Comorbidity burden heavier in generalized pustular psoriasis

17 Oct 2022
Comorbidity burden heavier in generalized pustular psoriasis

Patients with generalized pustular psoriasis (GPP) suffer from a heavier burden of comorbidities than the general population and comparators with psoriasis vulgaris (PV), a new study has found.

Drawing from the Swedish National Patient Register, the researchers collected data from 1,093 GPP patients diagnosed from 2004 to 2015. These were matched 1:3 with PV controls and 1:5 with general population controls. In all study groups, the average age was 56 years, and 60 percent were women. The prevalence rates of 34 selected comorbidities were compared across groups.

Seventy percent of GPP patients had at least one comorbidity, as compared with only 46 percent of general population controls and 63 percent of PV comparators.

Logistic regression analysis showed that the odds of developing any of the assessed comorbidities were higher in GPP patients than in either comparator group. Compared with general population controls, GPP patients were more likely to develop allergic contact dermatitis, Crohn’s disease, nonalcoholic fatty liver disease, and nephritic nonhypertensive disease.

Relative to PV comparators, GPP patients had higher odds of nephritic nonhypertensive disease, Crohn’s disease, chronic renal failure, and type 1 and 2 diabetes.

Of note, 53 percent of the GPP group also had PV. A subgroup analysis of GPP patients without PV showed that coeliac disease (odds ratio [OR], 2.82, 95 percent confidence interval [CI], 1.05–7.56), sinusitis (OR, 2.57, 95 percent CI, 1.37–4.83), and stroke (OR, 1.72, 95 percent CI, 1.14–2.59) were particularly elevated in this group.

J Am Acad Dermatol 2022;doi:10.1016/j.jaad.2022.09.049