Psoriasis in elderly and non-elderly population: clinical and molecular features

Psoriasis management in elderly may be difficult, mainly due to comorbidities and concomitant medications. The aim of this study was to compare elderly and non-elderly psoriatic patients in relation to their demographic, clinical and molecular characteristics.

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.

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.

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.