15838 Autoimmune comorbidities of psoriasis in US adults and children

Document Type

Conference Proceeding

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Publication Title

J Am Acad Dermatol


Background: Psoriasis is a chronic inflammatory skin disease affecting >7 million persons in the US. Few comprehensive large-scale and controlled studies examined the spectrum of autoimmune diseases occurring in psoriasis. Objective: To determine the autoimmune disorders associated with psoriasis in US adults and children, and the excess payer costs related to care for these autoimmune comorbidities. Methods: Data from the 2002-2012 National Inpatient Sample were analyzed, including a representative 20% sample of all US hospitalizations. Results: In adults, psoriasis was associated with ≥1 autoimmune disease (adjusted odds ratio [95% confidence interval]: 1.90 [1.86-1.94]), including 28 of 35 autoimmune disorders examined. Autoimmune disorders with the largest effect-size included including alopecia areata (8.61 [4.95-14.98]), vitiligo (5.88 [4.91-7.03]), erythema nodosum (3.59 [2.43-5.29]), ankylosing spondylitis (3.31 [2.86-3.83]), primary biliary cirrhosis (2.68 [2.21-3.25]), nonalcoholic steatohepatitis (2.71 [2.57-2.86]), and autoimmune hepatitis (2.88 [2.22-3.73]). In children, psoriasis was associated with increased odds of type 1 diabetes (1.68 [1.14-2.49]), rheumatoid arthritis (6.45 [2.65-15.69]), systemic lupus erythematosus (2.66 [1.18-5.99]), alopecia areata (49.11 [7.05-341.94]), vitiligo (23.11 [7.46-71.66]), autoimmune hemolytic anemia (7.23 [2.35-22.21]), and unspecified autoimmune disease [29.08 [8.23-102.83]). There were significant differences of geometric-mean cost of care among adult ($8168 [$8017-$8322] vs $7888 [$7780-$7997], P <.0001) and pediatric ($6842 [5808-8060] vs $5761 [5375-6176]), P =.0392) inpatients with psoriasis, with $76,120 and $49,991,534 in excess annual costs of inpatient care attributed to autoimmune disorders, respectively. Conclusions: Psoriasis was associated with hospitalization for multiple cutaneous and extracutaneous autoimmune disorders in adults and children, which contributed to substantial excess costs.





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