Study On Clinical Characteristics Of Early-onset And Late-onset Of Psoriasis In Gansu Area

Background: In 1985, Henseler and Christophers divided psoriasis into early-onset psoriasis(onset at the age of<40 years) and late-onset psoriasis (onset at the age of ?40 years) based on the age of onset, and found differences in clinical features of the two forms. In recent years, many scholars around the world have conducted epidemiological studies on early-onset psoriasis(EOP)and late-onset psoriasis(LOP), but there are some differences in clinical characteristics between different regions and different populations. In our country, there are few clinical studies on early onset and late onset psoriasis. There is no literature on the epidemiology of early-onset psoriasis and late-onset psoriasis in Gansu area.Purpose : To study the characteristics of EOP and LOP in Gansu province and to analyse possible incentives; To study their impacts on the physical and mental of patients; To study the differences in systemic treatment and complications between the two groups; To deeply understand pathogenesis and clinical manifestations.Method : To use epidemiological methods and to research 352 suitable samples by questionnaire.To establish the database with EpiData3.1 software and to analyze by SPSS21.0 software.Results:1) This study included 352 cases,of which 211 were male,141 were female,male to female ratio was 1.50:1, of which 279 cases of EOP, 73 cases of LOP, ratio of 3.82:1. The average age of onset of female was earlier than that of male, and the age onset of male and female had only one peak. The subjects were Han nationality (91.19%). EOP cases of occupation workers and students in the majority, accounting for 59.14%, while the LOP to workers and farmers, accounting for 65.76%,there was significant difference (x2=26.971,P<0.001).2) There is no significant difference between EOP and LOP positive rate of family history(x2=2.362,P=0.124),but the positive rate of Second-degree relative of EOP was higher than that of LOP (x3=6.044,P=0.014).3) Between the two groups with plaque psoriasis being in the majority, but the incidence of the point of guttate psoriasis is higher in early-onset group (x2=5.476,P=0.019). The lesions recurrence or exacerbation of EOP and LOP were higher in the winter season,accounted for 73.13% and 44.83%, of which the proportion of EOP patients in winter recurrence or worsening is more significant (X2Fisher=12.207,P<0.01). Damage in palmoplantar with late-onset patients appear higher proportion (x2=7.170,P < 0.01). The probability of the occurrence of the complication of LOP patients was significantly higher than that in patients with EOP (x2=10.528,P<0.01). EOP patients with the severity of lesions (Psoriasis Area and Severity Index, PASI) by age, sex, body mass index (BMI), complications, course of disease, nail damage and other factors;and the severity of the lesions(PASI) in patients with LOP is only related to age, complications and nail damage. Changing into pustular psoriasis is the risk factors of tongue change(OR=1.739,95%CI1.178 27.515,P=0.031); The metatarsal damage is a risk factor for nail injury(OR=5.282,95%CI 1.222 22.827,P=0.026), at the same time, changing into pustular psoriasis is a risk factor of nail damage (OR=3.801,95%CI 1.067 13.426,P=0.038).4) In the study of the health status of the patients with EOP and lop, the patients in the late group were significantly higher than those in the early group in Reported Health Transition(HT)(T=-2.406,P=0.017). Medical Outcome Survey Short Form 36(SF-36) regression showed that there is a negative correlation between patients with joint injury, PASI score and Physical Component Summary(PCS) (P<0.001); There was a positive correlation between the age of onset and PCS(P=0.014),and there was a positive correlation between gender and PCS(P=0.004). There is a negative correlation between patients with PASI score, pruritus and mental health (Mental Component Summary,MCS)(P<0.001); There was a positive correlation between the age of onset and MCS(P=0.010),and there was a positive correlation between gender and MCS(P=0.008).Conclusion: There is no obvious for bimodality in age of onset of psoriasis. There are some differences in clinical features and genetics between early-onset and late-onset psoriasis in Gansu area. There are some differences in demographic characteristics between early onset and late onset psoriasis in Gansu area. There was no significant difference in the quality of life and general health of the patients with early-onset and late onset psoriasis in Gansu area.