Poster abstracts
dataset of the Korean National Health Insurance Service database.
Study population includes subjects who had undergone health
screenings between January 2009 and December 2012. Patients
who were diagnosed with psoriasis prior to the health screening
or who were less than 20 years of age were excluded. This study
investigated newly diagnosed patients with psoriasis (ICD-10
code, L40) by dermatologists among subjects during the follow-up
period through the claim data.
Result: Total 22,633,536 subjects were included and psoriasis
newly developed in 399,461 subjects. Mean BMI among newly de-
veloped psoriasis group (23.9 ± 3.25) was higher than non-psoriasis
group (23.68 ± 3.27)(p < 0.0001). Mean WC of newly developed
psoriasis group (81.21 ± 9.27) was higher than non-psoriasis group
(79.99 ± 9.26) (p < 0.0001). BMI showed J-shaped association with
the risk of psoriasis. Subjects with BMI over 30 had higher risk
of psoriasis (HR 1.118, 95% CI 1.1–1.137). The risk of psoriasis
increased in proportion to WC. Subjects with WC over 105 cm
showed highest risk of psoriasis (HR 1.305, 95% CI 1.261–1.349)
after adjusting confounding factors including BMI. The risk of
psoriasis increased most in the male group with normal weight,
abdominal obesity (HR 1.175, 95% CI 1.15–1.2).
Conclusion: According to our study, the WC is more likely to affect
the risk of psoriasis than obesity. Our s tudy supports the associa-
tion between abdominal obesity and psoriasis, which increases
awareness of the role of abdominal obesity in the pathogenesis
and comorbidities of psoriasis.
P080
CLINICAL CHARACTERIZATION OF PSORIATIC
ARTHRITIS IN A MULTIDISCIPLINARY CARE MODEL
OF PATIENTS WITH PSORIASIS
Dalila Alejandra Lopez-Rodriguez
Dermatologico Country
Introduction: Psoriatic arthritis (PsA) is an inflammatory arthro-
pathy that occurs in patients with Psoriasis (PsO). The frequency
of PsA in patients with PsO has been estimated between 10–40%.
The presentation and clinical course are variable, therefore, it is
necessary to understand the clinical behavior, severity and as-
sociated factors that condition functional impairment, disability
and lost quality of life.
Objective:To describe the clinical features of the ApS, in a mul-
tidisciplinary PsO clinic.
Methods: Prospective study, August 2016-february 2018, patients
attending to Multidisciplinary Clinic for psoriasis in Dermatolo-
gico Country were included.
Results: A total of 53 participants were included, finding a preva-
lence of psoriatic arthropathy of 58.5%.
The median age was 42 years and 71% were female. Patients with
ApS have higher frequency of DM2, metabolic syndrome and
hepatic steatosis. However, the differences are not statistically
significant, which could be a result of the sample size. According
to the activity of PsO the most frequent presentation was plaque
psoriasis in 67.7%. Median PASI was 5.4 (1.5, 16.4). Axial pre-
sentation of ApS was observed in 51.6% and peripheral disease
in 71%, enthesitis was found in 54.8% and dactylitis 16.1%.
To determine the severity of PsA according DAS 28 score, we
found 45.2% of patients presented severe activity. One hundred
percent of the subjects with peripheral disease did not achieve
low activity criteria of the disease measured by MDA. When
calculating the tertiles of the HAQ instrument, it is possible to
observe that 51.6% of patients presented severe deterioration
in the quality of life. In the logistic regression model without
adjustment, the presence of a severe DAS 28 is associated with
an increase in the risk of deterioration in quality of life, with OR
of 6.24 (1.74, 22.2). The presence of BMI > 27 is associated with
an increase in the risk of deterioration in quality of life with OR
of 6.53 (1.59, 26.8). When performing the adjusted multivariate
35
model, the only variables that were associated with severe de-
terioration of quality of life were the presence of BMI > 27 and
on the other side, pain, with BMI > 27 is the factor that mostly
impairs the quality of life.
Conclusions: Prevalence of PsA in this series of patients with skin
or nail psoriasis was 58.3%. The 45.2% of patients showed severe
activity and 51.6% severe deterioration in their quality of life, that
leads to disability and limitation performing daily activities. An
early diagnosis provides the possibility of appropriate treatment
to improve function, quality of life and decrease the progression
and complications of the disease.
P081
TRIGGERING FACTORS IN CHILDHOOD PSORIASIS
Iveta Dencheva 1 , Ivan Botev 2 , Lyubka Miteva 1
Dermatology clinic “Persenk”, 2 Department of Dermatology and Venere-
ology, Medical University, Sofia, Bulgaria; Dermatology clinic “Persenk”,
Sofia, Bulgaria
1
Introduction: Psoriasis is a chronic multisystem, inflammatory di-
sease that occurs at any age. It represents about 4% of all dermato-
sis observed in children. Approximately one third of all patients
have onset of the disease under the age of 16. The most common
triggering factors in children are stress, Koebner phenomenon,
infections and seasonal change.
Objectives: The aim of this study was to assess the most common
triggering and precipitating factors of psoriasis among Bulgarien
children.
Materials and Methods: This study included 42 consecutively
diagnosed children with psoriasis who presented in the Department
of Dermatology and Venereology at Alexandrovska University
Hospital, in Sofia, Bulgaria. The inclusion criteria were a clinical
diagnosis of psoriasis and age under 18 years.
Results: A total of 42 children with psoriasis were examined, 18
(42.85%) males and 24 (57.15%) females. The most frequent fac-
tors precipitating psoriasis in our group of children were psycho-
emotional stress in 16 (38.09%) cases. Koebner`s phenomenon
was observed in 3 (7.14%) patients. In only two (4.76%) children
triggering factors associated with psoriasis were infections. In 17
(40.47%) cases aggravating factors could not be identified. The
influence of the season on disease activity could be determined
in 25 (59.52%) patients. All of them showed worsening in winter
and improvement in summer.
Conclusion: The most frequent factors precipitating psoriasis in
children revealed in this study, were stressful life events, Koebner
phenomenon and infectious disease. Among patients who reported
triggering factors, stress was the most common cause. The study
showed that psoriasis in children relapses and worsens mainly in
winter season.
P082
QUALITY OF CARE FOR PSORIASIS IN THE PAST 12
YEARS – RESULTS FROM A SERIES OF NATIONWIDE
HEALTH CARE STUDIES IN GERMANY
Matthias Augustin
Institute for Health Services Research in Dermatology
Introduction: In Germany, the quality of health care for psoriasis
was very critical in 2005. Most patients lacked of sufficient care
and there was only a minor proportion receiving systemic drugs.
In the mean time, there has been conducted a national psoriasis
program in order to improve the quality of psoriasis care, inclu-
ding development of an evidence-based guideline, a consensus of
treatment goals, the invention of a “culture of measurement” and
consented national goals for psoriasis care. These measures were
supported by the establishment of 30 regional psoriasis networks
involving more than 800 dermatologists.
Objectives: (1) Presentation of the very recent results on the health
care situation of patients with psoriasis vulgaris in dermatological
Acta Derm Venereol 2018