Comorbidities in pediatric psoriasis patients: A retrospective single-center study

Background and Design: This study aimed to investigate the effects of the comorbidities on disease severity and outcomes in pediatric psoriasis patients. Materials and Methods: A total of 366 patients enrolled to the study were ≤18 years old and were followed up between January 2013 and December 2017. Age, gender, family history, localization, clinical type, severity, treatments, duration of treatment/response, and comorbidities were retrieved retrospectively. Physician Global Assessment was used for psoriasis severity. All parameters were compared statistically in between groups that patients with or without comorbidities. Statistical significance was accepted p<0.05.
Results: Of the 366 patients 62.6% were women, and 37.4% were men. At least one comorbidity was detected in 39.3% of the patients. The most common observed comorbidity was allergic rhinitis (8.1%), and obesity (7.1%) was the second most common. The duration of treatment was higher in patients with comorbidity than in patients without comorbidities, and the duration of the disease was statistically significant (p=0.043). Scalp, face, nail, and palmoplantar involvement was more common in patients with comorbidity than in patients without comorbidity (p>0.05). Those with comorbidity were generally higher in patients with moderate to severe psoriasis (p=0.165). In patients with epilepsy, asthma, allergic rhinitis, and valvular disorders, the clinical manifestation was mild. Biological agent use is statistically higher in comorbidity group (p=0.045). It was found that the rates of complete and partial remission rates were lower, and relapse was higher in the comorbidity group, but this was not statistically significant.
Conclusion: In this study, a significant relationship was found between comorbidity and disease duration (p=0.043). Comorbidities in cases of moderate to severe psoriasis and accompanying cases. Our results are compatible with previous literature, which indicates that the key to managing pediatric psoriasis is investigation and recognition of comorbidities.

Pediatrik psoriazis hastalarýnda komorbiditeler: Tek merkezli retrospektif çalýþma

Amaç: Pediatrik psoriazis bazý komorbiditerle iliþkilendirilmiþtir. Çalýþmamýzda pediatrik psoriazis hastalarýnda komorbiditelerin varlýðýnýn psoriazis kliniði ve þiddeti, tedavi seçimi ve tedaviye yanýt üzerine etkilerinin araþtýrýlmasý amaçlandý.
Gereç ve Yöntem: Çalýþmaya Ocak 2013-Aralýk 2017 tarihleri arasýnda 18 yaþ ve altý toplam 366 hasta dahil edildi. Hastalarýn yaþý, cinsiyeti, aile öyküsü, lokalizasyonu, klinik tipi, klinik þiddeti, tedaviler, tedavi süreleri/yanýtlarý retrospektif olarak incelendi. Ýstatistiksel anlamlýlýk p<0,05 olarak kabul edildi.
Bulgular: Üç yüz altmýþ altý hastanýn %62,6’sý kýz, %37,4’ü erkek idi. Hastalarýn %39,3’ünde en az bir komorbidite saptandý. Komorbiditeler arasýnda en sýk alerjik rinit (%8,1), ikinci sýklýkta obezite (%7,1) görülmekte idi. Komorbidite olanlarda hastalýk süresi, istatistiksel olarak anlamlý olacak þekilde daha uzun bulundu (p=0,043). Saçlý deri, yüz, týrnak ve palmoplantar tutulum komorbidite olan grupta olmayanlara göre daha yüksek oranda idi (p>0,05). Þiddetli ve orta þiddetli psoriazis hastalarýnda, daha yüksek oranda komorbidite görülmekte idi (p=0,165). Epilepsi, astým, alerjik rinit, valvüler bozukluk olanlarda klinik hafif þiddette görülmekte idi. Biyolojik ajan kullanýmý komorbiditesi olan grupta istatistiksel olarak daha yüksek görüldü (p=0,045). Komorbidite olan grupta olmayan gruba göre tam remisyon ve kýsmi remisyon oranlarýnýn daha az, relaps oranlarýnýn daha fazla olduðu saptandý ama istatistiksel olarak anlamlý deðildi.
Sonuç: Bu çalýþmada komorbidite ile hastalýk süresi arasýnda anlamlý bir iliþki bulundu (p=0,043). Komorbiditeler, orta ile þiddetli psoriazis hastalýðý eþlik eden olgulardaydý. Sonuçlarýmýz, pediatrik psoriazis yönetiminde komorbiditelerin araþtýrýlmasý ve tanýnmasýnýn esas olduðu önceki literatürle uyumludur.