OBJECTIVES : Psoriasis is an immune mediated, chronic skin disease marked by red patches covered with white scales. Several comorbid conditions may exist with psoriasis, some of which may worsen psoriasis, significantly impacting quality of life. Psoriatic patients are prone to infections, a leading cause of death. Multiple therapeutic options are available for treatment of psoriasis. The objective of the present study was to examine comorbid conditions, infections, and treatment techniques in psoriatic patients.

METHODS : This retrospective study examined data from a US electronic health record database (Cerner Health Facts®). All visits, including inpatient (age ≥ 18 years), between 2012-2016 with a principal ICD9/10 diagnosis of psoriasis were included in the analysis. ICD9/10 diagnosis codes were used to identify comorbid health conditions and prevalence of infections. Type of treatment provided was identified via medication names as well as procedure codes.

RESULTS : The study included a total of 244,512 psoriasis-related visits (51.8% female), majority in the ‘36-65 years’ age group (64.7%). Psoriatic arthritis (21.7%), type 2 diabetes (12.2%), kidney disease (4.5%), and cardiovascular disease (3.9%) were the most commonly seen concomitant diseases. The most prevalent infections among psoriatic-patient visits were skin infections (2.7%), fungal infections (2.1%), urinary tract infections (2%), hepatitis C (1.4%), upper respiratory infections (1.4%), pneumonia (1.13%), herpes zoster (0.16%), hepatitis B (0.12%), and tuberculosis (0.03%). More than half of psoriasis patient visits were prescribed topical treatments (56.5%) as compared to light therapy (25.3%), and systemic medications (18.2%). The most commonly prescribed systemic medication was methotrexate (67.2%), followed by biologics (15.6%), cyclosporine (12.5%), and retinoids (4.7%).

CONCLUSIONS : This large database analysis examined various comorbidities and types of infections associated with psoriasis and provides insights into current pharmacological and other treatment strategies.