Topology of Psoriasis in Routine Care – Results from a High‐resolution Analysis in 2,009 Patients

Abstract

Background

In psoriasis, a variety of different phenotypes have been described. However, little details are known about the topology in patients from routine care.

Objectives

To characterize the frequency and distribution of body sites affected by psoriasis in Germany based on high‐resolution analysis.

Methods

Data from a national cross‐sectional study (PsoHealth2) were analysed. Each practice consecutively recruited 20 patients independently of treatment. The topical distribution was identified with a detailed grid scheme of 1,424 squares filled by the patient. Psoriasis history, clinical findings, comorbidity and patient‐reported outcomes were obtained.

Results

A total of 2,009 patients with psoriasis were observed. 19% of patients had psoriatic arthritis, 65.4% scalp involvement, 35.6% nail involvement and in 40.5% first‐degree relatives also had psoriasis. 1,927 (95.9%) provided complete grid data. The mean number of grids marked was 152.4+193.2 which corresponds with 10.7% of body surface. The most frequently affected body areas were the elbows, knees, lower legs and scalp (between 65% and 78%). In a linear regression analysis (corrected R²=0,093) the strongest predictors of health‐related quality of life (HRQoL), as measured by the DLQI, were the affection of the hands (Beta=0,147; p=0,000), the arms (Beta=0,097; p=0,008), the genitals (Beta=0,080; p=0,010), the neck (Beta=‐0,072; p=0,043), the scalp (Beta=0,068; p=0,010) and the nails (Beta=0,064; p=0,005).

Conclusions

Typical psoriatic lesions as described in the textbooks are found in real‐world care. However, also smaller areas, in particular in visible regions and in the genitals, are important determinants of HRQoL reductions.

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