Chaiyabutr Chayada, Silpa-Archa Narumol, Wongpraprarut Chanisada, Likittanasombat Surachanee, Phumariyapong Phumithep, Chularojanamontri Leena
Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.
Arch Dermatol Res. 2023 May;315(4):779-786. doi: 10.1007/s00403-022-02429-w. Epub 2022 Oct 29.
Psoriasis hospitalisation is not frequently reported. The objective of this study was to determine (1) the clinical, laboratory and treatment features of patients with psoriasis hospitalised due to flare-up and (2) other causes of admission of patients with psoriasis. We retrospectively reviewed data on 48 patients admitted due to psoriasis flare-up and 1908 patients with psoriasis admitted due to concomitant illnesses or comorbidities. The study period was 2005-2021. The latter group was compared with 821,804 patients without psoriasis admitted during the period. Of the 48 cases, 37.5% had erythroderma, and 62.5% had generalised pustular psoriasis (GPP). Women (68.8%) predominated, especially in the GPP group (76.7%). The mean age of admission with erythroderma (44.8 years) was higher than for GPP (32.1 years). Infection was the main trigger for psoriasis flare-up (46%). Abnormalities in liver function tests were found in 33.3% of the cases. These abnormalities usually subsided 1-2 months after skin improvement (83.4%). Acitretin was the most prescribed drug for GPP (81.4%), whereas topical treatment alone (50%) was the most frequent erythroderma therapy. Intensive care was needed by 9.3% of patients with GPP. In the psoriasis group admitted due to concomitant illnesses or comorbidities, admission due to digestive and infectious causes was significantly higher for psoriasis patients. Our study showed that trend of psoriasis admission due to disease flare-up was not significantly changed even in the era of biologics. We believed that patient education on avoiding the common precipitating factors of psoriasis flare-up and good self-care is mandatory to reduce the risk of hospitalisation.
银屑病住院情况并不常被报道。本研究的目的是确定：（1）因病情发作而住院的银屑病患者的临床、实验室和治疗特征；（2）银屑病患者的其他入院原因。我们回顾性分析了48例因银屑病发作而入院的患者以及1908例因合并疾病或共病而入院的银屑病患者的数据。研究时间段为2005年至2021年。后一组患者与同期入院的821804例无银屑病患者进行了比较。在这48例病例中，37.5%患有红皮病，62.5%患有泛发性脓疱型银屑病（GPP）。女性占主导（68.8%），尤其是在GPP组（76.7%）。红皮病患者的平均入院年龄（44.8岁）高于GPP患者（32.1岁）。感染是银屑病发作的主要诱因（46%）。33.3%的病例肝功能检查异常。这些异常通常在皮肤改善后1至2个月消退（83.4%）。阿维A是GPP最常使用的药物（81.4%），而单纯局部治疗（50%）是红皮病最常用的治疗方法。9.3%的GPP患者需要重症监护。在因合并疾病或共病而入院的银屑病组中，银屑病患者因消化系统和感染性原因入院的比例显著更高。我们的研究表明，即使在生物制剂时代，因病情发作而入院的银屑病患者的趋势也没有显著变化。我们认为，对患者进行关于避免银屑病发作常见诱发因素的教育以及良好的自我护理对于降低住院风险至关重要。
