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Liver Disease Among Patients with Psoriasis: The Malaysian Psoriasis Registry

Lim YT, Robinson S, Tang MM, Malaysian Psoriasis Registry Working Group

Clin Exp Dermatol, 2023 Jan 12.
PMID: 36632801 DOI: 10.1093/ced/llad013

BACKGROUND: Therapeutic options for psoriasis may be limited for patients with concomitant liver disease.
OBJECTIVE: We aim to report the frequency of liver disease among psoriasis patients, describe the clinical features, treatment modalities and quality of life.
METHODS: This was a multi-center cross-sectional study of psoriasis patients notified to the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018.
RESULTS: Of 21,735 psoriasis patients, 174 (0.8%) had liver disease. The three most common liver diseases were viral hepatitis (62.1%), fatty liver (14.4%) and liver cirrhosis (10.9%). The male-to-female ratio was 3.8:1. Mean age of onset of psoriasis was higher in those with liver disease compared to those without (37.25 ± 13.47 years vs 33.26 ± 16.96 years, p 10% and/or DLQI > 10) (59.3%vs49.9%, p = 0.027), psoriatic arthropathy (21.1%vs13.0%, p = 0.002), and nail involvement (78.2%vs56.1%, p group with liver disease. The mean Dermatology Life Quality Index were similar in both groups (9.69 ± 7.20vs9.62 ± 6.75, p = 0.88).
CONCLUSIONS: The frequency of psoriasis patients with liver disease in MPR was 0.8%. Psoriasis patients with liver disease were more likely to be male, had a higher rate of co-morbidities, severe disease, nail and joint involvement than those without liver disease.
Utilization of phototherapy and treatment response in adults with psoriasis: Data from the Malaysian Psoriasis Registry

Ooi SY, Tang MM, Loo CH, Tan WC, Robinson S, Malaysian Psoriasis Registry Working Group

Photodermatol Photoimmunol Photomed, 2023 Mar;39(2):155-158.
PMID: 36692070 DOI: 10.1111/phpp.12864
Pustular psoriasis in Malaysia: A review of the Malaysian Psoriasis Registry 2007-2018

Teoh XY, Suganthy R, Voo SYM, Tang MM, Malaysian Psoriasis Registry Working Group

Exp Dermatol, 2023 Aug;32(8):1253-1262.
PMID: 36794833 DOI: 10.1111/exd.14770

Pustular psoriasis (PP) is an uncommon subtype of psoriasis with distinct genetic features and clinical phenotypes. Patients with PP tend to experience frequent flares and significant morbidity. This study aims to determine the clinical characteristics, co-morbidities and treatment of PP patients in Malaysia. This was a cross-sectional study of patients with PP notified to the Malaysian Psoriasis Registry (MPR) between January 2007 and December 2018. Of 21 735 psoriasis patients, 148 (0.7%) had pustular psoriasis. Of these, 93 (62.8%) were diagnosed with generalized pustular psoriasis (GPP) and 55 (37.2%) with localized PP (LPP). The mean age for pustular psoriasis onset was 31.71 ± 18.33 years with a male to female ratio of 1:2.1. Patients with PP were more likely to have dyslipidaemia (23.6% vs. 16.5%, p = 0.022), severe disease (Body surface area >10 and/or Dermatology Life Quality Index [DLQI] >10) (64.8% vs. 50%, p = 0.003) and require systemic therapy (51.4% vs. 13.9%, p 10, 48.9% vs. 40.3%, p = 0.046), had more days off school/work (2.06 ± 6.09 vs. 0.5 ± 4.91, p = 0.004) and a higher mean number of hospitalizations (0.31 ± 0.95 vs. 0.05 ± 1.22, p = 0.001) in 6 months compared to non-PP patients. Overall, 0.7% of psoriasis patients in the MPR had pustular psoriasis. Patients with PP had a higher rate of dyslipidaemia, severe disease, greater impairment of quality of life and systemic therapy usage compared to other psoriasis subtypes.
Clinical characteristics, management, and quality of life of psoriasis patients with coexistent lupus erythematosus: Data from the Malaysian Psoriasis Registry

Gan TS, Ghazali NI, Voo SYM, Low DE, Tang JJ, Kiing JW, et al.

Int J Rheum Dis, 2023 Feb;26(2):327-336.
PMID: 36382593 DOI: 10.1111/1756-185X.14492

OBJECTIVE: To describe the clinical characteristics, management and quality of life of psoriasis patients with and without coexistent lupus erythematosus (LE).
METHODS: This retrospective cross-sectional study uses data from the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018.
RESULTS: Of 21 735 psoriasis patients, 34 (0.16%) had coexistent LE. The male to female ratio among psoriasis patients with coexistent LE was 1:5.8 versus 1.3:1 in patients with psoriasis but without LE. Nearly 70% presented with LE preceding psoriasis. Psoriasis patients with LE had an earlier age of psoriasis onset (27.56 ± 11.51 versus 33.31 ± 16.94 years, P = 0.006), a higher rate of psoriatic arthropathy (26.5% versus 13.0%, P = 0.02), and a significantly greater impairment of quality of life (Dermatology Quality of Life Index >10; 57.6% versus 40.3%, P = 0.04) compared with psoriasis patients without LE. The majority (87.5%) had systemic LE. The incidences of lupus nephritis (72.7% versus 40%) and hematological abnormalities (50% versus 20%) were higher among patients with LE preceding psoriasis compared with those with psoriasis preceding LE. Antinuclear antibody and double-stranded DNA were positive in 59.4% and 28.1% of psoriasis patients with LE, respectively. Hydroxychloroquine triggered the onset of psoriasis in 7 (24.1%) patients. Patients with LE were more likely to receive systemic treatment for psoriasis compared with those without LE (30.3% versus 14.2%, P = 0.008).
CONCLUSIONS: Psoriasis patients with coexistent LE were uncommon, displayed a female preponderance, were more likely to have joint involvement, and had greater quality of life impairment than those without LE. LE preceded psoriasis in most of these patients, and systemic LE was the most common subtype.