Clinical analysis of generalized pustular psoriasis in Chinese patients: A retrospective study of 110 patients

Zheng, Jianfeng; Chen, Wenjuan; Gao, Yunlu; Chen, Fujuan; Yu, Na; Ding, Yangfeng; Liu, Na

doi:10.1111/1346-8138.15958

Cited by 24 publications

(89 citation statements)

References 13 publications

(15 reference statements)

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“…The incidence of a family history of psoriasis ranged from 0 to 31.2% in previous reports. 12-14,17-18,21 In our study, 15.6% of patients had a family history, which is consistent with the findings of Zheng et al . 17 (14.5%).…”

Section: Discussionsupporting

confidence: 92%

“…Zheng et al . 17 included significantly more male than female patients (80/30), but the ratio was equal in the GPP −PsV group (8/8); this is consistent with our results (21/22).…”

Section: Discussionsupporting

confidence: 91%

“…Choon 12 in Malaysia (n = 95) Jin 13 patients in the GPP +PsV group affected; this is consistent with the findings of Zheng et al 17 (53.6%) and Kara Polat et al 14 (52.6%) and higher than the rate reported by Jin et al 13 (30.3%). These findings suggest that nail and scalp involvement may be more closely associated with PsV.…”

Section: Parameterssupporting

confidence: 87%

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Characterization of Generalized Pustular Psoriasis in Northwest China: A Single-Center Retrospective Study

Li¹,

Peng²,

Geng³

2022

International Journal of Dermatology and Venereology

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Objective: This study was performed to investigate the clinical characteristics of patients with generalized pustular psoriasis (GPP) in Northwest China. Methods: The clinical data of patients with GPP were retrospectively collected in the Second Affiliated Hospital of Xi’an Jiaotong University from January 1, 2017, to December 31, 2021 and analyzed using the chi-square test and Mann-Whitney U test. Results: In total, 179 hospitalized patients were included. The male:female ratio was 1.16:1.00, and the mean age at onset was 35.05 ± 19.11 years. Psoriasis vulgaris was also present in 76.0% of patients, and a family history of psoriasis was present in 15.6%. The mean duration of hospitalization was 10.67 ± 4.31 days, and the mean duration of flares was 29.58 ± 24.32 days. Infections and suspected drugs were predisposing factors. A fever developed in 54.7% of patients, and pruritus developed in 70.9%. Some patients had involvement of the nails (38.0%), scalp (46.9%), and tongue (4.5%). Cardiovascular disease, hypertension, and gallbladder-related disease were common comorbidities. The efficacy of acitretin was 84.7%, that of methotrexate was 66.7%, and that of cyclosporine was 100%. Fifteen patients were treated with secukinumab or adalimumab and responded well. The mean response time was 6.34 ± 2.91 days based on the combination treatments. The mean duration of the treatment regimen was 111.35 ± 94.25 days, and approximately 46.6% (n = 131) of patients developed recurrence. Conclusion: Our retrospective study showed that most cases of GPP were accompanied by psoriasis vulgaris and associated with fever or pruritus. Acitretin had good therapeutic efficacy, but recurrence should be noted. Biologics are increasingly becoming effective treatments, but their superiority and safety need further research.

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Section: Discussionsupporting

confidence: 92%

“…Zheng et al . 17 included significantly more male than female patients (80/30), but the ratio was equal in the GPP −PsV group (8/8); this is consistent with our results (21/22).…”

Section: Discussionsupporting

confidence: 91%

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Characterization of Generalized Pustular Psoriasis in Northwest China: A Single-Center Retrospective Study

Li¹,

Peng²,

Geng³

2022

International Journal of Dermatology and Venereology

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“…Like moderate-to-severe psoriasis, GPP is associated with an increased occurrence of comorbidities compared to the general population. 4 Comorbidities that have been reported in GPP include obesity, hypertension, hyperlipidemia, diabetes, uveitis, 4–7 cholestasis, 8 joint involvement, 4–7 , 9 , 10 allergic rhinoconjunctivitis and peptic ulcer disease. 4 , 7 …”

Section: Introductionmentioning

confidence: 99%

Economic Burden of Generalized Pustular Psoriasis in Sweden: A Population-Based Register Study

Löfvendahl¹,

Norlin²,

Schmitt‐Egenolf³

2022

PTT

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Background Generalized pustular psoriasis (GPP), which can occur with or without psoriasis vulgaris (PV), is a severe form of pustular psoriasis with potentially life-threatening symptoms. GPP is also associated with several comorbidities, which further adds to the burden of disease. This study investigates the economic burden of disease in patients with GPP. Methods All-cause and GPP-specific healthcare resource use (inpatient stays, physician visits and drug use), as well as associated costs, were compared for year 2015 between GPP patients (n = 914) and two matched control groups representing the general population (n = 4047) and patients with PV but no GPP (n = 2556). Information on resource use for 2015 was obtained from the Swedish National Patient Register and Swedish Prescribed Drug Register, respectively. Results All-cause inpatient stays, physician visits, and use of psoriasis-related drugs were significantly more common among GPP patients compared to both control groups. This difference was reflected in total direct cost for GPP patients (5062 euros/year) which was 3.1 and 1.8 times higher (p < 0.001) compared to the general population and PV controls, respectively. For GPP patients, the share of total cost was 22% for all-cause physician outpatient visits and 40% for all-cause inpatient stays. However, only 6.3% and 11.3% of these costs, respectively, were due to GPP-specific problems. Psoriasis-related drugs constituted 27% of total costs for GPP patients of which a large fraction (86%) was represented by biologics. Conclusion This study demonstrates a higher economic burden for GPP patients compared to both the general population and patients with PV, with inpatient visits and use of biologic drugs as major cost driving factors. Only fractions of the costs for physician visits and inpatient stays were attributable to specific GPP problems, indicating a higher economic burden of GPP-consequences and complications.

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“…GPP can be further classified as von Zumbusch‐type GPP, GPP of childhood and impetigo herpetiformis (GPP of pregnancy). Previous studies have shown that the mean age of GPP onset is around 40 years, 2,3 and onset at > 60 years of age is extremely rare 4 . For all types of psoriasis, patients with elderly‐onset GPP (onset at > 60 years) had milder disease and a lower incidence of positive family history.…”

mentioning

confidence: 99%

Elderly-onset generalized pustular psoriasis: a case series

Chao

Tsai

2022

Clinical and Experimental Dermatology

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Elderly‐onset (> 60 years of age) atopic dermatitis and psoriasis have been reported to present special clinical phenotypes; however, the study of elderly‐onset generalized pustular psoriasis (GPP) has been limited, mainly due to its rarity. Previous studies have shown that the mean age of GPP onset is around 40 years, and onset at > 60 years of age is extremely rare. We report a case series of seven patients with elderly‐onset GPP. The clinical features of the seven patients were assessed, and all seven patient were analysed for presence of the c.115+6T>C mutation in the gene encoding for interleukin‐36 receptor antagonist (IL36RN). These patients had an atypical clinical course and a lower frequency of the IL36RN c.115+6T>C mutation. IL36RN mutations may have a significant, dose‐dependent effect on the onset age of GPP.

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Clinical analysis of generalized pustular psoriasis in Chinese patients: A retrospective study of 110 patients

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 24 publications

References 13 publications

Characterization of Generalized Pustular Psoriasis in Northwest China: A Single-Center Retrospective Study

Characterization of Generalized Pustular Psoriasis in Northwest China: A Single-Center Retrospective Study

Economic Burden of Generalized Pustular Psoriasis in Sweden: A Population-Based Register Study

Elderly-onset generalized pustular psoriasis: a case series

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