Epidemiology and Clinical Features of Adult Patients with Psoriasis in Malaysia: 10-Year Review from the Malaysian Psoriasis Registry (2007–2016)

Abstract

Background Psoriasis is a chronic inflammatory skin disease affecting 2-3% of the general population. Aim To evaluate the epidemiology and clinical characteristics of patients with psoriasis who seek treatment in outpatient dermatology clinics throughout hospitals in Malaysia. Materials and Methods Data were obtained from the Malaysian Psoriasis Registry (MPR). All patients (aged 18 and above) who were notified to the registry from July 2017 to December 2017 were included in this study. Results Among 15,794 patients, Malays were the most common (50.4%), followed by Chinese (21.4%), Indian (17.6%), and others (10.6%). The mean age onset of psoriasis for our study population was 35.14 ± 16.16 years. Male to female ratio was 1.3 : 1. 23.1% of patients had positive family history of psoriasis. The most common clinical presentation was chronic plaque psoriasis (85.1%), followed by guttate psoriasis (2.9%), erythrodermic psoriasis (1.7%), and pustular psoriasis (1.0%). Majority of our patients (76.6%) had a mild disease with BSA < 10%. 57.1% of patients had nail involvement, while arthropathy was seen in 13.7% of patients. Common triggers of the disease include stress (48.3%), sunlight (24.9%), and infection (9.1%). Comorbidities observed include obesity (24.3%), hypertension (25.6%), hyperlipidemia (18%), diabetes mellitus (17.2%), ischaemic heart disease (5.4%), and cerebrovascular disease (1.6%). The mean DLQI (Dermatology Life Quality Index) was 8.5 ± 6.6. One-third (33.1%) of the patients had a DLQI score of more than 10, while 14.2% of patients reported no effect at all. Conclusion Our study on the epidemiological data of adult patients with psoriasis in Malaysia showed a similar clinical profile and outcome when compared to international published studies on the epidemiology of psoriasis.

Review of the Prevalence of Cardiovascular and Metabolic Comorbidities of Psoriasis

“…Another 2015 paper by Schaarschmidt et al reported the prevalence of DMII to be 14.5% 9 while a review from the Malaysian Psoriasis Registry, spanning 2007-2016, and a study of over 2,700 patients in the Bringham psoriasis and psoriatic arthritis registries both found the prevalence of DMII in their cohorts to be at or near 17%. 7,15 All other results were close to the results mentioned, and can be found in Table 1 below, except for one unusual finding. Far and away the largest percentage found of DMII in psoriasis patients was the 49.3% found in an observational study of psoriasis patients taking two or more drugs.…”

“…results of a ten-year review of Malaysian psoriasis patients, which reported the prevalence of ischemic heart disease at 5.45% and the prevalence of cerebrovascular disease at 1.6%. 7 A 2017 study of Czech registry patients found the prevalence of coronary heart disease to be 4.9%. 8 In contrast, Schaarschmidt et al found that the prevalence of cardiovascular disease was 15%.…”

Clinical and Demographic Profile of Patients With Psoriasis and Its Effect on the Quality of Life Using Dermatology Quality of Life Index: A Cross Sectional Study

“…This study shows that female have less severe psoriasis compared with male area and severity wise. An Iranian study on psoriasis shows that the negative impact on patient's QoL was higher for male than 18 female. In the present study, however, frequency was greater in female but the difference in mean DLQI for male and female was statistically insignificant.…”

The Brain–Skin Connection and the Pathogenesis of Psoriasis: A Review with a Focus on the Serotonergic System

“…The familial recurrence of psoriasis is well known and disease concordance is higher in monozygotic twins than in dizygotic twins [92]. Additionally, recent epidemiological studies have also confirmed that there is a genetic predisposition for psoriasis, with more than 20% of patients having a positive family history [93].…”