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 PSORIASIS 2010 Congress of the Psoriasis International Network PARIS, July 1-4, 2010 Palais des Congr è s

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 (2009.Nov.23-Dec. 12) ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●

New Data 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) % in first degree relatives % in first degree relatives % in second degree relatives % in second degree relatives in third degree relatives 9.76 % in third degree relatives Genetic epidemiology

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

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

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

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

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

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% ）。

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% ）。 Comorbiditiesin psoriatic patients Comorbidities in psoriatic patients

Management Systemic therapy; Topical therapy; Patient education.

79.55% (3809/4788) 79.55% (3809/4788) Traditional Chinese Medicine 89.47% Acitretin 22.06% Traditional Chinese Medicine 89.47% Acitretin 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 treatment

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

Topical 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 therapy 26.54%: 1244/ %: 1244/4688 NB-UVB ＞ 50% NB-UVB ＞ 50% UVB UVB PUVA PUVA

Insurance and treatment costs 71.2% patients have a social medical insurance (non-commercial), and 7.43% patients attend other commercial medical insurance 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 。 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 。

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. 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 The duration in the hospital is 27.26±46.27d ， mean spent is $1100±1200 ， and the patients 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 % 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 !  Beijing  Shanghai  Hangzhou

Zhejiang Univ. School of Med.