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. 2021 Feb 2:8:585634.
doi: 10.3389/fmed.2021.585634. eCollection 2021.

Epidemiological Variations in the Global Burden of Psoriasis, an Analysis With Trends From 1990 to 2017

Chen Peng  1   2 , Xin Xu  1   2 , Wenjuan Chen  1   2 , Xingzi Li  1   2 , Xuemei Yi  1   2 , Yangfeng Ding  1   2 , Ning Yu  1   2 , Jiajing Lu  1   2
Affiliations

Epidemiological Variations in the Global Burden of Psoriasis, an Analysis With Trends From 1990 to 2017

Chen Peng et al. Front Med (Lausanne). .

Abstract

Background: Although there have been many epidemiological studies, research focusing on psoriasis' health burden on a global scale is still lacking. Trends and variations in the global health burden of psoriasis are evaluated by time, age, gender, geographical location, and socioeconomic status, using disability-adjusted life years (DALYs) from the Global Burden of Disease Study. Methods: The health burden of psoriasis was evaluated by DALYs, which combined years lost to disability (a morbidity component) with years of life lost (a mortality component). The global and national DALYs number, crude DALYs rate, and age-standardized DALYs rate were obtained from the GBD 2017 study database. The corresponding human development index (HDI) was collected from the United Nations Development Programme. Results: From 1990 to 2017, the DALYs number and crude DALYs rate due to psoriasis increased by 73 and 22%, respectively. In comparison, the age-standardized DALYs rate showed a slight increase. Patients in the age range of 65-69 years bear a more significant psoriasis burden. Both males and females showed an increasing trend in burden caused by psoriasis over the past 27 years, with females bearing a more significant psoriasis burden than males. The health burden of psoriasis was substantially unequal in geography with a Gini coefficient of 0.27. The concentration indexes indicated a socioeconomic associated inequality in psoriasis burden with values of 0.22, accounting for 48.64% variance across countries (R2 = 0.4864, p < 0.001). Between-nation inequality in the distribution of psoriasis burden continued to decline throughout the past 27 years. Gini coefficients of psoriasis burden decreased from 0.280 in 1990 to 0.265 in 2017. The concentration indexes indicated the same trend with 0.236 in the 1990s and 0.223 in 2017. Conclusions: Global health progress in psoriasis together with inequality in the past few decades. Although the inequality of psoriasis burden has shown some improvement during the past 27 years, disparities still exist in age, gender, geographical location, as well as socioeconomic status. The findings of this study highlight the global importance of psoriasis and is important in policy planning for psoriasis services on a global scale.

Keywords: epidemiology; gender inequality; geographic and socioeconomic disparity; global burden; psoriasis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Trends in the global burden of cataract from 1990 to 2017, in terms of DALYs number (A), crude DALYs rate (B), and age-standardized DALYs rate (C). The part between the dotted lines represents 95% uncertainty intervals.
Figure 2
Figure 2
Global burden of psoriasis by age in 2017, in terms of crude DALYs rate.
Figure 3
Figure 3
The persistence of gender inequality in global psoriasis burden from 1990 to 2017, in terms of DALYs number (A), crude DALYs rate (B), and age-standardized DALYs rate (C).
Figure 4
Figure 4
Female-minus-male difference in age-standardized DALYs rate showed a slightly positive inclination to the level of national socioeconomic development (R2 = 0.1224, P < 0.001).
Figure 5
Figure 5
Global map of psoriasis burden in terms of DALYs number (A), crude DALYs rate (B), and age-standardized DALYs rate (C).
Figure 6
Figure 6
Psoriasis burden differed significantly across countries with different socioeconomic status levels. **P < 0.01 (A). Concentration index indicated that socioeconomic associated inequality in psoriasis burden across countries with values of 0.22 (B). Psoriasis burden was positively related to national socioeconomic development. The best-fitted line by linear regression analysis is presented (C).
Figure 7
Figure 7
Trends in the Gini coefficients (A) and the concentration indexes (B) of psoriasis burden across countries from 1990 to 2017.
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