Current Psoriasis Situation in China

1. PSORIASIS 2010 Congress of the Psoriasis International Network PARIS, July 1-4, 2010 Palais des Congrès Current Psoriasis Situation in China Zheng Min，M.D. Dermatology Department Second Hospital Zhejiang University, School of Medicine 浙江大学医学院附属第二医院郑敏

2. Practical organisation of Chinese Psoriasis Network National projects opportunitis to develop international collaborations on specific topics other issues

3. Chairman Prof. Zhu Xuejun, Chinese Dermatologist Association

4. Six National Psoriasis Center Chinese Psoriasis Network • 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.

5. Geographic Coverage of 46 hospitals in China 未覆盖区域 山西 贵州 四川 西藏 香港 台湾

6. Practical organisation of Chinese Psoriasis Network National projects opportunitis to develop international collaborations on specific topics other issues

7. World Psoriasis Day event Targeted Patients Epidermological Investigation National Treatment Guideline National projects

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

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

15. Beijing  Shanghai   Hangzhou 46 hospitals in different cities of China (2009.Nov.23-Dec. 12) ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● 4879 cases of psoriasis ● ● ● ● ● ●

16. New 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

17. Genetic epidemiology • Family history of psoriasis: 22.84% (1057/4628) • 62.53 % in first degree relatives 27.72 % in second degree relatives 9.76 % in third degree relatives

18. Peak age of first onset male: 20~29 years female: 10~19 years Zhang XJ et al: Analyses of Genetic Epidemiology of Psoriasis Vulgaris Chinese Journal of Dermatology 2000;33(6):383-385.

19. Psoriasis vulgaris may be a multigenic inheritable disease and the genetic factors play an important role in the pathogenesis of psoriasis. Zhang XJ et al: Analyses of Genetic Epidemiology of Psoriasis Vulgaris Chinese Journal of Dermatology 2000;33(6):383-385.

20. Causative factor • Psychological factor • Infection, wound • Alcohol, diet, smoking, drug • Endocrine and metabolic disease

21. Relapse and aggratate • Season, especially winter (83.36%) • Psychological factor • Pharyngolaryngitis or tonsillitis • Alcohol and food • Medicine and smoking

22. Releave Season • Summer（90.56%） • Spring • Paracmasia: 14.06±37.93m

23. Clinical Type of psoriasis 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%）。

24. Comorbiditiesin psoriatic patients • 19.67%:932/4737have 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%）。

25. Management Systemic therapy; Topical therapy; Patient education.

26. Systemic treatment • 79.55% (3809/4788) • Traditional Chinese Medicine 89.47% Acitretin 22.06% MTX 5.64% Immunosupressants 14.02% Steroids 13.30% Others 27.59%

27. Systemic treatment • Methotrexate 7.5mg/week widespread plaque, senile person • Acitretin 0.5mg/kg.d erythroderma and pustular psoriasis • Cyclosporin A 5mg/kg.d psoriasis arthritis • Corticosteroids. • Biologics • Alternative therapy TCM

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

29. Physical therapy • 26.54%: 1244/4688 • NB-UVB＞50% UVB PUVA

30. Insurance and treatment costs • 71.2% patients have a social medical insurance (non-commercial), and 7.43% patients attend other commercial medical insurance • In the past 6 months, about 29.84% went to see a dermatologist 6 times. The mean fees is $101±2000, and about $52±100 were paid by patients themselves。

31. Insurance and treatment costs • In the past 2 years, 7.07% patients were accepted in the hospital and 0.21% were in the hospital more than 6 times. • The duration in the hospital is 27.26±46.27d，mean spent is $1100±1200，and the patients themselves have to pay $600±1000

32. 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.

33. More to do • Update our National Treatment Guideline according to the new data from evidence based medicine: • National Disease Registration; • National Epi Invetigation; • International co-operation.

34. Practical organisation of Chinese Psoriasis Network • National projects • Opportunitis to develop international collaborations on specific topics and other issues

35. Comparison study on the background between Eastern and Western in genetics and clinical pattern background • Some mechanism study on traditional Chinese Medicine on psoriasis • …….

36. Beijing  Shanghai   Hangzhou THANK YOU !

37. Zhejiang Univ. School of Med.