Evidence map›Paper›PMID 40610872›Full record

Observational studyBMC immunology2025

Epidemiology and clinical features of psoriasis in hard-to-treat body locations: a Chinese nationwide population-based study.

Lingyi Lu, Lu Cao, Fan Jiang, Sihan Wang, Yingzhe Yu, Hua Huang, Bingjiang Lin

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lingyi LuDepartment of Dermatology, The First Affiliated Hospital of Ningbo University, No. 59, Liuting Street, Ningbo, Zhejiang, 315010, P.R. China.ORCID 0000-0003-4725-641X
Lu CaoDepartment of Dermatology, The First Affiliated Hospital of Ningbo University, No. 59, Liuting Street, Ningbo, Zhejiang, 315010, P.R. China.
Fan JiangDepartment of Dermatology, The First Affiliated Hospital of Ningbo University, No. 59, Liuting Street, Ningbo, Zhejiang, 315010, P.R. China.
Sihan WangDepartment of Dermatology, The First Affiliated Hospital of Ningbo University, No. 59, Liuting Street, Ningbo, Zhejiang, 315010, P.R. China.
Yingzhe YuDepartment of Dermatology, The First Affiliated Hospital of Ningbo University, No. 59, Liuting Street, Ningbo, Zhejiang, 315010, P.R. China.
Hua HuangDepartment of Rheumatology and Immunology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, P.R. China.
Bingjiang LinDepartment of Dermatology, The First Affiliated Hospital of Ningbo University, No. 59, Liuting Street, Ningbo, Zhejiang, 315010, P.R. China. linbingj@163.com.

Funding

Natural Science Fundation of Ningbo 2024J411
6 · The paper itself

Abstract

backgroundHaving psoriasis in hard-to-treat areas, such as the scalp, face, palms, soles, nails, and genitals, can suffer from a reduced quality of life. This study was designed to investigate the prevalence and risk factors of hard-to-treat body locations of psoriasis, and to describe patients' clinical and demographic characteristics, and quality of life impacts.

methodsWe conducted a multicenter observational epidemiological study involving over 1000 hospitals in China, enrolling a total of 7032 psoriasis patients. Groups were compared to patients without involvement of hard-to-treat areas.

resultsThe most frequently affected hard-to-treat area was the scalp (60.01%), followed by the face (22.47%), nails (18.87%), palms or soles (18.23%), genitals or vulvas (12.00%), respectively. Among all patients, 70.71%, 36.65%, 16.30%, 6.48% and 1.45% of patients had involvement of ≥ 1, ≥2, ≥ 3, ≥4 or ≥ 5 hard-to-treat areas. There was a male predominance among patients with involvement of at least one hard-to-treat area(P < 0.001). The smoking rate, BMI (body mass index) and psoriasis family history in patients with at least one hard-to-treat area involvement were significantly higher than those in patients without hard-to-treat area involvement (P < 0.001), especially among patients with nail involvement. With regards to current DLQI (dermatology life quality index), satisfactory rate, and current BSA (body surface area), these findings were all significantly different (P < 0.001) when compared to patients without involvement of a hard-to-treat area. Notably, even in mild-to-moderate psoriasis (BSA < 10), 65.10% of patients showed involvement of ≥ 1 hard-to-treat area, with significant impacts on quality of life (DLQI increase, all P < 0.001) and treatment satisfaction (P < 0.001 vs. non-involved).

conclusionPsoriasis commonly affects hard-to-treat locations, even in patients with mild to moderate disease (BSA < 10). The disproportionate impact on quality of life (particularly genital/face involvement) and treatment satisfaction underscores the need for: (1) routine assessment of these areas regardless of BSA, and (2) targeted management of modifiable risk factors (smoking, obesity). These findings support incorporating hard-to-treat area evaluation into psoriasis severity assessments and treatment algorithms.

Indexed as

PsoriasisAdolescentAdultAgedChinaEast Asian PeopleFemaleHumansMaleMiddle AgedPrevalenceQuality of LifeRisk FactorsYoung AdultChinaHard-to-treat body locationsPsoriasisRisk factor

Identifiers

PMID40610872
PMCPMC12225188

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.