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Background@#Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. @*Objective@#To investigate the economic burden of psoriasis in Korea. @*Methods@#The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. @*Results@#The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. @*Conclusion@#This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.
ABSTRACT
Background@#Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. @*Objective@#To investigate the economic burden of psoriasis in Korea. @*Methods@#The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. @*Results@#The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. @*Conclusion@#This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.
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Background@#Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. @*Objective@#To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. @*Methods@#We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. @*Results@#A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI ＜10 (87.5% vs 59.1%). @*Conclusion@#Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD.Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI ＜10.
ABSTRACT
Background@#Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. @*Objective@#To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. @*Methods@#We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. @*Results@#A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI ＜10 (87.5% vs 59.1%). @*Conclusion@#Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD.Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI ＜10.
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No abstract available.
Subject(s)
Cyclosporine , Eczema , Hand , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: Psoriasis is an immune-mediated, chronic inflammatory disease affecting multiple aspects of patients' lives. Its epidemiology varies regionally; however, nationwide epidemiologic data on psoriasis depicting profile of Korean patients has not been available to date. OBJECTIVE: To understand nationwide epidemiologic characteristics and clinical features of adult patients with psoriasis visited university hospitals in Korea. METHODS: This multicenter, non-interventional, cross-sectional study recruited 1,278 adult patients with psoriasis across 25 centers in Korea in 2013. Various clinical data including PASI, BSA, DLQI, SF-36 and PASE were collected. RESULTS: A total of 1,260 patients completed the study (male:female=1.47:1). The mean age was 47.0 years with a distribution mostly in the 50s (24.9%). Early onset (<40 years) of psoriasis accounted for 53.9% of patients. The mean disease duration was 109.2 months; mean body mass index was 23.9 kg/m²; and 12.7% of patients had a family history of psoriasis. Plaque and guttate types of psoriasis accounted for 85.8% and 8.4%, respectively. Patients with PASI ≥10 accounted for 24.9%; patients with body surface area ≥10 were 45.9%. Patients with DLQI ≥6 accounted for 78.8%. Between PASI <10 and PASI ≥10 groups, significant difference was noted in age at diagnosis, disease duration, blood pressure, waist circumference of female, and treatment experiences with phototherapy, systemic agents, and biologics. CONCLUSION: This was the first nationwide epidemiologic study of patients with psoriasis in Korea and provides an overview of the epidemiologic characteristics and clinical profiles of this patient population.
Subject(s)
Adult , Female , Humans , Biological Products , Blood Pressure , Body Mass Index , Body Surface Area , Cross-Sectional Studies , Diagnosis , Epidemiologic Studies , Epidemiology , Hospitals, University , Korea , Phototherapy , Psoriasis , Waist CircumferenceABSTRACT
BACKGROUND: Facial involvement of psoriasis is known to be one of the clinical manifestations that indicate the severity of the psoriasis and thought to be more closely associated with certain distribution. Centrofacial (CF) psoriasis has been suggested to be related with severity of systemic disease while peripherofacial (PF) psoriasis has been thought to have connection with scalp psoriasis. OBJECTIVE: To analyze the epidemiologic characteristics, clinical features and subjective feelings of patients with facial psoriasis and to find out relationship between scalp psoriasis and facial involvement according to the facial types. METHODS: One hundred nineteen facial psoriasis patients were categorized into 3 types according to the distribution: PF type, CF type and mixed facial (MF) type. Onset and duration of facial and scalp psoriasis, and their relationship were questioned. Severity and extent of psoriasis on whole body, face, and scalp were rated by clinicians. RESULTS: There was no significant difference of whole body psoriasis area and severity index (PASI) and body surface area (BSA) score but scalp PASI and BSA was much higher in PF psoriasis compared to CF psoriasis (scalp PASI, 17.9 vs. 10.1; p=0.005) (scalp BSA, 40.9 vs. 22.2; p=0.002). According to the questionnaire, patient's objective feeling about the spreading of scalp lesion to facial area was markedly more prominent in the patients with peripheral involvement (PF+MF, 90.1%; CF, 54.2%; p<0.0001). CONCLUSION: Among subtypes of facial psoriasis, PF psoriasis is closely associated with spreading of scalp lesion into the face rather than reflecting the disease severity.
Subject(s)
Humans , Body Surface Area , Psoriasis , ScalpABSTRACT
BACKGROUND: The development of therapies for psoriasis has led to the need for a new strategy to the treatment of patients with moderate-to-severe psoriasis. New consensus guidelines for psoriasis treatment have been developed in some countries, some of which have introduced treatment goals to determine the timing of therapeutic regimens for psoriasis. OBJECTIVE: To investigate the opinions held by Korean dermatologists who specialize in psoriasis about treatment goals, and to compare these with the European consensus. METHODS: Korean dermatologists who specialize in psoriasis were asked 11 questions about defining the treatment goals for psoriasis. The questionnaire included questions about the factors used to classify the severity of psoriasis, defining the induction and maintenance phases of psoriasis treatment, defining treatment responses during the induction phase, and defining treatment responses during the maintenance phase. RESULTS: The Korean consensus showed responses that were almost similar to the European consensus, even without using the Delphi technique, which uses repeated rounds of questions to reach a consensus. Only one response that related to psoriasis severity in the context of the quality of patients' lives differed from the European consensus. CONCLUSION: The concept of using treatment goals in the treatment of moderate-to-severe psoriasis can be applied to Korean psoriasis patients. Since a tool for assessing the quality of patients' lives is not commonly used in Korea, the development of a simple, rapidly completed, and region-specific health-related quality of life assessment tool would enable treatment goals to be used in routine clinical practice.
Subject(s)
Humans , Consensus , Delphi Technique , Korea , Psoriasis , Quality of Life , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
Nowadays, tumor necrosis factor-alpha (TNF-alpha) blockers are used for treatment of rheumatoid arthritis, inflammatory bowel diseases, ankylosing spondylitis, psoriatic arthritis, and psoriasis. Paradoxically, there are some reports on the appearance of psoriasis after administration of TNF-alpha blockers. Here, we report on a patient with monoarthritis in a knee joint who experienced psoriasis after TNF-alpha blocker therapy (adalimumab and etanercept). Oral medication was not a treatment option due to patient intolerance; thus, we tried ustekinumab, an anti-interleukin (IL)-12/23 monoclonal antibody used for treatment of psoriasis. Following ustekinumab injection, psoriatic skin lesions and joint symptoms were much improved. However, in the following period, joint pain and swelling became aggravated and synovial fluid cytokine levels including IL-6 and IL-17 were elevated. The treatment was changed to tocilizumab, a humanized monoclonal antibody against IL-6 receptor. After injection, knee joint swelling rapidly subsided without worsening of psoriatic skin lesions.
Subject(s)
Humans , Arthralgia , Arthritis, Psoriatic , Arthritis, Rheumatoid , Inflammatory Bowel Diseases , Interleukin-17 , Interleukin-6 , Joints , Knee Joint , Psoriasis , Receptors, Interleukin-6 , Skin , Spondylitis, Ankylosing , Synovial Fluid , Tumor Necrosis Factor-alpha , UstekinumabABSTRACT
BACKGROUND: Allergic skin diseases such as atopic dermatitis and urticaria are known to be mediated by IgE. It is important to confirm a causative allergen for diagnosis and treatment. The multiple allergosorbent test (MAST) is a simple method for simultaneously measuring total and allergen-specific IgE. OBJECTIVE: The purpose of this study was to analyze results from the MAST, which measures total and specific IgE, and to compare the different results. METHODS: We reviewed the MAST results of 270 allergic disease patients tested between June 2007 and May 2012. RESULTS: There were statistical differences in total IgE production and in positive sensitization to specific allergens between the disease groups. The level of total IgE and positive rates of specific IgE were highest in atopic dermatitis patients, followed by urticaria, allergic contact dermatitis, and pruritus patients. Atopic dermatitis patients had significantly more allergens than those with other diseases. There were no statistical differences in total IgE level, rates of positive sensitization to specific allergens, and the number of causative allergens between the patients with acute and chronic urticaria. CONCLUSION: Each disease showed a different IgE pattern. Atopic dermatitis showed the highest level of serum IgE. There were no differences in IgE levels between acute and chronic urticaria patients. We identified an increase in IgE level in allergic contact dermatitis patients. Further study is needed to determine whether these patterns could be useful in diagnosis and choice of treatment methods.
Subject(s)
Humans , Allergens , Dermatitis, Allergic Contact , Dermatitis, Atopic , Diagnosis , Immunoglobulin E , Immunoglobulins , Pruritus , Skin Diseases , UrticariaABSTRACT
Atopic dermatitis and psoriasis are common, chronic inflammatory skin diseases. They are mediated by different subsets of Th cells (Th1 vs. Th2), so they are believed to be mutually exclusive. However, they have many similar features. Both show epidermal hyperplasia, aberrant immunity, and skin barrier anomalies. We describe the case of an 11-year-old girl with concomitant psoriasis and atopic eczema. She had atopic dermatitis since infancy and had developed psoriatic plaques a few years later. She was diagnosed with atopic dermatitis and psoriasis, and was treated with cyclosporine. Here, we present this case, with a literature review.
Subject(s)
Child , Female , Humans , Cyclosporine , Dermatitis, Atopic , Hyperplasia , Psoriasis , Skin , Skin DiseasesABSTRACT
BACKGROUND: Pores are the openings of the pilosebaceous unit or the apocrine gland. Increase in pore size or in the number of dilated pores may be a cosmetic problem. To date, epidemiological studies on the numbers of dilated pores have been rarely reported. OBJECTIVE: To analyze the distribution of pores and the factors affecting pores. METHODS: We compared the number of dilated facial pores on the face according to site, age group, and sex. The relations of pore counts to wrinkle severity and to the amount of hydration were also analyzed. Dermavision(TM), a device that can take cross-polarization, parallel polarization, and ultraviolet light images, was used. Parameters were measured at three points: the forehead, cheek, and nose. RESULTS: The results revealed that dilated pores were more common on the nose and forehead. The pore counts were increased with age, and the increment was significant between participants in their 30s and 40s. Moreover, dilated pore counts were affected by wrinkle severity. The amount of hydration did not affect the counts of dilated pores. CONCLUSION: In this study, the number of dilated pores differed depending on the location. Moreover, it was confirmed that pore counts were higher in older persons. The pore counts showed a correlation with wrinkle severity.