The global, regional, and national burden of psoriasis in 195 countries and territories, 1990 to 2017: A systematic analysis from the Global Burden of Disease Study 2017 - 19/07/20

Doi : 10.1016/j.jaad.2020.04.139

Sino Mehrmal, BSN ^a, Prabhdeep Uppal, MS ^a, Natalie Nedley, BS ^b, Rachel L. Giesey, DO ^c,^⁎ , Gregory R. Delost, DO ^b,^d
^a Arizona College of Osteopathic Medicine, Midwestern University, Glendale, Arizona
^b Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania
^c Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
^d Apex Dermatology and Skin Surgery Center, Mayfield Heights, Mayfield Heights, Ohio

^∗Correspondence to: Rachel Giesey, DO, Department of Dermatology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Lakeside 3500, Cleveland, OH 44106.Department of DermatologyUniversity Hospitals Cleveland Medical Center11100 Euclid AveLakeside3500, Cleveland, OH 44106

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Abstract

Background

Few existing studies on the global incidence, prevalence, and burden of disease from psoriasis are of high quality, making reliable data and comparisons difficult to find.

Methods

We analyzed global psoriasis trends from 1990 to 2017 in 195 countries worldwide through the Global Burden of Disease Study database, including age-standardized prevalence rates, percent change in age-standardized prevalence rates, age and sex patterns, and psoriasis burden using disability-adjusted life years.

Results

The age-specific prevalence rate in 2017 showed a left-skewed distribution with a peak between 60 and 70 years of age and a roughly equal male-to-female ratio across all ages. Psoriasis burden was greatest in countries with high income and high sociodemographic index. A positive linear relationship between psoriasis prevalence and comorbidities is seen with cardiovascular disease (R = .67), mental health (R = .63), type 2 diabetes mellitus (R = .55), stroke (R = .51), non-Hodgkin lymphoma (R = .84), Hodgkin lymphoma (R = .77), nonmelanoma skin cancer (R = .68), and inflammatory bowel disease (R = .55) across all countries in 2017.

Conclusion

There is increasing prevalence, burden, and associated comorbidities of psoriasis on a global scale and the need for support to reduce this important global health disparity.

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Key words : age-standardized prevalence rates, cardiovascular disease, diabetes, disability-adjusted life years (DALYs), global medicine, Global Burden of Disease Study (GBD) database, gross domestic product (GDP) per capita, health care disparities, Hodgkin lymphoma, inflammatory bowel disease, mental health, non-Hodgkin lymphoma, nonmelanoma skin cancer, psoriasis, stroke

Abbreviations used : BSA, CVD, DALY, GBD, HL, IBD, IHME, NHL, NMSC, SDI, TFR, T2DM, WHO

Plan

Methods

Results

Discussion

	Funding sources: This research has been conducted as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), coordinated by the Institute for Health Metrics and Evaluation. The GBD was partially funded by the Bill & Melinda Gates Foundation; the funders had no role in the study design, data analysis, data interpretation, or writing of the report. Author Mehrmal is a collaborator with the GBD. This article was not developed with consultation or support with the GBD research team.
	Conflicts of interest: None disclosed.
	IRB approval status: Not applicable.
	Reprints not available from the authors.