Clinical characteristics, management, and quality of life of psoriasis patients with coexistent lupus erythematosus: Data from the Malaysian Psoriasis Registry.

OBJECTIVE: To describe the clinical characteristics, management and quality of life of psoriasis patients with and without coexistent lupus erythematosus (LE). METHODS: This retrospective cross-sectional study uses data from the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018. RESULTS: Of 21 735 psoriasis patients, 34 (0.16%) had coexistent LE. The male to female ratio among psoriasis patients with coexistent LE was 1:5.8 versus 1.3:1 in patients with psoriasis but without LE. Nearly 70% presented with LE preceding psoriasis. Psoriasis patients with LE had an earlier age of psoriasis onset (27.56 ± 11.51 versus 33.31 ± 16.94 years, P = 0.006), a higher rate of psoriatic arthropathy (26.5% versus 13.0%, P = 0.02), and a significantly greater impairment of quality of life (Dermatology Quality of Life Index >10; 57.6% versus 40.3%, P = 0.04) compared with psoriasis patients without LE. The majority (87.5%) had systemic LE. The incidences of lupus nephritis (72.7% versus 40%) and hematological abnormalities (50% versus 20%) were higher among patients with LE preceding psoriasis compared with those with psoriasis preceding LE. Antinuclear antibody and double-stranded DNA were positive in 59.4% and 28.1% of psoriasis patients with LE, respectively. Hydroxychloroquine triggered the onset of psoriasis in 7 (24.1%) patients. Patients with LE were more likely to receive systemic treatment for psoriasis compared with those without LE (30.3% versus 14.2%, P = 0.008). CONCLUSIONS: Psoriasis patients with coexistent LE were uncommon, displayed a female preponderance, were more likely to have joint involvement, and had greater quality of life impairment than those without LE. LE preceded psoriasis in most of these patients, and systemic LE was the most common subtype.

A 5-years Retrospective Study on Narrowband Ultraviolet B (NBUVB) Phototherapy Utilisation Experience in A Tertiary Hospital in East Malaysia

Background@#Phototherapy had been a less favourable treatment in recent years. Our study aims to audit the usage of NB-UVB phototherapy service in a tertiary hospital in East Malaysia.@*Methods@#This is a retrospective study. Phototherapy file of patients who underwent NB-UVB phototherapy between year 2016 and 8 March 2021 were reviewed. Demographic data, treatment history, and acute side effects were analysed.@*Results@#Forty eight subjects were recruited in this study. The majority (33.3%) of the subjects were in 20-29 age group. There was an equal number of male and female subjects. About 66.7% of the subjects had psoriasis and 18.8% of them had vitiligo. Nearly 36.6% of the subjects had 26-50% body surface area involved at initial phototherapy. Almost 54.2% of the subjects had <50 sessions of NB-UVB phototherapy. About 52.1% of the subjects had a cumulative dose of NB-UVB <25 J/cm2 while 26.7% of subjects had a cumulative dose >200 J/cm2. Acute side effects including burning (17.8%), pruritus (4.4%) and flare of psoriasis (2.2%).@*Discussion@#Low utilization rate of NB-UVB phototherapy was likely due to logistical and transportation factors. Psoriasis was the commonest indication for NB-UVB in our study followed by vitiligo. Annual skin malignancy surveillance should be done especially on patients received NB-UVB >350 sessions even after the discontinuation of treatment. Most patients tolerate NB-UVB phototherapy well with no major side effects.@*Conclusion@#In conclusion, NB-UVB phototherapy is a relatively safe yet underutilised treatment in our centre.