Demographic and Clinical Characteristics of MS Patients Concomitant with Psoriasis: Lower Relapses, Lower Disability

Abstract

Multiple Sclerosis (MS) and psoriasis are immune-mediated diseases. The prevalence estimation of psoriasis in the general population is 0.9-8.5% in adults, that depending on the region. Similar to MS, it seems to be higher in the region with more distance from the equator. The most prevalent autoimmune diseases associated with MS were thyroid disease and psoriasis based on previouos findings in the literature. To assess the demographic and clinical characteristics of MS patients associated with psoriasis, this prospective, cross-sectional study was designed on 2019 in Multiple Sclerosis Research Center, Tehran, Iran. We reported 12 MS patients associated with psoriasis. The mean age, duration of MS and psoriasis onset was 34.16±9.90, 6.21±4.65 and 10.75±8.08 years respectively. Mean Expanded Disability Status Scale (EDSS) and Annualized Relapse Rate (ARR) was 2.17±1.72 and 0.67±0.48 (relapse per year) respectively. Eleven patients (91.7%) suffered from Relapsing Remission Multiple Sclerosis (RRMS) with mean age, EDSS, ARR, duration of MS and onset of psoriasis 33.91±10.34 (years), 1.86±1.43, 0.68±0.50 (relapse per year), 5.23±3.33 (years), 9.00±5.60 (years) respectively. Only one 37 years old patient (8.3%) suffered from Secondary Progressive Multiple Sclerosis (SPMS) with EDSS=5 and ARR=0.59 relapse per year, duration of MS and onset of psoraisis 17and 30 years respectively. In nine patients, the onset of psoriasis was before MS (mean=7.28±4.64 years), and in two patients, the onset of psoriasis was after MS. In one of the patient's MS and psoriasis happened at the same time. The mean ARR in RRMS patients were 0.68±0.50 relapse per year which is lower than the natural course of MS (0.7-1.2 relapse per year). Also, all of MS patients were in the inactive phase of psoriasis without any treatment of this disease. The result of this study suggests a milder course of association of MS and psoriasis in patients with this concomitantly.