Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Dermatol Ther. 2022 Aug;35(8):e15628. doi: 10.1111/dth.15628. Epub 2022 Jun 29.
Geriatric psoriasis, due to its unusual clinical manifestations and higher rates of systemic complications in this age group, is a challenging issue for dermatologists. Therefore, we aimed to provide an overview of the epidemiological, clinical, and therapeutic consequences among patients aged over 60 years with psoriasis in a referral center in Iran. This cross-sectional study was conducted on 156 patients over 60 years with the definitive diagnosis of psoriasis that were referred to our center between 2015 and 2019. By reviewing the recorded files of the patients, baseline characteristics including demographics, underlying comorbidities, age of disease onset, clinical type of the disease, clinical manifestations, and therapeutic approaches were extracted. The most common clinical feature was plaque type (73.1%) followed by pustular type (10.9%). The most frequent involved zone was the lower extremities (84.6%). Most of the patients were treated topically (87.1%), while as the most frequent systemic approaches, methotrexate and acitretin were considered for 74.4% and 60.3%, respectively. A significantly higher mean age at disease onset was found in female patients compared to male patients. The plaque type was more prevalent in men than in women. Also, the chance of nail involvement was 2.43 times higher in men than in women (p = 0.011, 95%CI: 1.22-4.84). The disease duration was significantly longer in patients suffering from plaque compared to those without this feature. Conversely, those with palmoplantar type experienced shorter disease duration. Psoriatic arthritis was also revealed in patients of lower ages. As in other societies, in our society, clinical characteristics, disease involvement patterns, as well as considered treatment approaches, can be influenced by demographic characteristics.
老年银屑病由于其在该年龄段的不典型临床表现和更高的全身性并发症发生率，是皮肤科医生面临的一个挑战。因此，我们旨在提供伊朗一个转诊中心 60 岁以上银屑病患者的流行病学、临床和治疗结果概述。这项横断面研究纳入了 2015 年至 2019 年期间在我们中心确诊为银屑病且年龄在 60 岁以上的 156 例患者。通过查阅患者的记录档案，提取了包括人口统计学、基础合并症、发病年龄、疾病临床类型、临床表现和治疗方法在内的基线特征。最常见的临床特征是斑块型（73.1%），其次是脓疱型（10.9%）。最常见的受累部位是下肢（84.6%）。大多数患者接受了局部治疗（87.1%），而最常见的系统治疗方法是甲氨蝶呤和阿维 A 酯，分别有 74.4%和 60.3%的患者使用。与男性患者相比，女性患者的发病年龄明显较高。斑块型在男性中比在女性中更为常见。此外，男性指甲受累的几率是女性的 2.43 倍（p=0.011，95%CI：1.22-4.84）。与没有斑块特征的患者相比，患有斑块型银屑病的患者的疾病持续时间明显更长。相反，患有掌跖脓疱型银屑病的患者的疾病持续时间更短。银屑病关节炎也在年龄较低的患者中发现。与其他社会一样，在我们的社会中，临床特征、疾病受累模式以及考虑的治疗方法可能受到人口统计学特征的影响。
