Psoriasis in Latin America and the Caribbean: a systematic review

Abstract

Psoriasis is a chronic inflammatory disease that generally affects the skin, nails and joints. The burden of psoriatic disease in Latin America and the Caribbean (LAC) remains largely unknown. To estimate the burden of psoriasis in LAC. We conducted a systematic review following the MOOSE and PRISMA statements. We searched published studies in MEDLINE, EMBASE, LILACS and CENTRAL from 1st January 2000 to 5th August 2015. We included studies that reported incidence, prevalence, health resource use and health expenditures, treatment patterns, comparative effectiveness of different drugs, patients reported outcomes, adherence to treatment and patient preferences in LAC. Risk of bias was assessed evaluating selection of participants, control of cofounders, measurement of exposure and outcome and conflict of interest. Pairs of reviewers independently selected, extracted and assessed the bias risk of the studies. The systematic review was registered at PROSPERO (CRD42016038325). A total of 18 studies from 12 LAC countries were included. Most were observational studies, between which there was a large heterogeneity of outcomes. Population-based studies were not found and most data came from hospital registries. One study reported an incidence of psoriatic arthritis in 6.26 cases per 100 000 person-years. Another study found an incidence of psoriasis 1020 per 100 000 patient-year attending at a dermatology clinic. The prevalence reported in the Argentinean health service was 74 cases per 100 000. Further, psoriasis has been shown to have a substantial negative impact on quality of life. A number of studies also indicated that non-communicable disease burden increases with the presence and severity of psoriasis. With regard to treatment pattern, methotrexate was the dominant systemic therapy. In conclusion, there is an important lack of information from LAC concerning the burden of psoriasis. Further studies investigating the burden of psoriasis in representative LAC populations are needed.

Clinical Goals and Barriers to Effective Psoriasis Care

“…For example, Brazil has adopted the European targets with a few modifications due to the high local prevalence of human T-lymphotropic virus (HTLV) and tuberculosis infection burden, which demands screening before initiating treatment with immunosuppressive therapies [ 47 ]. More information is needed to establish the burden of psoriasis within populations of Latin America and the Caribbean in order to gain a stronger understanding of patient perspectives and barriers to care [ 48 ].…”

The incidence of psoriasis in Chile: an analysis of the National Waiting List Repository

“…A recent systematic analysis reported an estimated prevalence of psoriasis of 0.87% (95% uncertainty interval 0.29%–2.41%) for high‐income southern Latin America 1 . There are no population‐level reports of the incidence of psoriasis from the region, a finding that was also corroborated by a regional systematic review 4 …”

“… 1 There are no population‐level reports of the incidence of psoriasis from the region, a finding that was also corroborated by a regional systematic review. 4 …”

Translation, cultural adaptation and validation of the Somatic Symptom Scale-8 (SSS-8) for the Brazilian Portuguese language

“…For the present study, the sample was composed entirely of patients with psoriasis, which is a chronic immune-mediated inflammatory disease that affects approximately 2% of the world population [ 10 , 11 ]. Clinically, the classic form of the disease is characterized by erythematous plaques covered by greyish-white scales, most commonly on the elbows and knees.…”