Severe Psoriasis May be More Common in Men

A majority of autoimmune diseases, such as systemic lupus erythematosus, multiple sclerosis, and rheumatoid arthritis, are more common among women than men.

It has long been speculated that men may face a higher risk of developing psoriasis, but a new study published by the American Journal of Clinical Dermatology is the first to discover that women have a statistically lower risk of developing severe psoriasis than men.

"Our results tell us that the well-established gender differences in the utilization of psoriasis care can at least partially be explained by a higher prevalence of more severe disease in men," said senior study author Marcus Schmitt-Egenolf, MD, PhD.

Psoriasis is a common autoimmune condition that is characterized by skin cells building up and creating itchy and dry patches. Patients can experience psoriasis in different areas of the body, which dictates the treatment options.

Included in the study were 5438 patients with psoriasis who were part of the Swedish quality register for systemic treatment of psoriasis. This registry contains Psoriasis Area Severity Index (PSAI) scores, which are used as a means to measure disease severity.

The authors discovered that women, on average, had a higher PSAI value than men. Women with psoriasis were observed to have an average PSAI value of 5.4, compared with 7.3 for men, according to the study.

These results were proven true across men of all age groups and for areas of the body except for the head.

"These findings should motivate a gender perspective in the management of severe psoriasis and its comorbidities, such as cardiovascular and metabolic disease," Dr Marcus Schmitt-Egenolf said.

The investigators reported no differences between men and women regarding medication use prior to inclusion in the registry that would be responsible for the results. These findings suggest an explanation for the male dominance in systemic treatment of psoriasis, according to the study.

Additional studies are needed to further examine the relationship between gender and psoriasis and to determine what plays a role in disease prevalence.

"For over 70 years, psoriasis researchers have speculated that women have less severe psoriasis compared to men. Our study is the first to investigate sex differences in psoriasis severity using the golden standard of severity measurement, the PASI score,” Dr Marcus Schmitt-Egenolf said. “Furthermore, we have also looked more in-depth at distinct elements of the PASI score. The results allow us to verify this thesis in a nationwide population. However, further research is needed to substantiate our findings in different populations.”