST) questionnaire, to identify PsA among Japanese patients with psoriasis. […] Taken together, our study suggests that the PEST questionnaire is a useful tool to identify PsA among Japanese patients with psoriasis. […] To address these problems, the psoriasis epidemiology screening tool (PEST) questionnaire was developed as a modified version of the PsA questionnaire. […] Although the usefulness of the PEST questionnaire to detect PsA has been validated in some Asian countries, it remains unclear whether it can be used for the Japanese population.
- #2 Validity and reliability of the Turkish version of Psoriasis Epidemiology Screening Tool for the detection of psoriatic arthritis in patients with psoriasis | Volume 37 – Issue 4 – December 2022 | Archives of Rheumatologyhttps://archivesofrheumatology.org/full-text/1415
The Psoriasis Epidemiology Screening Tool (PEST) is a simple and useful questionnaire designed to screen arthritis in patients with psoriasis. This study aims to evaluate the validity and reliability of the PEST questionnaire in Turkish patients with psoriasis. […] The Turkish version of PEST is a reliable and valid tool for screening PsA in Turkish patients with psoriasis. […] The PEST scale provides a significant advantage in PsA screening due to its properties such as being an easy questionnaire consisting of only five questions, which takes a very short time to complete without a physical examination component. […] The Turkish version of PEST showed good psychometric properties. The test-retest reliability of the Turkish version of PEST seemed to be good. […] These results demonstrated the validity and reliability of the Turkish version of the PEST for screening PsA.
- #2 Validity and reliability of the Turkish version of Psoriasis Epidemiology Screening Tool for the detection of psoriatic arthritis in patients with psoriasis | Volume 37 – Issue 4 – December 2022 | Archives of Rheumatologyhttps://www.tjr.org.tr/full-text/1415
The Psoriasis Epidemiology Screening Tool (PEST) is a simple and useful questionnaire designed to screen arthritis in patients with psoriasis. This study aims to evaluate the validity and reliability of the PEST questionnaire in Turkish patients with psoriasis. […] The Turkish version of PEST is a reliable and valid tool for screening PsA in Turkish patients with psoriasis. […] The PEST scale provides a significant advantage in PsA screening due to its properties such as being an easy questionnaire consisting of only five questions, which takes a very short time to complete without a physical examination component. […] The sensitivity and specificity for the diagnosis of PsA were 93% and 89%, respectively, with a cut-off value of 3 in our study. […] These results demonstrated the validity and reliability of the Turkish version of the PEST for screening PsA.
- #2 Psoriasis: Epidemiology, clinical manifestations, and diagnosis – UpToDatehttps://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-diagnosis-of-psoriasis
Psoriasis: Epidemiology, clinical manifestations, and diagnosis […] The epidemiology, clinical manifestations, and diagnosis of psoriatic skin disease will be reviewed here. […] Psoriasis has also been identified as a multisystem chronic inflammatory disorder associated with multiple comorbidities. Psoriatic arthritis is a common comorbidity that should be screened for in all patients. Examples of other comorbidities that are more common in individuals with psoriasis and may warrant intervention include obesity, metabolic syndrome, hypertension, diabetes, and atherosclerotic disease.
- #2 What Is Psoriasis Epidemiology? – Consensus: AI Search Engine for Researchhttps://consensus.app/home/blog/what-is-psoriasis-epidemiology/
Psoriasis is a chronic inflammatory skin disease characterized by scaling and inflammation, affecting the quality of life and daily functioning of patients. The prevalence of psoriasis is estimated to reach 2% of the global population, highlighting its significant impact on public health. […] The burden of psoriasis extends beyond the physical symptoms, significantly impairing patients quality of life. Studies have shown that psoriasis can affect bodily pain and social functioning, although there is no direct correlation between overall disease severity and quality of life measures. […] Psoriasis is a prevalent chronic inflammatory disease with a complex etiology involving genetic, immunological, and microbial factors. It significantly impacts patients quality of life, with visible lesions contributing to psychological and social burdens.
- #2 Azthena logo with the word Azthenahttps://www.news-medical.net/health/Psoriasis-Epidemiology.aspx
The severity of psoriasis symptoms can vary significantly between different patients; however, for the majority of patients, it presents a large problem for their everyday life. […] Nearly 1 in 4 of psoriasis patients have severe symptoms, which is more likely to have an impact on their quality of life. […] The total healthcare costs attributable to the management and treatment of psoriasis in the United States are estimated to be more than $135 billion each year.
- #2https://www.globalpsoriasisatlas.org/en/explore
Further research is required to determine the reasons driving the increase in psoriasis prevalence over time. […] Eighty one per cent of the countries of the world lack information on the epidemiology of psoriasis. […] Considerable gaps still exist in the geographical areas reporting data on incidence and prevalence of psoriasis. […] Prevalence data are presented for 196 countries of the world. Countries are nested into regions which are nested into super-regions. […] Prevalence data are presented for 21 regions of the world (which contain 196 countries). Regions are nested into super-regions. […] Prevalence data are presented for 7 super-regions of the world (which contain 21 regions in which are nested 196 countries). […] Uncertainty intervals have been produced by the statistical models to quantify the uncertainty around prevalence estimates. These intervals thus reflect the uncertainty levels around the psoriasis prevalence estimates.