Clinical features and severity of psoriasis: a comparison of facial and nonfacial involvement in Iran.

BACKGROUND Facial involvement in psoriasis is accomplished with poor prognosis. In this study, clinical features and severity of psoriasis were compared between facial and nonfacial psoriasis involvement groups in Iran. It also evaluated these characteristics in different subtypes of facial psoriasis. METHODS One hundred and thirty- eight psoriatic patients having referred to our clinic entered in this cross- sectional study in 2006 - 2007. Medical information, whole body and scalp Psoriasis Area and Severity Index (PASI) scores were obtained. Variables were compared between the facial and nonfacial involvement groups and also in different subtypes of the former including peripherofacial (PF), centrofacial (CF), and mixedfacial (MF). A P-value of < 0.05 was considered as significant. RESULTS We found 55.0% facial involvement in Iranian psoriatic patients. MF (52.6%), CF (28.9%), and PF (18.4%), respectively were the common forms of facial involvement. The median whole body and scalp PASI scores, the number of male participants, and tongue involvement were significantly higher in patients with facial involvement. Comparing different subtypes of facial psoriasis, whole body PASI and scalp PASI scores were significantly higher in MF subtype and lower in CF subtype. Despite the least severity in the latter subtype, psoriatic arthritis and geographic tongue were shown to be more common in this subtype. Moreover, relapse history was correlated with PF subtype. CONCLUSIONS Facial involvement in psoriasis had significantly higher whole body and scalp PASI scores in Iran which may be an indication of more severe disease. This difference was more prominent in MF subtype.