1.Clinical profile, morbidity and outcome of adult patients with psoriasis at a district hospital in Northern Malaysia
Chai Har Loo ; Yong Chieh Chan ; Kai Quan Lee ; Tharmalingam Palanivelu
The Medical Journal of Malaysia 2015;70(3):177-181
SUMMARY
Introduction: Psoriasis is a common, chronic, relapsing,
immune-mediated inflammatory disease. Our objective is to
review the clinical profile, co-morbidities, and outcome of
patients with psoriasis.
Methods: This is a cross-sectional study of outpatient
psoriasis patients attending the dermatology clinic, Hospital
Sultan Abdul Halim (HSAH) between January 2012 and June
2014. Data collection was based on Malaysian Psoriasis
Registry.
Results: Among 296 patients with psoriasis, Malays were the
most common 175 (59.1%), followed by Indians 82 (27.7%),
Chinese 37 (12.5%) and others 2 (0.6%). Male to female ratio
was 1.2:1. More than half (54.7%) of the patients had early
onset disease (age 40 or less). Only 26 patients (8.8%) have
positive family history. The most common clinical
presentation was chronic plaque psoriasis (89.9%), followed
by erythrodermic psoriasis (4.7%), guttate psoriasis (3.0%)
and pustular psoriasis (1.7%). Twenty eight percent had nail
involvement while arthropathy was seen only in 14.7%.
Common triggers were sunlight (46.0%), stress (31.1%),
trauma (5.4%), food (4.0%), pregnancy (4.0%), and upper
respiratory tract infections (2.7%). Co-morbidities observed
include ischaemic heart disease (7.1%), hypertension
(26.7%), dyslipidemia (17.6%), and diabetes mellitus (22.0%).
All patients were on topical medications. About 6.8% of the
patients were treated with phototherapy. One third of
patients (35.5%) were given systemic therapy. Out of these,
84 patients (80.0%) were on methotrexate while only 16
(15.2%) on acitretin. None was on cyclosporine or biologic.
In term of disease severity, 41.7% of patients had BSA >10%
and 31.4% patients had DLQI > 10.
Conclusion: Our patients show a similar clinical profile and
outcome as our Malaysian psoriasis population. However
they tend to have a more severe disease. There is a need for
a more effective targeted therapy for a better outcome.
Psoriasis