Decreased prevalence of atopic features in patients with psoriatic arthritis, but not in psoriasis vulgaris

Background: The prevalence of atopic disorders is reduced in patients with various autoinflammatory diseases but, to our knowledge, this association has not been studied in psoriasis vulgaris or psoriatic arthritis (PSA). Objective: Prevalence of hay fever, asthma, and sensitization to common aeroallergens was compared in patients with psoriasis vulgaris to patients with PSA and control subjects; we also investigated whether atopy influences the arthritis activity and severity scores in patients with PSA. Methods: In a cross-sectional cohort study design, the differences in patient-reported lifetime prevalence of atopic disorders and serum IgE directed against common aeroallergens were compared. The effect of atopy on arthritis severity was assessed using the 28-joint Disease Activity Score and Health Assessment Questionnaire. Logistic regression models were used to calculate crude and adjusted odds ratios with 95% confidence intervals (CI) for presence of atopy. Results: A total of 168 patients with PSA, 133 patients with psoriasis vulgaris, and 147 control subjects were included. The lifetime prevalence of hay fever did not differ across groups. Patients with PSA were less likely to have had asthma than control subjects (adjusted odds ratio 0.20; 95% CI 0.04-0.92) and they were less likely to be sensitized (adjusted odds ratio 0.50; 95% CI 0.25-0.99). Health Assessment Questionnaire-visual analog scales for pain and for patient global score were significantly reduced by sensitization to common aeroallergens (beta-coefficients -0.54 [95% CI -0.84 to -0.25] and -18.4 [95% CI -28.5 to -8.25], respectively.) Limitations: This was a cross-sectional, small-numbered study. Conclusion: Atopy may protect against development of PSA and diminish its severity.

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