Psoriasis in the elderly: epidemiological and clinical aspects, and evaluation of patients with very late onset psoriasis.
BACKGROUND
Age of the patients and age of onset of psoriasis may have an impact on the disease. There is little information about psoriasis in elderly patients.


OBJECTIVE
We evaluated epidemiological, clinical aspects, comorbidities and treatments of psoriasis in the elderly (>70 years) patients, and in patients with very late onset psoriasis (onset ≥ 70 years).


METHODS
This observational multicentre non-interventional study of adults with psoriasis was conducted in 29 departments of dermatology in France. A total of 2210 adults with psoriasis were included.


RESULTS
A total of 212 (9.5%) patients were elderly. This group had a higher frequency of females (P = 0.005), a later onset of the disease (P < 0.0001), a lower frequency of familial (P < 0.0001) and plaque psoriasis (P < 0.0001), but higher frequency of guttate and inverse psoriasis (P ≤ 0.005). Hypertension, diabetes, dyslipidaemia, and major cardiovascular events (MACE) were more frequent in this group (P < 0.0001), but not tobacco (P < 0.0001). Systemic and biological therapies were used less frequently in the elderly group (P < 0.0001). Fifty-eight (2.7%) patients had late onset psoriasis. Patients with very late onset psoriasis were more frequently women (P = 0.02) and older (P < 0.0001), among elderly group. They had significantly less frequently familial (P < 0.0001) and plaque psoriasis (P < 0.0001), and were less often on systemic treatment including biological. Frequencies of comorbidities were not statically different but patients with 'early' onset psoriasis have a tendency (P < 0.5) to have higher frequencies of obesity, diabetes, dyslipidaemia, hypertension and MACE.


CONCLUSIONS
This study highlights phenotypic features of psoriasis in elderly and in very late onset psoriasis. The management of these fragile patients remains poorly codified and needs further investigation.
Department of Dermatology, Hôpital Victor Dupouy Hospital, Argenteuil, France.
C
C
Phan
Department of Dermatology, Hôpital Victor Dupouy Hospital, Argenteuil, France.
M-L
ML
Sigal
Department of Dermatology, Centre Hospitalier Régional d'Orléans, Orléans, France.
E
E
Estève
Department of Dermatology, Hôpital Robert Debré, Reims, France.
Z
Z
Reguiai
Department of Dermatology, Centre Hospitalier d'Auxerre, Auxerre, France.
H
H
Barthélémy
Department of Dermatology, Centre Hospitalier du Mans, Le Mans, France.
N
N
Beneton
Department of Dermatology, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France.
F
F
Maccari
Department of Dermatology, Hôpital Larrey, Centre Hospitalier Universitaire de Toulouse, Paul Sabatier-Toulouse 3 University, Toulouse, France.
M
M
Lahfa
Department of Dermatology, Centre Hospitalier de Poissy, Saint Germain en Laye, France.
D
D
Thomas-Beaulieu
Department of Dermatology, Hôpital d'Instruction des Armées Percy, Clamart, France.
T
T
Le Guyadec
Department of Dermatology, Hôpital Jean Bernard, Valenciennes, France.
A
A
Vermersch-Langlin
Department of Dermatology, Hôpital François Quesnay, Mantes La Jolie, France.
L
L
Mery-Bossard
Department of Dermatology, Centre Hospitalier Universitaire Saint-Eloi, Montpellier, France.
V
V
Pallure
Private Office, Charenton-Le Pont, France.
M
M
Kemula
Department of Dermatology, Centre Hospitalier Universitaire, Saint-Etienne, France.
B
B
Labeille
Department of Public Health, Centre Hospitalier Universitaire Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne Billancourt, France.
A
A
Beauchet
Department of Dermatology, Hôpital Victor Dupouy Hospital, Argenteuil, France.
E
E
Mahé
D017668:Age of Onset; D000368:Aged; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000453:epidemiology*; D012307:Risk Factors