Clinical study of psoriasis occurring over the age of 60 years: is elderly-onset psoriasis a distinct subtype?

Background  Previous studies demonstrated clinical differences of early‐ and late‐onset psoriasis. However, epidemiological data and clinical characteristics of psoriasis occurring in geriatric patients have been rarely studied. Objective  Assessment of epidemiology and clinical features of psoriasi...

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Veröffentlicht in:International journal of dermatology 2012-01, Vol.51 (1), p.53-58
Hauptverfasser: Kwon, Hyuck Hoon, Kwon, In Ho, Youn, Jai Il
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container_title International journal of dermatology
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creator Kwon, Hyuck Hoon
Kwon, In Ho
Youn, Jai Il
description Background  Previous studies demonstrated clinical differences of early‐ and late‐onset psoriasis. However, epidemiological data and clinical characteristics of psoriasis occurring in geriatric patients have been rarely studied. Objective  Assessment of epidemiology and clinical features of psoriasis first occurring over the age of 60 years, so‐called elderly‐onset psoriasis, based on clinical data. Materials and methods  Among 4049 patients visiting our psoriasis clinic for the last 27 years, patients were first divided into early‐ (onset age before 30 years) and late‐onset psoriasis (onset age after 30 years) based on our previous studies. Then, patients of late‐onset psoriasis were further divided into middle age‐onset group (onset age between 30 and 60 years) and elderly‐onset group (onset age over 60 years). Clinical characteristics of elderly‐onset psoriasis were compared with early‐ and middle age‐onset groups. We acquired the data both by physician’s assessments and patients’ responses. Results  Elderly‐onset patients comprised 3.2% of total patients, 129 out of 4049. They have shown a lower incidence of family history (P 
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However, epidemiological data and clinical characteristics of psoriasis occurring in geriatric patients have been rarely studied. Objective  Assessment of epidemiology and clinical features of psoriasis first occurring over the age of 60 years, so‐called elderly‐onset psoriasis, based on clinical data. Materials and methods  Among 4049 patients visiting our psoriasis clinic for the last 27 years, patients were first divided into early‐ (onset age before 30 years) and late‐onset psoriasis (onset age after 30 years) based on our previous studies. Then, patients of late‐onset psoriasis were further divided into middle age‐onset group (onset age between 30 and 60 years) and elderly‐onset group (onset age over 60 years). Clinical characteristics of elderly‐onset psoriasis were compared with early‐ and middle age‐onset groups. We acquired the data both by physician’s assessments and patients’ responses. Results  Elderly‐onset patients comprised 3.2% of total patients, 129 out of 4049. They have shown a lower incidence of family history (P < 0.05). The severity assessed by PASI score, body surface extent, and activity of individual lesions demonstrated that psoriasis of the elderly‐onset group was generally milder compared with early‐ and middle age‐onset groups (P < 0.05). In clinical phenotypes, the proportion of guttate type and generalized pustular psoriasis type decreased remarkably, while that of erythroderma type increased (P < 0.05). There was a significant change in the body part of origin comparing early‐ and middle age‐onset groups (P < 0.05). The proportion of scalp increased, while that of knee–elbow and trunk decreased significantly (P < 0.05). Patients’ subjective sensation of disease course improved statistically comparing early‐ and middle age‐onset groups (P < 0.05). There was no significant change in the degree of pruritus on psoriatic lesions and nail involvement (P > 0.05). Conclusion  The elderly‐onset group demonstrated milder disease courses and some changes in clinical phenotypes and body part of origin compared with early‐ and middle age‐onset groups. Therefore, it seems that patients whose onset of psoriasis was over the age of 60 years might have distinct clinical features in some clinical aspects.]]></description><identifier>ISSN: 0011-9059</identifier><identifier>EISSN: 1365-4632</identifier><identifier>DOI: 10.1111/j.1365-4632.2011.04979.x</identifier><identifier>PMID: 22182378</identifier><identifier>CODEN: IJDEBB</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Age Distribution ; Age of Onset ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Child ; Child, Preschool ; Dermatology ; Female ; Humans ; Incidence ; Infant ; Male ; Medical sciences ; Middle Aged ; Nail Diseases - epidemiology ; Nail Diseases - pathology ; Pruritus - epidemiology ; Pruritus - pathology ; Psoriasis - epidemiology ; Psoriasis - pathology ; Psoriasis. Parapsoriasis. Lichen ; Retrospective Studies ; Scalp Dermatoses - epidemiology ; Scalp Dermatoses - pathology ; Severity of Illness Index ; Young Adult</subject><ispartof>International journal of dermatology, 2012-01, Vol.51 (1), p.53-58</ispartof><rights>2012 The International Society of Dermatology</rights><rights>2015 INIST-CNRS</rights><rights>2012 The International Society of Dermatology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3669-b63535c68231a5dc686d97588a039c41ee9ea8c6ef19c4645993eecec3a4c2de3</citedby><cites>FETCH-LOGICAL-c3669-b63535c68231a5dc686d97588a039c41ee9ea8c6ef19c4645993eecec3a4c2de3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-4632.2011.04979.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-4632.2011.04979.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,4010,27900,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=25299999$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22182378$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kwon, Hyuck Hoon</creatorcontrib><creatorcontrib>Kwon, In Ho</creatorcontrib><creatorcontrib>Youn, Jai Il</creatorcontrib><title>Clinical study of psoriasis occurring over the age of 60 years: is elderly-onset psoriasis a distinct subtype?</title><title>International journal of dermatology</title><addtitle>Int J Dermatol</addtitle><description><![CDATA[Background  Previous studies demonstrated clinical differences of early‐ and late‐onset psoriasis. However, epidemiological data and clinical characteristics of psoriasis occurring in geriatric patients have been rarely studied. Objective  Assessment of epidemiology and clinical features of psoriasis first occurring over the age of 60 years, so‐called elderly‐onset psoriasis, based on clinical data. Materials and methods  Among 4049 patients visiting our psoriasis clinic for the last 27 years, patients were first divided into early‐ (onset age before 30 years) and late‐onset psoriasis (onset age after 30 years) based on our previous studies. Then, patients of late‐onset psoriasis were further divided into middle age‐onset group (onset age between 30 and 60 years) and elderly‐onset group (onset age over 60 years). Clinical characteristics of elderly‐onset psoriasis were compared with early‐ and middle age‐onset groups. We acquired the data both by physician’s assessments and patients’ responses. Results  Elderly‐onset patients comprised 3.2% of total patients, 129 out of 4049. They have shown a lower incidence of family history (P < 0.05). The severity assessed by PASI score, body surface extent, and activity of individual lesions demonstrated that psoriasis of the elderly‐onset group was generally milder compared with early‐ and middle age‐onset groups (P < 0.05). In clinical phenotypes, the proportion of guttate type and generalized pustular psoriasis type decreased remarkably, while that of erythroderma type increased (P < 0.05). There was a significant change in the body part of origin comparing early‐ and middle age‐onset groups (P < 0.05). The proportion of scalp increased, while that of knee–elbow and trunk decreased significantly (P < 0.05). Patients’ subjective sensation of disease course improved statistically comparing early‐ and middle age‐onset groups (P < 0.05). There was no significant change in the degree of pruritus on psoriatic lesions and nail involvement (P > 0.05). Conclusion  The elderly‐onset group demonstrated milder disease courses and some changes in clinical phenotypes and body part of origin compared with early‐ and middle age‐onset groups. Therefore, it seems that patients whose onset of psoriasis was over the age of 60 years might have distinct clinical features in some clinical aspects.]]></description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Distribution</subject><subject>Age of Onset</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Dermatology</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nail Diseases - epidemiology</subject><subject>Nail Diseases - pathology</subject><subject>Pruritus - epidemiology</subject><subject>Pruritus - pathology</subject><subject>Psoriasis - epidemiology</subject><subject>Psoriasis - pathology</subject><subject>Psoriasis. Parapsoriasis. Lichen</subject><subject>Retrospective Studies</subject><subject>Scalp Dermatoses - epidemiology</subject><subject>Scalp Dermatoses - pathology</subject><subject>Severity of Illness Index</subject><subject>Young Adult</subject><issn>0011-9059</issn><issn>1365-4632</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM-O0zAQhy0EYrsLr4B8QZwS_CdxYiSEUIFlVxUgAVpulutMFpc0CZ5kaW5IvClPgkNL4chcbGu-39j-CKGcpTzW403KpcqTTEmRCsZ5yjJd6HR3iyyOjdtkwWIr0SzXJ-QUcROPUvDsLjkRgpdCFuWC9MvGt97ZhuIwVhPtatpjF7xFj7RzbgzBt9e0u4FAh89A7TXMjGI_v_-YwAZ8QiMITQWhmZKuRRj-GWBp5XHwrRsojuth6uHZPXKntg3C_cN6Rj6-evlh-TpZvT2_WD5fJU4qpZO1krnMnYrP5Dav4kZVusjL0jKpXcYBNNjSKah5PKos11oCOHDSZk5UIM_Io_3cPnRfR8DBbD06aBrbQjei0VyIQhaaRbLcky50iAFq0we_tWEynJlZt9mY2aqZrZpZt_mt2-xi9MHhknG9heoY_OM3Ag8PgMUouQ62dR7_crnQc0Xu6Z775huY_vsB5uLyxbyL-WSfj7phd8zb8MWo-MvcXL05N-L9pyv2bsXNpfwFQnKsRQ</recordid><startdate>201201</startdate><enddate>201201</enddate><creator>Kwon, Hyuck Hoon</creator><creator>Kwon, In Ho</creator><creator>Youn, Jai Il</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201201</creationdate><title>Clinical study of psoriasis occurring over the age of 60 years: is elderly-onset psoriasis a distinct subtype?</title><author>Kwon, Hyuck Hoon ; Kwon, In Ho ; Youn, Jai Il</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3669-b63535c68231a5dc686d97588a039c41ee9ea8c6ef19c4645993eecec3a4c2de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Distribution</topic><topic>Age of Onset</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Dermatology</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nail Diseases - epidemiology</topic><topic>Nail Diseases - pathology</topic><topic>Pruritus - epidemiology</topic><topic>Pruritus - pathology</topic><topic>Psoriasis - epidemiology</topic><topic>Psoriasis - pathology</topic><topic>Psoriasis. Parapsoriasis. Lichen</topic><topic>Retrospective Studies</topic><topic>Scalp Dermatoses - epidemiology</topic><topic>Scalp Dermatoses - pathology</topic><topic>Severity of Illness Index</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kwon, Hyuck Hoon</creatorcontrib><creatorcontrib>Kwon, In Ho</creatorcontrib><creatorcontrib>Youn, Jai Il</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kwon, Hyuck Hoon</au><au>Kwon, In Ho</au><au>Youn, Jai Il</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical study of psoriasis occurring over the age of 60 years: is elderly-onset psoriasis a distinct subtype?</atitle><jtitle>International journal of dermatology</jtitle><addtitle>Int J Dermatol</addtitle><date>2012-01</date><risdate>2012</risdate><volume>51</volume><issue>1</issue><spage>53</spage><epage>58</epage><pages>53-58</pages><issn>0011-9059</issn><eissn>1365-4632</eissn><coden>IJDEBB</coden><abstract><![CDATA[Background  Previous studies demonstrated clinical differences of early‐ and late‐onset psoriasis. However, epidemiological data and clinical characteristics of psoriasis occurring in geriatric patients have been rarely studied. Objective  Assessment of epidemiology and clinical features of psoriasis first occurring over the age of 60 years, so‐called elderly‐onset psoriasis, based on clinical data. Materials and methods  Among 4049 patients visiting our psoriasis clinic for the last 27 years, patients were first divided into early‐ (onset age before 30 years) and late‐onset psoriasis (onset age after 30 years) based on our previous studies. Then, patients of late‐onset psoriasis were further divided into middle age‐onset group (onset age between 30 and 60 years) and elderly‐onset group (onset age over 60 years). Clinical characteristics of elderly‐onset psoriasis were compared with early‐ and middle age‐onset groups. We acquired the data both by physician’s assessments and patients’ responses. Results  Elderly‐onset patients comprised 3.2% of total patients, 129 out of 4049. They have shown a lower incidence of family history (P < 0.05). The severity assessed by PASI score, body surface extent, and activity of individual lesions demonstrated that psoriasis of the elderly‐onset group was generally milder compared with early‐ and middle age‐onset groups (P < 0.05). In clinical phenotypes, the proportion of guttate type and generalized pustular psoriasis type decreased remarkably, while that of erythroderma type increased (P < 0.05). There was a significant change in the body part of origin comparing early‐ and middle age‐onset groups (P < 0.05). The proportion of scalp increased, while that of knee–elbow and trunk decreased significantly (P < 0.05). Patients’ subjective sensation of disease course improved statistically comparing early‐ and middle age‐onset groups (P < 0.05). There was no significant change in the degree of pruritus on psoriatic lesions and nail involvement (P > 0.05). Conclusion  The elderly‐onset group demonstrated milder disease courses and some changes in clinical phenotypes and body part of origin compared with early‐ and middle age‐onset groups. Therefore, it seems that patients whose onset of psoriasis was over the age of 60 years might have distinct clinical features in some clinical aspects.]]></abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22182378</pmid><doi>10.1111/j.1365-4632.2011.04979.x</doi><tpages>6</tpages></addata></record>
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source MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects Adolescent
Adult
Age Distribution
Age of Onset
Aged
Aged, 80 and over
Biological and medical sciences
Child
Child, Preschool
Dermatology
Female
Humans
Incidence
Infant
Male
Medical sciences
Middle Aged
Nail Diseases - epidemiology
Nail Diseases - pathology
Pruritus - epidemiology
Pruritus - pathology
Psoriasis - epidemiology
Psoriasis - pathology
Psoriasis. Parapsoriasis. Lichen
Retrospective Studies
Scalp Dermatoses - epidemiology
Scalp Dermatoses - pathology
Severity of Illness Index
Young Adult
title Clinical study of psoriasis occurring over the age of 60 years: is elderly-onset psoriasis a distinct subtype?
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