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Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Online ISSN 1827-1820
Napolitano M., Balato N., Ayala F., Patruno C., Patrì A., Megna M., Balato A.
Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
BACKGROUND: Psoriasis management in elderly may be difficult, mainly due to comorbidities and concomitant medications.
OBJECTIVE: To compare elderly and non elderly psoriatic patients in relation to their demographic, clinical and molecular characteristics.
METHODS: A prospective observational study on 502 psoriatic patients attending our outpatient clinic was performed. We analyzed their demographical and clinical features, highlighting differences in comorbidities and treatment adverse events. Moreover, real-time PCR was used to analyze lesional skin expression of CCL-20, HBD-2, Hpt, IFN-α, IL-1β, IL-8, IL-23A, IL-33, IL- 36γ, TGF-β, TNF-α, S100A7 and VEGF, in 15 adults and 15 elderly.
RESULTS: The two groups of patients differed for comorbidities and treatment profile. Particularly, non-elderly were treated more frequently with biologic drugs compared to elderly. However, elderly did not develop more metabolic, hepatic and/or renal abnormalities than younger patients. Serious adverse events were comparable between elderly and non-elderly. No difference in gene expression of the investigated mediators was found.
LIMITATIONS: The heterogeneous duration of follow-up
CONCLUSIONS: Our study did not show substantial clinical or molecular differences between elderly and non-elderly. Older patients should be treated with systemic drugs when required. Safety and tolerability profiles of biological drugs seemed at least comparable with those of traditional systemic ones.