Psoriatic erythroderma: comparative patient profile and association with psoriatic arthritis

Abstract

Background. Psoriatic erythroderma is rare and one of the most severe forms of psoriasis characterized by involvement of 8090% of body surface area. Aims. To compare clinical and demographic characteristics of patients with psoriasis, depending on presence of psoriatic erythroderma in medical history; to assess the association between psoriatic arthritis and a history of psoriatic erythroderma. Materials and methods. Patients aged 18 years and older with a duration of psoriasis of 10 years, from the psoriasis patients registry were included. Comparison of continuous quantitative variables was performed using t-test or MannWhitney U-test. The 2 test or Fisher's exact test was used to compare qualitative binary variables. The odds ratio of psoriatic arthritis in patients with and without a history of psoriatic erythroderma was calculated, unadjusted and adjusted for other independent variables. Results. The number of patients included in the analysis was 1,870. A history of psoriatic erythroderma (PE) had 227 (12.1%) of them. There were no significant differences in patient age at inclusion to the registry (47.1 13.1 years vs. 47.7 13.3 years), and prevalence of PE among men and women (12.6% vs. 11. 4%). Higher prevalence of arterial hypertension (47.9% vs 32.7%), angina pectoris (6.4% vs. 1.9%), myocardial infarction (3.2% vs. 1.0%), biliary dyskynesia (14.3% vs. 3.9%), fatty liver (12.2% vs. 7.7%), cholelithiasis (8.6% vs. 3.6%), and toxic liver disease (2.2% vs. 0.5%) among patients with vs without history of PE was found. Psoriatic arthritis was diagnosed in 67.0% patients with a history of psoriatic erythroderma. The odds of having psoriatic arthritis in patients with a history of psoriatic erythroderma were 4 times higher than in patients without erythroderma: 4.043 [2.9755.493]. When adjusted for sex, age, duration of psoriasis, and body mass index, the odds ratio and statistical significance were maintained: 4.064 [2.9395.619]. Conclusions. Compared to patients without PE those with a history of psoriatic erythroderma have a greater comorbidity burden: a higher prevalence of cardiovascular diseases, diseases of the liver and biliary tract. A significant association between psoriatic arthritis and a history of PE was established.