title: Psoriasis in elderly and non-elderly population: clinical and molecular features.
abstract: BACKGROUND
  Psoriasis management in elderly may be difficult, mainly due to comorbidities and concomitant medications. The aim of this study was to compare elderly and non-elderly psoriatic patients in relation to their demographic, clinical and molecular characteristics.
  
  
  METHODS
  A prospective observational study on 502 psoriatic patients attending our outpatient clinic was performed. We analyzed their demographical and clinical features, highlighting differences in comorbidities and treatment adverse events. Moreover, real-time PCR was used to analyze lesional skin expression of CCL-20, HBD-2, Hpt, IFN-α, IL-1β, IL-8, IL-23A, IL-33, IL-36γ, TGF-β, TNF-α, S100A7 and VEGF, in 15 adults and 15 elderly.
  
  
  RESULTS
  The two groups of patients differed for comorbidities and treatment profile. Particularly, non-elderly were treated more frequently with biologic drugs compared to elderly. However, elderly did not develop more metabolic, hepatic and/or renal abnormalities than younger patients. Serious adverse events were comparable between elderly and non-elderly. No difference in gene expression of the investigated mediators was found.
  
  
  CONCLUSIONS
  Our study did not show substantial clinical or molecular differences between elderly and non-elderly. Older patients should be treated with systemic drugs when required. Safety and tolerability profiles of biological drugs seemed at least comparable with those of traditional systemic ones.
authors.affiliation: Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy - maddy.napolitano@gmail.com.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Napolitano
authors.forename: Nicola
authors.initials: N
authors.lastname: Balato
authors.forename: Fabio
authors.initials: F
authors.lastname: Ayala
authors.forename: Cataldo
authors.initials: C
authors.lastname: Patruno
authors.forename: Angela
authors.initials: A
authors.lastname: Patrì
authors.forename: Matteo
authors.initials: M
authors.lastname: Megna
authors.forename: Anna
authors.initials: A
authors.lastname: Balato
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005786:Gene Expression Regulation / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D060888:Real-Time Polymerase Chain Reaction; D055815:Young Adult
chemical_list: D001688:Biological Products; D003879:Dermatologic Agents