| Purpose: By collecting and sorting out the clinical data of psoriasis patients hospitalized in the dermatology department of our hospital from 2017 to 2021,retrospectively analyzing and discussing the general data,clinical data and relevant factors affecting psoriasis comorbidities,it is helpful for clinicians to fully understand psoriasis and provide reference and suggestions for early diagnosis,early treatment and prevention of psoriasis.Method:A retrospective survey was used to collect 712 psoriasis patients hospitalized in the dermatology department of our hospital from January 2017 to December 2021,and the general and clinical data of the patients were statistically analyzed.After entering all the collected data into Excel 2010 for preliminary sorting,software are used for analysis and plotting,counting data for chi-square test,measurement data for normality test,measurement data for normal distribution is expressed in the form of "mean ± standard deviation",and non-normal distribution is expressed by median and quartile M(P25～P75);The comparison between the two groups with normal distribution was carried out by independent sample t-test,the Mann-Whitney U test between the two groups with nonnormal distribution,and the influencing factors of the occurrence of special types of psoriasis were analyzed by logistics regression.P<0.05 is a significant difference.Result:1.General information: A total of 712 patients were included in this study in the past 5 years,and the peak age of the first onset was mainly concentrated in 13-45 years old(509 people),and the course of the disease was mainly concentrated in the initial cases within 1 year(154cases).In terms of clinical classification,there were 476(66.9%)cases of psoriasis vulgaris,95 cases(13.3%)of pustular psoriasis,76 cases(10.6%)of erythrodermic psoriasis,58 cases(8.1%)of arthropathy psoriasis,and 7(0.9%)cases of patients with 2 or more types of psoriasis.The number of psoriasis hospitalizations decreased by 35.02% in five years,and the number of hospitalizations in winter and spring was slightly higher than that in summer and autumn.The male-to-female ratio was 1.56:1,with an average hospital age(45.85±16.98)and an average hospitalization day(13.68±5.20)days.The ratio of Han and Mongolian hospitalized people was 1:0.11,the most common cause was upper respiratory tract infection,followed by cold,24.72% of patients suggested a clear family genetic history,smoking history(36.23%)and drinking history(17.93%)in psoriasis hospitalized people.There were208(29.21%)patients with A changes.2.Clinical data: Among hospitalized patients with a family history of psoriasis,the onset age(26.93±13.88)and admission age(42.63±16.02 years)were earlier than those without a family history(P<0.05),BSA of skin lesions in patients with psoriasis vulgaris ranged from 15% to 35%,all of which were severe plaque psoriasis.208(29.21%)patients had nail changes,and joint psoriasis and nail changes had a very significant correlation.Correlation(P<0.05).Nail changes were more likely to be involved in men than women(P<0.05);special types(pustular,erythrodermic,articular)psoriasis were also correlated with nail changes(P<0.05).Among hospitalized patients,patients with nail changes were also significantly positively correlated with admission age and disease course(P<0.05).Among patients with nail changes,the use of biological agents was also significantly different,and the probability of using adalimumab was also higher(P<0.05).BMI suggested that 307 cases(41.7%)were overweight,and BMI value,body weight and comorbidity were significantly correlated(P<0.05).In 223 cases(31.32%)with abnormal inflammatory indicators,the total number of WBC,neutrophil count and percentage of neutrophils increased,which was more significant in patients with pustular psoriasis(P<0.05);No association with pustular psoriasis.HLA-B27 was positive in 18 cases,and the ratio of male to female was 1:0.28.HLA-B27 positive was correlated with psoriasis joints(P<0.05).There were 273(38.34%)cases of psoriasis comorbidity,including 119(43.59%)cases of hypertension,74(27.10%)cases of diabetes,69(25.27%)cases of liver damage,34(12.45%)cases of cardiovascular disease,obesity 32(11.72%)cases.The 50 to 60 age group had the highest proportion of comorbidities,and there was no significant difference in comorbidities between Han and ethnic minorities in this region(P>0.05),and there was no significant difference in comorbidities between males and females(P>0.05).Specific psoriasis was associated with comorbidities in hospitalized patients(P<0.05).The younger the age of onset and the older the age of admission,the more severe the severity of the skin lesions and the longer the course of the disease,the more likely to have comorbidities(P<0.05).A total of 77 inpatients were treated with biological agents during the five years,including 41(53.57%)patients with comorbidities.Conclusion:(1)The incidence of psoriasis is mainly concentrated in 13-45 years(509 people)in young and middle-aged men.Winter and spring are good seasons.The most common cause of onset is an upper respiratory tract infection,followed by colds.Patients with psoriasis have a history of smoking(36.23%)and drinking alcohol(17.93%).(2)The hospitalized patients were mainly severe plaque psoriasis(66.9%).The number of overweight accounted for 307cases(41.7%),psoriasis comorbidities are mainly hypertension,diabetes and cardiovascular disease,clinicians need to carefully inquire about the medical history,detect the comorbidities as soon as possible and actively treat,and at the same time educate patients,patients should actively control weight.(3)Men are more likely to have nail changes than women,and articular psoriasis is related to the occurrence of nail changes.Specific types of psoriasis are also more susceptible to nail changes.Patients with nail changes have a longer course of disease,also have higher BSA values.Pustular psoriasis was associated with increased WBC count and neutrophil count.Patients with joint symptoms are advised to be screened for HLA-B27 markers.Dyslipidemia is not indicated in different types of psoriasis.(4)The older the age of admission,the longer the course of the disease,the larger the area of skin lesions,the more likely to be combined with psoriasis comorbidities,and patients with comorbidities have greater weight and higher BMI index.Specific psoriasis has a higher risk of comorbidities than psoriasis vulgaris.Patients with a family history of psoriasis have an earlier age of onset and admission than those without a family history.Patients with comorbid conditions are also more affected by BSA.Neutrocyte count,lesion size,family history,and cumulative nail changes have an impact on specific types of psoriasis.soriasis is more common in young and middle-aged men,and the peak age of first onset of hospitalized patients in this area is mainly concentrated in 13-45 years old.The total number of hospitalized patients decreased by more than 35%,and the disease was more likely to occur in winter and spring than in summer and autumn.The most common cause is an upper respiratory tract infection.(5)In the past 5 years,I wish patients a significant increase in the use of biological agents,topical drugs and acitretin A and other treatments are still the most basic treatment,traditional immunosuppressive drugs are rarely used,55-60 years old patients with comorbidities account for the largest proportion,The use of biological agents has led to a decrease in hospitalizations for moderate to severe plaque psoriasis patients,and the total number of psoriasis hospitalizations has decreased by more than 35% in 5 years. |
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