Department of Dermatology, Medical and Health Science Centre, University of Debrecen, Hungary.
Ann Epidemiol. 2013 Nov;23(11):688-92. doi: 10.1016/j.annepidem.2013.08.006. Epub 2013 Oct 4.
We compared the clinical and epidemiologic characteristics of early and late onset psoriasis with an emphasis on potential differences in the comorbidities associated with each subtype.
An observational, multicenter study was performed, and associations between the age at the time of diagnosis and binary comorbidity outcomes were evaluated using multiple logistic regression analysis adjusted for age and other relevant confounders.
An increased prevalence of positive family history, psoriatic arthritis, and depression was observed in patients with early onset psoriasis. On the other hand, late onset psoriasis was more frequently associated with obesity and elevated waist circumference compared with early onset form. Elderly psoriatic patients (at the age of 75 years) with late onset psoriasis are at an especially high risk for obesity compared with individuals at the same age with an early onset disease.
The increased frequency of psoriasis in the family of early onset patients may suggest that manifestation of psoriasis at younger age is driven by strong genetic influence. However, such a remarkable association of abdominal obesity with late onset psoriasis may suggest that obesity can be one of the acquired factors that may predispose for the development of psoriasis in the elderly.
我们比较了早发性和晚发性银屑病的临床和流行病学特征，并特别强调了每种亚型相关合并症的潜在差异。
进行了一项观察性、多中心研究，并使用多元逻辑回归分析评估了诊断时年龄与二元合并症结局之间的关联，该分析针对年龄和其他相关混杂因素进行了调整。
早发性银屑病患者的阳性家族史、银屑病关节炎和抑郁的患病率增加。另一方面，与早发型相比，晚发型银屑病更常与肥胖和腰围升高相关。与同年龄段早发性疾病患者相比，年龄较大（75 岁）的晚发性银屑病老年患者肥胖的风险尤其高。
早发性患者家族中银屑病的高发频率可能表明银屑病在年轻时发病是由强烈的遗传影响驱动的。然而，腹部肥胖与晚发性银屑病如此显著的关联可能表明，肥胖可能是导致老年人发生银屑病的后天因素之一。
