Defining the Natural Course of Psoriasis: A Single-Center Cohort Study of 100 Patients

Objective: The aim of this study is to determine chronologically the occurrence of clinical forms and individual lesions of psoriasis patients. Methods: A total of 100 patients (mean age 42.07 +/- 16.12 years) were included in this retrospective cohort study. Individual lesions and changes in clinic forms recorded chronologically. The patients were also assessed for accompanying comorbidities during the course of disease. Results: Skin manifestations were the most frequent observed onset area of the disease (95%) and the most common clinical morphology at the onset of the disease was psoriasis vulgaris (92%). Scalp (19%) was the most frequent onset area of the disease. Clinical morphologic changes were detected in 26 patients during the course of the disease. The most common clinical morphological change was guttate psoriasis (n=17). In survival analysis, average time between the appearance of the first symptom and skin involvement, nail involvement, and articular involvement was calculated as 0.23 +/- 0.106, 5.89 +/- 1.07 and 2.25 +/- 1.10 (mean +/- standard error) years, respectively. During the average 11-year disease course, two-fold increase observed in accompanying diseases. Conclusion: Our study shows that psoriasis starts with the skin involvement, nail and joint involvement develop later. Psoriasis vulgaris is the most frequently observed clinical morphology; scalp is the most commonly affected skin area at the onset of the disease. Over time, the number of comorbidities accompanying psoriasis increases.