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Published in: Archives of Dermatological Research 9/2017

Open Access 01-11-2017 | Review

Digestive system in psoriasis: an update

Authors: Daniel Pietrzak, Aldona Pietrzak, Dorota Krasowska, Andrzej Borzęcki, Kinga Franciszkiewicz-Pietrzak, Beata Polkowska-Pruszyńska, Maja Baranowska, Kristian Reich

Published in: Archives of Dermatological Research | Issue 9/2017

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Abstract

Psoriasis is a chronic inflammatory immune-mediated disorder associated and often coexisting with many other immune-related clinical conditions including those affecting the gastrointestinal tract. Data obtained from the reviewed literature suggest an association between psoriasis and pathologies of the oral cavity, both psoriasis-specific lesions, as well as non-specific, such as geographic tongue or fissured tongue. These findings show the importance of thorough examination of oral mucosa in psoriatic patients. Inflammatory bowel diseases (IBD) are also linked with psoriasis. Crohn’s disease and ulcerative colitis share a common genetic background, inflammatory pathways and have an evident iatrogenic anti-TNF treatment link, necessitating dermatological or gastroenterological care in patients with IBD or psoriasis, respectively, as well as treatment adjusted to manifestations. The presence of celiac disease-specific antibodies in psoriatic patients and their correlation with the severity of the disease show the association between these disorders. The linking pathogenesis comprises vitamin D deficiency, immune pathway, genetic background and increase in the intestinal permeability, which suggests a potential benefit from gluten-free diet among psoriatic patients. The link between psoriasis and non-alcoholic fatty liver disease implies screening patients for components of metabolic syndrome and lifestyle changes necessity. Some studies indicate increased prevalence of cancer in patients with psoriasis, probably due to negative influence of skin lesion impact on lifestyle rather than the role of psoriasis in carcinogenesis. However, there are no sufficient data to exclude such an oncogenic hit, which is yet to be confirmed. Therefore, all psoriasis-associated comorbidities establish the importance of a multidisciplinary approach in the treatment of these patients.
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Metadata
Title
Digestive system in psoriasis: an update
Authors
Daniel Pietrzak
Aldona Pietrzak
Dorota Krasowska
Andrzej Borzęcki
Kinga Franciszkiewicz-Pietrzak
Beata Polkowska-Pruszyńska
Maja Baranowska
Kristian Reich
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
Archives of Dermatological Research / Issue 9/2017
Print ISSN: 0340-3696
Electronic ISSN: 1432-069X
DOI
https://doi.org/10.1007/s00403-017-1775-7

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