Clinical profile of childhood-onset psoriasis and prevalence of HLA-Cw6: a hospital-based study from India.

Abstract

BACKGROUND:

Childhood-onset psoriasis (COP), a distinct clinical entity, may be associated with HLA-Cw6 positivity and metabolic and cardiovascular complications. There is some evidence that HLA-Cw6 positivity is associated with more extensive or severe disease and that positivity is lower in Asian patients than in Caucasians. We describe the clinical profile, prevalence of the HLA-Cw6 allele, metabolic syndrome (MetS) and vitamin D deficiency in Indian patients with COP.

METHODS:

In this cross-sectional hospital-based study over 15 months (June 2010-August 2011), 108 consecutive patients with disease onset ≤16 years were enrolled. Demographic, clinical and laboratory data were collected. Patients were categorised as children with COP (CCOP; n=69) or adults with COP (ACOP; n=39). Disease severity was assessed using body surface area (BSA) involved and Psoriasis Area and Severity Index (PASI) score.

RESULTS:

The most common morphological type was chronic plaque psoriasis; follicular psoriasis was seen only in children. Adults with disease onset in childhood, when compared with CCOP, had later disease onset (11.0±4.0 vs 6.9±3.8 (mean±SD) years; p<0.0001) of greater severity (p=0.021) based on BSA involved. PASI scores were, however, similar in ACOP and CCOP. Body mass index was not associated with disease severity. Of the 83 who underwent HLA-C typing, 46 (55.4%) were positive; positivity was associated with guttate lesions (p=0.031), scalp involvement (p=0.004), greater BSA involvement (p=0.002) and higher PASI scores (p=0.013). Vitamin D deficiency, obesity and MetS were present in 77.4%, 10.7% and 14.5% of patients, respectively.

CONCLUSIONS:

Among Indian patients, CCOP have earlier disease onset than ACOP. HLA-Cw6 was associated with guttate psoriasis, scalp involvement and disease severity. Vitamin D deficiency was common.

• Authors: Dharshini Sathishkumar, Renu George, Dolly Daniel, John Victor Peter
• Journal: Postgraduate medical journal (Postgrad Med J) Vol. 91 Issue 1076 Pg. 309-14 (Jun 2015) ISSN: 1469-0756 [Electronic] England
• PMID: 25947201 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Chemical References

• HLA-C Antigens
• HLA-C*06 antigen

Topics

• Age of Onset
• Child
• Child, Preschool
• Cross-Sectional Studies
• Female
• HLA-C Antigens (blood, genetics)
• Humans
• India (epidemiology)
• Male
• Prevalence
• Psoriasis (blood, epidemiology, genetics, immunology)
• Severity of Illness Index