Acta Dermato-Venereologica 99-4CompleteContent | Page 12

400 CLINICAL REPORT Psoriasis Incidence and Lifetime Prevalence: Suggestion for a Higher Mortality Rate in Older Age-classes among Psoriatic Patients Compared to the General Population in Italy Elena PEZZOLO 1 , Simone CAZZANIGA 1,2 , Paolo COLOMBO 3 , Liliane CHATENOUD 4 and Luigi NALDI 1,5 1 Study Center of the Italian Group for Epidemiologic Research in Dermatology (GISED), Bergamo, Italy, Bergamo, Italy, 2 Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland, 3 DOXA, Cattolica University od Sacro Cuore, 4 Laboratory of Clinical Epidemiology, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, and 5 Department of Dermatology, San Bortolo Hospital, Vicenza, Italy Data on the psoriasis incidence and prevalence in the Italian population are limited, and a timely and ac- curate understanding of the disease epidemiology is needed. This ad hoc study investigated psoriasis inci- dence and lifetime prevalence in a representative sam- ple (n  = 14,705) of the Italian population. Information on lifetime history of skin disorders with details about their onset, duration, and treatment was collected. Psoriasis incidence showed a bimodal distribution pat- tern, with peaks in age classes characteristic of ear- ly-onset (35–44 years) and late-onset (65–74 years) psoriasis. Late-onset psoriasis showed some varia- tions according to the sex, with females being diag- nosed earlier than males. Lifetime prevalence of pso- riasis was 2.7% (95% confidence interval: 2.5–3.0): it increased to 3.5% at age 60–64 years, then decreased steadily after age 64, to 1.7% at age > 74 years. This decrease, despite a peak in incidence rates, after age 64, may suggest a higher mortality rate among pso- riasis patients in older age classes, compared to the general population. Key words: age-classes; incidence; lifetime prevalence; mor- tality; psoriasis. Accepted Jan 23, 2019; E-published Jan 23, 2019 Acta Derm Venereol 2019; 99: 400–403. Corr: Elena Pezzolo, Study Center of the Italian Group for Epidemiologic Research in Dermatology (GISED), Via Clara Maffei 4, IT-24121 Bergamo, Italy. E-mail: [email protected] D espite psoriasis being a common skin disease, data on its epidemiology worldwide are still scarce. Most of the available evidence on the descriptive epi- demiology of psoriasis has been summarised in a recent systematic review (1). The incidence and prevalence of psoriasis show remarkable variations by country. These variations may be explained by several factors, including geographic, environmental, and ethnic diversity, lack of standardised diagnostic criteria and variable disease presentation and clinical course. Reliable epidemiological data are crucial to define the disease burden, and may offer clues on the aetiology of the disease (1, 2). Limited data are available in the Italian population, with not homogenous prevalence estimates, probably doi: 10.2340/00015555-3130 Acta Derm Venereol 2019; 99: 400–403 SIGNIFICANCE Little is known about psoriasis incidence and prevalence in Italy. Such information is important in order to define the disease burden. Therefore, an accurate and timely understanding of the disease epidemiology is needed. We investigated incidence rates and lifetime prevalence of pso- riasis in a representative sample of adult Italian popula- tion, assessing the disease history through a face-to-face interview. We documented a bimodal distribution pattern in the incidence. We also observed a decrease in the lifetime prevalence after age 64. This suggests a higher mortality rate in older psoriasis patients compared to the general population. due to different sampling procedures and case definition (3, 4). We investigated the incidence rates and lifetime preva- lence of psoriasis in a representative sample of the adult Italian population. Data were collected in the context of the Prevalence of Actinic Keratoses Italian Study (PraK- tis) (5, 6). The PraKtis Study was designed to evaluate the point prevalence of actinic keratoses (AKs) and related disorders, e.g. photoaging, in the adult Italian population through a face-to face, computer-assisted interviews and direct clinical evaluation. In addition, a thorough history of selected skin conditions was collected. METHODS Study design We collected a randomised sample of the adult Italian population and assessed, through a standardised face-to-face interview, the history of skin diseases, including psoriasis, with reported age- at-onset, duration and treatment (5, 6) (Fig. 1). Study population This study was embedded within the previously described PraK- tis Study (5, 6). In short, the Italian Group for Epidemiological Research in Dermatology (GISED), in collaboration with the Ita- lian branch of the Gallup International Association (DOXA) and the Institute of Pharmacological Research Mario Negri IRCCS, conducted a survey from March 2003 through April 2004. Over- all 14,705 participants aged ≥ 25 years were recruited from the general Italian population through a stratified sampling design, This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica.