Skip to main content
Top
Published in: Dermatology and Therapy 9/2023

Open Access 05-08-2023 | Vulgar Psoriasis | Original Research

The Prevalent Comorbidome at the Onset of Psoriasis Diagnosis

Authors: Alessandra Buja, Andrea Miatton, Claudia Cozzolino, Alessandra Rosalba Brazzale, Roberta Lo Bue, Santo Raffaele Mercuri, Fabian Nikolai Proft, Khalaf Kridin, Arnon Dov Cohen, Giovanni Damiani

Published in: Dermatology and Therapy | Issue 9/2023

Login to get access

Abstract

Introduction

Psoriasis (PsO) is currently regarded as a systemic inflammatory disease with a growing burden of post-diagnosis associated comorbidities. To determine the initial burden of comorbiditis we evaluated the comorbidome at PsO onset.

Methods

In a matched case–control study, we extracted data on 57,228 patients and 125 morbidities from the Clalit Health Services Israeli insurance database. PsO cases were matched with control individuals by sex and age at enrolment. As pre-existing comorbidities, we considered all conditions already present in controls at the same age as the matched PsO case at the time of their diagnosis. To test for differences in the odds of comorbidities between the case and control groups, logistic regression analyses were run to calculate the odds ratio (OR) for each comorbidity, after which the comorbidome was graphically represented.

Results

In this study we enrolled 28,614 PsO patients and 28,614 controls with an average age of 45.3 ± 19.6 years. At the time of diagnosis, PsO patients were more likely to be diagnosed with 2–4 comorbidities (28.8% vs 23.8%) and > 5 (19.6% vs 12.9%,). PsO patients’ specific comorbidomes evidenced several pathological cores: autoimmune and inflammatory systemic diseases [i.e., hidradenitis suppurativa (OR 3.55, 95% CI 1.88–7.28) or polymyalgia rheumatica (OR 3.01 95% CI 1.96–4.77)], inflammatory bowel diseases [i.e., Crohn’s disease (OR 2.99 95% CI 2.20–4.13)], pulmonary inflammatory diseases [i.e., chronic obstructive pulmonary disease (OR 1.81 95% CI 1.61–2.04)], hepatological diseases [i.e., cirrhosis (OR 2.00 95% CI 1.36–3.00)], endocrine diseases [dysthyroidisms (OR 1.82 95% CI 1.30–2.59)], mental disorders [i.e., depression (OR 1.72 95% CI 1.57–1.87)], and cardiovascular diseases (i.e., hypertension (OR 1.47 95% CI 1.41–1.53)].

Conclusion

The PsO-onset comorbidome may help health professionals plan more comprehensive patient management. By screening for these common PsO-linked conditions, early diagnosis and treatment may become more frequent, thus greatly benefiting patients on their medical journey.
Literature
4.
go back to reference Lee Y, Nam Y-H, Lee J-H, et al. Hypocalcaemia-induced pustular PsO-like skin eruption. Br J Dermatol. 2005;152:591–3.PubMedCrossRef Lee Y, Nam Y-H, Lee J-H, et al. Hypocalcaemia-induced pustular PsO-like skin eruption. Br J Dermatol. 2005;152:591–3.PubMedCrossRef
6.
go back to reference Long S-Q, Fang J, Shu H-L, et al. Correlation of catecholamine content and clinical influencing factors in depression among PsO patients: a case-control study. Biopsychosoc Med. 2022;16:17.PubMedPubMedCentralCrossRef Long S-Q, Fang J, Shu H-L, et al. Correlation of catecholamine content and clinical influencing factors in depression among PsO patients: a case-control study. Biopsychosoc Med. 2022;16:17.PubMedPubMedCentralCrossRef
7.
go back to reference Nadeem A, Ahmad SF, Al-Harbi NO, et al. IL-17A causes depression-like symptoms via NFκB and p38MAPK signaling pathways in mice: implications for PsO associated depression. Cytokine. 2017;97:14–24.PubMedCrossRef Nadeem A, Ahmad SF, Al-Harbi NO, et al. IL-17A causes depression-like symptoms via NFκB and p38MAPK signaling pathways in mice: implications for PsO associated depression. Cytokine. 2017;97:14–24.PubMedCrossRef
8.
go back to reference Samarasekera E, Sawyer L, Parnham J, Smith CH. Guideline development group assessment and management of PsO summary of NICE guidance. BMJ. 2012;345:e6712.PubMedCrossRef Samarasekera E, Sawyer L, Parnham J, Smith CH. Guideline development group assessment and management of PsO summary of NICE guidance. BMJ. 2012;345:e6712.PubMedCrossRef
10.
go back to reference Kridin K, Ludwig RJ, Damiani G, Cohen AD. Increased risk of pemphigus among patients with PsO: a large-scale cohort study. Acta Derm Venereol. 2020;100:1–4.CrossRef Kridin K, Ludwig RJ, Damiani G, Cohen AD. Increased risk of pemphigus among patients with PsO: a large-scale cohort study. Acta Derm Venereol. 2020;100:1–4.CrossRef
11.
go back to reference Kridin K, Vanetik S, Damiani G, Cohen AD. Big data highlights the association between PsO and fibromyalgia: a population-based study. Immunol Res. 2020;68:135–40.PubMedCrossRef Kridin K, Vanetik S, Damiani G, Cohen AD. Big data highlights the association between PsO and fibromyalgia: a population-based study. Immunol Res. 2020;68:135–40.PubMedCrossRef
14.
go back to reference Mahroum N, Elsalti A, Alwani A, et al. The mosaic of autoimmunity – finally discussing in person. The 13th International Congress on Autoimmunity (AUTO13) Athens. Autoimmun Rev. 2022;2022(21): 103166.CrossRef Mahroum N, Elsalti A, Alwani A, et al. The mosaic of autoimmunity – finally discussing in person. The 13th International Congress on Autoimmunity (AUTO13) Athens. Autoimmun Rev. 2022;2022(21): 103166.CrossRef
15.
go back to reference Wu JJ, Nguyen TU, Poon K-YT, Herrinton LJ. The association of PsO with autoimmune diseases. J Am Acad Dermatol. 2012;67:924–30.PubMedCrossRef Wu JJ, Nguyen TU, Poon K-YT, Herrinton LJ. The association of PsO with autoimmune diseases. J Am Acad Dermatol. 2012;67:924–30.PubMedCrossRef
16.
go back to reference Kjærsgaard Andersen R, Saunte SK, Jemec GBE, Saunte DM. PsO as a comorbidity of hidradenitis suppurativa. Int J Dermatol. 2020;59:216–20.PubMedCrossRef Kjærsgaard Andersen R, Saunte SK, Jemec GBE, Saunte DM. PsO as a comorbidity of hidradenitis suppurativa. Int J Dermatol. 2020;59:216–20.PubMedCrossRef
19.
go back to reference Wanat KA, Schaffer A, Richardson V, et al. Sarcoidosis and PsO: a case series and review of the literature exploring co-incidence vs coincidence. JAMA Dermatol. 2013;149:848–52.PubMedCrossRef Wanat KA, Schaffer A, Richardson V, et al. Sarcoidosis and PsO: a case series and review of the literature exploring co-incidence vs coincidence. JAMA Dermatol. 2013;149:848–52.PubMedCrossRef
21.
23.
go back to reference Wang X, Zhang C, Huang G, et al. Resveratrol inhibits dysfunction of dendritic cells from chronic obstructive pulmonary disease patients through promoting miR-34. Int J Clin Exp Pathol. 2015;8:5145–52.PubMedPubMedCentral Wang X, Zhang C, Huang G, et al. Resveratrol inhibits dysfunction of dendritic cells from chronic obstructive pulmonary disease patients through promoting miR-34. Int J Clin Exp Pathol. 2015;8:5145–52.PubMedPubMedCentral
26.
go back to reference Weidinger S, Willis-Owen SAG, Kamatani Y, et al. A genome-wide association study of atopic dermatitis identifies loci with overlapping effects on asthma and PsO. Hum Mol Genet. 2013;22:4841–56.PubMedPubMedCentralCrossRef Weidinger S, Willis-Owen SAG, Kamatani Y, et al. A genome-wide association study of atopic dermatitis identifies loci with overlapping effects on asthma and PsO. Hum Mol Genet. 2013;22:4841–56.PubMedPubMedCentralCrossRef
27.
go back to reference Kere J. Mapping and identifying genes for asthma and PsO. Philos Trans R Soc B Biol Sci. 2005;360:1551–61.CrossRef Kere J. Mapping and identifying genes for asthma and PsO. Philos Trans R Soc B Biol Sci. 2005;360:1551–61.CrossRef
29.
go back to reference Damiani G, Radaeli A, Olivini A, et al. Increased airway inflammation in patients with PsO. Br J Dermatol. 2016;175:797–9.PubMedCrossRef Damiani G, Radaeli A, Olivini A, et al. Increased airway inflammation in patients with PsO. Br J Dermatol. 2016;175:797–9.PubMedCrossRef
30.
go back to reference Al-Harbi NO, Nadeem A, Al-Harbi MM, et al. Psoriatic inflammation causes hepatic inflammation with concomitant dysregulation in hepatic metabolism via IL-17A/IL-17 receptor signaling in a murine model. Immunobiology. 2017;222:128–36.PubMedCrossRef Al-Harbi NO, Nadeem A, Al-Harbi MM, et al. Psoriatic inflammation causes hepatic inflammation with concomitant dysregulation in hepatic metabolism via IL-17A/IL-17 receptor signaling in a murine model. Immunobiology. 2017;222:128–36.PubMedCrossRef
31.
go back to reference Imafuku S, Naito R, Nakayama J. Possible association of hepatitis C virus infection with late-onset PsO: a hospital-based observational study. J Dermatol. 2013;40:813–8.PubMed Imafuku S, Naito R, Nakayama J. Possible association of hepatitis C virus infection with late-onset PsO: a hospital-based observational study. J Dermatol. 2013;40:813–8.PubMed
32.
go back to reference Chun K, Afshar M, Audish D, et al. Hepatitis C may enhance key amplifiers of PsO. J Eur Acad Dermatol Venereol JEADV. 2017;31:672–8.PubMedCrossRef Chun K, Afshar M, Audish D, et al. Hepatitis C may enhance key amplifiers of PsO. J Eur Acad Dermatol Venereol JEADV. 2017;31:672–8.PubMedCrossRef
34.
go back to reference Elias AN, Dangaran K, Barr RJ, et al. A controlled trial of topical propylthiouracil in the treatment of patients with PsO. J Am Acad Dermatol. 1994;31:455–8.PubMedCrossRef Elias AN, Dangaran K, Barr RJ, et al. A controlled trial of topical propylthiouracil in the treatment of patients with PsO. J Am Acad Dermatol. 1994;31:455–8.PubMedCrossRef
35.
go back to reference Chowdhury MMU, Marks R. Oral propylthiouracil for the treatment of resistant plaque PsO. J Dermatol Treat. 2001;12:81–5.CrossRef Chowdhury MMU, Marks R. Oral propylthiouracil for the treatment of resistant plaque PsO. J Dermatol Treat. 2001;12:81–5.CrossRef
36.
go back to reference Arican O, Bilgic K, Koc K. The effect of thyroid hormones in PsO vulgaris. Indian J Dermatol Venereol Leprol. 2004;70:353.PubMed Arican O, Bilgic K, Koc K. The effect of thyroid hormones in PsO vulgaris. Indian J Dermatol Venereol Leprol. 2004;70:353.PubMed
37.
go back to reference Aksoylar S, Aydinok Y, Serdaroğlu E, et al. HDR (hypoparathyroidism, sensorineural deafness, renal dysplasia) syndrome presenting with hypocalcemia-induced generalized PsO. J Pediatr Endocrinol Metab. 2004;17:1031–4.PubMedCrossRef Aksoylar S, Aydinok Y, Serdaroğlu E, et al. HDR (hypoparathyroidism, sensorineural deafness, renal dysplasia) syndrome presenting with hypocalcemia-induced generalized PsO. J Pediatr Endocrinol Metab. 2004;17:1031–4.PubMedCrossRef
39.
go back to reference Chang Y, Wu W, Chen C, et al. Association between the insertion/deletion polymorphism of the angiotensin I-converting enzyme gene and risk for PsO in a Chinese population in Taiwan. Br J Dermatol. 2007;156:642–5.PubMedCrossRef Chang Y, Wu W, Chen C, et al. Association between the insertion/deletion polymorphism of the angiotensin I-converting enzyme gene and risk for PsO in a Chinese population in Taiwan. Br J Dermatol. 2007;156:642–5.PubMedCrossRef
40.
go back to reference Muñoz-Torres M, Aguado P, Daudén E, et al. Osteoporosis and PsO. Actas Dermo-Sifiliogr Engl Ed. 2019;110:642–52.CrossRef Muñoz-Torres M, Aguado P, Daudén E, et al. Osteoporosis and PsO. Actas Dermo-Sifiliogr Engl Ed. 2019;110:642–52.CrossRef
41.
go back to reference Kincse G, Bhattoa PH, Herédi E, et al. Vitamin D3 levels and bone mineral density in patients with PsO and/or psoriatic arthritis. J Dermatol. 2015;42:679–84.PubMedCrossRef Kincse G, Bhattoa PH, Herédi E, et al. Vitamin D3 levels and bone mineral density in patients with PsO and/or psoriatic arthritis. J Dermatol. 2015;42:679–84.PubMedCrossRef
44.
go back to reference Chen Y-H, Wang W-M, Li I-H, et al. Major depressive disorder increased risk of PsO: a propensity score matched cohort study. J Affect Disord. 2021;278:407–12.PubMedCrossRef Chen Y-H, Wang W-M, Li I-H, et al. Major depressive disorder increased risk of PsO: a propensity score matched cohort study. J Affect Disord. 2021;278:407–12.PubMedCrossRef
45.
go back to reference Blackstone B, Patel R, Bewley A. Assessing and improving psychological well-being in PsO: considerations for the clinician. PsO Targets Ther. 2022;12:25–33.CrossRef Blackstone B, Patel R, Bewley A. Assessing and improving psychological well-being in PsO: considerations for the clinician. PsO Targets Ther. 2022;12:25–33.CrossRef
46.
go back to reference Späh F. Inflammation in atherosclerosis and PsO: common pathogenic mechanisms and the potential for an integrated treatment approach. Br J Dermatol. 2008;159:10–7.PubMedCrossRef Späh F. Inflammation in atherosclerosis and PsO: common pathogenic mechanisms and the potential for an integrated treatment approach. Br J Dermatol. 2008;159:10–7.PubMedCrossRef
47.
go back to reference Alexandroff AB, Pauriah M, Camp RDR, et al. More than skin deep: atherosclerosis as a systemic manifestation of PsO. Br J Dermatol. 2009;161:1–7.PubMedCrossRef Alexandroff AB, Pauriah M, Camp RDR, et al. More than skin deep: atherosclerosis as a systemic manifestation of PsO. Br J Dermatol. 2009;161:1–7.PubMedCrossRef
48.
49.
50.
go back to reference Shiba M, Kato T, Izumi T, et al. Risk of myocardial infarction in patients with PsO: a cross-sectional patient-population study in a Japanese hospital. J Cardiol. 2019;73:276–9.PubMedCrossRef Shiba M, Kato T, Izumi T, et al. Risk of myocardial infarction in patients with PsO: a cross-sectional patient-population study in a Japanese hospital. J Cardiol. 2019;73:276–9.PubMedCrossRef
51.
go back to reference Fry L, Baker BS. Triggering PsO: the role of infections and medications. Clin Dermatol. 2007;25:606–15.PubMedCrossRef Fry L, Baker BS. Triggering PsO: the role of infections and medications. Clin Dermatol. 2007;25:606–15.PubMedCrossRef
52.
go back to reference Roszkiewicz M, Dopytalska K, Szymańska E, et al. Environmental risk factors and epigenetic alternations in PsO. Ann Agric Environ Med. 2020;27:335–42.PubMedCrossRef Roszkiewicz M, Dopytalska K, Szymańska E, et al. Environmental risk factors and epigenetic alternations in PsO. Ann Agric Environ Med. 2020;27:335–42.PubMedCrossRef
53.
go back to reference Shibata S, Tada Y, Hau CS, et al. Adiponectin regulates psoriasiform skin inflammation by suppressing IL-17 production from γδ-T cells. Nat Commun. 2015;6:7687.PubMedCrossRef Shibata S, Tada Y, Hau CS, et al. Adiponectin regulates psoriasiform skin inflammation by suppressing IL-17 production from γδ-T cells. Nat Commun. 2015;6:7687.PubMedCrossRef
54.
go back to reference Kumar S, Han J, Li T, Qureshi AA. Obesity, waist circumference, weight change and the risk of PsO in US women. J Eur Acad Dermatol Venereol. 2013;27:1293–8.PubMedCrossRef Kumar S, Han J, Li T, Qureshi AA. Obesity, waist circumference, weight change and the risk of PsO in US women. J Eur Acad Dermatol Venereol. 2013;27:1293–8.PubMedCrossRef
55.
go back to reference Kanemaru K, Matsuyuki A, Nakamura Y, Fukami K. Obesity exacerbates imiquimod-induced PsO-like epidermal hyperplasia and interleukin-17 and interleukin-22 production in mice. Exp Dermatol. 2015;24:436–42.PubMedCrossRef Kanemaru K, Matsuyuki A, Nakamura Y, Fukami K. Obesity exacerbates imiquimod-induced PsO-like epidermal hyperplasia and interleukin-17 and interleukin-22 production in mice. Exp Dermatol. 2015;24:436–42.PubMedCrossRef
57.
go back to reference Hu SC-S, Lin C-L, Tu H-P. Association between PsO, psoriatic arthritis and gout: a nationwide population-based study. J Eur Acad Dermatol Venereol. 2019;33:560–7.PubMedCrossRef Hu SC-S, Lin C-L, Tu H-P. Association between PsO, psoriatic arthritis and gout: a nationwide population-based study. J Eur Acad Dermatol Venereol. 2019;33:560–7.PubMedCrossRef
58.
go back to reference Lynde CW, Poulin Y, Vender R, Bourcier M, Khalil S. Interleukin 17A: toward a new understanding of PsO pathogenesis. J Am Acad Dermatol. 2014;71:141–50.PubMedCrossRef Lynde CW, Poulin Y, Vender R, Bourcier M, Khalil S. Interleukin 17A: toward a new understanding of PsO pathogenesis. J Am Acad Dermatol. 2014;71:141–50.PubMedCrossRef
59.
go back to reference Luo G, Yi T, Zhang G, et al. Increased circulating Th22 cells in patients with acute gouty arthritis. Medicine (Baltimore). 2017;96: e8329.PubMedCrossRef Luo G, Yi T, Zhang G, et al. Increased circulating Th22 cells in patients with acute gouty arthritis. Medicine (Baltimore). 2017;96: e8329.PubMedCrossRef
60.
go back to reference Puri P, Nandar SK, Kathuria S, Ramesh V. Effects of air pollution on the skin: a review. Indian J Dermatol Venereol Leprol. 2017;83:415.PubMedCrossRef Puri P, Nandar SK, Kathuria S, Ramesh V. Effects of air pollution on the skin: a review. Indian J Dermatol Venereol Leprol. 2017;83:415.PubMedCrossRef
61.
62.
go back to reference Fortes C, Mastroeni S, Leffondré K, et al. Relationship between smoking and the clinical severity of PsO. Arch Dermatol. 2005;141:1580–4.PubMedCrossRef Fortes C, Mastroeni S, Leffondré K, et al. Relationship between smoking and the clinical severity of PsO. Arch Dermatol. 2005;141:1580–4.PubMedCrossRef
63.
go back to reference Vickman RE, Aaron-Brooks L, Zhang R, et al. TNF is a potential therapeutic target to suppress prostatic inflammation and hyperplasia in autoimmune disease. Nat Commun. 2022;13:2133.PubMedPubMedCentralCrossRef Vickman RE, Aaron-Brooks L, Zhang R, et al. TNF is a potential therapeutic target to suppress prostatic inflammation and hyperplasia in autoimmune disease. Nat Commun. 2022;13:2133.PubMedPubMedCentralCrossRef
Metadata
Title
The Prevalent Comorbidome at the Onset of Psoriasis Diagnosis
Authors
Alessandra Buja
Andrea Miatton
Claudia Cozzolino
Alessandra Rosalba Brazzale
Roberta Lo Bue
Santo Raffaele Mercuri
Fabian Nikolai Proft
Khalaf Kridin
Arnon Dov Cohen
Giovanni Damiani
Publication date
05-08-2023
Publisher
Springer Healthcare
Published in
Dermatology and Therapy / Issue 9/2023
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI
https://doi.org/10.1007/s13555-023-00986-0

Other articles of this Issue 9/2023

Dermatology and Therapy 9/2023 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.