Abstract
Psoriasis is a chronic relapsing/remitting autoimmune disease affecting skin and fingernails. It is associated with many other autoimmune diseases such as rheumatoid arthritis, celiac disease, Crohn's disease, and thyroid diseases. Two important autoimmune thyroid diseases - Hashimoto's thyroiditis (hypothyroidism) and Grave's disease (hyperthyroidism) - affect the body's significant organs such as the brain, muscles, digestive function, and the skin. Although some studies have established the connection between psoriasis and thyroid diseases with autoimmunity, our article provides an in-depth analysis of the connection between these two diseases and other common etiological factors associated with them, along with autoimmunity.We reviewed articles from PubMed using regular keywords and Medical Subject Headings (MeSH) keywords and finalized 45 articles to find an association between these two diseases. These articles showed that this association is more prevalent in obese patients and late-onset psoriasis. Most of the articles showed a positive association, but few articles showed no connection between them. However, there is no concrete explanation to prove the association due to limited research; additional studies are necessary. It requires the attention of both clinicians and researchers to develop a universal drug that will work on both diseases, and also thyroid evaluation could be included in psoriatic patient care so that there is a possibility to decrease cost and efforts while treating these diseases.
Highlights
BackgroundPsoriasis (PSO) is a chronic, relapsing/remitting autoimmune inflammatory skin disorder
On PubMed, the keyword psoriasis generated 49,146 articles; hypothyroidism resulted in 44,229 articles; autoimmunity gave 45,135 articles, thyroid function tests brought up 18,082 articles, propylthiouracil resulted in 573 articles, and psoriatic arthritis gave 9,927 articles
Five articles showed thyroid hormones' effect on psoriasis pathogenesis, two articles showed genetic association (long non-coding ribonucleic acid (RNA), signal transducer and activator of transcription 4 (STAT4) gene polymorphism play a crucial role in both the diseases), immunological association (interleukin 17 (IL17), CX-C motif chemokine ligand 10 (CXCL10), CXCL9, C-C motif chemokine ligand 2 (CCL2), and CCL22associated inflammation are evidenced in both the disorders) is found in six articles, reactive oxygen species-related pathogenesis observed in two articles, and positive thyroid peroxidase antibodies, thyroglobulin antibodies and Hashimoto's thyroiditis ultrasound features in psoriasis patients are exhibited in five articles
Summary
Psoriasis (PSO) is a chronic, relapsing/remitting autoimmune inflammatory skin disorder. It presents as red, scaly patches, plaques with variable severity affecting elbows, knees, scalp, palms/soles, and nails. Psoriasis affects up to 2-4% of the studied population [1]. A genetic predisposition is significant in the pathogenesis of PSO; environmental factors can activate the disease [2]. Psoriasis is associated with a variety of other morbidities, including diabetes mellitus, metabolic syndrome, cardiovascular disease [3], and other inflammatory autoimmune diseases such as psoriatic and rheumatoid arthritis, celiac disease, thyroid disease, and Crohn's disease [4]. Psoriatic arthritis (PsA) is an inflammatory arthritis of the joints in 7-26% of psoriatic patients [5]
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