Características epidemiológicas de la psoriasis. Un estudio poblacional / Epidemiology of Psoriasis. A Population-Based Study

Antecedentes y objetivo: La psoriasis es una enfermedad inmunoinflamatoria crónica de la piel muy frecuente en el mundo occidental. Muchos autores han intentado calcular su prevalencia en diversas regiones, aunque en la mayoría de los casos esta se ha obtenido mediante encuestas y existen escasas publicaciones procedentes del área mediterránea. El objetivo de nuestro estudio era analizar la prevalencia y severidad de la psoriasis en Lleida (región del noreste de España), identificar diferencias en edad y sexo, y comparar nuestros resultados con otras series europeas. Materiales y métodos: Se obtuvo una base de datos conjunta entre medicina primaria y el departamento de dermatología de toda la provincia de Lleida con datos epidemiológicos, diagnóstico de psoriasis y codificación de tratamiento. Resultados: La base de datos final comprendía a 398.701 individuos y 6.868 de ellos (1,72%) fueron codificados con el diagnóstico de psoriasis. La prevalencia de psoriasis fue significativamente mayor en hombres que en mujeres (1,88 vs. 1,56%; OR = 1,21; IC 95%: 1,15-1,27). La prevalencia más alta de psoriasis se encontró en el grupo de edad de los 61-70 años (2,90%) y la prevalencia de psoriasis en menores de 18 años fue del 0,30%. En nuestra población, el 7,27% de los pacientes fueron clasificados como psoriasis moderada-severa (499/6.868). Conclusiones: Este estudio reporta la prevalencia y severidad de la psoriasis en una muestra amplia de una región mediterránea, obteniendo la información mediante una base de datos electrónica. Además, se evidencia una prevalencia menor de psoriasis comparada con otros países europeos y una proporción de psoriasis severa (basado en criterios de tratamiento) menor que en otros estudios. Estas diferencias podrían deberse a factores genéticos, estilo de vida y dieta

Background and objectives: Psoriasis is a chronic immunoinflammatory skin disease very frequent in the western world. Several authors have tried to calculate its prevalence in different regions, although most of them obtained the data from surveys and there are few publications from Mediterranean areas. The objective of our study was to analyze the prevalence and severity of psoriasis in Lleida (a northeastern region in Spain), identify age and sex specific differences and compare our results with other European series. Materials and methods: A joint database of primary care medicine and the dermatology department was obtained from the entire province of Lleida with epidemiological data and psoriasis diagnosis and treatment codification. Results: A corrected database was obtained with 398,701 individuals and 6,868 of them (1.72%) were coded with the diagnosis of psoriasis. The prevalence was significantly higher in men than in women (1.88% vs 1.56%, OR = 1.21, 95% CI: 1.15-1.27). The highest prevalence of psoriasis was found in the 61-70 years group (2.90%) and psoriasis in population under 18 years of age was 0.30%. In our sample, 7.27% of the patients were classified as moderate-severe psoriasis (499/6,868). Conclusion: This study reports the prevalence and severity of psoriasis in a large Mediterranean region sample, obtaining the information through a electronic database. This study reveals a lower prevalence of psoriasis compared to other European countries, and the proportion of severe psoriasis (based on treatment criteria) is lower than in other studies. We emphasize that these differences could probably due to genetic background, life style and diet

Psoriasis, metabolic syndrome and cardiovascular risk factors. A population-based study.

BACKGROUND: Psoriasis is a very prevalent systemic chronic inflammatory disease. Major cardiovascular events are the main cause of mortality in these patients which suggests an association between psoriasis and traditional cardiovascular risk factors. OBJECTIVE: To identify classic cardiovascular risk factors and metabolic syndrome (MS) in patients with psoriasis, their possible association with its severity and compare it with the non-psoriatic population. METHODS: This is an observational and cross-sectional population study in Lleida (Spain) from a joint hospital/primary care database. RESULTS: The database comprised 398 701 individuals. There were 6868 cases registered as psoriasis (1.7%), and 499 of them (7.3%) were classified as moderate-severe psoriasis. Patients with psoriasis had a higher prevalence of traditional cardiovascular risk factors than non-psoriatic population: diabetes mellitus 2 (13.9% vs 7.4%, OR 2.01), dyslipidaemia (28.8% vs 17.4%, OR 1.92), arterial hypertension (31.2% vs 19.0%, OR 1.93), obesity (33.7% vs 28.1%, OR 1.30), altered fasting basal glycaemia (21.4% vs 15.1%, OR 1.54), low cholesterol HDL (38.1% vs 32.3%, OR 1.29), hypertriglyceridaemia (45.7% vs 35.2%, OR 1.55) and high waist circumference (75.7% vs 72.3%, OR 1.19). MS was more prevalent in psoriatic patients (28.3% vs 15.1%, OR 2.21), and cardiovascular risk factors were similar between psoriasis severity groups. Psoriatic patients had a higher prevalence of ischaemic heart disease (3.3% vs 1.8%, OR 1.87) and vascular cerebral accidents (1.8% vs 1.2%, OR 1.55). A model for MS showed a significant nonlinear relationship with age and sex and significant differences between patients with and without psoriasis. CONCLUSION: We found statistically significant differences in relation to the prevalence of cardiovascular risk factors, MS and major cardiovascular events in psoriatic patients. However, differences were not seen between psoriasis severity groups. Our work reinforces the need for a multidisciplinary approach and close monitoring of cardiovascular risk factors in these patients to prevent a cardiovascular event.

Epidemiology of Psoriasis. A Population-Based Study. / Características epidemiológicas de la psoriasis. Un estudio poblacional.

BACKGROUND AND OBJECTIVES: Psoriasis is a chronic immunoinflammatory skin disease very frequent in the western world. Several authors have tried to calculate its prevalence in different regions, although most of them obtained the data from surveys and there are few publications from Mediterranean areas. The objective of our study was to analyze the prevalence and severity of psoriasis in Lleida (a northeastern region in Spain), identify age and sex specific differences and compare our results with other European series. MATERIALS AND METHODS: A joint database of primary care medicine and the dermatology department was obtained from the entire province of Lleida with epidemiological data and psoriasis diagnosis and treatment codification. RESULTS: A corrected database was obtained with 398,701 individuals and 6,868 of them (1.72%) were coded with the diagnosis of psoriasis. The prevalence was significantly higher in men than in women (1.88% vs 1.56%, OR=1.21, 95% CI: 1.15-1.27). The highest prevalence of psoriasis was found in the 61-70 years group (2.90%) and psoriasis in population under 18 years of age was 0.30%. In our sample, 7.27% of the patients were classified as moderate-severe psoriasis (499/6,868). CONCLUSION: This study reports the prevalence and severity of psoriasis in a large Mediterranean region sample, obtaining the information through a electronic database. This study reveals a lower prevalence of psoriasis compared to other European countries, and the proportion of severe psoriasis (based on treatment criteria) is lower than in other studies. We emphasize that these differences could probably due to genetic background, life style and diet.