A Egeberg1,2, L Mallbris3, R B Warren4, H Bachelez5, G H Gislason6,7,8, P R Hansen6, L Skov9. 1. Department of Dermato-Allergology, University of Copenhagen, 2900, Hellerup, Denmark. alexander.egeberg@gmail.com. 2. Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark. alexander.egeberg@gmail.com. 3. Unit of Dermatology and Venereology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. 4. The Dermatology Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, M6 8HD, U.K. 5. Sorbonne Paris Cité Université Paris Diderot, INSERM U1163, Imagine Institute, Necker Hospital, Paris, France. 6. Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, 2900, Hellerup, Denmark. 7. The Danish Heart Foundation, DK-1127, Copenhagen, Denmark. 8. The National Institute of Public Health, University of Southern Denmark, DK-1353, Copenhagen, Denmark. 9. Department of Dermato-Allergology, University of Copenhagen, 2900, Hellerup, Denmark.
Abstract
BACKGROUND: Psoriasis, Crohn disease (CD) and ulcerative colitis (UC) are chronic inflammatory disorders with overlapping genetic architecture. However, data on the frequency and risk of CD and UC in psoriasis are scarce and poorly understood. OBJECTIVES: To investigate the association between CD and UC in patients with psoriasis. METHODS: All Danish individuals aged ≥ 18 years between 1 January 1997 and 31 December 2012 were linked in nationwide registers. Psoriasis severity was defined in two models: hospital visits and medication. Incidence rates per 10 000 person-years were calculated, and incidence rate ratios (IRRs) were estimated by Poisson regression. RESULTS: In the total cohort (n = 5 554 100) there were 75 209 incident cases of psoriasis, 11 309 incident cases of CD and 30 310 incident cases of UC, during follow-up. The adjusted IRRs (95% confidence intervals) of CD were 1·28 (1·03-1·59), 2·56 (1·87-3·50), 2·85 (1·72-4·73) and 3·42 (2·36-4·95) in patients with mild psoriasis, severe psoriasis (hospital), severe psoriasis (medication) and psoriatic arthritis, respectively. Similarly, the adjusted IRRs of UC were 1·49 (1·32-1·68), 1·56 (1·22-2·00), 1·96 (1·36-2·83) and 2·43 (1·86-3·17), respectively. The 10-year incidence of CD was 2-5 per 1000 patients and of UC 7-11 per 1000 patients, depending on psoriasis severity and the presence of psoriatic arthritis. Additionally, an increased risk of incident psoriasis was found following CD or UC. CONCLUSIONS: We observed a psoriasis-associated increased risk of CD and UC, which was higher in severe psoriasis, and an increased risk of psoriasis in patients with inflammatory bowel disease. Increased focus on gastrointestinal symptoms in patients with psoriasis may be warranted.
BACKGROUND:Psoriasis, Crohn disease (CD) and ulcerative colitis (UC) are chronic inflammatory disorders with overlapping genetic architecture. However, data on the frequency and risk of CD and UC in psoriasis are scarce and poorly understood. OBJECTIVES: To investigate the association between CD and UC in patients with psoriasis. METHODS: All Danish individuals aged ≥ 18 years between 1 January 1997 and 31 December 2012 were linked in nationwide registers. Psoriasis severity was defined in two models: hospital visits and medication. Incidence rates per 10 000 person-years were calculated, and incidence rate ratios (IRRs) were estimated by Poisson regression. RESULTS: In the total cohort (n = 5 554 100) there were 75 209 incident cases of psoriasis, 11 309 incident cases of CD and 30 310 incident cases of UC, during follow-up. The adjusted IRRs (95% confidence intervals) of CD were 1·28 (1·03-1·59), 2·56 (1·87-3·50), 2·85 (1·72-4·73) and 3·42 (2·36-4·95) in patients with mild psoriasis, severe psoriasis (hospital), severe psoriasis (medication) and psoriatic arthritis, respectively. Similarly, the adjusted IRRs of UC were 1·49 (1·32-1·68), 1·56 (1·22-2·00), 1·96 (1·36-2·83) and 2·43 (1·86-3·17), respectively. The 10-year incidence of CD was 2-5 per 1000 patients and of UC 7-11 per 1000 patients, depending on psoriasis severity and the presence of psoriatic arthritis. Additionally, an increased risk of incident psoriasis was found following CD or UC. CONCLUSIONS: We observed a psoriasis-associated increased risk of CD and UC, which was higher in severe psoriasis, and an increased risk of psoriasis in patients with inflammatory bowel disease. Increased focus on gastrointestinal symptoms in patients with psoriasis may be warranted.
Authors: Karin Bengtsson; Helena Forsblad-d'Elia; Anna Deminger; Eva Klingberg; Mats Dehlin; Sofia Exarchou; Ulf Lindström; Johan Askling; Lennart T H Jacobsson Journal: Rheumatology (Oxford) Date: 2021-06-18 Impact factor: 7.580
Authors: Cæcilie Bachdal Johansen; Alexander Egeberg; Espen Jimenez Solem; Ida Vittrup; Lone Skov; Simon Francis Thomsen Journal: Int J Womens Dermatol Date: 2020-11-27