Gender differences in the association between adverse childhood experiences and early onset psoriasis

Abstract

Psoriasis, a chronic autoimmune skin disease, arises from both genetic predisposition and environmental factors, including Adverse Childhood Experiences (ACEs). This cross-sectional study investigated the association between ACEs, family history, and early-onset psoriasis (≤ 18 years), with particular attention to gender differences. Among 102 psoriasis patients (54 early-onset, 48 late-onset), the early-onset group demonstrated a higher proportion of females, greater prevalence of parental psoriasis, and elevated anxiety levels compared to the late-onset group. However, multivariable regression analysis revealed that parental psoriasis was not significantly associated with early-onset psoriasis. Exposure to three or more ACEs significantly associated with early-onset psoriasis (adjusted OR = 2.61, p = 0.014), with specific associations observed for emotional neglect, domestic violence, and loneliness. Gender-stratified analysis showed a stronger association in females (adjusted OR = 6.609, p = 0.016) than in males (adjusted OR = 2.494, p = 0.115), though no significant gender-ACEs interaction was detected (p = 0.289). These findings demonstrate a gender differences, dose-response relationship between ACEs and early-onset psoriasis, highlighting the potential value of early psychological interventions for at-risk individuals, particularly females with high ACE exposure.