Objective To describe the clinical characteristics, management and quality of life of psoriasis patients with and without coexistent lupus erythematosus (LE). Methods This retrospective cross‐sectional study uses data from the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018. Results Of 21 735 psoriasis patients, 34 (0.16%) had coexistent LE. The male to female ratio among psoriasis patients with coexistent LE was 1:5.8 versus 1.3:1 in patients with psoriasis but without LE. Nearly 70% presented with LE preceding psoriasis. Psoriasis patients with LE had an earlier age of psoriasis onset (27.56 ± 11.51 versus 33.31 ± 16.94 years, P = 0.006), a higher rate of psoriatic arthropathy (26.5% versus 13.0%, P = 0.02), and a significantly greater impairment of quality of life (Dermatology Quality of Life Index >10; 57.6% versus 40.3%, P = 0.04) compared with psoriasis patients without LE. The majority (87.5%) had systemic LE. The incidences of lupus nephritis (72.7% versus 40%) and hematological abnormalities (50% versus 20%) were higher among patients with LE preceding psoriasis compared with those with psoriasis preceding LE. Antinuclear antibody and double‐stranded DNA were positive in 59.4% and 28.1% of psoriasis patients with LE, respectively. Hydroxychloroquine triggered the onset of psoriasis in 7 (24.1%) patients. Patients with LE were more likely to receive systemic treatment for psoriasis compared with those without LE (30.3% versus 14.2%, P = 0.008). Conclusions Psoriasis patients with coexistent LE were uncommon, displayed a female preponderance, were more likely to have joint involvement, and had greater quality of life impairment than those without LE. LE preceded psoriasis in most of these patients, and systemic LE was the most common subtype.
Background Psoriasis imposes a substantial burden on patients’ social, emotional, physical, and family life. Although psoriasis has no complete cure, various treatments are available to control its symptoms and improve a patients’ quality of life. Objective We aimed to compare the effectiveness of biologic versus non-biologic treatments on health-related quality of life among patients with psoriasis in Malaysia. Methods This retrospective cross-sectional study evaluated data of adult patients diagnosed with psoriasis during 2007–18 from the Malaysian Psoriasis Registry. Baseline demographics, disease, and treatment characteristics were described. For a subset of patients treated with biologics and non-biologics who had baseline and 6-month follow-up data available, changes in the mean Dermatology Life Quality Index scores and the proportion of patients with a clinically relevant improvement (≥ 4 points) post-treatment were assessed. Results Overall, 15,238 adult patients with psoriasis from the Malaysian Psoriasis Registry were included in the analysis. Patients receiving biologics showed a statistically significant reduction in the mean Dermatology Life Quality Index scores after 6 months compared with those receiving non-biologic treatment (− 5.7 vs − 0.8%; p < 0.001). The proportion of patients who achieved a ≥ 4-point improvement in Dermatology Life Quality Index scores was approximately two times greater in the biologic-treated group versus the non-biologic-treated group (56.4 vs 27.7%). Conclusions Biologic treatment showed a greater reduction in the Dermatology Life Quality Index scores of patients with psoriasis versus non-biologic treatment. These results highlight the importance of early treatment with more efficacious treatment options, such as biologic therapies, to improve the overall health-related quality of life of patients with psoriasis.
BackgroundPsoriatic arthritis (PsA) which is a member of the spondyloarthritides includes spinal and peripheral joint involvement. It affects women and men equally. The clinical patterns of PsA were classified into 5 groups according to Moll and Wright..1 Psoriasis is a common chronic inflammatory skin disease and chronic plaque psoriasis is the commonest form.ObjectivesTo study the relationship between plaque and non-plaque psoriasis with their joint manifestation and to describe the demographic characteristics of PsA patients.MethodsThis was a restrospective study. The electronic medical records of all PsA patients under rheumatology clinic Hospital Sultan Ismail followed up from 1/1/2009 to 31/12/2017 were reviewed. Data on demography, type of skin disease, joint manifestation, past medical history, fasting serum lipid and body mass index were obtained and analysed.ResultsWe identified 163 patients, 84 were male patients with male to female ratio of 1.06. The Malays (84/163) were the majority being affected, followed by the Chinese (46/163), Indians (30/163) and others (3/163). The patients were divided into plaque psoriasis (140/163) and non-plaque psoriasis (23/163). The commonest joint involvement in the study was peripheral joint involvement (121/163), axial involvement (22/163) and both axial and peripheral joint involvement (20/163). The peripheral joint involvement was categorised as polyarthritis (67/121), followed by oligoarthritis (47/121), distal interphalangeal arthritis (4/121) and arthritis mutilans (3/121). In the study, we divided the patients into plaque psoriasis [peripheral joint involvement (102/140); axial involvement (16/140); both (18/140)] and non-plaque psoriasis [peripheral joint involvement (15/23); axial involvement (6/23); both (2/23)] and analysed the results by using the SPSS logistic regression. It showed no significant association between type of skin psoriasis with its joint manifestation. (p>0.05).Amongst the 163 patients, 68/163 (42%) had hypertension, 50/163 (31%) had diabetes mellitus, 32/163 (20%) had hypercholesterolemia, 12/163 have ischaemic heart disease, 1 patient had congestive heart disease, 3 had breast cancer, 1 had hepatocellular carcinoma and 2 have chronic kidney disease and cerebral vascular disease respectively.The fasting serum lipid (FSL) was taken for 140 of them (23 patients no data available) and it was noted in 64/140 (without background history of hypercholesterolemia was noted to have FSL≥5.18 mmol/L). 37/64 have borderline high total cholesterol (5.18 mmol/L –<6.2 mmol/L) and 27/64 have high total cholesterol (≥6.2 mmol/L) according to ATP iii cholesterol classification..2 43% (61/142 patients) had body mass index in the overweight group, 29% (41/142 patients) in the obese group and 25% (36/142 patients) in normal group according to WHO classification.3 ConclusionsThere was no association between types of skin psoriasis with their joint manifestation. There was a significant number of patients who had deranged fasting serum lipid and majority of them...
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