title: Incidence, prevalence and mortality of patients with psoriasis: a U.K. population-based cohort study.
abstract: BACKGROUND
  The burden of psoriasis across many world regions is high and there is a recognized need to better understand the epidemiology of this common skin disorder.
  
  
  OBJECTIVE
  To examine changes in the prevalence and incidence of psoriasis, and mortality rates over a 15-year period.
  
  
  METHODS
  Cohort study involving analysis of longitudinal electronic health records between 1999 and 2013 using the U.K. Clinical Practice Research Datalink (CPRD).
  
  
  RESULTS
  The prevalence of psoriasis increased steadily from 2·3% (2297 cases per 100 000) in 1999 to 2·8% (2815 per 100 000) in 2013, which does not appear to be attributable to changes in incidence rates. We observed peaks in age bands characteristic of early-onset (type I) and late-onset (type II) psoriasis, and changes in incidence and prevalence rates with increasing latitude in the U.K. All-cause mortality rates for the general population and for patients with psoriasis have decreased over the last 15 years. However, the risk of all-cause mortality for patients with psoriasis remains elevated compared with people without psoriasis (hazard ratio 1·21; 95% confidence interval 1·13-1·3) and we found no significant change in this relative excess mortality gap over time.
  
  
  CONCLUSIONS
  We found an increasing population living longer with psoriasis in the U.K., which has important implications for healthcare service delivery and for resource allocation. Importantly, early mortality in patients with psoriasis remains elevated compared with the general population and we found no evidence of change in this premature mortality gap.
authors: NIHR School for Primary Care Research (Centre for Primary Care), University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, U.K.|Centre for Biostatistics, University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, U.K.
authors: D A
authors: DA
authors: Springate
authors: Centre for Pharmacoepidemiology and Drug Safety, Manchester Pharmacy School, University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, U.K.
authors: R
authors: R
authors: Parisi
authors: NIHR School for Primary Care Research (Centre for Primary Care), University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, U.K.|Centre for Health Informatics, Institute of Population Health, University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, U.K.
authors: E
authors: E
authors: Kontopantelis
authors: NIHR School for Primary Care Research (Centre for Primary Care), University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, U.K.|Centre for Biostatistics, University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, U.K.
authors: D
authors: D
authors: Reeves
authors: Dermatology Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.
authors: C E M
authors: CE
authors: Griffiths
authors: NIHR School for Primary Care Research (Centre for Primary Care), University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, U.K.|Centre for Pharmacoepidemiology and Drug Safety, Manchester Pharmacy School, University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, U.K.
authors: D M
authors: DM
authors: Ashcroft
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011565:Psoriasis / Q000453:epidemiology* / Q000401:mortality; D012111:Residence Characteristics / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult