Five Different Clinical Phenotypes Of Han Ethnic In Vulgaris Psoriatic Patients

Objective:Psoriasis is a serious inflammatory skin disease. It was considered as asingle entity all the time. Some studies found that there were different pathophysiologyand response to treatment between the early-onset and late-onset psoriasis patients. Itsuggest that it is necessary to distinguish distinct psoriasis phenotype. Some Frenchdermatologists used multiple correspondence analysis and cluster analysis to divided1484psoriatic patients into6different clinical psoriasis phenotypes which developed anew way to focus genetic, pharmaco-genetic, pathophysiological and therapeutic studieson more homogenous group of patients. The objective of our study was try to find outwhether this way can be use in Han ethnic population.Method:This was a prospective epidemiological study and a specific questionnairewas developed to get datas about the main clinical characteristics of455psoriasisvulgaris patients of Han population in the northeast China. K-means cluster classifysystem was use to analyze the date.the statistical analysis were performed using SPSSsoftware release16.0.Result:Five different clinical psoriasis vulgaris phenotypes were identified.Type1(40patients,8.8%of the total sample) group patients is characterized by male patientswith a late onset of disease,the age of onset is between30to50years old,with guttatalesions the first time,with discontinuous clinical course,without familialantecedents,with sensitivity to season change and koebner phenomenon,with verysevere forms involving all body sites.Type2(72patients,15.8%of the totalsample)group patients with no difference between male and female person,with a earlyonset before30years old.with nummular plaques or guttata lesions the first time.Type3(70patients,15.4%of the total sample) group patients with no difference between maleand female person,with a late onset between30to50years old.with nummular plaquesor guttata lesions the first time,mostly with guttata lesions,there is no link to familial antecedents and few body sites are involved.Type4(29patients,6.4%of the total sample)group patients with no difference between male and female person,with a late onsetbetween30to50years old.with nummular plaques or guttata lesions the firsttime,without familial antecedents,without sensitivity to season change and koebnerphenomenon.Type5(244patients,53.6%of the total sample) group patients with nodifference between male and female person,with a early onset before30years old,withnummular plaques or guttata lesions the first time,mostly with guttata lesions,withsensitivity to season change,with few body sites are involved.this type is the largest one.Conclusion:Using this statistical mothed we successfully identified five distinctclinical phenotypes of psoriasis vulgaris which may reflect differentgenetic,pathophysiological processes in the development of this disease and treatmentresponsiveness.This method is not only suitable for European people, also applies inHan population.