An analysis of psoriasis hospitalisation in Thailand.
Admission
Hospitalisation
Inpatient
Psoriasis
Journal
Archives of dermatological research
ISSN: 1432-069X
Titre abrégé: Arch Dermatol Res
Pays: Germany
ID NLM: 8000462
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
28
05
2022
accepted:
13
10
2022
revised:
30
09
2022
medline:
12
4
2023
pubmed:
30
10
2022
entrez:
29
10
2022
Statut:
ppublish
Résumé
Psoriasis hospitalisation is not frequently reported. The objective of this study was to determine (1) the clinical, laboratory and treatment features of patients with psoriasis hospitalised due to flare-up and (2) other causes of admission of patients with psoriasis. We retrospectively reviewed data on 48 patients admitted due to psoriasis flare-up and 1908 patients with psoriasis admitted due to concomitant illnesses or comorbidities. The study period was 2005-2021. The latter group was compared with 821,804 patients without psoriasis admitted during the period. Of the 48 cases, 37.5% had erythroderma, and 62.5% had generalised pustular psoriasis (GPP). Women (68.8%) predominated, especially in the GPP group (76.7%). The mean age of admission with erythroderma (44.8 years) was higher than for GPP (32.1 years). Infection was the main trigger for psoriasis flare-up (46%). Abnormalities in liver function tests were found in 33.3% of the cases. These abnormalities usually subsided 1-2 months after skin improvement (83.4%). Acitretin was the most prescribed drug for GPP (81.4%), whereas topical treatment alone (50%) was the most frequent erythroderma therapy. Intensive care was needed by 9.3% of patients with GPP. In the psoriasis group admitted due to concomitant illnesses or comorbidities, admission due to digestive and infectious causes was significantly higher for psoriasis patients. Our study showed that trend of psoriasis admission due to disease flare-up was not significantly changed even in the era of biologics. We believed that patient education on avoiding the common precipitating factors of psoriasis flare-up and good self-care is mandatory to reduce the risk of hospitalisation.
Identifiants
pubmed: 36308558
doi: 10.1007/s00403-022-02429-w
pii: 10.1007/s00403-022-02429-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
779-786Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM (2020) National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ 369:m1590
doi: 10.1136/bmj.m1590
pubmed: 32467098
pmcid: 7254147
Mrowietz U, Kragballe K, Reich K, Spuls P, Griffiths CE, Nast A et al (2011) Definition of treatment goals for moderate to severe psoriasis: a European consensus. Arch Dermatol Res 303(1):1–10
doi: 10.1007/s00403-010-1080-1
pubmed: 20857129
Yeung H, Takeshita J, Mehta NN, Kimmel SE, Ogdie A, Margolis DJ et al (2013) Psoriasis severity and the prevalence of major medical comorbidity: a population-based study. JAMA Dermatol 149(10):1173–1179
doi: 10.1001/jamadermatol.2013.5015
pubmed: 23925466
pmcid: 3800487
Rodriguez-Jato Q, Pereira AR, Batalla A, Abalde MT, Salgado-Boquete L, Martinez-Reglero C et al (2021) Hospitalization in patients with psoriasis: impact of biological therapies on temporal evolution. J Drugs Dermatol 20(2):208–214
doi: 10.36849/JDD.4931
pubmed: 33538560
Prodanovich S, Kirsner RS, Taylor JR (2000) Treatment of patients hospitalized for psoriasis. Dermatol Clin. 18(3):425–435
doi: 10.1016/S0733-8635(05)70191-1
pubmed: 10943538
Austad SS, Athalye L (2022) Exfoliative dermatitis. StatPearls. StatPearls Publishing LLC., Treasure Island, FL
Langenbruch A, Mohr N, Kirsten N, Reich K, von Kiedrowski R, Strömer K et al (2021) Quality of psoriasis care in Germany—results from the nationwide health care studies PsoHealth 2004–2017. J Eur Acad Dermatol Venereol 35(7):1536–1542
doi: 10.1111/jdv.17220
pubmed: 33714231
Polivka L, Oubaya N, Bachelez H, Paul C, Richard MA, Beylot-Barry M et al (2018) Trends in hospitalization rates for psoriasis flares since the introduction of biologics: a time series in France between 2005 and 2015. J Eur Acad Dermatol Venereol 32(11):1920–1929
doi: 10.1111/jdv.15044
pubmed: 29729123
Hsu DY, Gordon K, Silverberg JI (2016) The inpatient burden of psoriasis in the United States. J Am Acad Dermatol 75(1):33–41
doi: 10.1016/j.jaad.2016.03.048
pubmed: 27210045
Nelson AA, Pearce DJ, Fleischer AB Jr, Balkrishnan R, Feldman SR (2005) Inpatient management of severe psoriasis. J Drugs Dermatol 4(5):564–570
pubmed: 16167414
Finet A, Viguier M, Chazouillères O, Amatore F, Paul C, Richard MA et al (2016) Liver test abnormalities in patients admitted for severe psoriasis: prevalence and associated risk factors. J Eur Acad Dermatol Venereol 30(10):1742–1748
doi: 10.1111/jdv.13674
pubmed: 27226222
Miyachi H, Konishi T, Kumazawa R, Matsui H, Shimizu S, Fushimi K et al (2021) Treatments and outcomes of generalized pustular psoriasis: a cohort of 1516 patients in a nationwide inpatient database in Japan. J Am Acad Dermatol 86:1266–1274
doi: 10.1016/j.jaad.2021.06.008
pubmed: 34116101
Hanna ML, Singer D, Bender SD, Valdecantos WC, Wu JJ (2021) Characteristics of hospitalizations and emergency department visits due to generalized pustular psoriasis in the United States. Curr Med Res Opin 37:1697
doi: 10.1080/03007995.2021.1951192
pubmed: 34289766
Borges-Costa J, Silva R, Gonçalves L, Filipe P, Soares de Almeida L, Marques Gomes M (2011) Clinical and laboratory features in acute generalized pustular psoriasis: a retrospective study of 34 patients. Am J Clin Dermatol 12(4):271–276
doi: 10.2165/11586900-000000000-00000
pubmed: 21495733
Tosukhowong T, Kiratikanon S, Wonglamsam P, Netiviwat J, Innu T, Rujiwetpongstorn R et al (2021) Epidemiology and clinical features of pustular psoriasis: a 15-year retrospective cohort. J Dermatol 48(12):1931–1935
doi: 10.1111/1346-8138.16164
pubmed: 34532894
Zhou J, Luo Q, Cheng Y, Wen X, Liu J (2021) An update on genetic basis of generalized pustular psoriasis (review). Int J Mol Med. https://doi.org/10.3892/ijmm.2021.4951
doi: 10.3892/ijmm.2021.4951
pubmed: 34935058
pmcid: 8711589
Viguier M, Allez M, Zagdanski AM, Bertheau P, de Kerviler E, Rybojad M et al (2004) High frequency of cholestasis in generalized pustular psoriasis: evidence for neutrophilic involvement of the biliary tract. Hepatology 40(2):452–458
doi: 10.1002/hep.20305
pubmed: 15368450
Allez M, Roux ME, Bertheau P, Erlinger S, Degott C, Morel P et al (2000) Recurrent cholestatic jaundice associated with generalized pustular psoriasis: evidence for a neutrophilic cholangitis. J Hepatol 33(1):160–162
doi: 10.1016/S0168-8278(00)80174-9
pubmed: 10905601
Cabanillas M, Pérez-Pérez L, Sánchez-Aguilar D, Toribio J (2006) Generalized pustular psoriasis and cytolytic hepatitis associated with neutrophilic cholangitis. Actas Dermosifiliogr 97(5):330–333
doi: 10.1016/S0001-7310(06)73412-3
pubmed: 16956566
Robinson A, Van Voorhees AS, Hsu S, Korman NJ, Lebwohl MG, Bebo BF Jr et al (2012) Treatment of pustular psoriasis: from the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol 67(2):279–288
doi: 10.1016/j.jaad.2011.01.032
pubmed: 22609220
Hoegler KM, John AM, Handler MZ, Schwartz RA (2018) Generalized pustular psoriasis: a review and update on treatment. J Eur Acad Dermatol Venereol 32(10):1645–1651
doi: 10.1111/jdv.14949
pubmed: 29573491
Chularojanamontri L, Silpa-Archa N, Wongpraparut C, Limphoka P (2019) Long-term safety and drug survival of acitretin in psoriasis: a retrospective observational study. Int J Dermatol 58(5):593–599
doi: 10.1111/ijd.14349
pubmed: 30548592
Choon SE, Navarini AA, Pinter A (2022) Clinical course and characteristics of generalized pustular psoriasis. Am J Clin Dermatol 23(Suppl 1):21–29
doi: 10.1007/s40257-021-00654-z
pubmed: 35061227
pmcid: 8801409
Vaidya TS, Lewallen RS, Feldman SR (2016) Erythrodermic psoriasis and severe hypotension requiring intensive care unit hospitalization: poor treatment outcome as a result of poor adherence. J Dermatol Treat 27(2):134–135
doi: 10.3109/09546634.2015.1087462
Schaefer C, Mamolo C, Cappelleri JC, Daniel S, Le C, Tatulych S et al (2017) Treatment patterns and outcomes among adults admitted to hospital in the U.K. due to plaque or erythrodermic psoriasis. Br J Dermatol 177(3):e52–e54
doi: 10.1111/bjd.15270
pubmed: 28012158
Green MS, Prystowsky JH, Cohen SR, Cohen JI, Lebwohl MG (1996) Infectious complications of erythrodermic psoriasis. J Am Acad Dermatol 34(5 Pt 2):911–914
doi: 10.1016/S0190-9622(96)90078-X
pubmed: 8621827
Rosenbach M, Hsu S, Korman NJ, Lebwohl MG, Young M, Bebo BF Jr et al (2010) Treatment of erythrodermic psoriasis: from the medical board of the National Psoriasis Foundation. J Am Acad Dermatol 62(4):655–662
doi: 10.1016/j.jaad.2009.05.048
pubmed: 19665821
Nair KM, Kannayiram SS, Guraya A, Idolor ON, Aihie OP, Sanwo EJ et al (2020) Reasons for hospitalization of psoriasis patients: a report from the national inpatient sample. Cureus 12(12):e12271
pubmed: 33520487
pmcid: 7834545
Vaengebjerg S, Skov L, Egeberg A, Loft ND (2020) Prevalence, incidence, and risk of cancer in patients with psoriasis and psoriatic arthritis: a systematic review and meta-analysis. JAMA Dermatol 156(4):421–429
doi: 10.1001/jamadermatol.2020.0024
pubmed: 32074260
pmcid: 7042857
Miller IM, Ellervik C, Yazdanyar S, Jemec GB (2013) Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors. J Am Acad Dermatol 69(6):1014–1024
doi: 10.1016/j.jaad.2013.06.053
pubmed: 24238156
Yiu ZZN, Parisi R, Lunt M, Warren RB, Griffiths CEM, Langan SM et al (2021) Risk of hospitalization and death due to infection in people with psoriasis: a population-based cohort study using the clinical practice research datalink. Br J Dermatol 184(1):78–86
doi: 10.1111/bjd.19052
pubmed: 32222069
Wakkee M, de Vries E, van den Haak P, Nijsten T (2011) Increased risk of infectious disease requiring hospitalization among patients with psoriasis: a population-based cohort. J Am Acad Dermatol 65(6):1135–1144
doi: 10.1016/j.jaad.2010.08.036
pubmed: 21664719
Hsu DY, Gordon K, Silverberg JI (2016) Serious infections in hospitalized patients with psoriasis in the United States. J Am Acad Dermatol 75(2):287–296
doi: 10.1016/j.jaad.2016.04.005
pubmed: 27324314
Chaiyabutr C, Jiamton S, Silpa-Archa N, Wongpraparut C, Wongdama S, Chularojanamontri L (2022) Retrospective study of psoriasis in people living with HIV: Thailand’s experience. J Dermatol. https://doi.org/10.1111/1346-8138.16352
doi: 10.1111/1346-8138.16352
pubmed: 35293003