Clinical and economic burden of psoriasis: a retrospective study of the cost implications among cohorts in Abuja, Nigeria


  • Bob A. Ukonu Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
  • Perpetua U. Ibekwe Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria



Psoriasis, Level of severity, Cost of treatment, Economic burden, PASI


Background: Psoriasis is a common chronic cutaneous inflammatory disorder of the skin which presents as sharply demarcated scaly erythematous papules or plaques. The level of its clinical severity at presentation largely determines the cost implications and economic burden on the patient. The study aimed to determine the direct cost of treating various clinical severity of psoriasis and its economic consequences to our healthcare system.

Methods: This is a retrospective study that was conducted between May 2016 and October 2019 at the Dermatology Unit of University of Abuja Teaching Hospital. Data was retrieved from patient’s folder into a designed proforma, noting their biodata, clinical level of severity using psoriasis area severity index (PASI) score, amount of money spent on drugs, laboratory test, nursing time and consultation fees.

Results: Out of 82 psoriasis patients seen during the study period, 66 fulfilled the inclusion criteria. About 51.5% of them had severe psoriasis with a mean PASI score 33.2. The annual cost of treating mild, moderate and severe psoriasis was N198,900.00, N261,633.00 and N323,708.00 respectively. This accounted for 1.77% of the national annual healthcare spending within the years under review.

Conclusions: The cost of treating psoriasis and its economic burden is largely determined by the level of its clinical severity.


Institute for Health Metrics and Evaluation (HME). Global Burden of Diseases Study 2010. Results by cause 1990-2010. Seattle: IHME; 2012.

Gibbs S. Skin disease and social economic conditions in rural Africa: Tanzania. Int J Dermatol. 1996;35(9):633-9.

Danielsen K, Olsen AO, Wilsgaard T, Furberg AS. Is the prevalence of Psoriasis increasing? A 30 years follow up population-based cohort. Br J Dermatol 2013;168:1303-10.

Christopher Z. Psoriasis epidemiology and clinical spectrum. Clin Exp Dermatol. 2001;26:314-20.

Shrank AB, Harman RR. The incidence of Skin diseases in Nigerian Dermatology clinic. Br J Dermatolo. 1966;78:235-41.

Fekete E. The Pattern of diseases of the skin in the Nigerian Guinea Savanna. Int J Dermatol. 1978;17:331-8.

Nnoruka EN. Skin diseases in the South East Nigeria. A current perspective. Int J Dermatol. 2005;44:29-33.

Ogunbiyi AO, Daramola OO, Alese OO. Prevalence of skin diseases in Ibadan Nigeria. Int J Dermatol. 2004;43:31-6.

Onayemi O, Isezuo SA, Njoku CH. Prevalence of different skin conditions in outpatients setting in Northwestern Nigeria. Int J Dermatol. 2005;44:7-11.

International Federation of Psoriasis Associations’ World Psoriasis Day 2015. Available at Accessed on April 2017.

Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263-71.

Nestle FO, Kaplan DH, Barker J. Psoriasis. N Engl J Med. 2009;361:496-509.

Harde JL, Kruger JG, Bowcock AM. The immunogenesis of psoriasis: a comprehensive review. J Autoimmun. 2015;64:66-73.

Boehncke WH, Schon MP. Psoriasis. Lancet. 2015;386(999):983-94.

Eder L. Genetic and Environmental Risk factors for psoriatic arthritis among patients with psoriasis. PhD Thesis, Institute for Medical Science, University of Toronto. Available at https://www. Accessed on 16 December 2014.

Anyanlowo O, Akinkugbe AY. Clinical pattern of psoriasis in patients seen at a tertiary hospital in Nigeria. J Clin Sci. 2016:137-42.

Raychaudhuri SP, Gross J. Psoriasis risk factors: role of lifestyle practices. Cutis. 2000;66:348-52.

Alshanii MA. Clinical Profile of psoriasis in Yemen, a 4 years retrospective study of 241 patients. J Eur Acad Dermatol Venerol. 2010;24(4): 14.

Falodun OA. Characteristics of patients with psoriasis seen at the Dermatology clinic of a tertiary hospital in Nigeria: a 4 years review 2008-2012. J Eur Acad Dermatol Venerol. 2013;7.

Reich K, Kruger K, Mossner R, Augustin M. Epidemiology and clinical pattern of psoriatic arthritics in Germany: a prospective interdisciplinary epidemiological study of 151 patients with plaque-type psoriasis. Br J Dermatol. 2009;160(5):1040-7.

Young H, Takeshita J, Mehta NN, Kimmel SE, Ogdie A, Margolis DJ, et al. Psoriasis severity and prevalence of major medical comorbidity: a population-based study. JAMA Dermatol. 2013;149:1173-9.

Ukonu BA, Ibekwe PU. Metabolic syndrome and clinical characteristics profile among psoriasis patients in Nigeria. Quest J. 2016;3(3):1-8.

Hayes J, Koo J. Psoriasis: Depression, anxiety, smoking, and drinking habits. Dermatol Therapy. 2010;23(20):174-80.

Raboobee, Aboobaker J, Jordaan HF. Guideline on the management of psoriasis in South Africa. S Afr Med J. 2010;100:255-82.

Menter A, Korman NJ, Elmets CA. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 4 guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009;61:451-85.

Brezinski EA, Dhillon JA, Armstrong AW. Economic Burden of Psoriasis in the united states: A systematic Review. JAMA Dermatol. 2015;151(6): 658-751.

Dehkharghanis S, Bride J, Chen JG. The economic burden of skin disease in the united states. J Am Acad Dermatol. 2003:48:592-9.

Navarini AA, Laffittle H, Conradc, Piffaretti P, Brock E, Ruckdaeschel S, et al. Estimation of cost-of-illness in patients with psoriasis in Switzerland. Swiss Med wkly. 2010;140(5-6):85-91.

Feldman SR, Fleischer AB, Reboussin DM. The economic impact of Psoriasis increases with Psoriasis severity. JAMA Acad Dermatol. 1997:37:5464-559.

Altobelli E, Maccarone M, Petrocelli R. Analysis of healthcare and actual needs of patients with Psoriasis: a survey on the Italian Population. BMC Public Health. 2007;7:59.

Finlay AY. Severe psoriasis and the rule of tens. BR J Dermatol. 2005;152:861-7.

Berger K, Ehlken B, Kugland B, Augustin M. Cost-of-illness in patients with moderate and severe chromic psoriasis vulgaris in Germany. J Dtsch Dermatol GES. 2005;3(7):511-8.

Obradors M, Figueras M, Paz S, Comellas M, Lizan L. Cost of psoriasis in Europe. A systematic Review of literature. Value Health J. 2014;17(7):606.

Eghlileb AM, Davis EEG, Finlay AY. Psoriasis has a major secondary impact on the lives of family members and partners. Clin Lab Invest. 2007;156(6):1245-50.

Pariser D, Schenkel B, Carter C, Farahi K, Brown TM, Ellis CN. Psoriasis patient Literature review study Group. A multicenter non-interventional study to evaluate Patient-reported experiences of living with psoriasis. J Dermatol Treat. 2015;1-8.

Nigeria Population 2020. Available at

Horn EJ, Fox KM, Patel V, Chiou CF, Dann F, Labwohl M. Association of Patient-reported Psoriasis severity with income and employment. J AMACAD Dermatol. 2007;47(6):963-71.

Nigeria National Minimum Wage. Available at






Original Research Articles