The burden of palmoplantar pustulosis: A Canadian population-based study of inpatient care, emergency departments, and outpatient clinics

Jean-Eric Tarride; Vimal H Prajapati; Charles Lynde; Gord Blackhouse

doi:10.1016/j.jdin.2023.04.002

The burden of palmoplantar pustulosis: A Canadian population-based study of inpatient care, emergency departments, and outpatient clinics

JAAD Int. 2023 Apr 15:12:151-159. doi: 10.1016/j.jdin.2023.04.002. eCollection 2023 Sep.

Authors

Jean-Eric Tarride^{1

2

3}, Vimal H Prajapati⁴, Charles Lynde⁵, Gord Blackhouse¹

Affiliations

¹ Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
² Programs for Assessment of Technology in Health (PATH), The Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare, Hamilton, Canada.
³ Center for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
⁴ Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Canada; Section of Community Pediatrics, Department of Pediatrics, University of Calgary, Calgary, Canada; Section of Pediatric Rheumatology, Department of Pediatrics, University of Calgary, Calgary, Canada; Skin Health & Wellness Centre, Calgary, Canada; Dermatology Research Institute, Calgary, Canada; Probity Medical Research, Calgary, Canada.
⁵ Department of Medicine, University of Toronto, Toronto, Canada.

Abstract

Background: Not much is known about the burden of palmoplantar pustulosis (PPP).

Objectives: To document the burden of PPP in Canada, and to compare with psoriasis vulgaris (PV).

Methods: Adult Canadians (excluding the province of Quebec) hospitalized or visiting an emergency department (ED) or hospital-/community-based clinic between April 1, 2007, and March 31, 2020, with a diagnostic code indicating PPP (ICD-10-CA: L40.3) or PV (ICD10-CA: L40.9 or L40.0) were identified using Canadian administrative data. 10-year prevalent- and 3-year incident-based approaches were conducted. Costs were determined when the most responsible diagnosis (MRD) for the admission was PPP or PV (MRD costs) and for all reasons (all-cause costs).

Results: In the prevalence analysis, the 10-year mean (standard deviation [SD]) and MRD costs were $544 ($1874) for PPP and $222 ($1828) for PV (P < .01). In the incidence analysis, PPP patients had higher 3-year mean (SD) MRD costs ($1078 [$2705]) than PV ($503 [$2267]) (P < .01). All-cause costs were lower for the PPP cohort in the prevalent and incident analyses. There were no differences in all-cause inpatient mortality between PPP and PV.

Limitations: Physician and prescription data were not available.

Conclusion: PPP patients incurred significantly higher MRD costs than PV patients.

Keywords: Canada; all-cause inpatient mortality; healthcare expenditures; palmoplantar pustulosis.