Global Burden of Psoriasis Has Risen for 3 Decades

A global epidemiological study on psoriasis has found that the prevalence, incidence, and burden of suffering caused by the disease has risen over the last 3 decades.

The new study, published in the International Journal of Dermatology, used the Global Burden of Disease dataset, which includes information on disease-specific burden. The database was constructed by the Institute of Health Metrics at the University of Washington, Seattle, to evaluate burden of psoriasis over 3 decades in major geographical regions (African region, region of the Americas, European region, Eastern Mediterranean region, Southeast Asia, and Western Pacific region) globally.

“Epidemiological studies are an important contributor to our understanding of psoriasis,” the authors explained. “Unfortunately, we found no studies that provide a global picture of psoriasis epidemiology based on recently published data.”

As part of the evaluation, the researchers, all from the College of Medicine and Health Sciences at United Arab Emirates University, assessed prevalence, incidence (new diagnosis), disability-adjusted life-years (DALYs), and years lived with disability (YLDs), all per 100,000 population. They used age-adjusted values to compare rates from 1990 to 2017.

Globally, all of the evaluated variables increased over the 27 years studied, but the Western Pacific region had the lowest rates in all categories.

From 1990 to 2017, the global prevalence of psoriasis increased from 758 cases per 100,000 to 812 cases per 100,000. The highest rates were seen in the Americas region (increasing from 1326 cases per 100,000 to 1437 cases), and the lowest rates were in the Western Pacific region (increasing from 423 cases per 100,000 to 528 cases).

Globally, the incidence of psoriasis increased from 92.3 individuals per 100,000 to 99.5 individuals. Again, the Western Pacific region had the lowest rates (increasing from 57.7 cases per 100,000 to 72.4 cases), but for this variable, the European region had the highest rates (increasing from 143.7 cases per 100,000 to 72.4 cases).

YLDs, which indicate burden of suffering, increased globally from 65.2 per 100,000 to 70. The Americas had the highest rates again (increasing from 114.3 per 100,000 to 123.9), and the Western Pacific region had the lowest rates (increasing from 36.8 per 100,000 to 46.1).

Finally, DALYs, which combines YLDs with years of life lost to premature deaths and reflects overall suffering, increased from 65.1 per 100,000 to 70, globally. The Americas had the highest rates (increasing from 1114.3 per 100,000 to 123.9) and the Western Pacific region had the lowest rates (increasing from 36.8 per 100,000 to 46.1).

The authors speculated that a reason for the high prevalence rates in some regions may be a combination of genetic and environmental factors, and the reason for high incidence rates in some regions could be because of improved access to medical care leading to diagnosis of milder cases and increased public awareness that causes people to recognize the disease and seek medical care.

In addition, high-income countries tended to have highest rates of psoriasis DALYs, possibly because people in these countries live longer and their countries have a better capacity to handle the costs of psoriasis care.

“The public health implications of these findings include the need for awareness campaigns, early diagnosis in primary care, timely treatment, and appropriate referrals,” the authors concluded. “Our findings emphasize the need to address not only the physical but also the psychosocial aspects of psoriasis for a true multidisciplinary approach to psoriasis care.”

Reference

AlQassimi S, AlBrashdi S, Galadari H, Hashim MJ. Global burden of psoriasis - Comparison of regional and global epidemiology, 1990 to 2017. Int J Dermatol. 2020;59(5):566-571. doi:10.1111/ijd.14864