Retrospective Analysis Of Comorbidities Of 254 Hospitalized Patients With Psoriasis

BackgroundPsoriasis is a common chronic recurrent inflammatory skin disease characterized by scaly erythema,papules and plaques.Epidemiological studies at home and abroad have found that psoriasis is associated with metabolic syndrome(MS),cardiovascular and cerebrovascular diseases,infection,malignant tumor,psoriatic arthritis(PsA),digestive tract disease,kidney disease,etc.However,studies on the distribution and clinical features of psoriasis and its comorbidities are rare.Therefore,254 hospitalized patients with psoriasis are collected in this study,and their general data and distribution of psoriatic comorbidities are retrospectively analyzed.ObjectiveRetrospective analysis of the distribution and clinical features of comorbidity in hospitalized patients with psoriasis,providing guidance and assistance for the integrated management of psoriasis.MethodsPsoriasis patients who were first admitted to Qilu Hospital of Shandong University and whose medical records were complete from December 2015 to November 2018 were collected and divided to different groups according to age,gender,BMI,age of onset,clinical type,whether with comorbidities,PASI scores,etc.Analyzing the distribution and clinical features of comorbidities in different groups.Data are analyzed by SPSS 19.0,and P<0.05 was considered statistically significant.Results1.Of the 254 hospitalized patients with psoriasis,163 are males,and 91 are female,male:female = 1.8:1.A total of 35 patients aged<18 years old,accounting for 13.8%of the total number of patients.The median BSA is 36%,and the median PASI score is 24.9.The severity of lesions is graded according to BSA:11 patients(4.3%)with moderate psoriasis(3≤BSA≤10)and 243 patients(95.7%)with severe psoriasis(BSA>10);They are graded according to the PASI score:4 patients(1.6%)with mild to moderate psoriasis(PASI≤10)and 250 patients(98.4%)with severe psoriasis(PASI>10).2.Psoriasis vulgaris is the most common,with a total of 139 cases(54.7%),followed by pustular psoriasis,erythrodermic psoriasis,and arthritic psoriasis,respectively 57 cases(22.4%),33 cases(13.0%)and 25 cases(9.8%).A total of 83 patients(32.7%)had a history of smoking,a total of 40(15.7%)had a history of alcohol abuse(long-term drinking history lasts for more than 5 years;daily alcohol consumption is equivalent to ethanol>80g/d;Amount of ethanol(g)= alcohol consumption(ml)×concentration(%)×0.8),and a total of 58(22.8%)had a positive family history3.In this study,there are 164 cases(64.6%)of patients with comorbidities,and 90 cases(35.4%)without comorbidities.The most common comorbidity is hyperlipidemia with a total of 102 cases(40.2%),followed by hypertension(41 cases,16.1%),MS(35 cases,13.8%),Hyperuricemia(29 cases,11.4%),cardiovascular disease(29 cases,11.4%),infection(28 cases,11.0%),PsA(25 cases,9.8%),type 2 diabetes(24 cases,9.4%).In addition,there are comorbidities such as liver diseases,malignant tumors,digestive tract diseases,cerebrovascular diseases,and kidney diseases.4.Patients with comorbidities are older than those without comorbidity(48.3 ±16.6,27.7±17.3 years old,respectively),and there is a statistically significant difference between the two groups(P<0.001).The severity of the disease in the group with comorbidities is significantly higher than that in the group without comorbidity(P values of BSA and PASI scores are all<0.001).5.In this study,there are 139,57,33 and 25 cases of psoriasis vulgaris,pustular psoriasis,erythrodermic psoriasis,and arthritic psoriasis,respectively.The distribution of comorbidities of various clinical types is different.6.The severity of the disease in the juvenile group is milder than that in the adult group(P values of BSA and PASI scores is 0.001 and<0.001,respectively),and the percentage of comorbidities is also significantly lower than that of the adult group(P<0.001),especially for metabolic-related diseases(such as MS,hypertension,hyperlipidemia).The common comorbidities in the juvenile group are hyperlipidemia(20.0%)and hyperuricemia(5.7%).In addition,there are 1 case of infection,liver disease and cardiovascular disease,respectively.7.The results show that the BMI of male patients is(25.0±4.9)kg/m2,and that of female patients is(23.5±4.1)kg/m2.The BMI of males is significantly higher than that of females(P=0.019).There is no significant difference in the percentage of psoriatic comorbidities between the male and female groups(P>0.05).8.Compared with the normal group,the obese group has higher BSA(%)and PASI(P values are 0.036 and 0.011,respectively).The proportion of comorbidities in the normal group is 54.5%,while that in the obese group is 77.5%.There is a significant difference between the two groups(P<0.001).The percentage of metabolic-related comorbidities(such as MS,hypertension,hyperlipidemia,diabetes,hyperuricemia,liver disease,cardiovascular disease)is significantly higher in the obese group than in the normal group(P<0.05).9.The percentage of comorbidities in the early-onset group is 56%,and that in the late-onset group is 86.1%,with significant differences(P<0.001).The percentage of MS,hypertension,hyperlipidemia,diabetes,hyperuricemia,cardiovascular disease,kidney disease,and digestive tract disease in the late-onset group is higher than that in the early-onset group.10.The study has found that patients with more severe disease is more likely to have smoking and alcohol abuse histories than patients with milder disease,and is more likely to suffer from MS,hypertension,hyperlipidemia,infection,liver disease,cardiovascular and cerebrovascular diseases,PsA,and digestive diseases.Conclusions1.Hospitalized patients with psoriasis have higher BSA and PASI scores,and are easily associated with comorbidities such as MS,cardiovascular and cerebrovascular diseases,PsA,malignant tumors,infection,digestive tract diseases,kidney diseases,etc.2.The severity of psoriasis is associated with comorbidities.The more severe the condition,the higher the risk of developing comorbidities.3.The hospitalized patients in the juvenile group are less severe,and the distribution of comorbidities is also significantly different from that in the adult group.The more common comorbidities are hyperlipidemia(20.0%)and hyperuricemia(5.7%).4.There is no significant difference in the distribution of comorbidities among patients of different genders.Obese patients are more severe and have a higher risk of developing metabolically related diseases.