Department of Dermatology, Hospital Queen Elizabeth, Ministry of Health Malaysia, Kota Kinabalu, Malaysia.
Department of Dermatology, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
Exp Dermatol. 2023 Aug;32(8):1253-1262. doi: 10.1111/exd.14770. Epub 2023 Feb 26.
Pustular psoriasis (PP) is an uncommon subtype of psoriasis with distinct genetic features and clinical phenotypes. Patients with PP tend to experience frequent flares and significant morbidity. This study aims to determine the clinical characteristics, co-morbidities and treatment of PP patients in Malaysia. This was a cross-sectional study of patients with PP notified to the Malaysian Psoriasis Registry (MPR) between January 2007 and December 2018. Of 21 735 psoriasis patients, 148 (0.7%) had pustular psoriasis. Of these, 93 (62.8%) were diagnosed with generalized pustular psoriasis (GPP) and 55 (37.2%) with localized PP (LPP). The mean age for pustular psoriasis onset was 31.71 ± 18.33 years with a male to female ratio of 1:2.1. Patients with PP were more likely to have dyslipidaemia (23.6% vs. 16.5%, p = 0.022), severe disease (Body surface area >10 and/or Dermatology Life Quality Index [DLQI] >10) (64.8% vs. 50%, p = 0.003) and require systemic therapy (51.4% vs. 13.9%, p < 0.001) compared to non-PP patients. Patients with PP also suffered greater impairment to their quality of life (DLQI >10, 48.9% vs. 40.3%, p = 0.046), had more days off school/work (2.06 ± 6.09 vs. 0.5 ± 4.91, p = 0.004) and a higher mean number of hospitalizations (0.31 ± 0.95 vs. 0.05 ± 1.22, p = 0.001) in 6 months compared to non-PP patients. Overall, 0.7% of psoriasis patients in the MPR had pustular psoriasis. Patients with PP had a higher rate of dyslipidaemia, severe disease, greater impairment of quality of life and systemic therapy usage compared to other psoriasis subtypes.
脓疱型银屑病（PP）是一种罕见的银屑病亚型，具有独特的遗传特征和临床表型。PP 患者往往频繁发作，发病率较高。本研究旨在确定马来西亚 PP 患者的临床特征、合并症和治疗方法。这是一项针对 2007 年 1 月至 2018 年 12 月期间向马来西亚银屑病登记处（MPR）报告的 PP 患者的横断面研究。在 21735 例银屑病患者中，有 148 例（0.7%）患有脓疱型银屑病。其中，93 例（62.8%）诊断为泛发性脓疱型银屑病（GPP），55 例（37.2%）为局限性脓疱型银屑病（LPP）。脓疱型银屑病发病的平均年龄为 31.71±18.33 岁，男女比例为 1:2.1。PP 患者更易发生血脂异常（23.6%比 16.5%，p=0.022）、疾病严重程度较高（体表面积>10 和/或皮肤病生活质量指数[DLQI]>10）（64.8%比 50%，p=0.003）和需要系统治疗（51.4%比 13.9%，p<0.001），而非 PP 患者。PP 患者的生活质量受损更严重（DLQI>10，48.9%比 40.3%，p=0.046），在校/工作缺勤天数更多（2.06±6.09 比 0.5±4.91，p=0.004），6 个月内住院治疗的平均次数也更多（0.31±0.95 比 0.05±1.22，p=0.001），而非 PP 患者。总体而言，MPR 中 0.7%的银屑病患者患有脓疱型银屑病。PP 患者的血脂异常、疾病严重程度、生活质量受损和系统治疗使用率均高于其他银屑病亚型。
