Research Explores Sex Differences in Generalized Pustular Psoriasis, Highlights Female Preponderance

The sex differences, as well as other demographic differences, between GPP patients were assessed in a recent research letter.

Vinod E. Nambudiri, MD, MBA

The greater likelihood of a patient being female if they have generalized pustular psoriasis (GPP), a majority of GPP patients being hospitalized in the American south, and genetic factors relating to GPP were all elements highlighted in a recent research letter.

The research was conducted to assess sex differences for GPP patients and was led by Vinod E. Nambudiri, MD, MBA, from the Department of Dermatology at Brigham and Women’s Hospital in Boston.

“Generalized pustular psoriasis (GPP) is a rare subtype of psoriasis characterized by the formation of painful pustules alongside widespread inflammation, “ Nambudiri and colleagues wrote. “We sought to explore demographic differences in GPP hospitalizations using a national database of hospital encounters.”

The research team used National Inpatient Sample (NIS) data from the period of 2016 to 2020 to assess the demographic distinctions between male and female GPP patients.

The NIS is known for being a stratified sample of publicly-accessible data representing about 20% of all inpatient hospitalizations from across the country.

Background and Findings

The investigators used the NIS data gathered data on GPP patient demographics, including sex, patient’s insurance status, race, quartile classification of the patient zip code’s residents’ estimated median household income, region of hospital census, and urban-rural code.

The team also gathered information on the cost for patient’s care and the length of their hospital stays, with this and the aforementioned data being collected and separated into cohorts by sex.

The investigators identified 860 patients in their research who had GPP diagnoses, and the sample gathered was reported to be 64% female, around 37% recipients of Medicare, and around 57% White.

They identified the common age among men with GPP diagnoses as being in the range of 40 to 59, contrasting with the female range which was over 60 years.

They also noted that about 27% of those hospitalized for the condition were Black, compared to around 11.5% of those in the male arm.

No statistical significance was identified when the researchers compared GPP patients by race (P = 0.056), but hospitalizations of women with GPP were found to be in greater number in the South at a rate of 42.7%.

Lastly, the investigators noted that average hospitalization length was slightly lower for males than females (4.9 days versus 6.3, respectively), but care costs, insurance status, and median incomes were all found to be relatively similar between both sexes.

“Consistent with a prior study, our data on demographic information suggests that there is a female preponderance among patients with GPP,” they wrote. “Additionally, our study highlights regional differences among GPP hospitalizations, with which a majority of female patients with GPP were hospitalized in the southern region of the United States. Underlying genetic factors may play a role in the increased frequency of GPP among female patients.”

The letter, “Exploring sex differences in generalized pustular psoriasis hospitalizations,” was published online in Experimental Dermatology.

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