Scalp psoriasis in China: a survey on epidemiological characteristics and influencing factors

Objective To describe epidemiological characteristics of scalp psoriasis in China,and to determine its influencing factors through a hospital-based,multicenter and large-scale survey.Methods An epidemiological survey was conducted on patients with scalp psoriasis in 42 hospitals in 11 provinces and 4 municipalities.A questionnaire was designed to collect general and clinical information of patients,including clinical type,lesion distribution,psoriasis scalp severity index (PSSI),aggravating factors,influence on quality of life,treatment course,degree of satisfaction with treatment,etc.Participants were asked to fill out the questionnaire with the help of well-trained dermatologists.Data were processed with the EpiData software.The WPS system and Epi Info 5.0 statistics software were used for descriptive analysis of the data.Results Totally,3 901 patients participated this study,and 3 586 valid questionaires were obtained.The mean age at onset of scalp lesions was (27.40 ± 13.34) years,and the male to female ratio was 1.6∶1 with a mean PSSI score of 13.61 ± 12.31.The hairline of the forehead was the most frequently affected area with the constituent ratio of forehead psoriasis being 74.3％ (2 663/3 586).The duration of scalp psoriasis reached 3 to 6 months every year in 1 136 (31.7％) patients,and the area affected by scalp psoriasis was less than 25％ of the total surface area of the scalp in 1 649 (46％) patients.The most frequent clinical presentation was scaling (92.1％),followed by erythema (80.6％),itching(76.7％),bunchy hairs (39.9％) and hair loss(18.0％).Disease aggravation was most frequently associated with seasons (76.7％),emotions (47.4％),stress (47.1％) and fatigue (46.6％).The quality of life (especially social,outdoor and entertainment activities) was reported to be negatively influenced by this entity to different degrees in 2 529 (70.5％) patients.Of these patients,583 (17.8％) received combination therapy (topical and systemic),with glucocorticoid ointment (27.5％),calcipotriol scalp solution (22.7％) and glucocorticoid-containing solution (11.9％) being the most commonly used topical drugs; only 38.6％ complied with medication requirements and doctors' advice for 3 to 5 weeks,and 35.2％ believed that the primary reason for poor compliance was unsatisfactory response to drugs.It was considered that an ideal drug for the treatment of scalp psoriasis should be highly effective (50.3％),safe (17.8％) and easy to apply (11％) with a rapid onset of action(11.9％).Conclusions Scalp psoriasis has a predilection for the hairline of the forehead with scaling as the main clinical presentation.Winter and spring seasons appear to be the most common aggravating factor of scalp psoriasis.The quality of life is negatively influenced to different degrees in many patients with scalp psoriasis.Topical corticosteroids plus non-hormonal drugs should be the first choice for the treatment of scalp psoriasis.Patients consider that the ideal drugs for the treatment of scalp psoriasis should be effective,safe,and easy to apply. Key words: Psoriasis;  Scalp;  Disease attributes;  Data collection