Clinical characteristics of childhood psoriasis in a multi‐ethnic Asian population

Abstract

Dear Editor,Psoriasis in childhood is a well-recognized entity and is distinctfrom adult psoriasis. Little is known on the effects of ethnicityon patterns of childhood psoriasis in Asians. To elucidate theclinical characteristics of childhood psoriasis in our multi-ethnicAsian population, we conducted a retrospective study on 315consecutive patients under the age of 16 years diagnosed withpsoriasis at our center between January 2002 and December2009; data was extracted from patients’ medical records. TheWilcoxon–Mann–Whitney test was used to test the difference incontinuous measurement and Fisher’s exact test was used forcategorical data.The majority were female (183, 58.1%). Chinese, Malay, Indiansand patients of other ethnicity comprised 144 (45.7%), 83 (26.4%),61 (19.4%) and 27 (8.6%) patients, respectively. The proportion ofIndians differs significantly from the general ethnic distribution ofSingapore (9.2% Indian). The mean age at onset of psoriasis was7.7 years (range, 0.08–16 years). Fifty-four patients had a positivefamily history, with 79.6% (43 patients) in first-degree relatives(15mothers,21fathers,sevensiblings). This was not associatedwith a younger age at onset. Malays formed the highest proportion(22.9%) withapositi vefamilyhistory.Thescalpwasthemostfrequentlyinvolved siteatthetimeoffirstpresentation in all ethnicities (Table 1). Malays and Indians hadTable 1. Distributionofpsoriaticlesionsatfirstpresentationamongdifferentethnicgroups(%)Chinese(n = 144)Malay(n = 83)Indian(n = 61)Otherethnicities(n = 27)Total(n = 315) P-value*Scalp 53.5 77.1 78.7 55.6 64.8 <0.001Nails 47.2 30.1 32.8 29.6 38.4 0.034Extensor limbs 36.8 39.8 31.2 44.4 37.1 0.609Trunk 30.6 34.9 23.0 37.0 30.8 0.389Face 13.2 30.1 16.4 29.6 19.7 0.009Ears 13.2 26.5 16.4 11.1 17.1 0.076Buttocks or perineum 15.3 24.1 3.3 25.9 16.2 0.002Axilla 6.3 6.0 4.9 3.7 5.7 1.000Neck 5.6 8.4 4.9 0 5.7 0.511Palms or soles 6.3 1.2 6.6 7.4 5.1 0.202