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Background: Psoriasis is associated with hyperlipidemia. Few studies have examined the association among psoriasis, hyperlipidemia, and chronic kidney disease (CKD). It remains a topic of debate whether statin treatment for hyperlipidemia prevents the development of CKD in patients with psoriasis., Objective: We investigated whether there is an association among psoriasis, hyperlipidemia and CKD. If so, we asked whether statin treatment for hyperlipidemia reduces the risk of CKD in patients with psoriasis., Methods: A Taiwan nationwide population-based cohort study between 1997 and 2010 included 2,912 patients with psoriasis and 8,736 matched patients without psoriasis (1:3 propensity score matched according to age, sex, and region); 104,609 patients without psoriasis but with hyperlipidemia and 104,609 matched patients without psoriasis or hyperlipidemia (1:1). The hazard ratios, relative risks, and 95% confidence intervals were calculated using Cox proportional hazards model., Results: Psoriasis significantly increased the risk of CKD (adjusted hazard ratio 2.48, 95% confidence interval 1.81-3.40), and so did hyperlipidemia (adjusted hazard ratio 2.93, 95% confidence interval 2.79-3.08). Compared to treatment without statins, statin treatment for hyperlipidemia reduced the risk of CKD in patients with psoriasis (adjusted relative risk 0.58, 95% confidence interval 0.55-0.62)., Conclusion: As well as hyperlipidemia, psoriasis significantly increased the risk of CKD. Statin treatment for hyperlipidemia reduced the risk of CKD in patients with psoriasis., Competing Interests: WCT is employed by Huang PH Dermatology and Aesthetics. This does not alter our adherence to PLOS ONE policies on data and materials sharing.

Psoriasis is associated with certain psychiatric disorders such as anxiety and depression. Although a growing body of literature has indicated high prevalence of anxiety in patients with psoriasis, it is unclear if the incidence of anxiety is correlated with severity of psoriasis. In this article, we hypothesize that anxiety is not correlated with severity of psoriasis, and therefore the issue of anxiety should not be neglected in patients with mild psoriasis. To testify this hypothesis, we performed a pilot study to investigate the correlation between anxiety questionnaires and severity of psoriasis. Thirty-two patients with psoriasis were recruited. The patients were further classified into mild or moderate to severe psoriasis according to their body surface area or Psoriasis Area Severity Index (PASI). Zung's self-rating anxiety scale (SAS) and SF-36 were adopted to evaluate anxiety and quality of life, respectively. Spearman's rank correlation coefficients were calculated between SAS and each scale of SF-36 among these 32 patients. SAS is negatively correlated with role limitation due to emotional problems, vitality, emotional well-being of SF-36. Although SAS is not significantly different between mild and moderate to severe psoriasis, the detected levels of anxiety were higher than normative standards. Physicians should not neglect potential anxiety in patients who have mild psoriasis. Inter-discipline collaboration between psychiatry and dermatology is required to provide comprehensive patient care., (Copyright © 2019. Published by Elsevier Ltd.)

The epidemiology of depression in patients with psoriasis has not been well defined in the Asian population. This study evaluated the epidemiological features of, and risk factors for, depression among patients with psoriasis in Taiwan. A nationwide population-based cross-sectional study was undertaken using the National Health Insurance Research Database. This study included 17,086 patients with psoriasis and 1,607,242 patients from the general population. The prevalence of depression in patients with psoriasis was 11.52%, while the prevalence of depression in the general population was 7.73% (prevalence ratio 1.49, 95% confidence interval 1.43-1.55). Multivariable analysis showed that, in patients with psoriasis, risk factors associated with depression were: age 20-50 years, female sex, low income, and major comorbid diseases, including liver cirrhosis, renal disease, cardiovascular disease and cerebrovascular disease. Therefore, the prevalence of depression is higher in patients with psoriasis, particularly in young and middle-aged women with low income and major comorbidities.

Background: Psoriasis is a chronic inflammatory disease involving the skin and/or joints. Till 2016, there were five biologic agents for psoriatic arthritis treatment in Taiwan: etanercept, adalimumab, golimumab, ustekinumab, and secukinumab. Although European guidelines recommend tumor necrosis factor-α (TNF-α) inhibitors as the first-line biologic agents for axial disease of psoriatic arthritis, the drug survival of biologic agents in Asian populations remains unclear. Objectives: We investigated 5-year drug survival of biologic agents in patients with psoriatic arthritis. Methods: We used Kaohsiung Medical University Hospital Research Database to evaluate real-world 5-year drug survival of biologic agents for psoriatic arthritis in a medical center from southern Taiwan. Results: The 5-year drug survival rates of ustekinumab, etanercept, and adalimumab were significantly different. Ustekinumab and etanercept showed higher 5-year survival rates for psoriatic disease than adalimumab. Golimumab and secukinumab had a short follow-up time to obtain a conclusive 5-year survival rate. Conclusion: Considering that TNF-α inhibitors are often the first-line biologic agents for psoriatic arthritis in guidelines in western countries, the finding that ustekinumab is superior to TNF-α inhibitor adalimumab in terms of 5-year survival for psoriatic disease may imply that the therapeutic response of biologic agents may differ between different ethnic groups. [ABSTRACT FROM AUTHOR]

Background Psoriasis is a chronic inflammatory disease that affects the skin, joints, and cardiovascular system. Although a potential association of end-stage renal disease (ESRD) with psoriasis has been demonstrated in patients, the potential for the use of cyclosporin in these patients for the modulation of the course of ESRD remains doubted. Furthermore, the association between psoriasis and renal diseases in general remains unclear. This study aimed to investigate the risk of renal disease in psoriatic patients with or without the use of cyclosporin. Methods We performed a retrospective cohort study using the National Health Insurance Database of Taiwan from 1996 to 2010 to identify patients with psoriasis, renal disease, chronic renal failure, and ESRD, and the use of cyclosporin. Overall, 3502 psoriatic patients and 10,506 matched population comparisons were identified. The hazard ratios (HRs) for renal events during the follow-up period were computed. Results Patients with psoriasis had an increased risk of chronic renal failure [HR = 3.00; 95% confidence interval (CI), 2.30–3.93; p < 0.0001] and ESRD (HR = 2.03; 95% CI, 1.04–3.96; p = 0.0393). Cyclosporin increased the risk of renal disease in patients without psoriasis (HR = 6.34; 95% CI, 3.57–11.26; p < 0.0001), but not in patients with psoriasis (HR = 1.33; 95% CI = 0.66–2.69; p = 0.4299). Conclusion Psoriasis is an independent risk factor of chronic renal failure and ESRD. Cyclosporin, a commonly used antipsoriatic agent, does not significantly increase the risk of renal disease in patients with psoriasis. Further studies with larger sample size are indicated to validate this result. [ABSTRACT FROM AUTHOR]

Background/Objective The prevalence of selected psychiatric disorders, such as depression and anxiety, is higher in patients with psoriasis. However, the association between psoriasis and schizophrenia is less clear. Here, we investigated whether the prevalence of schizophrenia is higher in patients with psoriasis. Methods In this cross-sectional study, we analyzed the 1-million-person cohort enrolled from Taiwan's National Health Insurance Research Database. Psoriasis, schizophrenia, and comorbidities were ascertained by the International Classification of Diseases, 9 th revision, Clinical Modification coding. For schizophrenia, the concomitant catastrophic illness certificate was used to verify the diagnosis. The prevalence of schizophrenia in patients with psoriasis was compared with the prevalence of schizophrenia in a comparable population using a generalized linear mixed model. Results The prevalence of schizophrenia was significantly higher in patients with psoriasis than in the comparison population [prevalence ratio = 1.77, 95% confidence interval (CI) = 1.48–2.12, p < 0.0001)]. Within the psoriasis cohort, patients aged between 40 years and 59 years had a higher odds ratio (OR) for schizophrenia (OR = 2.49, 95% CI = 1.55–4.00, p = 0.0002). Furthermore, psoriatic patients with comorbid cerebrovascular disease (OR = 2.01, 95% CI = 1.11–3.65, p = 0.0220) and chronic pulmonary disease (OR = 1.64, 95% CI = 1.07–2.49, p = 0.0218) had higher odds for schizophrenia. Conclusion Schizophrenia is more prevalent in patients with psoriasis. Although the exact mechanisms remain to be clarified, the finding that psoriatic patients with comorbid cerebrovascular disease or chronic pulmonary disease have higher odds for schizophrenia may imply psoriatic patients with those comorbidities are likely to have higher inflammatory burden, which would contribute to the development of schizophrenia if a disruption of the blood–brain barrier is present. Further investigations are indicated to validate the hypothesis explaining the association between known comorbidies of psoriasis and schizophrenia. [ABSTRACT FROM AUTHOR]