Lim Y T, Robinson S, Tang M M
Department of Dermatology, Hospital Sultanah Aminah, Ministry of Health Malaysia, Johor Bahru, Malaysia.
Department of Dermatology, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
Clin Exp Dermatol. 2023 Apr 27;48(5):476-483. doi: 10.1093/ced/llad013.
Therapeutic options may be limited for patients with psoriasis who have concomitant liver disease (PsL).
We aimed to report the frequency of liver disease among patients with psoriasis, and describe the clinical features, treatment modalities and quality of life.
This was a multicentre cross-sectional study of patients with psoriasis notified to the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018.
Of 21 735 patients with psoriasis, 174 (0.8%) had liver disease. The three most common liver diseases were viral hepatitis (62.1%), fatty liver (14.4%) and liver cirrhosis (10.9%). The male-to-female ratio was 3.8 : 1. Mean age (SD) of onset of psoriasis was higher in those with liver disease vs. those without [37.25 years (13.47) vs. 33.26 years (16.96), P < 0.001]. Patients with PsL, compared with those without liver disease, had a higher rate of dyslipidaemia (27.5% vs. 16.4%, P < 0.001), hypertension (33.9% vs. 23.7%, P = 0.002), diabetes mellitus (22.4% vs. 15.9%, P = 0.021) and HIV infection (5.3% vs. 0.4%, P < 0.001). Those with PsL were also more likely than those without liver disease to have severe disease [body surface area > 10% and/or Dermatology Life Quality Index (DLQI) > 10] (59.3% vs. 49.9%, P = 0.027), psoriatic arthropathy (21.1% vs. 13.0%, P = 0.002) and nail involvement (78.2% vs. 56.1%, P < 0.001). Also significantly higher in the group with PsL were the use of phototherapy (8.4% vs. 2.6%, P < 0.001), acitretin (7.3% vs. 2.8%, P < 0.001) and ciclosporin (3.0% vs. 0.7%, P < 0.001). Mean DLQI was similar in both groups [9.69 (7.20) vs. 9.62 (6.75), P = 0.88].
The frequency of patients with PsL in the MPR was 0.8%. Patients with PsL were more likely to be male, had a higher rate of comorbidities, severe disease, and nail and joint involvement than those without liver disease.
对于合并肝脏疾病的银屑病患者（PsL），治疗选择可能有限。
我们旨在报告银屑病患者中肝脏疾病的发生率，并描述其临床特征、治疗方式和生活质量。
这是一项多中心横断面研究，研究对象为2007年1月至2018年12月通知马来西亚银屑病登记处（MPR）的银屑病患者。
在21735例银屑病患者中，174例（0.8%）患有肝脏疾病。三种最常见的肝脏疾病是病毒性肝炎（62.1%）、脂肪肝（14.4%）和肝硬化（10.9%）。男女比例为3.8:1。与无肝脏疾病的患者相比，合并肝脏疾病的患者银屑病发病的平均年龄（标准差）更高[37.25岁（13.47）对33.26岁（16.96），P<0.001]。与无肝脏疾病的患者相比，PsL患者血脂异常发生率更高（27.5%对16.4%，P<0.001）、高血压发生率更高（33.9%对23.7%，P = 0.002）、糖尿病发生率更高（22.4%对15.9%，P = 0.021）以及HIV感染率更高（5.3%对0.4%，P<0.001）。与无肝脏疾病的患者相比，PsL患者也更有可能患有重度疾病[体表面积>10%和/或皮肤病生活质量指数（DLQI）>10]（59.3%对49.9%，P = 0.027）、银屑病关节炎（21.1%对13.0%，P = 0.002）和指甲受累（78.2%对56.1%，P<0.001）。PsL组中光疗（8.4%对2.6%，P<0.001）、阿维A（7.3%对2.8%，P<0.001）和环孢素（3.0%对0.7%，P<0.001）的使用比例也显著更高。两组的平均DLQI相似[9.69（7.20）对9.62（6.75），P = 0.88]。
MPR中PsL患者的发生率为0.8%。与无肝脏疾病的患者相比，PsL患者更可能为男性，合并症、重度疾病以及指甲和关节受累的发生率更高。
