Enteropathy in Psoriasis: A Systematic Review of Gastrointestinal Disease Epidemiology and Subclinical Inflammatory and Functional Gut Alterations

Abstract

Psoriasis in an inflammatory skin disorder associated with systemic inflammation. This systematic review summarizes the epidemiology, histology, and function of the gastrointestinal (GI) system in patients with psoriasis. Although psoriasis patients are at higher risk for developing inflammatory bowel disease and celiac disease, estimates of their prevalence have varied and it is unclear whether psoriasis patients without GI symptoms may harbor subclinical inflammation. In a meta-analysis, the pooled prevalence of Crohn disease, ulcerative colitis (UC), and celiac disease among patients with psoriasis was 0.4, 0.5, and 2%, respectively. The pooled prevalence of psoriasis among patients with Crohn disease was 9.5% and among patients with UC was 6.6%. A significant proportion of psoriasis patients harbor lymphocytic infiltrates in the small and large intestine; 40–50% of the psoriasis patients demonstrate abnormal intestinal absorption based on fecal fat, D-xylose, and lactose tolerance tests. These results suggest that the inflammatory state of psoriasis may in some patients extend to the GI tract.