C Phan1, M-L Sigal1, E Estève2, Z Reguiai3, H Barthélémy4, N Beneton5, F Maccari6, M Lahfa7, D Thomas-Beaulieu8, T Le Guyadec9, A Vermersch-Langlin10, L Mery-Bossard11, V Pallure12, M Kemula13, B Labeille14, A Beauchet15, E Mahé1. 1. Department of Dermatology, Hôpital Victor Dupouy Hospital, Argenteuil, France. 2. Department of Dermatology, Centre Hospitalier Régional d'Orléans, Orléans, France. 3. Department of Dermatology, Hôpital Robert Debré, Reims, France. 4. Department of Dermatology, Centre Hospitalier d'Auxerre, Auxerre, France. 5. Department of Dermatology, Centre Hospitalier du Mans, Le Mans, France. 6. Department of Dermatology, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France. 7. Department of Dermatology, Hôpital Larrey, Centre Hospitalier Universitaire de Toulouse, Paul Sabatier-Toulouse 3 University, Toulouse, France. 8. Department of Dermatology, Centre Hospitalier de Poissy, Saint Germain en Laye, France. 9. Department of Dermatology, Hôpital d'Instruction des Armées Percy, Clamart, France. 10. Department of Dermatology, Hôpital Jean Bernard, Valenciennes, France. 11. Department of Dermatology, Hôpital François Quesnay, Mantes La Jolie, France. 12. Department of Dermatology, Centre Hospitalier Universitaire Saint-Eloi, Montpellier, France. 13. Private Office, Charenton-Le Pont, France. 14. Department of Dermatology, Centre Hospitalier Universitaire, Saint-Etienne, France. 15. Department of Public Health, Centre Hospitalier Universitaire Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne Billancourt, France.
Abstract
BACKGROUND: Age of the patients and age of onset of psoriasis may have an impact on the disease. There is little information about psoriasis in elderly patients. OBJECTIVE: We evaluated epidemiological, clinical aspects, comorbidities and treatments of psoriasis in the elderly (>70 years) patients, and in patients with very late onset psoriasis (onset ≥ 70 years). METHODS: This observational multicentre non-interventional study of adults with psoriasis was conducted in 29 departments of dermatology in France. A total of 2210 adults with psoriasis were included. RESULTS: A total of 212 (9.5%) patients were elderly. This group had a higher frequency of females (P = 0.005), a later onset of the disease (P < 0.0001), a lower frequency of familial (P < 0.0001) and plaque psoriasis (P < 0.0001), but higher frequency of guttate and inverse psoriasis (P ≤ 0.005). Hypertension, diabetes, dyslipidaemia, and major cardiovascular events (MACE) were more frequent in this group (P < 0.0001), but not tobacco (P < 0.0001). Systemic and biological therapies were used less frequently in the elderly group (P < 0.0001). Fifty-eight (2.7%) patients had late onset psoriasis. Patients with very late onset psoriasis were more frequently women (P = 0.02) and older (P < 0.0001), among elderly group. They had significantly less frequently familial (P < 0.0001) and plaque psoriasis (P < 0.0001), and were less often on systemic treatment including biological. Frequencies of comorbidities were not statically different but patients with 'early' onset psoriasis have a tendency (P < 0.5) to have higher frequencies of obesity, diabetes, dyslipidaemia, hypertension and MACE. CONCLUSION: This study highlights phenotypic features of psoriasis in elderly and in very late onset psoriasis. The management of these fragile patients remains poorly codified and needs further investigation.
BACKGROUND: Age of the patients and age of onset of psoriasis may have an impact on the disease. There is little information about psoriasis in elderly patients. OBJECTIVE: We evaluated epidemiological, clinical aspects, comorbidities and treatments of psoriasis in the elderly (>70 years) patients, and in patients with very late onset psoriasis (onset ≥ 70 years). METHODS: This observational multicentre non-interventional study of adults with psoriasis was conducted in 29 departments of dermatology in France. A total of 2210 adults with psoriasis were included. RESULTS: A total of 212 (9.5%) patients were elderly. This group had a higher frequency of females (P = 0.005), a later onset of the disease (P < 0.0001), a lower frequency of familial (P < 0.0001) and plaque psoriasis (P < 0.0001), but higher frequency of guttate and inverse psoriasis (P ≤ 0.005). Hypertension, diabetes, dyslipidaemia, and major cardiovascular events (MACE) were more frequent in this group (P < 0.0001), but not tobacco (P < 0.0001). Systemic and biological therapies were used less frequently in the elderly group (P < 0.0001). Fifty-eight (2.7%) patients had late onset psoriasis. Patients with very late onset psoriasis were more frequently women (P = 0.02) and older (P < 0.0001), among elderly group. They had significantly less frequently familial (P < 0.0001) and plaque psoriasis (P < 0.0001), and were less often on systemic treatment including biological. Frequencies of comorbidities were not statically different but patients with 'early' onset psoriasis have a tendency (P < 0.5) to have higher frequencies of obesity, diabetes, dyslipidaemia, hypertension and MACE. CONCLUSION: This study highlights phenotypic features of psoriasis in elderly and in very late onset psoriasis. The management of these fragilepatients remains poorly codified and needs further investigation.
Authors: Marieke E C van Winden; Elke L M ter Haar; Hans M M Groenewoud; Peter C M van de Kerkhof; Elke M G J de Jong; Satish F K Lubeek Journal: Acta Derm Venereol Date: 2020-07-28 Impact factor: 3.875
Authors: E L M Ter Haar; S E Thomas; J M P A van den Reek; M E Otero; M D Njoo; P M Ossenkoppele; E N Kop; S R P Dodemont; J E M Körver; A L A Kuijpers; R J Lindhout; R A Tupker; J M Mommers; M A M Berends; M I A Koetsier; M S de Bruin-Weller; M B Visch; W P Arnold; P P M van Lümig; M M Kleinpenning; S F K Lubeek; E M G J de Jong Journal: Drugs Aging Date: 2022-07-21 Impact factor: 4.271