Huseynova Terzi Leyla, Dogan Gunaydin Sibel
Hacettepe University, Faculty of Medicine, Department of Dermatology and Venereology, Ankara, Turkey.
Hacettepe University, Graduate School of Medical Sciences, Department of Pediatric Basic Sciences, Immunology, Ankara, Turkey.
Dermatol Pract Concept. 2022 Jul 1;12(3):e2022144. doi: 10.5826/dpc.1203a144. eCollection 2022 Jul.
Early onset psoriasis (EOP) and late onset psoriasis (LOP) differ regarding genetic background, clinical presentation and course of disease.
In this study, comparison of EOP and LOP regarding systemic inflammatory comorbidities which are frequently seen in psoriasis and determination of possible differences is aimed.
A total of 160 plaque psoriasis patients (121 with EOP and 39 with LOP) were enrolled for the study. Data was collected with face-to-face questionnaire and patients medical chart evaluation. Collected data included medical and family history, clinical features and parameters indicating severity of psoriasis, results of laboratory work-up, physical and dermatological examination findings, presence of joint and nail involvement and associated inflammatory systemic comorbidities such as cardiovascular diseases (CVD), diabetes mellitus (DM), hypertension (HT), metabolic syndrome (MS), obesity.
Nail involvement and PsA occurred more rapidly in LOP compared to EOP (P < 0.01, P < 0.01). Compared frequencies in LOP and EOP were 7.7% versus 0.8% for CVD, 38.5% versus 14% for HT, 33.3% versus 9.9% for DM and 44.7% versus 24.8% for MS, respectively. CVD, HT, DM and MS were significantly more frequent in LOP compared to EOP (P = 0.045, P = 0.001, P < 0.01, P = 0.022). Results of multivariate analysis performed taking into account the age, gender, severity parameters of disease, alcohol consumption, smoking habits and other concurrent systemic comorbidities revealed LOP to be an independent risk factor for CVD and DM (P < 0.01, R: 0.036, P < 0.01, R: 0.077).
LOP seems to interact with systemic comorbidities hence generates more severe inflammatory burden and shows a more rapid course.
早发型银屑病（EOP）和晚发型银屑病（LOP）在遗传背景、临床表现和病程方面存在差异。
本研究旨在比较EOP和LOP在银屑病中常见的全身性炎症合并症，并确定可能存在的差异。
共纳入160例斑块状银屑病患者（121例EOP患者和39例LOP患者）进行研究。通过面对面问卷调查和患者病历评估收集数据。收集的数据包括病史和家族史、银屑病严重程度的临床特征和参数、实验室检查结果、体格检查和皮肤科检查结果、关节和指甲受累情况以及相关的炎症性全身性合并症，如心血管疾病（CVD）、糖尿病（DM）、高血压（HT）、代谢综合征（MS）、肥胖症。
与EOP相比，LOP的指甲受累和银屑病关节炎（PsA）出现得更快（P < 0.01，P < 0.01）。LOP和EOP中CVD的发生率分别为7.7%和0.8%，HT分别为38.5%和14%，DM分别为33.3%和9.9%，MS分别为44.7%和24.8%。与EOP相比，LOP中CVD、HT、DM和MS的发生率显著更高（P = 0.045，P = 0.001，P < 0.01，P = 0.022）。在考虑年龄、性别、疾病严重程度参数、饮酒、吸烟习惯和其他并发的全身性合并症后进行的多变量分析结果显示，LOP是CVD和DM的独立危险因素（P < 0.01，R：0.036，P < 0.01，R：0.077）。
LOP似乎与全身性合并症相互作用，因此产生更严重的炎症负担，并呈现出更快的病程。
