Latent tuberculosis infection in psoriasis patients

Abstract

Aims: Psoriasis is a chronic, inflammatory, and life-long skin disease. Patients may need to change the treatment regimen by time due to the course of the disease. According to the guidelines, patients should be screened for latent tuberculosis infection (LTBI) before starting treatment with biological agents. We aimed to evaluate the associations between positive interferon-gamma release assay (IGRA) tests, the chest CT findings and inflammatory blood markers of the psoriasis patients who have undergone screening for LTBI before starting systemic treatment with biological agents or conventional options. Methods: The electronic medical records, Chest CT reports and blood tests of 123 consecutive patients with a diagnosis of psoriasis who were candidates for systemic treatment (methotrexate, cyclosporin and biological agents) and screened for LTBI were examined. Results: The mean age of the patients was 49.24 and 64 (52%) of them were males. 37(30%) had a family history of tuberculosis 103(83%) of them had BCG vaccination scars. 59% had radiological features on their Chest CT scans. 28% of the patients had positive Quantiferon test results. When compared to the Quantiferon negative group, there was no difference between the two groups according to demographic characteristics, comorbidities, family history of tuberculosis, BCG vaccination status, smoking habits, occupation, and qualification details (p>0.05). The values of WBC, neutrophils, lymphocyte, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, systemic inflammation index and erythrocyte sedimentation rates were found statistically higher in the patients with positive Quantiferon test (p<0.05). Conclusion: The patients with psoriasis requiring systemic treatment and having positive IGRA test results have increased levels of inflammation. Psoriasis and LTBI might have a synergistic action in the inflammatory response which necessitates further studies to find out the associations between these two entities.