title: EPIMAG: International Cross-Sectional Epidemiological Psoriasis Study in the Maghreb.
abstract: BACKGROUND
  Psoriasis is a common skin disorder that is characterized by red plaques covered with silvery scales and is associated with considerable psychosocial impact. It has been described in several studies worldwide, but specific data from the Maghreb (Algeria, Morocco and Tunisia) are unavailable.
  
  
  OBJECTIVE
  To characterize the frequency of new psoriasis cases and to describe the epidemiological and clinical profile of psoriasis in the Maghreb.
  
  
  METHODS
  A psoriasis working group for the Maghreb initiated the EPIMAG international multicentre cross-sectional observational epidemiological study coupled with a 2-week psoriasis screening study via medical consultation. Data were collected via questionnaires.
  
  
  RESULTS
  The total analysis population included 373 pre-existing and 326 new psoriasis cases, described by 261 participating investigators. The frequency of new psoriasis cases was 10.26/1,000 in Algeria, 15.04/1,000 in Morocco and 13.26/1,000 in Tunisia, and thus 12.08/1,000 in the Maghreb. In all 699 psoriasis subjects, the mean age was 46 years, the mean BMI was 26.6, and 55.7% of subjects were men. Two thirds of the subjects had never smoked, and 85.0% had never consumed alcohol. Half had brown skin, and 28.6% had a family history of psoriasis. Three quarters had localized psoriasis, 85.8% had plaque psoriasis, coupled with pruritus in over 70.0% of cases. Flares or outbreaks were most often triggered by stress (79.4%) and change of season (43.1%). The majority of subjects used topical therapy, and the investigators considered overall treatment efficacy to be partial in over half of the cases. Among patients with pre-existing psoriasis, secondary analyses showed that 73.2% had severe psoriasis, and that quality of life was severely affected in 40.1% of cases. The mean number of missing school or work days over 6 months was 3.2 (±12.1) days.
  
  
  CONCLUSIONS
  Our study provides novel information relative to psoriasis epidemiology and characterization in the Maghreb and highlights the need to improve psoriasis screening and management in the region. The data will help optimize psoriasis management, to ensure appropriate national health care policies.
authors.affiliation: Department of Dermatology, CHU Mustapha, Algiers, Algeria.
authors.forename: Aomar
authors.initials: A
authors.lastname: Ammar-Khodja
authors.forename: Ismail
authors.initials: I
authors.lastname: Benkaidali
authors.forename: Bakar
authors.initials: B
authors.lastname: Bouadjar
authors.forename: Amina
authors.initials: A
authors.lastname: Serradj
authors.forename: Abdelhamid
authors.initials: A
authors.lastname: Titi
authors.forename: Hakima
authors.initials: H
authors.lastname: Benchikhi
authors.forename: Said
authors.initials: S
authors.lastname: Amal
authors.forename: Badreddine
authors.initials: B
authors.lastname: Hassam
authors.forename: Abdelhak
authors.initials: A
authors.lastname: Sekkat
authors.forename: Fatima Zahra
authors.initials: FZ
authors.lastname: Mernissi
authors.forename: Inçaf
authors.initials: I
authors.lastname: Mokhtar
authors.forename: Raouf
authors.initials: R
authors.lastname: Dahoui
authors.forename: Mohamed
authors.initials: M
authors.lastname: Denguezli
authors.forename: Nejib
authors.initials: N
authors.lastname: Doss
authors.forename: Hamida
authors.initials: H
authors.lastname: Turki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000462:Algeria / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D011537:Pruritus / Q000453:epidemiology / Q000209:etiology; D011565:Psoriasis / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics / Q000473:pathology; D011788:Quality of Life; D012621:Seasons; D012720:Severity of Illness Index; D018582:Sick Leave / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000150:complications; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult