Current therapeutic approaches of psoriasis are affected by age at disease onset

Psoriasis in patients with early onset follows an irregular course with tendency to become severe and extensive. The aim of this study was to look for an association between age at onset of psoriasis and use of biologic agents for its treatment. We reviewed the medical records of 350 patients with moderate to severe psoriasis treated with systemic therapies and compared differences in age at disease onset between patients who had received biologics and those who had not. The mean age of our patients was 54.9 ± 15.1 years; 100 of them (28.6%) were currently receiving or had previously received treatment with a biologic agent. For those with biologic use, average age at the time of diagnosis of psoriasis was 28.2 ± 14.7 years, compared with 40.4 ± 18.1 years for those who had not received biologics. A total of 139 patients had psoriasis diagnosed before or at age 30 years. Sixty out of them (43.1%) had used biologics. Forty-four patients had psoriasis diagnosed after age 60 years, but only three out of them (6.8%) had used biologics. Concomitant arthritis was significantly associated with use of biologics. In our patients with psoriasis disease, frequency of treatment with a biologic agent varied inversely with age at disease onset.