Diabetes, cardiovascular disease (CVD), and mood disorders may be comorbidities highly prevalent in patients with palmoplantar plaque psoriasis, and suggest the implementation of targeted preventative approaches and therapies that address these concomitant health concerns should be considered in a comprehensive treatment regimen for this form of plaque psoriasis. This is according to study findings published in the Journal of the American Academy of Dermatology.
The study was a retrospective investigation of medical charts of 163 patients with palmoplantar plaque psoriasis who were treated with topical psoralen and ultraviolet A from 2009 to 2017. Each patient was matched with up to 5 age- and sex-adjusted healthy control patients (n=781) who were identified through the Tel-Aviv Medical Center Inflammation Survey. The mean age in the patient cohort was 55.5 ± 14 years and the mean age in the healthy control group was 55 ± 14 years. The ratio of men to women was 0.47 to 0.53 in both the patient and the control groups.
The researchers found that a significantly higher percentage of patients with psoriasis had diabetes mellitus (14.1% vs 5.9%; odds ratio [OR], 2.296; 95% CI, 1.384-3.809; P =.001). In addition, a significantly greater percentage of patients with psoriasis had a CVD diagnosis compared with control patients (13.5% vs 7.4%, respectively; OR, 1.797; 95% CI 1.097-2.942; P =.02). Mood disorders were also more common in patients with psoriasis compared with the healthy control population (23.9% vs 3.8%, respectively; OR, 6.232; 95% CI, 3.869-10.036; P <.001).
And although not statistically significant, patients with palmoplantar plaque psoriasis also had higher rates of dyslipidemia (32.5% vs 26.1%; OR, 1.236; 95% CI, 0.913-1.672; P =.17), hypertension (26.4% vs 22.8%; OR, 1.125; 95% CI, 0.805-1.572; P =.49), and psoriatic arthritis (19.6% vs 13.1%; OR, 1.423; 95% CI, 0.953-2.124; P =.08) compared with control patients.
Limitations of this study included its retrospective design and the relatively small number of patients in the psoriasis cohort.
The researchers of this study suggest that patients with palmoplantar plaque psoriasis should be informed of their risks for these comorbid disorders as well as “possible preventive measures, as currently practiced for patients with more common and generalized forms of psoriasis.”
Greenberg R, Goldsmith T, Zeltser D, et al. Comorbidities in patients with palmoplantar plaque psoriasis. Published online August 15, 2020. J Am Acad Dermatol. doi:10.1016/j.jaad.2020.03.112