Comorbid skin diseases in psoriasis – results of nationwide occupational skin screenings

Abstract

Background: Psoriasis is a skin disease with high relevance for public health that causes burden both for the patients and the society. While general comorbidities of psoriasis are known quite well, the field of comorbid skin diseases is only fragmentarily explored with partly opposing results.

Objective: To further investigate the complex field of psoriasis and associated skin diseases by identifying skin comorbidity patterns and defining patient groups with special needs in an extensive cohort of employees in Germany.

Methods: Multivariate analysis of data deriving from occupational skin cancer screenings was conducted. From 2001 to 2014 German workers between 16 and 70 years from different branches underwent single whole-body screenings provided by trained dermatologists on the occasion of screening for skin cancer as offered by the companies. All clinical dermatological findings were recorded electronically using a standardized data entry mask. Need for treatment was determined on the basis of the dermatologist’s assessment. Next to descriptive analyses correlations were examined by cross tabulations, t-test analyses and analyses of variance.

Results: Data from 138,930 persons (56.5% male, mean age 43.2) were evaluated. Psoriasis prevalence was 2.0%. Compared to participants without psoriasis, increased prevalences of further skin diseases were found for teleangiectasia (12.1%), onychomycosis (8.6%), folliculitis (6.4%), tinea pedis (6.2%), and rosacea (3.8%). Psoriatic patients had significantly higher BMI. Cardiovascular remedies and steroids were used more frequently by psoriasis patients. An increased need for treatment among psoriatic patients was found for onychomycosis (4.5%), tinea pedis (3.5%), dysplastic nevi (6.0%), actinic keratosis (1.4%), and basal cell carcinoma (1.1%).

Conclusion: People with psoriasis are at special risk to suffer from comorbid diseases. In the dermatological context, particular attention should be paid on fungal diseases.