Abstract
Psoriasis (PsO) is a chronic relapsing/remitting autoimmune skin disease, associated with an increased risk of other autoimmune disorders. Psoriatic arthritis (PsA) is a chronic inflammatory arthritis occurring approximately in 30% of PsO patients. Sporadic cases of association between PsO and autoimmune thyroid disorders (AITDs) have been reported. However, two different recent studies did not find any association between them. In patients with PsO and PsA, an association with AITD has been shown by most of the studies in adults, but not in the juvenile form. In PsA women and men, thyroid autoimmunity [positive antithyroid peroxidase (AbTPO) antibodies, hypoechoic thyroid pattern] and subclinical hypothyroidism were more prevalent than in the general population. An association has been shown also in patients with PsO, arthritis, and inflammatory bowel disease, who have more frequently AITD. A Th1 immune predominance has been shown in early PsO, and PsA, with high serum CXCL10 (Th1 prototype chemokine), overall in the presence of autoimmune thyroiditis. This Th1 immune predominance might be the immunopathogenetic base of the association of these disorders. A raised incidence of new cases of hypothyroidism, thyroid dysfunction, positive AbTPO, and appearance of a hypoechoic thyroid pattern in PsA patients, especially in women, has been shown recently, suggesting to evaluate AbTPO levels, thyroid function, and thyroid ultrasound, especially in PsA women. Thyroid function follow-up and suitable treatments should be performed regularly in PsA female patients at high risk (thyroid-stimulating hormone within the normal range but at the higher limit, positive AbTPO, hypoechoic, and small thyroid).
Highlights
Psoriasis (PsO) [1] affects about 2–4% of the population [2]; it is a chronic relapsing/remitting autoimmune skin disease [1] and presents with itchy red, scaly patches, papules, and plaques, with different severity, from localized patches to general body coverage
Psoriasis is associated with an increased risk of other autoimmune disorders like ulcerative colitis, Crohn’s disease, and autoimmune thyroiditis (AT) too [12]
anti-thyroglobulin antibodies (AbTg) prevalence 3%; anti-microsome antibodies prevalence 0% antithyroid peroxidase antibodies (AbTPO) levels were increased in 6 subjects (6%), AbTg levels were increased in 11 subjects (11%) and both of them were increased in 6 subjects (6%) Prevalence of AT 19.6%
Summary
Psoriasis (PsO) [1] affects about 2–4% of the population [2]; it is a chronic relapsing/remitting autoimmune skin disease [1] and presents with itchy red, scaly patches, papules, and plaques, with different severity, from localized patches to general body coverage. A subsequent study evaluated prospectively the prevalence of other autoimmune disorders in outpatient clinic in 3,069 consecutive patients with diagnosed chronic AT, with respect to two age- and sex-matched control groups: (a) a control group of 1,023 subjects, extracted from a random sample of the general population without thyroid disorders and (b) 1,023 patients with non-toxic multinodular goiter drawn by the same random sample of the general population, with similar iodine intake. A more recent study [18] aimed to assess the incidence of new cases of clinical and subclinical thyroid dysfunction (TD) in a broad group of PsA patients versus a control group, matched by age and gender with a similar iodine intake. These data suggested that a Th1 immune predominace, both in PsA such as in AT, might be the immunopathogenetic base of the association of these diseases
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