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CORRESPONDENCE
Year : 2011  |  Volume : 56  |  Issue : 1  |  Page : 118-119
Pattern of psoriasis in a tertiary care teaching hospital in South India


Department of Dermatology and Venereology, Trichur Medical College, Trichur, Kerala, India

Date of Web Publication10-Mar-2011

Correspondence Address:
N Asokan
"Prashanthi," Kanattukara (P.O.), Thrissur 11
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.77575

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How to cite this article:
Asokan N, Prathap P, Ajithkumar K, Betsy A, Binesh V G. Pattern of psoriasis in a tertiary care teaching hospital in South India. Indian J Dermatol 2011;56:118-9

How to cite this URL:
Asokan N, Prathap P, Ajithkumar K, Betsy A, Binesh V G. Pattern of psoriasis in a tertiary care teaching hospital in South India. Indian J Dermatol [serial online] 2011 [cited 2019 Jul 18];56:118-9. Available from: http://www.e-ijd.org/text.asp?2011/56/1/118/77575


Sir,

Psoriasis is a major cause of morbidity in our population. There have been several published studies on the pattern of the disease in North India. [1],[2],[3] The only previous study from South India which we could locate after an extensive literature search was published nearly 50 years ago and consisted only of 45 patients. [4] This study is undertaken to fill this data gap to a limited extent. Thrissur Medical College is a tertiary care teaching hospital in public sector in the South Indian State of Kerala. We started a twice-weekly psoriasis clinic from March 1, 2007. Here, we report the pattern of disease among the patients attending this clinic.

All patients who attended the out patient section of the Department of Dermatology and Venereology with a confirmed diagnosis of psoriasis were selected to the psoriasis clinic. Diagnosis of psoriasis was confirmed by a consultant in dermatology primarily on clinical grounds, supported by histopathology when needed. The socio-demographic and clinical details of all cases were routinely entered in a specially designed proforma. Records of consecutive patients who attended the clinic from March 1, 2007 to February 29, 2008 were analyzed using descriptive statistics.

Of 275 patients, there were 206 males and 69 females (male-to-female ratio = 2.9:1). The youngest patient was of 6 years age, and the oldest was of 79 years. The mean age of onset was 38.9 years (±SD 14.5). The mean age of onset in males was 40.3 years (±SD 13.4), and this was 34.7 years (±SD 16.4) in females. A total of 156 patients (56.7%) had psoriasis of more than 5 years duration; 92 (33.5%) of more than 10 years; 57 (20.7%) of more than 15 years, and 26 (9.5%) of more than 20 years duration. A 79-year-old patient had psoriasis for 49 years.

A total of 120 patients (45.1%) were tobacco smokers either currently or in the past and 141 patients (51.3%) were past or current habitual users of alcohol. A total of 258 patients (93.8%) had previously been on modern medical treatment, and 160 (58.2%) had indigenous (Ayurvedic) treatment. Fifty-four (19.6%) had Homeopathic treatment.

A total of 246 patients (89.5%) had chronic plaque type of psoriasis, 35 patients (12.7%) had guttate type, and nine (3.3%) had erythrodermic type. Seven patients (2.6%) had pustular psoriasis, whereas five (1.8%) each had flexural and arthropathic types. There were four cases (1.5%) of sebopsoriasis. A total of 246 patients (89.5%) had scalp involvement, whereas 163 (59.3%) had nail involvement. A total of 129 patients (46.9%) had involvement of palms or soles. A total of 197 (71.6%) patients were treated only with topical therapy.

Most studies from India report a male preponderance similar to the findings of this study. [1],[3] However, in contrast to most previous studies, this study shows a higher mean age of onset of the disease in both sexes. [1],[2] Nearly a half of the patients were found to be current or past tobacco smokers and/or current or past consumers of alcohol. Involvement of the scalp was found to be higher in this series compared to previous reports, though more frequent involvement of scalp compared to nails has been noted previously. [5]

A majority of the patients had tried Ayurvedic and Homeopathic systems of medicine, which probably points to a low-satisfaction level of patients with this chronic disease with any single medical system. This highlights the need for proper counseling of patients with psoriasis.

It is worthwhile to note that more than two-third of the patients could be treated with only topical therapy. As topical therapy is simple and does not need elaborate monitoring, care of most of these patients could be undertaken by general practitioners provided they are adequately trained on the basics of dermatology including topical therapeutics.

It will not be possible to extrapolate the findings of this clinic-based study to the general population. Population-based studies are required in this regard. Yet, this study provides important information on the pattern of psoriasis in South India.


   Acknowledgment Top


The authors thank Dr. K. Praveenlal, Principal, Medical College, Trichur for his advice and help.

 
   References Top

1.Bedi TR. Psoriasis in North India. Geographical variations. Dermatologica 1977;155:310-4.  Back to cited text no. 1
[PUBMED]    
2.Kaur I, Handa S, Kumar B. Natural history of psoriasis: A study from the Indian subcontinent. J Dermatol 1997;24:230-4.  Back to cited text no. 2
[PUBMED]    
3.Mehta TK, Shah RN, Marquis L. A study of 300 cases of psoriasis. Indian J Dermatol Venereol Leprol 1978;44:242-4.  Back to cited text no. 3
  Medknow Journal  
4.Ambady BM, Gopinath T, Nair BKH. Psoriasis. Indian J Dermatol Venereol Leprol 1961;27:23-30.  Back to cited text no. 4
    
5.Fatani MI, Abdulghani MH, Al-Afif KA. Psoriasis in the eastern Saudi Arabia. Saudi Med J 2002;23:213-7.  Back to cited text no. 5
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