Clinical and Psychosocial Differences in Early and Late-Onset Psoriasis: A Comparative Study

Background: Psoriasis is a chronic inflammatory skin disease mediated by the immune system, known for significantly impacting psychosocial well-being. This study aims to compare clinical and psychosocial characteristics between early-onset (< 40 years) and late-onset (≥ 40 years) psoriasis patients. Methods: This cross-sectional study included 190 patients diagnosed with psoriasis. Patients were categorized into early-onset (n = 135) and late-onset (n = 55) groups. Data on demographics, clinical features, comorbidities, and psychosocial factors were collected. The Hospital Anxiety and Depression (HAD) scale and the Dermatology Life Quality Index (DLQI) were used to assess psychological impact and quality of life. Statistical analyses included chi-square tests, t-tests, and correlation analyses. Results: Early-onset patients were more likely to have a family history of psoriasis (43.7% vs. 16.4%, p < 0.001). Pustular psoriasis was more prevalent in the late-onset group (27.3% vs. 11.1%, p = 0.006). A significant positive correlation was found between DLQI scores and HAD-Total, HAD-A, and HAD-D scores (p < 0.001). Psychological stress was reported as a disease trigger by 63.1% of patients, with a higher proportion in the early-onset group (p = 0.025). Despite no significant difference in DLQI and HAD scores between the groups, early-onset patients showed higher sensitivity to stress. Conclusions: Early-onset psoriasis patients are more likely to report stress as a trigger and have a stronger family history, while late-onset patients exhibit higher rates of pustular psoriasis and increased BMI. These findings highlight the need for tailored management strategies addressing the distinct clinical and psychosocial needs of early and late-onset psoriasis patients. Future research should focus on longitudinal studies to better understand these relationships.