Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland.
Faculty of Science, University of Zürich, Zurich, Switzerland.
Arch Dermatol Res. 2024 Oct 1;316(9):654. doi: 10.1007/s00403-024-03375-5.
Real-world data on anatomically localized psoriasis and its response to systemic therapy across different age-groups and sexes is limited. This study aimed to evaluate the severity and distribution of psoriasis over time in female and male patients receiving systemic therapies, categorized by age within the Swiss psoriasis registry (SDNTT). Patient-data was obtained over 11 years through the SDNTT. The localized Psoriasis Area and Severity Index (locPASI) of the head, trunk, upper and lower extremities was analyzed over two years following the start of systemic non-/biologic treatment. A total of 316 female and 517 male patients were analyzed. Male patients had a higher baseline locPASI for legs, trunk and arms (p < 0.001), but not for the head (p = 0.961). The locPASI for the head in younger female patients (18-40 years) had a higher score than those aged 55 + (p = 0.022) and after two years, middle aged (41-54) showed a lower score compared to younger patients (p = 0.045). Younger male patients revealed a lower score after two years of therapy in the leg- and arm-area compared to older (p = 0.018 and p = 0.048, respectively). Female patients on non-biologics had a fast initial response, converging with male patients' scores over 24 months. Over 75% locPASI reduction was observed for female head-area (81.4%), male trunk (82.7%) and legs (76.1%). Absolute locPASI ≤ 2 was achieved 3-6 months for all locations with interleukin (IL)-17, IL-12/23 and IL-23-inhibitors, except for the legs of male patients on anti-IL-17 and female patients on anti-IL-12/23 and -IL-23. After two years, male patients did not achieve a locPASI ≤ 2 for any biologic-treatment in the legs, nor for the arms on anti-TNF-α. Significant disparities in localized PASI were observed between female and male patients. The age, sex and severity of distinct localizations should be considered to optimize treatment goals.
关于不同年龄组和性别的解剖定位银屑病及其对全身治疗的反应的真实世界数据有限。本研究旨在评估瑞士银屑病登记处（SDNTT）中按年龄分类的接受全身治疗的女性和男性患者的银屑病严重程度和分布情况。通过 SDNTT 在 11 年内获得患者数据。在开始全身非生物/生物治疗后的两年内，分析头、躯干、上肢和下肢的局部银屑病面积和严重程度指数（locPASI）。共分析了 316 名女性和 517 名男性患者。男性患者腿部、躯干和手臂的基线 locPASI 较高（p < 0.001），但头部没有（p = 0.961）。年轻女性患者（18-40 岁）头部 locPASI 评分高于 55 岁以上患者（p = 0.022），两年后，中年患者（41-54 岁）与年轻患者相比，评分较低（p = 0.045）。年轻男性患者在接受两年治疗后，腿部和手臂区域的评分低于年龄较大的患者（p = 0.018 和 p = 0.048）。非生物制剂的女性患者初始反应较快，在 24 个月内与男性患者的评分趋同。女性头部区域（81.4%）、男性躯干（82.7%）和腿部（76.1%）观察到超过 75%的 locPASI 减少。除男性患者腿部的抗 IL-17 和女性患者的抗 IL-12/23 和抗 IL-23 外，所有部位的白细胞介素（IL）-17、IL-12/23 和 IL-23 抑制剂在 3-6 个月内达到绝对 locPASI ≤ 2。两年后，男性患者腿部的任何生物制剂治疗和抗 TNF-α 手臂均未达到 locPASI ≤ 2。女性和男性患者的局部 PASI 存在显著差异。应考虑年龄、性别和不同部位的严重程度，以优化治疗目标。
