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Psoriasis beyond the skin surface: a pilot study on the ocular involvement

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Abstract

The ocular involvement in psoriasis is not a completely well-known problem. The ophthalmologic involvement occurs in about 10 % of patients, particularly in case of arthropathic or pustular psoriasis. Ocular lesions are more common in males, and they often occur during psoriasis exacerbations. Our study aimed to assess the prevalence and type of ocular involvement in psoriasis, by a comparison between psoriasis and healthy subjects, and if/how a 12-week long systemic immunosuppressive therapy is able to modify them. This study involved thirty-two psoriatic patients and thirty-two healthy subjects. Dermatological evaluation was done using Psoriasis Area and Severity Index, Physician Global Assessment, and Dermatology Life Quality Index (PASI, PGA, and DLQI score). Ophthalmological evaluation included ocular surface involvement (Schirmer, Jones, break-up time—BUT, DR-1 camera), retinal pathologies, and ocular surface disease index. Laboratory investigations including the C-reactive protein (CRP) of all the patients were performed. At baseline, the values of Schirmer, Jones, and BUT tests in the patient group were significantly lower compared to controls; moreover, conjunctival hyperemia was more frequent in psoriatic patients than in healthy subjects. Ocular involvement was more prominent in the subset of psoriatic patients with sebo-psoriasis than in general psoriatic population. A statistically significant correlation was found in sebo-psoriasis between PASI and Schirmer, between PASI and Jones, and between PASI and BUT. On the other hand, the results obtained from DR1 camera showed statistically significant difference between psoriatic and sebo-psoriatic patients at the end of the follow-up. After 12 weeks of treatment, the mean values of PASI, PGA, DLQI, CRP, and BUT showed significant changes in psoriatic patients. Our findings suggest a high rate of ocular involvement in psoriatic patients, emphasizing the need of performing periodic ophthalmological examinations in order to avoid underestimating eye diseases and to allow early diagnosis and treatment of patients.

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References

  1. Wolf K, Goldsmith LA, Kats SI, Gilchrest BA, Paller AS, Leffell DJ (eds) (2008) Psoriasis. In: Fitzpatrick’s dermatology in general medicine, vol 1, 7th edn. McGraw-Hill, New York, pp 169–193

  2. Orciani M, Campanati A, Salvolini E, Lucarini G, Di Benedetto G, Offidani A, Di Primio R (2011) The mesenchymal stem cell profile in psoriasis. Br J Dermatol 165(3):92–585

    Google Scholar 

  3. Votrubova J, Juzlova K, Smerhovsky Z, Fialova J, Gopfertova D, Vojackova N, Hercogova J (2013) Risk factors for comorbidities in Czech psoriatic patients: results of a hospital-based case-control study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. doi:10.5507/bp.2013.062

    PubMed  Google Scholar 

  4. Campanati A, Ganzetti G, Di Sario A, Damiani A, Sandroni L, Rosa L, Benedetti A, Offidani A (2013) The effect of etanercept on hepatic fibrosis risk in patients with non-alcoholic fatty liver disease, metabolic syndrome, and psoriasis. J Gastroenterol 48(7):839–846. doi:10.1007/s00535-012-0678-9

    Article  CAS  PubMed  Google Scholar 

  5. Campanati A, Orciani M, Gorbi S, Regoli F, Di Primio R, Offidani A (2012) Effect of biologic therapies targeting tumour necrosis factor-α on cutaneous mesenchymal stem cells in psoriasis. Br J Dermatol 167(1):68–76. doi:10.1111/j.1365-2133.2012.10900.x

    Article  CAS  PubMed  Google Scholar 

  6. Campanati A, Gesuita R, Giannoni M, Piraccini F, Sandroni L, Martina E, Conocchiari L, Bendia E, Di Sario A, Offidani A (2013) Role of small intestinal bacterial overgrowth and Helicobacter pylori infection in chronic spontaneous urticaria: a prospective analysis. Acta Derm Venereol 93(2):4–161

    Article  Google Scholar 

  7. Ganzetti G, Campanati A, Offidani A (2012) Alopecia Areata: a possible extraintestinal manifestation of Crohn’s disease. J Crohns Colitis 6(9):3–962

    Article  Google Scholar 

  8. Campanati A, Giuliodori K, Ganzetti G, Liberati G, Offidani AM (2010) A patient with psoriasis and vitiligo treated with etanercept. Am J Clin Dermatol 11(Suppl 1):8–46

    Google Scholar 

  9. Chandran NS, Greaves M, Gao F, Lim L, Cheng BC (2007) Psoriasis and eye: prevalence of the disease in Singaporean Asian patients with psoriasis. J Dermatol 34(12):10–805

    Article  Google Scholar 

  10. Hamideh F, Prete PE (2001) Ophthalmologic manifestations of rheumatic diseases. Semin Arthritis Rheum 30(4):4–1217

    Article  Google Scholar 

  11. Rehal B, Modjtahedi BS, Morse LS, Schwab IR, Maibach HI (2011) Ocular psoriasis. J Am Acad Dermatol 65(6):12–1202

    Google Scholar 

  12. Stuart JA (1963) Ocular psoriasis. Am J Ophthalmol 55:7–615

    Google Scholar 

  13. Kaldeck R (1953) Ocular psoriasis; clinical review of eleven cases and some comments on treatment. AMA Arch Dermatol Syphilol 68(1):9–44

    Google Scholar 

  14. Yokoi N, Takehisa Y, Kinoshita S (1996) Correlation of lipid layer interference patterns with the diagnosis and severity of dry eye. Am J Ophthalmol 122:818–824

    Article  CAS  PubMed  Google Scholar 

  15. Goto E, Tseng SC (2003) Differentiation of lipid tear deficiency dry eye by kinetic analysis of tear interference images. Arch Ophthalmol 121:173–180

    Article  PubMed  Google Scholar 

  16. Lambert JR, Wright V (1976) Eye inflammation in psoriatic arthritis. Ann Rheum Dis 35(4):6–354

    Article  Google Scholar 

  17. Erbagci I, Erbagci Z, Gungor K, Bekir N (2003) Ocular anterior segment pathologies and tear film changes in patients with psoriasis vulgaris. Acta Med Okayama 57(6):299–303

    PubMed  Google Scholar 

  18. Varma S, Woboso AF, Lane C, Holt PJ (1999) The peripheral corneal melting syndrome and psoriasis: coincidence or association? Br J Dermatol 141(2):6–344

    Google Scholar 

  19. Kilic B, Dogan U, Parlak AH, Goksugur N, Polat M, Serin D, Ozmen S (2013) Ocular findings in patients with psoriasis. Int J Dermatol 52(5):9–554

    Article  Google Scholar 

  20. Rehal B, Modjtahedi BS, Morse LS, Schwab IR, Maibach HI (2011) Ocular psoriasis. J Am Acad Dermatol 65(6):1202–1212

  21. Her Y, Lim JW, Han SH (2013) Dry eye and tear film functions in patients with psoriasis. Jpn J Ophthalmol 57(4):341–346

    Article  PubMed  Google Scholar 

  22. Sandvig K, Westwrbwrg P (1955) Ocular findings in psoriatics. Acta ophthalmol (Copenh) 33(4):7–463

    Google Scholar 

  23. Knox DL (1979) Psoriasis and intraocular inflammation. Trans Am Ophthalmol Soc 77:24–210

    Google Scholar 

  24. Lima FB, Abalem MF, Ruiz DG, Gomes Bde A, Azevedo MN, Moraes HV Jr, Yeskel AS, Kara-Junior N (2012) Prevalence of eye disease in Brazilian patients with psoriatic arthritis. Clinics (Sao Paulo) 67(3):249–253

    Article  Google Scholar 

  25. Zengin N, Tol H, Balevi S, Gündüz K, Okudan S, Endoğru H (1996) Tear film and meibomian gland functions in psoriasis. Acta Ophthalmol Scand 74(4):60–358

    Google Scholar 

  26. Cram DL (1981) Corneal melting in psoriasis. J Am Acad Dermatol 5(5):617

    Article  CAS  PubMed  Google Scholar 

  27. Collier M (1962) Modifications of the crystalline in psoriasis patients. Bull Soc Ophtalmol Fr 62:59–65

    CAS  PubMed  Google Scholar 

  28. Manna F, Jankowski W (1966) Biomicroscopic examinations of the lens in cases of psoriasis. Klin Oczna 36(3):4–371

    Google Scholar 

  29. Schmitt J, Zhang Z, Wozel G, Meurer M, Kirch W (2008) Efficacy and tolerability of biologic and nonbiologic systemic treatments for moderate-to-severe psoriasis: meta-analysis of randomized controlled trials. Br J Dermatol 159(3):26–513

    Google Scholar 

  30. De Simone C, Amerio P, Amoruso G, Bardazzi F, Campanati A, Conti A, Gisondi P, Gualdi G, Guarneri C, Leoni L, Loconsole F, Mazzotta A, Musumeci ML, Piaserico S, Potenza C, Prestinari F (2013) Immunogenicity of anti-TNFα therapy in psoriasis: a clinical issue? Expert Opin Biol Ther 13(12):82–1673

    Article  Google Scholar 

  31. Campanati A, Ganzetti G, Di Sario A, Benedetti A, Offidani A (2013) Insulin resistance, serum insulin and HOMA-R. J Gastroenterol 48(5):673

    Article  CAS  PubMed  Google Scholar 

  32. Campanati A, Moroncini G, Ganzetti G, Pozniak KN, Goteri G, Giuliano A, Martina E, Liberati G, Ricotti F, Gabrielli A, Offidani A (2013) Adalimumab modulates angiogenesis in psoriatic skin. Eur J Inflamm 11(2):489–498

    CAS  Google Scholar 

  33. Huynh N, Cervantes-Castaneda RA, Bhat P et al (2008) Biologic response modifier therapy for psoriatic ocular inflammatory disease. Ocul Immunol Inflamm 16(3):89–93

    Article  CAS  PubMed  Google Scholar 

  34. Mease PJ, Goffe BS, Metz J et al (2000) Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial. Lancet 356:90–385

    Article  Google Scholar 

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Conflict of interest

The authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Dermatology Unit, University of Marche, Azienda Ospedaliera Universitaria-Ospedali Riuniti di, Ancona Via Conca 71, 60126, Ancona, Torrette, Italy

    A. Campanati, K. Giuliodori, E. Borioni & A. Offidani

  2. Ocular Immunology Service, The Eye Clinic, Polytechnic University of Marche, Azienda Ospedaliera Universitaria-Ospedali Riuniti di Ancona, Via Conca 71, 60126, Ancona, Torrette, Italy

    P. Neri, I. Arapi, G. Carbonari, C. Mariotti & A. Giovannini

  3. Retinal and Inflammatory Eye Disease, Centre for Ophthalmic Specialized Care (COS), Clinic Montchoisi, Lausanne, Switzerland

    C. P. Herbort

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  1. A. Campanati
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  2. P. Neri
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  3. K. Giuliodori
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  4. I. Arapi
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  5. G. Carbonari
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  6. E. Borioni
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  7. C. P. Herbort
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  8. C. Mariotti
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  9. A. Giovannini
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  10. A. Offidani
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Correspondence to G. Carbonari.

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A. Campanati and P. Neri have equally contributed to the manuscript.

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Campanati, A., Neri, P., Giuliodori, K. et al. Psoriasis beyond the skin surface: a pilot study on the ocular involvement. Int Ophthalmol 35, 331–340 (2015). https://doi.org/10.1007/s10792-014-9950-8

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  • DOI: https://doi.org/10.1007/s10792-014-9950-8

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