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Arch Dermatol Res. 2017 Nov;309(9):679-693. doi: 10.1007/s00403-017-1775-7. Epub 2017 Sep 13.

Digestive system in psoriasis: an update.

Author information

1
Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland.
2
Chair and Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, Poland.
3
Chair and Department of Hygiene, Medical University of Lublin, Lublin, Poland.
4
Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland.
5
Student's Scientific Association at the Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland. polkowska.beata@gmail.com.
6
Institute of Fine Arts University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
7
Dermatologikum Hamburg, Hamburg, Germany.

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.

KEYWORDS:

Cancer; Celiac disease; Geographic tongue; Inflammatory bowel disease; Non-alcoholic fatty liver disease; Oral cavity; Psoriasis

PMID:
28905102
PMCID:
PMC5648743
DOI:
10.1007/s00403-017-1775-7
[Indexed for MEDLINE]
Free PMC Article

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