{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:20:07Z","timestamp":1790698807851,"version":"4.1.0"},"reference-count":55,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Psoriatic disease is a chronic inflammatory disease that is associated with morbidity and a poor quality of life. However, studies on the trends of psoriatic disease incidence are limited. We examined trends in psoriasis and psoriatic arthritis from 2002 to 2016 in Taiwan and distinguished the effects of age, period, and cohort on those trends. Methods: Data from the National Health Insurance Research Database were analyzed for the annual incidence of psoriasis and psoriatic arthritis. An age\u2013period\u2013cohort model was designed in order to investigate the effects of each age, period, and birth cohort on the incidence. Results: From 2002 to 2016, the incidence of psoriasis significantly decreased from 43.33 to 23.14 per 100,000 persons. The incidence of psoriatic arthritis significantly increased from 3.57 to 5.22 per 100,000 persons. In the age\u2013period\u2013cohort analysis, the net age effect on the incidence of psoriasis and psoriatic arthritis increased with advancing age (6-fold and 7.7-fold difference, respectively). Conclusion: The age\u2013period\u2013cohort analysis revealed that the incidence of psoriasis and psoriatic arthritis is associated with older age and early birth cohorts. Elderly individuals in Taiwan may be at a higher risk of developing new-onset psoriasis and psoriatic arthritis.<\/jats:p>","DOI":"10.3390\/jcm11133744","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T01:48:38Z","timestamp":1656467318000},"page":"3744","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Time Trends in Psoriasis and Psoriatic Arthritis Incidence from 2002 to 2016 in Taiwan: An Age\u2013Period\u2013Cohort Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Yu-Tsung","family":"Chen","sequence":"first","affiliation":[{"name":"School of Public Health, College of Public Health, Taipei Medical University, Taipei 110, Taiwan"},{"name":"Department of Dermatology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Yi","family":"Wu","sequence":"additional","affiliation":[{"name":"Institute of Population Health Sciences, National Health Research Institutes, Miaoli 350, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4283-3978","authenticated-orcid":false,"given":"Yu-Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of Population Health Sciences, National Health Research Institutes, Miaoli 350, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Health Data Analytics and Statistics Center, Office of Data Science, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Yi","family":"Chiou","sequence":"additional","affiliation":[{"name":"School of Public Health, College of Public Health, Taipei Medical University, Taipei 110, Taiwan"},{"name":"Institute of Population Health Sciences, National Health Research Institutes, Miaoli 350, Taiwan"},{"name":"Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taipei 110, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1056\/NEJMra0804595","article-title":"Psoriasis","volume":"361","author":"Nestle","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1111\/j.1365-2133.2007.08068.x","article-title":"Obesity in psoriasis: The metabolic, clinical and therapeutic implications. Report of an interdisciplinary conference and review","volume":"157","author":"Sterry","year":"2007","journal-title":"Br. J. Dermatol."},{"key":"ref_3","first-page":"40","article-title":"Smokers Report More Psoriasis, but Not Atopic Dermatitis or Hand Eczema: Results from a Norwegian Population Survey among Adults","volume":"216","author":"Thoresen","year":"2007","journal-title":"Dermatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1046\/j.1468-3083.2001.00192.x","article-title":"The prevalence of psoriasis in the world","volume":"15","author":"Raychaudhuri","year":"2001","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jdermsci.2011.03.002","article-title":"Epidemiology and comorbidities of psoriasis patients in a national database in Taiwan","volume":"63","author":"Tsai","year":"2011","journal-title":"J. Dermatol. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"385","DOI":"10.3899\/jrheum.170516","article-title":"Epidemiology and Medication Pattern Change of Psoriatic Diseases in Taiwan from 2000 to 2013: A Nationwide, Population-based Cohort Study","volume":"45","author":"Wei","year":"2018","journal-title":"J. Rheumatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.dsi.2018.06.001","article-title":"Psoriasis in Taiwan: From epidemiology to new treatments","volume":"36","author":"Chiu","year":"2018","journal-title":"Dermatol. Sin."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0140-6736(07)61128-3","article-title":"Pathogenesis and clinical features of psoriasis","volume":"370","author":"Griffiths","year":"2007","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1111\/j.1365-2133.2011.10688.x","article-title":"HLA polymorphism among Chinese patients with chronic plaque psoriasis: Subgroup analysis","volume":"166","author":"Chiu","year":"2011","journal-title":"Br. J. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1111\/pde.12568","article-title":"Epidemiology of Frequently Occurring Skin Diseases in Italian Children from 2006 to 2012: A Retrospective, Population-Based Study","volume":"32","author":"Cantarutti","year":"2015","journal-title":"Pediatr. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1111\/bjd.15021","article-title":"Incidence, prevalence and mortality of patients with psoriasis: A U.K. population-based cohort study","volume":"176","author":"Springate","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_12","first-page":"593","article-title":"Incidence of psoriasis and association with comorbidities in Italy: A 5-year observational study from a national primary care database","volume":"20","author":"Altomare","year":"2010","journal-title":"Eur. J. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"301","DOI":"10.4143\/crt.2019.194","article-title":"Time Trends for Prostate Cancer Incidence from 2003 to 2013 in South Korea: An Age-Period-Cohort Analysis","volume":"52","author":"Lee","year":"2020","journal-title":"Cancer Res. Treat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"8589","DOI":"10.7314\/APJCP.2015.16.18.8589","article-title":"Age-Period-Cohort Analysis of Liver Cancer Mortality in Korea","volume":"16","author":"Park","year":"2015","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1016\/j.socscimed.2009.08.040","article-title":"Do birth cohorts matter? Age-period-cohort analyses of the obesity epidemic in the United States","volume":"69","author":"Reither","year":"2009","journal-title":"Soc. Sci. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e2018062","DOI":"10.4178\/epih.e2018062","article-title":"Data resource profile: The National Health Insurance Research Database (NHIRD)","volume":"40","author":"Lin","year":"2018","journal-title":"Epidemiol. Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1016\/j.jid.2017.01.036","article-title":"All-Cause and Cause-Specific Mortality in Patients with Psoriasis in Taiwan: A Nationwide Population-Based Study","volume":"137","author":"Lee","year":"2017","journal-title":"J. Investig. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z","article-title":"Permutation tests for joinpoint regression with applications to cancer rates","volume":"19","author":"Kim","year":"2000","journal-title":"Stat. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1002\/sim.4780060405","article-title":"Models for temporal variation in cancer rates. I: Age-period and age-cohort models","volume":"6","author":"Clayton","year":"1987","journal-title":"Stat. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1002\/sim.4780060406","article-title":"Models for temporal variation in cancer rates. II: Age-period-cohort models","volume":"6","author":"Clayton","year":"1987","journal-title":"Stat. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"m1590","DOI":"10.1136\/bmj.m1590","article-title":"National, regional, and worldwide epidemiology of psoriasis: Systematic analysis and modelling study","volume":"369","author":"Parisi","year":"2020","journal-title":"BMJ"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1046\/j.1365-2133.2003.05166.x","article-title":"A study of candidate genes for psoriasis near HLA-C in Chinese patients with psoriasis","volume":"148","author":"Chang","year":"2003","journal-title":"Br. J. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/bjd.19169","article-title":"Systematic review examining changes over time and variation in the incidence and prevalence of psoriasis by age and gender","volume":"184","author":"Iskandar","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_24","first-page":"504","article-title":"Prevalence of Psoriasis in Spain in the Age of Biologics","volume":"105","author":"Carrascosa","year":"2014","journal-title":"Actas Dermosifiliogr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1111\/jdv.15762","article-title":"Incidence and prevalence of psoriasis in Israel between 2011 and 2017","volume":"33","author":"Schonmann","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"262","DOI":"10.2340\/00015555-0642","article-title":"Epidemiological Study of Psoriasis in the National Health Insurance Database in Taiwan","volume":"89","author":"Chang","year":"2009","journal-title":"Acta Derm. Venereol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1016\/j.ypmed.2011.11.011","article-title":"Age-associated chronic diseases require age-old medicine: Role of chronic inflammation","volume":"54","author":"Prasad","year":"2012","journal-title":"Prev. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1111\/jdv.16099","article-title":"Bodyweight variability and the risk of psoriasis: A nationwide population-based cohort study","volume":"34","author":"Kim","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Kim, H.-N., Han, K., Song, S.-W., and Lee, J.H. (2018). Hypertension and risk of psoriasis incidence: An 11-year nationwide population-based cohort study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0202854"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1038\/s41598-017-01983-y","article-title":"Impact of metabolic status on the incidence of psoriasis: A Korean nationwide cohort study","volume":"7","author":"Kim","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"20285","DOI":"10.1038\/s41598-020-77306-5","article-title":"Association between obesity and education level among the elderly in Taipei, Taiwan between 2013 and 2015: A cross-sectional study","volume":"10","author":"Hsieh","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_32","unstructured":"(2021, June 09). Directorate-General of Budget, Accounting and Statistics, Executive Yuan, R.O.C. (Taiwan), Available online: https:\/\/www.stat.gov.tw\/public\/Data\/169152483HCL2D3O.pdf."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1001\/jamadermatol.2013.5264","article-title":"Undertreatment, treatment trends, and treatment dissatisfaction among patients with psoriasis and psoriatic arthritis in the United States: Findings from the National Psoriasis Foundation surveys, 2003\u20132011","volume":"149","author":"Armstrong","year":"2013","journal-title":"JAMA Dermatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/S0190-9622(96)90676-3","article-title":"Utilization of outpatient care for psoriasis","volume":"35","author":"Stem","year":"1996","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"361","DOI":"10.3899\/jrheum.080691","article-title":"Time Trends in Epidemiology and Characteristics of Psoriatic Arthritis over 3 Decades: A Population-based Study","volume":"36","author":"Wilson","year":"2009","journal-title":"J. Rheumatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1136\/annrheumdis-2016-210963","article-title":"Incidence and prevalence of psoriatic arthritis in Denmark: A nationwide register linkage study","volume":"76","author":"Egeberg","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.jdermsci.2016.08.535","article-title":"Epidemiology of psoriatic disease and current treatment patterns from 2003 to 2013: A nationwide, population-based observational study in Taiwan","volume":"84","author":"Wang","year":"2016","journal-title":"J. Dermatol. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.jaad.2021.09.019","article-title":"Incidence and prevalence of psoriatic arthritis in patients with psoriasis stratified by psoriasis disease severity: Retrospective analysis of an electronic health records database in the United States","volume":"86","author":"Merola","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"151949","DOI":"10.1016\/j.semarthrit.2021.12.013","article-title":"Time to transition from psoriasis to psoriatic arthritis: A population-based study","volume":"52","author":"Karmacharya","year":"2021","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1136\/annrheumdis-2017-211109","article-title":"The preclinical phase of PsA: A challenge for the epidemiologist","volume":"76","author":"Ogdie","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1146\/annurev-soc-070308-120011","article-title":"Social Relationships and Health Behavior Across the Life Course","volume":"36","author":"Umberson","year":"2010","journal-title":"Annu. Rev. Sociol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S1499-4046(06)60265-0","article-title":"An Overview of the Life Course Perspective: Implications for Health and Nutrition","volume":"37","author":"Wethington","year":"2005","journal-title":"J. Nutr. Educ. Behav."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1353\/dem.0.0000","article-title":"Trends in U.S. adult chronic disease mortality, 1960\u20131999: Age, period, and cohort variations","volume":"45","author":"Yang","year":"2008","journal-title":"Demography"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"997","DOI":"10.2105\/AJPH.2012.300993","article-title":"Education: A Missed Opportunity for Public Health Intervention","volume":"103","author":"Cohen","year":"2013","journal-title":"Am. J. Public Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"djv107","DOI":"10.1093\/jnci\/djv107","article-title":"Female Breast Cancer Incidence Among Asian and Western Populations: More Similar Than Expected","volume":"107","author":"Sung","year":"2015","journal-title":"JNCI J. Nat. Cancer Inst."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"J314","DOI":"10.1016\/j.jaut.2009.12.001","article-title":"Geoepidemiology and environmental factors of psoriasis and psoriatic arthritis","volume":"34","author":"Chandran","year":"2010","journal-title":"J. Autoimmun."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2849","DOI":"10.1007\/s12325-019-01049-7","article-title":"Humanistic and Economic Impact of Moderate to Severe Plaque Psoriasis in Brazil","volume":"36","author":"Lopes","year":"2019","journal-title":"Adv. Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.jdin.2021.02.003","article-title":"Societal impact for patients with psoriasis: A nationwide Swedish register study","volume":"3","author":"Wettermark","year":"2021","journal-title":"JAAD Int."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1159\/000499924","article-title":"Socioeconomic Costs and Health Inequalities from Psoriasis: A Cohort Study","volume":"235","author":"Thomsen","year":"2019","journal-title":"Dermatology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1136\/annrheumdis-2016-210579","article-title":"Societal costs and patients\u2019 experience of health inequities before and after diagnosis of psoriatic arthritis: A Danish cohort study","volume":"76","author":"Kristensen","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"278","DOI":"10.5114\/reum.2016.64902","article-title":"Prevalence of psoriatic arthritis and costs generated by treatment of psoriatic arthritis patients in the public health system\u2013the case of Poland","volume":"54","author":"Raciborski","year":"2016","journal-title":"Rheumatology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1136\/annrheumdis-2013-204858","article-title":"Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis","volume":"74","author":"Haroon","year":"2014","journal-title":"Ann. Rheum. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"350","DOI":"10.3109\/09546630902817887","article-title":"Rheumatologists\u2019 recommendations on what to do in the dermatology office to evaluate and manage psoriasis patients\u2019 joint symptoms","volume":"20","author":"Taylor","year":"2009","journal-title":"J. Dermatolog. Treat."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/S0190-9622(03)02474-5","article-title":"Treatment of psoriatic arthritis with granulocyte and monocyte adsorption apheresis","volume":"50","author":"Kanekura","year":"2004","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1177\/0964528420920281","article-title":"Acupuncture for pain management in pediatric psoriatic arthritis: A case report","volume":"38","author":"Marchetti","year":"2020","journal-title":"Acupunct. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/13\/3744\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:39:44Z","timestamp":1760139584000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/13\/3744"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,28]]},"references-count":55,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["jcm11133744"],"URL":"https:\/\/doi.org\/10.3390\/jcm11133744","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,28]]}}}