Clinical, Cosmetic and Investigational Dermatology (Feb 2025)
Comorbidity Pattern in Patients with Moderate-to-Severe Plaque Psoriasis: Network Analysis of a Hospitalized Database in China
Abstract
Wenjuan Chen,1– 3,* Jianfeng Zheng,2,3,* Xin Wang,2,3,* Xingzi Li,2,3 Yangfeng Ding,2,3 Chen Peng,1– 3 Yuling Shi2,3 1School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of China; 2Department of Dermatology, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200092 People’s Republic of China; 3Institute of Psoriasis, Tongji University School of Medicine, Shanghai, 200092 People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuling Shi; Chen Peng, Shanghai Skin Disease Hospital, 1278 Baode Road, Jingan District, Shanghai, 200443, People’s Republic of China, Email shiyuling1973@tongji.edu.cn; bs1936@163.comIntroduction: Psoriasis is a chronic systemic inflammatory disorder characterized by a high prevalence of comorbid conditions, profoundly affecting patient quality of life and complicating treatment strategies. This study aims to analyze demographic characteristics, prevalence, age distribution, and gender differences of psoriatic comorbidities in hospitalized patients with moderate-to-severe psoriasis at a single center. Additionally, we explore the correlation between comorbidities and psoriasis through network analysis.Methods: A retrospective cross-sectional study was conducted using electronic medical records from the Shanghai Skin Disease Hospital, spanning 2021 to 2023. After removing duplicates, 506 patients diagnosed with plaque psoriasis were included. Comprehensive data on demographics, medical histories, laboratory indices, and comorbid conditions were collected. The Phenotypic Comorbidity Network (PCN) method was employed to examine coexistence patterns of psoriasis with various diseases.Results: 79.64% of patients had at least one comorbidity, with Non-alcoholic Fatty Liver Disease (NAFLD), hypertension, hyperlipidemia, overweight/obesity, and hyperuricemia being the top five common comorbidities. The prevalence of these comorbidities increased substantially in the 30– 40 and 50– 70 age cohorts, notably in hepatic dysfunction and metabolic syndrome. Male patients showed a slightly higher propensity for comorbidities compared to females. Early-onset psoriasis (EOP) patients showed a higher risk for specific conditions than late-onset psoriasis (LOP) patients. PCN analysis identified hepatic dysfunction, hypertension, metabolic syndrome, NAFLD, obesity, hyperlipidemia, and diabetes as strongly associated with psoriasis.Conclusion: This study underscores the systemic nature of psoriasis and its association with diverse comorbidities, emphasizing the necessity of a holistic management approach that addresses both dermatological and comorbid conditions. Identifying key comorbidities guides clinicians in implementing targeted screening and preventive strategies, enhancing patient care and potentially alleviating the overall disease burden.Keywords: plaque psoriasis, comorbidity, age distribution, phenotypic comorbidity network, PCN
