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RESEARCH · September 05, 2014

TAKE-HOME MESSAGE

• In this prospective study, prevalence of Dupuytren contractures was increased in patients with psoriasis (19.6%) compared with the non-psoriasis population (3.6%). Even greater prevalence rates were seen in those with palmoplantar involvement or intertriginous psoriasis.
• Assessment for Dupuytren contractures in patients with psoriasis may allow for earlier referral and better management.

– Joshua Arbesman, MD

ABSTRACT

BACKGROUND

Dupuytren contracture (DC) is a fibrocontractile disease of the palms, affecting approximately 4% of the population, while psoriasis is an immune-mediated disease, affecting 2% of the population. Through clinical observation in our psoriasis clinic, we found an apparent increased prevalence of DC in patients with psoriasis compared with the general population. This has not previously been statistically verified in a clinical study.

AIM

To evaluate the prevalence of DC in the full range of clinical psoriasis phenotypes.

METHODS

In total, 98 patients with psoriasis attending our psoriasis clinic were examined for DC, based on predetermined criteria. In addition, 84 patients with DC, obtained from a specialist hand clinic, were assessed using a validated psoriasis questionnaire. We utilized Bayes theorem and bootstrap simulation to calculate the conditional prevalence of DC, then we used the results to compare the prevalence of DC between patients with psoriasis and a nonpsoriasis population.

RESULTS

The percentage of patients with DC was 19.6% in the psoriasis population and 3.6% in the nonpsoriasis population. Development of DC showed a phenotypic predilection, with 39.1% of patients with predominantly palmoplantar involvement and 38.9% of patients with intertriginous psoriasis developing DC compared with 12.7% of patients with psoriasis who did not have these two phenotypical presentations.

CONCLUSIONS

Our data show a positive correlation between psoriasis and DC. Patients with the palmoplantar phenotype of psoriasis were more likely to develop DC. By understanding this relationship, dermatologists may diagnose DC early in its onset in patients with psoriasis, prompting referral to hand surgeons when appropriate.

Clinical and Experimental Dermatology
The Prevalence of Dupuytren Contractures in Patients With Psoriasis

Clin Exp Dermatol 2014 Sep 05;[EPub Ahead of Print], M Patel, NR Freeman, S Dhaliwal, N Wright, Y Daoud, C Ryan, AV Dibella, A Menter

Journal Reference