Presentation of early onset psoriasis in comparison with late onset psoriasis: A clinical study from Pakistan

Background: Early onset psoriasis and late onset psoriasis are known to have different clinical patterns in Caucasian population. However, there is paucity of data among Asian patients. Aims: To compare the clinical presentation of early onset psoriasis with late onset psoriasis in Pakistani population. Methods: During the study period, participating dermatologists filled a pre-tested questionnaire for each patient with psoriasis on first encounter. The questionnaire incorporated information regarding clinical and demographic features of psoriasis including age of onset, clinical type of psoriasis, nail or joint involvement, and PASI score. Patients were then divided into early onset (age of onset <30 years, group I) and late onset (age of onset >= 30 years, group II) psoriasis. Results: Five hundred and fifteen questionnaires were filled and returned for evaluation. There was no statistically significant difference in both groups with regards to gender, family history (P = 0.09), nail (P = 0.69) and joint (P = 0.74) involvement, disease severity (P = 0.68), and clinical type of psoriasis (P = 0.06). No significant difference between disease severities measured by PASI score was observed in the two groups (P = 0.68). Presence of nail involvement was associated with joint disease in both groups (odds ratio 2.8, confidence interval 1.9-4.1). Conclusion: Patients with early and late onset psoriasis in Pakistani population do not show different clinical and demographic features contrary to the Western patients.