Epidemiological and clinical characteristics, treatments, and comorbidities in elderly patients with psoriasis and the evaluation of patients according to the age of onset

Abstract

Introduction: There is limited data regarding epidemiological and clinical characteristics of psoriasis in the elderly population. We sought to demonstrate epidemiological and clinical features, treatments, and comorbidities in elderly patients with psoriasis. Additionally, we evaluated whether the age at disease onset had an impact on disease characteristics. Materials and Method: We performed a retrospective review of 508 psoriasis cases and evaluated 89 patients, older than 65-years-old, with psoriasis. Patients were divided into two groups according to the age at disease onset: early-onset psoriasis (before age 40) and late-onset psoriasis (after age 40). All data were compared for the two groups. Results: Elderly patients with psoriasis comprised 17.6% of all patients. The median age was 70-years-old, with a male to female ratio of 1.4. Past family history was known for 25% of patients. The primary subtype was plaque-type psoriasis and 78.7% of patients had moderate-severe psoriasis. The two common comorbidities were hypertension (57.3%) and diabetes mellitus (33.7%). In total, 32.5% had early-onset psoriasis and 67.5% had late-onset psoriasis. Patients with early-onset psoriasis had a significantly higher prevalence in their family history (p=0.020). There was no significant difference between clinical subtypes, disease severity, nail and joint involvement, or treatment modalities, according to the age at disease onset. Nevertheless, we found a statistically significant correlation between late-onset psoriasis and hypertension (p=0.014). Conclusion: This study underlined epidemiological and clinical features of psoriasis in the elderly. Excluding hypertension, the age at disease onset did not show an impact on disease characteristics or comorbidities.