Late-onset development of psoriasis in Japan: a population-based cohort study

Background: Evidence of factors associated with psoriasis from large population -based cohort studies is scarce. Objective: We aimed to explore the risk factors of late -onset psoriasis. Methods: This study included 487,835 Japanese participants aged 40-107 years, who were followed prospectively from 2012 to 2018 using individually linked databases between annual health checkups and medical claims. Results: During the study period, 2793 patients (0.57%) newly developed psoriasis; 13.8% had moderateto -severe psoriasis. In the multivariate analysis, factors associated with psoriasis onset were age (hazard ratio [HR] 1.11 {95% confidence interval [CI]: 1.06-1.16}), male sex (HR: 1.11 [95% CI: 1.02-1.21]), body mass index (HR: 1.09 [95% CI: 1.05-1.14]), smoking (HR: 1.46 [95% CI: 1.31-1.63]), not exercising >= 1 hour per week (HR: 1.13 [95% CI: 1.05-1.22]), and gamma-glutamyl transpeptidase (HR: 1.04 [95% CI: 1.01-1.06]). When we used weight increment of >= 10 kg since the age of 20 years instead of body mass index in the multivariate model, this was also a risk factor (HR: 1.12 [95% CI: 1.04-1.21]). Limitations: This study targeted people aged [ 40 years, thereby narrowing the search to the risk factors of late -onset psoriasis. Conclusion: We showed that increasing age, male sex, body mass index, smoking, low physical activity, weight gain, and gamma-glutamyl transpeptidase are associated with late -onset development of psoriasis and revealed a relationship between liver dysfunction and psoriasis development. ( JAAD Int 2021;2:51-61.)