EPIMAG: International Cross-Sectional Epidemiological Psoriasis Study in the Maghreb

Abstract

Background: Psoriasis is a common skin disorder that is characterized by red plaques covered with silvery scales and is associated with considerable psychosocial impact. It has been described in several studies worldwide, but specific data from the Maghreb (Algeria, Morocco and Tunisia) are unavailable. Objectives: To characterize the frequency of new psoriasis cases and to describe the epidemiological and clinical profile of psoriasis in the Maghreb. Methods: A psoriasis working group for the Maghreb initiated the EPIMAG international multicentre cross-sectional observational epidemiological study coupled with a 2-week psoriasis screening study via medical consultation. Data were collected via questionnaires. Results: The total analysis population included 373 pre-existing and 326 new psoriasis cases, described by 261 participating investigators. The frequency of new psoriasis cases was 10.26/1,000 in Algeria, 15.04/1,000 in Morocco and 13.26/1,000 in Tunisia, and thus 12.08/1,000 in the Maghreb. In all 699 psoriasis subjects, the mean age was 46 years, the mean BMI was 26.6, and 55.7% of subjects were men. Two thirds of the subjects had never smoked, and 85.0% had never consumed alcohol. Half had brown skin, and 28.6% had a family history of psoriasis. Three quarters had localized psoriasis, 85.8% had plaque psoriasis, coupled with pruritus in over 70.0% of cases. Flares or outbreaks were most often triggered by stress (79.4%) and change of season (43.1%). The majority of subjects used topical therapy, and the investigators considered overall treatment efficacy to be partial in over half of the cases. Among patients with pre-existing psoriasis, secondary analyses showed that 73.2% had severe psoriasis, and that quality of life was severely affected in 40.1% of cases. The mean number of missing school or work days over 6 months was 3.2 (±12.1) days. Conclusions: Our study provides novel information relative to psoriasis epidemiology and characterization in the Maghreb and highlights the need to improve psoriasis screening and management in the region. The data will help optimize psoriasis management, to ensure appropriate national health care policies.

Influence of stress on the development of psoriasis

“…a life experience involving a profound change in a person’s existence, had occurred 1 month before the onset of psoriasis in 72% of 179 patients. Overall, estimates of the rates of stress‐related psoriasis range from 26 to 88% in epidemiological studies . Additionally, patients who report high levels of psychological stress display more severe skin and joint symptoms than those with lower reported levels of psychological stress .…”

Psychological stress and psoriasis: a systematic review and meta-analysis

“…Thirty‐nine studies, evaluating 32 537 patients, fulfilled the eligibility criteria (19 surveys, seven cross‐sectional studies, 12 case–control studies, one cohort study). The characteristics of the case–control and cohort studies are presented in Table ; the characteristics of the included surveys and cross‐sectional studies are presented in Tables S1 and S2 (see Supporting Information).…”

“…Nineteen studies surveyed 26 099 patients with psoriasis regarding their beliefs in the role of stress in their disease . On average, 46% of patients believed their disease was reactive to stress.…”

Ethnopharmacological survey of medicinal plants used by patients with psoriasis in the West Bank of Palestine

“…However, prevalence of psoriasis varies across geographical locations and races. Research conducted in the Middle East showed that the incidence of psoriasis in Algeria, Tunisia and Morocco was estimated at 10.36, 13.26 and 15.04 per 1000, respectively [3]. The severity of psoriasis varies from scattered papules to generalized scaly plaques [4].…”