Retrospective analysis of systemic treatments for psoriasis patients attending a Psocare center in Florence. Relevance of biological drugs use and comorbidities.

Abstract Background Psoriasis is a chronic inflammatory skin condition associated with several risk factors and comorbidities. Methods The present study outlines patient and therapy profiles emerging from the analysis of 471 patients affected by plaque psoriasis or psoriatic arthritis (PsA). Results In our sample, the age of onset and first diagnosis of PsA is significantly higher than plaque psoriasis and about 65\% of the patients are either smoker or ex-smokers, while 79\% are not drinkers. We also report a different distribution in the use of systemic treatments compared to the Psocare report 2007, with a tendency for a larger use of biologics over classical systemic drugs and in particular etanercept is the main treatment for PsA, and efalizumab for plaque psoriasis. All biological treatments used in the study significantly reduced PASI score. The main comorbidity associated both with plaque psoriasis and with PsA was hypertension, while hyperlipidaemia was frequently present in patients under biologics treatment. Finally, a strong association between type II diabetes and PsA was also reported. Conclusions Current treatments have to consider general health conditions and patients habits. In this picture, biological drugs are emerging as the therapy of choice for their good efficacy in the long term management of psoriasis.