A Retrospective, Cross-sectional Hospital-based Study to Determine the Epidemiological, Clinical and Comorbidity Characteristics in Older Adults with Psoriasis

Abstract

Background: Psoriasis is extensively studied among middle-aged adults, but not many have studied psoriasis in older adults(geriatrics). Objectives: To analyze epidemiological, clinical, comorbidities and therapeutic profile of geriatric psoriasis(GP). Methods: All consenting clinically diagnosed psoriatic patients ≥60 years were divided into two groups: Elderly psoriatic(EP)(60-75 years) and Ultra elderly psoriatic(UP)(>75 years). The dermatologist filled their clinical characteristics' standardised questionnaire to determine comorbidities, drug interactions profile and compared with age-matched controls using Chi square test. Results: Prevalence of GP is 14.5%(Average age:68 years; Sex ratio=2.5:1) among geriatrics attending dermatology OPD. Most common(49.9%) as well as initial site affected(39.3%) were Palms±Soles. Nummular plaque (90.2%) was most common type. Superficial fungal infection(26.9%) and pruritus(90.8%) were commonly associated cutaneous disease and symptom(p<0.05) respectively. Hypertension(49.7%), Diabetes Mellitus(22.8%), dyslipidemia(25.8%) and Metabolic syndrome(MS)(17.8%) were associated systemic comorbidities. Dyslipidemia and MS(p<0.0001) were more common among GP(163) than controls(963). Drug aggravated psoriasis could not be linked to polypharmacy. Although, topicals were mainstay, oral Methotrexate was most efficacious systemically. Conclusion: Our findings suggest a trimodal age of psoriasis onset at 68 years. As age advances, psoriasis severity decreases, unstable guttate lesions decrease; palms±soles commonly involved; infrequent familial occurrence with Polypharmacy not aggravating psoriasis. Active screening for cardiovascular comorbidities in all geriatric psoriasis patients is highly recommended.