Current Psoriasis Current Psoriasis Situation in ChinaSituation in China

Zheng MinZheng Min ，， M.D.M.D.Dermatology DepartmentDermatology DepartmentSecond HospitalSecond HospitalZhejiang University, School of MedicineZhejiang University, School of Medicine浙江大学医学院附属第二医院郑敏浙江大学医学院附属第二医院郑敏

PSORIASIS 2010Congress of the Psoriasis International Network

PARIS, July 1-4, 2010Palais des Congrès

Practical organisation of Chinese Psoriasis Network

National projects opportunitis to develop

international collaborations on specific topics

other issues

Chairman Prof. Zhu Xuejun, Chinese Dermatologist Association

Six National Psoriasis Center Institute of Dermatology, Chinese Academy of

Medical Sciences and Peking Union Medical College.Nanjing;

First Hospital Beijing Univerity.Beijing; Second Hospital Zhejiang University.Hangzhou; Huashan Hospital, Fudan University.Shanghai; Xijing Hospital, Fourth Military Medical

University; Xi’an ; Peking Union Medical College Hospital.Beijing.

Chinese Psoriasis Network

Geographic Coverage of 46 hospitals in China

未覆盖区域山西贵州四川西藏香港台湾

Practical organisation of Chinese Psoriasis Network

National projects opportunitis to develop

international collaborations on specific topics

other issues

World Psoriasis Day event Targeted Patients

Epidermological Investigation National Treatment Guideline

National projects

Press conference focus on national psoriasis prevention and treatment on 29. Oct.

Prof. Zhu Xuejun, chairman of China Dermatologist Association, in Press conference in International day of Psoriasis

Beijing

Shanghai

Hangzhou

46 hospitals in different cities of China

4879 cases of psoriasis

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New Data 2009New Data 2009

46 hospitals in China 4879 cases of psoriasis vulgaris Male, 61.14%; Female, 38.86% ， Male : Female=1.57 ： 1 Mean age 40.49±22.11

Family history of psoriasis: 22.84% (1057/4628)

62.53 % in first degree relatives 62.53 % in first degree relatives 27.72 % in second degree relatives27.72 % in second degree relatives 9.76 % in third degree relativesin third degree relatives

Genetic epidemiologyGenetic epidemiology

Peak age of first onsetPeak age of first onset male: 20~29 years male: 20~29 years female: 10~19 yearsfemale: 10~19 years

Zhang XJ et al: Analyses of Genetic Epidemiology of Psoriasis VulgarisChinese Journal of Dermatology 2000;33(6):383-385.

Psoriasis vulgaris may be a Psoriasis vulgaris may be a multigenic inheritable disease multigenic inheritable disease and the genetic factors play an and the genetic factors play an important role in the important role in the pathogenesis of psoriasis.pathogenesis of psoriasis.

Zhang XJ et al: Analyses of Genetic Epidemiology of Psoriasis VulgarisChinese Journal of Dermatology 2000;33(6):383-385.

Causative factorCausative factor

Psychological factorPsychological factor

Infection, wound

Alcohol, diet, smoking, drug

Endocrine and metabolic diseaseEndocrine and metabolic disease

Relapse and aggratateRelapse and aggratate

Season, especially winter (83.36%) Psychological factor Pharyngolaryngitis or tonsillitisPharyngolaryngitis or tonsillitis Alcohol and food Medicine and smoking

Releave SeasonReleave Season

Summer （ 90.56% ） Spring Paracmasia: 14.06±37.93 m

Clinical Type of psoriasis Clinical Type of psoriasis in China in China Psoriasis vulgaris: 4489 （ 92.01% ） Guttae 26.09% Plaque 57.01% Mix 16.91% Psoriasis pustulosa: 169 （ 3.46% ） Psoriasis erythroderma: 79 （ 1.62% ） Psoriasis arthropathica: 142 例（ 2.91% ）。

19.67%: 932/4737 have accompanied disease

High blood pressure: 576 （ 12.16% ） Diabetes: 237 （ 5.00% ） Coronary heart disease:149 （ 3.15% ） Hyperlipemia: 340 （ 7.18% ） Rheumatoid arthritis: 61 （ 1.29% ）， Tumor: 40 （ 0.84% ）。

ComorbiditiesComorbidities in psoriatic patientsin psoriatic patients

ManagementManagement

Systemic therapy;Systemic therapy;Topical therapy;Topical therapy;Patient education.Patient education.

79.55% (3809/4788)79.55% (3809/4788) Traditional Chinese Medicine Traditional Chinese Medicine

89.47% 89.47% Acitretin Acitretin 22.06% 22.06% MTX 5.64%MTX 5.64% Immunosupressants 14.02%Immunosupressants 14.02% Steroids 13.30%Steroids 13.30% Others 27.59%Others 27.59%

Systemic treatmentSystemic treatment

Systemic treatmentSystemic treatment Methotrexate 7.5mg/weekMethotrexate 7.5mg/week widespread plaque, senile personwidespread plaque, senile person Acitretin 0.5mg/kg.dAcitretin 0.5mg/kg.d erythroderma and pustular psoriasiserythroderma and pustular psoriasis Cyclosporin A 5mg/kg.d psoriasis arthritisCyclosporin A 5mg/kg.d psoriasis arthritis Corticosteroids.Corticosteroids. BiologicsBiologics Alternative therapy TCMAlternative therapy TCM

Topical therapyTopical therapy

90.34% (4283/4741)90.34% (4283/4741) Topical steroids: 85.59%Topical steroids: 85.59% Vitamin D3 analogue: 31.64%Vitamin D3 analogue: 31.64% Topical retinoids: 27.01%Topical retinoids: 27.01% Salicylic acid: 18.98%Salicylic acid: 18.98% Coal tar: 14.57%Coal tar: 14.57% Anthralin: 3.34%Anthralin: 3.34% Topical TCM: 23.67%Topical TCM: 23.67% Others: 25.40%Others: 25.40%

Physical therapyPhysical therapy

26.54%: 124426.54%: 1244//46884688 NB-UVB NB-UVB ＞＞ 50%50% UVBUVB PUVAPUVA

Insurance and treatment costs Insurance and treatment costs

71.2% patients have a social medical 71.2% patients have a social medical insurance (non-commercial), and insurance (non-commercial), and 7.43% patients attend other 7.43% patients attend other commercial medical insurancecommercial medical insurance

In the past 6 months, about 29.84% In the past 6 months, about 29.84% went to see a dermatologist 6 times. went to see a dermatologist 6 times. The mean fees is $101±2000, and The mean fees is $101±2000, and about $52±100 were paid by patients about $52±100 were paid by patients themselvesthemselves 。。

Insurance and treatment costsInsurance and treatment costs

In the past 2 years, 7.07% patients were In the past 2 years, 7.07% patients were accepted in the hospital and 0.21% were in accepted in the hospital and 0.21% were in the hospital more than 6 times. the hospital more than 6 times.

The duration in the hospital is 27.26±46.27dThe duration in the hospital is 27.26±46.27d，， mean spent is $1100±1200mean spent is $1100±1200 ，， and the and the patients themselves have to pay $600±1000patients themselves have to pay $600±1000

QOL

18.73% patients were affected severely, 29.45% moderately ， and 37.56% slightly. Only 14.27% were unaffected.

13.31% patients’ family expenditure were affected greatly, 25.96% moderately, 38.90% slightly and 21.82% unaffected.

Update our National Treatment Guideline according to the new data from evidence based medicine:

National Disease Registration; National Epi Invetigation; International co-operation.

More to do

Practical organisation of Chinese Psoriasis Network

National projects Opportunitis to develop

international collaborations on specific topics and other issues

Comparison study on the background between Eastern and Western in genetics and clinical pattern background

Some mechanism study on traditional Chinese Medicine on psoriasis

…….

THANK YOU !THANK YOU !

Beijing

ShanghaiHangzhou

Zhejiang Univ. School of Zhejiang Univ. School of Med.Med.