The characteristics of severe forms of psoriasis on pigmented skins: A retrospective study of 102 cases in Dakar, Senagal

Background: Severe forms of psoriasis can be life-threatening for patients. Our objective was to determine the epidemiological, clinical, therapeutic aspects and outcome of severe forms of psoriasis. Methodology: A 18 years retrospective study conducted in the department of Dermatology at Le Dantec hospital listed all the severe forms of psoriasis. Results: We have collected 102 cases of severe forms. The sex ratio was 1.55 and the average age of 47 years. The family histories of psoriasis were reported in 5 patients. Arterial hypertension was noted in 10 patients, diabetes in 4 patients and obesity in 6 patients. Smoking and alcoholism were found respectively in 10 cases and 7 cases. The average duration of the lesions was 2 years. Phytotherapy was reported in 62 patients (62%). Pruritus was present in 86 patients (84%). The clinical forms of psoriasis were: erythroderma in 76 cases (74.5%), psoriatic arthritis in 14 cases (13.7%) and a pustular form in 12 cases (11%). HIV serology was positive in 12 patients. All patients had received a treatment with topical corticosteroids and emollients. Methotrexate was initiated in 57 patients and retinoids in 27 cases. The outcome was favorable in 67 patients (65%). We recorded 6 deaths (6%). Conclusion: The large use of oral phytotherapy medicines and inappropriate treatment precipitated or speeded up the occurrence of severe forms of psoriasis among our patients.