Psoriasis Comorbidities at Hospital Calderón Guardia

Prevalence of Metabolic Comorbidities, Atherosclerotic Arterial Disease, and Psoriatic Arthritis in Patients With Psoriasis and Their Association With Clinical Severity and Therapeutic Profile Among Patients Treated at Hospital Rafael Ángel Calderón Guardia During 2024-2025

The goal of this observational study is to characterize the epidemiologic, clinical, severity, and therapeutic features of patients with psoriasis treated in Costa Rica between 2024 and 2025. The main questions it aims to answer are:

What are the demographic and clinical characteristics and severity profiles of psoriasis patients?

What treatments are used in routine clinical practice, and how are they associated with disease severity and outcomes?

Patients with psoriasis receiving dermatologic care during the study period will be included. Data will be obtained retrospectively from electronic medical records and clinical registries without intervention or modification of treatment.

Study Overview

• Status: Not yet recruiting
• Conditions: Psoriasis; Psoriasis (PsO); Psoriasis Arthritis; Psoriasis Patients

Detailed Description

Psoriasis is a chronic immune-mediated inflammatory dermatosis with variable severity, systemic associations, and substantial quality-of-life impact. Although multiple topical, phototherapy, systemic, and biologic treatments are available, real-world epidemiologic and therapeutic data in Costa Rica remain limited. This study is a retrospective observational characterization of psoriasis patients treated between 2024 and 2025. Unlike interventional trials evaluating specific drugs or prospective registries of targeted therapies, this study analyzes existing clinical records to describe demographic distribution, clinical subtypes, severity (PASI/BSA/DLQI), comorbidities, and treatment patterns across routine care. It does not introduce therapeutic modifications or standardized follow-up, but reflects real-world management decisions across disease severities. By capturing population-level data on psoriasis presentation and treatment in Costa Rica, the study provides baseline national evidence distinct from drug-specific or interventional psoriasis studies.

• Study Type: Observational
• Enrollment (Estimated): 350

Contacts and Locations

• Study Contact: Name: Daniel E Barquero-Orias, Dermatologist; Phone Number: +506 83411026; Email: debarque@ccss.sa.cr

Study Locations

• Costa Rica
  • Provincia de San José
    • San José, Provincia de San José, Costa Rica, 40901
      • Caja Costarricense del Seguro Social
      • Contact: Daniel E Barquero-Orias, Dermatologist; Phone Number: +506 83411026; Email: debarque@ccss.sa.cr
      • Sub-Investigator: Daniel E Barquero-Orias, Dermatologist
      • Sub-Investigator: Benjamin Hidalgo-Matlock, Dermatologist
      • Principal Investigator: Pamela Cambronero-Ulate, Dermatology Resident

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population comprises adolescents and adults (≥12 years) with a confirmed diagnosis of psoriasis documented in the Electronic Health Record (EHR-EDUS) of Hospital Calderón Guardia who were evaluated in outpatient dermatology or rheumatology clinics between 2024 and 2025. Eligible patients received systemic therapy and/or phototherapy for psoriasis and had sufficient clinical information to assess disease severity, metabolic comorbidities, atherosclerotic cardiovascular disease, and psoriatic arthritis. This hospital-based cohort reflects real-world patients with moderate-to-severe psoriasis managed in specialized care within the Costa Rican public health system during the study period.

Description

Inclusion Criteria:

• Patients evaluated in outpatient clinics during the period 2024-2025.
• Patients receiving systemic therapy and/or phototherapy.
• Patients aged 12 years or older, of any sex.
• Availability of sufficient clinical information to assess psoriasis severity, metabolic comorbidities, atherosclerotic cardiovascular disease, and psoriatic arthritis.
• At least one dermatologic or rheumatologic evaluation recorded in the Electronic Health Record (EHR-EDUS) during the study period.
• Confirmed diagnosis of psoriasis documented in the Electronic Health Record (EHR-EDUS) of Hospital Calderón Guardia.

Exclusion Criteria:

• Clinical records insufficient to evaluate psoriasis severity, comorbidities, or therapeutic profile.
• Patients managed exclusively with topical therapies.
• Duplicate or inconsistent records, preventing accurate patient classification.
• Cutaneous conditions not compatible with psoriasis.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prevalence of Metabolic Comorbidities in Patients With Psoriasis	Proportion (%) of patients with documented diagnosis of obesity (BMI ≥30 kg/m²), diabetes mellitus (prior diagnosis or HbA1c ≥6.5%), hypertension (prior diagnosis or BP ≥140/90 mmHg), dyslipidemia (prior diagnosis or abnormal lipid profile), and metabolic syndrome.	2024-2025
Prevalence of Atherosclerotic Cardiovascular Disease	Proportion (%) of patients with documented history of coronary artery disease, myocardial infarction, angina/revascularization, ischemic stroke, or peripheral arterial disease.	2024-2025
Prevalence of Psoriatic Arthritis	Proportion (%) of patients with rheumatologist-confirmed diagnosis of psoriatic arthritis, including characterization of predominant clinical domain (peripheral arthritis, axial involvement, enthesitis, dactylitis).	2024-2025

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psoriasis Severity	Psoriasis Area and Severity Index (PASI), continuous score (0-72), categorized as mild (<10), moderate (10-20), or severe (>20).	2024-2025
Psoriasis Severity	Body Surface Area (BSA) Affected, percentage of body surface area affected by psoriasis	2024-2025
Association Between Psoriasis Severity and Comorbidities	Statistical association between severity categories and presence of metabolic comorbidities, atherosclerotic disease, and psoriatic arthritis using chi-square, Fisher's exact test, t-test or Mann-Whitney U test.	2024-2025
Inflammatory and Metabolic Biomarkers	Continuous values of C-reactive protein, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, cardiac troponin, B-type natriuretic peptide, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, fasting plasma glucose, glycated hemoglobin, serum creatinine, estimated glomerular filtration rate, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and total bilirubin.	2024-2025

Collaborators and Investigators

• Sponsor: Caja Costarricense de Seguro Social

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): May 1, 2027
• Study Completion (Estimated): May 1, 2027

Study Registration Dates

• First Submitted: February 26, 2026
• First Submitted That Met QC Criteria: March 2, 2026
• First Posted (Actual): March 4, 2026

Study Record Updates

• Last Update Posted (Actual): April 8, 2026
• Last Update Submitted That Met QC Criteria: April 2, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Psoriasis; Epidemiology; Costa Rica; Real-world data; Comorbidities; Disease severity
• Additional Relevant MeSH Terms: Skin Diseases, Papulosquamous; Skin Diseases; Skin and Connective Tissue Diseases; Psoriasis
• Other Study ID Numbers: CEC HCG 03-2026

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: According to the protocol.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No