Assessment of Psoriasis Incidence in Patients with Active Systemic Lupus Erythematosus

Document Type : Original Article (s)

Authors

1 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Rheumatologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Dermatologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Coincidence of systemic lupus erythematosus (SLE) and psoriasis is rare, but by consideration of skin involvement in both diseases and exacerbation of psoriasis with routine anti-malaria remedies used for lupus, assessment of coincidence of two diseases is important. In the current study, coincidence of psoriasis in cases with active SLE was assessed.Methods: This was a cross-sectional study on 148 cases with active SLE performed during the years 2015-17. Lupus activity was assessed based on Systemic Lupus Erythematosus Disease Activity Index-2K (SLEDAI-2K). Then, psoriasis was evaluated in patients. Demographics of patients were recorded as well.Findings: Mean score of SLEDAI-2K was 19.77 ± 14.10. Duration of SLE and score of SLEDAI-2K had significant association (P = 0.001, r = 0.294). Gender distribution in psoriasis was significant (P = 0.019). There was no association between psoriasis and patients' age (P = 0.08), duration of SLE (P = 0.316), and SLEDAI-2K score (P = 0.295).Conclusion: Mean age of patients, duration of SLE, and mean score of lupus activity were not in association with coincidence of psoriasis and SLE, but gender distribution of psoriasis among patients with active SLE was probably more among men.

Keywords

References

  1. Lai NS, Tsai TY, Koo M, Huang KY, Tung CH, Lu MC. Patterns of ambulatory medical care utilization and rheumatologist consultation predating the diagnosis of systemic lupus erythematosus: a national population-based study. PLoS One 2014; 9(7): e101485.
  2. Agmon-Levin N, Damoiseaux J, Kallenberg C, Sack U, Witte T, Herold M, et al. International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies. Ann Rheum Dis 2014; 73(1): 17-23.
  3. Eriksson C, Kokkonen H, Johansson M, Hallmans G, Wadell G, Rantapaa-Dahlqvist S. Autoantibodies predate the onset of systemic lupus erythematosus in northern Sweden. Arthritis Res Ther 2011; 13(1): R30.
  4. Perricone C, Agmon-Levin N, Ceccarelli F, Valesini G, Anaya JM, Shoenfeld Y. Genetics and autoantibodies. Immunol Res 2013; 56(2-3): 206-19.
  5. Turner-Stokes T, Lu TY, Ehrenstein MR, Giles I, Rahman A, Isenberg DA. The efficacy of repeated treatment with B-cell depletion therapy in systemic lupus erythematosus: an evaluation. Rheumatology (Oxford ) 2011; 50(8): 1401-8.
  6. Sadat Shakeri H, Jokar M, Jafarzade F, Noorshafiee S, Akhlaghi S. Evaluation the incidence of infections in patients with systemic lupus erythematous. J North Khorasan Univ Med Sci 2013; 5(3): 579-83. [In Persian].
  7. Bruyn GA. Controversies in lupus: nervous system involvement. Ann Rheum Dis 1995; 54(3): 159-67.
  8. Moutsopoulos HM, Zampeli E, Vlachoyiannopoulos PG. Systemic Lupus Erythematosus, Antiphospholipid Syndrome, and Mixed Connective Tissue Disease. In: Moutsopoulos HM, Zampeli E, Vlachoyiannopoulos PG, editors. Rheumatology in Questions.Cham: Springer International Publishing; 2018. p. 59-70.
  9. Postal M, Costallat LT, Appenzeller S. Neuropsychiatric manifestations in systemic lupus erythematosus: epidemiology, pathophysiology and management. CNS Drugs 2011; 25(9): 721-36.
  10. Zhou Q, Mrowietz U, Rostami-Yazdi M. Oxidative stress in the pathogenesis of psoriasis. Free Radic Biol Med 2009; 47(7): 891-905.
  11. Varada S, Gottlieb AB, Merola JF, Saraiya AR, Tintle SJ. Treatment of coexistent psoriasis and lupus erythematosus. J Am Acad Dermatol 2015; 72(2): 253-60.
  12. Ghazizadeh R, Tosa M, Ghazizadeh M. Clinical improvement in psoriasis with treatment of associated hyperlipidemia. Am J Med Sci 2011; 341(5): 394-8.
  13. Pons-Estel GJ, Wojdyla D, McGwin G, Jr., Magder LS, Petri MA, Pons-Estel BA, et al. The American College of Rheumatology and the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus in two multiethnic cohorts: a commentary. Lupus 2014; 23(1): 3-9.
  14. Yee CS, Farewell VT, Isenberg DA, Griffiths B, Teh LS, Bruce IN, et al. The use of Systemic Lupus Erythematosus Disease Activity Index-2000 to define active disease and minimal clinically meaningful change based on data from a large cohort of systemic lupus erythematosus patients. Rheumatology (Oxford) 2011; 50(5): 982-8.
  15. Raychaudhuri SK, Maverakis E, Raychaudhuri SP. Diagnosis and classification of psoriasis. Autoimmun Rev 2014; 13(4-5): 490-5.
  16. Kido M, Takeuchi S, Sugiyama N, Esaki H, Nakashima H, Yoshida H, et al. T cell-specific overexpression of interleukin-27 receptor alpha subunit (WSX-1) prevents spontaneous skin inflammation in MRL/lpr mice. Br J Dermatol 2011; 164(6): 1214-20.
  17. Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet 2007; 370(9583): 263-71.
  18. Sticherling M. Psoriasis and autoimmunity. Autoimmun Rev 2016; 15(12): 1167-70.
  19. Tan JAS, Tababa EJL, Dimacali CD, Yap-Silva C. Systemic Lupus Erythematosus with Coexistent Psoriasis Vulgaris: A case report. Acta Medica Philippina 2017; 51(4): 348.
  20. Ibanez D, Gladman DD, Urowitz MB. Adjusted mean Systemic Lupus Erythematosus Disease Activity Index-2K is a predictor of outcome in SLE. J Rheumatol 2005; 32(5): 824-7.
  21. Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol 2002; 29(2): 288-91.
  22. Zalla MJ, Muller SA. The coexistence of psoriasis with lupus erythematosus and other photosensitive disorders. Acta Derm Venereol Suppl (Stockh) 1996; 195: 1-15.
  23. Berthelot C, Nash J, Duvic M. Coexistent psoriasis and lupus erythematosus treated with alefacept. Am J Clin Dermatol 2007; 8(1): 47-50.
  24. Millns JL, Muller SA. The coexistence of psoriasis and lupus erythematosus. An analysis of 27 cases. Arch Dermatol 1980; 116(6): 658-63.
  25. Dubois EL. Lupus Erythematosus: A Review of the Current Status of Discoid and Systemic Lupus Erythematosus and Their Variants. McGraw-Hill, Blakiston Division; 1966.
  26. Tselios K, Yap KS, Pakchotanon R, Polachek A, Su J, Urowitz MB, et al. Psoriasis in systemic lupus erythematosus: a single-center experience. Clin Rheumatol 2017; 36(4): 879-84.
  27. Avriel A, Zeller L, Flusser D, Abu SM, Halevy S, Sukenik S. Coexistence of psoriatic arthritis and systemic lupus erythematosus. Isr Med Assoc J 2007; 9(1): 48-9.
  28. Tsai TF, Wang TS, Hung ST, Tsai PI, Schenkel B, Zhang M, et al. Epidemiology and comorbidities of psoriasis patients in a national database in Taiwan. J Dermatol Sci 2011; 63(1): 40-6.
Journal of Isfahan Medical School
Volume 36, Issue 489 - Serial Number 489
July and August 2018
Pages 859-864

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History

  • Receive Date: 22 June 2018
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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