Comorbidity burden is higher in generalized pustular psoriasis patients

Patients with generalized pustular psoriasis (GPP) have increased comorbidity compared with the general population and with patients with psoriasis vulgaris (PV), according to a study published online Oct. 11 in the Journal of the American Academy of Dermatology.

Sofia Löfvendahl, Ph.D., from the Swedish Institute for Health Economics in Lund, Sweden, and colleagues examined the comorbidity profile of GPP compared to the general population and patients with PV using the Swedish National Patient Register. A total of 1,093 GPP cases were identified during 2004 to 2015 and were matched in a 1:3 ratio with PV controls without GPP and in a 1:5 ratio with general population controls. Fifty-three percent of the GPP cases also had PV. A subgroup analysis was conducted including 514 GPP cases without PV and 1,518 corresponding PV controls.

The researchers found that 70 percent of the GPP cases had any of the selected comorbidities compared with 46 and 63 percent of general population controls and PV controls, respectively. Hypertension, psoriatic arthritis, type 2 diabetes, and hyperlipidemia were the most prevalent conditions in GPP. Compared with both the general population controls and PV controls, GPP cases had significantly higher odds ratios for any of the selected comorbidities. The largest significant differences between GPP cases and general population controls were for allergic contact dermatitis, Crohn disease, non-alcoholic fatty liver disease, nephritic nonhypertensive disease, and obesity. Comparing GPP cases with PV controls, the largest significant differences were seen for hypertensive disease, Crohn disease, chronic renal failure, type 1 and 2 diabetes, peptic ulcer disease, and psoriasis arthritis.

"The study indicates a higher comorbidity burden in GPP in Sweden compared to both the general population and PV," the authors write.