Autoimmune Diseases Prevalent Among Patients With Psoriasis, Study Finds

Recent findings from a single tertiary care center show that nearly three-quarters of patients with psoriasis developed autoimmune diseases, with hypothyroidism and alopecia areata being the most common.

The single-center retrospective cohort study is published in Cureus.¹

“Psoriasis disease has a high tendency to coincide with other autoimmune diseases,” wrote the researchers of the study. “This study aims to identify the prevalence of other autoimmune disorders with psoriasis, mainly alopecia areata, SLE [systemic lupus erythematosus], autoimmune thyroid diseases, rheumatoid arthritis, celiac disease, Crohn’s disease, and vitiligo.”

Psoriasis is a common chronic inflammatory skin disorder, which has been associated with several autoimmune diseases. Although the pathogenesis of psoriasis is not fully understood, previous research has suggested a link between the T-cell immune-mediated process and the disease’s development.

Findings from a study published in 2019 observed increases in the age-standardized incidence rate of rheumatoid arthritis and surge in cases of asthma, inflammatory bowel disease (IBD), multiple sclerosis, psoriasis, and atopic dermatitis, highlighting the need for a better understanding of prevention and mitigation strategies for immune-mediated inflammatory diseases.²

“The magnitude of incident cases of [immune-mediated inflammatory diseases] has increased significantly over the past few decades,” wrote the researchers of the study.² “As a result, there is an urgent need for an integrative management strategy to address the increasing [age-standardized incidence rate] of rheumatoid arthritis and the upsurge in new cases of the other 5 [immune-mediated inflammatory diseases] studied.”

Utilizing electronic medical records, the researchers identified patients with psoriasis at King Abdulaziz Medical City in Riyadh, Saudi Arabia. After the initial patient recruitment, the researchers reviewed for the presence of autoimmune diseases, including hypothyroidism, hyperthyroidism, alopecia areata, vitiligo, atopic dermatitis, and IBD, like Crohn disease and celiac disease.

A total of 1098 patient medical records were reviewed, in which 839 (76.4%) had documented autoimmune diseases. Additionally, 56.4% of the patients were female, 37.1% were aged 31 to 50 years, and 17.6% were children.

The most associated autoimmune diseases identified in this patient cohort were hypothyroidism (6.8%), alopecia areata (3.6%), atopic dermatitis (2.9%), and hyperthyroidism (2.6%). Vitiligo, rheumatoid arthritis, SLE, and IBD were observed in less than 2% of patients each. Additionally, the distribution of autoimmune diseases was similar among males and females, except for hypothyroidism, which was more common among females (9.3% vs 3.6%; P = .001).

The researchers acknowledged some limitations to their findings, including being a single-center retrospective study and that the diagnosis of the associated autoimmune diseases was based on documentation in medical records. Additionally, the researchers hypothesized that the study’s lower prevalence of autoimmune diseases may have been related to the study’s small sample size, in which larger studies are needed to confirm these findings.

Despite these limitations, the researchers believe the study was able to find a connection between psoriasis and the incidence of autoimmune diseases.

“Thyroid diseases were the most encountered autoimmune disease (6.8%), followed by skin autoimmune diseases,” wrote the researchers.¹ “Connective tissue diseases and inflammatory bowel diseases were uncommon in our cohort. Further multicenter larger studies are needed to understand the extent of autoimmune diseases associated with psoriasis in our region.”

References

1. Hakami AR, AlSalman SA, Aljaziri NJ, et al. Prevalence of autoimmune diseases among patients with psoriasis: a single tertiary center experience. Cureus. 2024;16(5):e60455. Published 2024 May 16. doi:10.7759/cureus.60455

2. Brooks A. Immune-mediated inflammatory diseases increase despite available treatment. HCPLive^®. September 29, 2023. Accessed June 18, 2024. https://www.hcplive.com/view/immune-mediated-inflammatory-diseases-increase-despite-available-treatment