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P400. Psoriasis phenotype in inflammatory bowel disease

E. Lolli1, R. Saraceno1, G. Condino1, C. Petruzziello1, S. Onali1, E. Calabrese1, S. Chimenti1, F. Pallone1, L. Biancone1, 1Università Tor Vergata, Roma, Roma, Italy

Background

Psoriasis has been associated with Inflammatory Bowel Disease (IBD). However, whether IBD is associated with specific phenotypes of psoriasis is undefined. In a prospective longitudinal study, we aimed to assess the psoriatic phenotype in IBD patients, when compared with non-IBD control patients (non-IBD C).

Methods

From January 2011 to November 2012, dermatological assessment was performed in 152 IBD patients under follow up. Dermatological assessment was focused in detecting the presence and features of psoriasis (present/ absent, localization, phenotype, severity: defined as mild/moderate/severe). In order to define psoriasis phenotype, each IBD patient with psoriasis was matched for gender, ethnicity and age with one patient with psoriasis and no-IBD, referring to the same University/Hospital.

Results

Dermatological assessment was performed in 152 IBD patients (72 F, median age 46, range 18–80; IBD duration median 9 yrs, range 1–45). Among these 152 patients, there were 55 UC (22 M, median age 47, range 23–80; median duration 6yrs, range 1–40; UC distal 22, left 8, extensive 22, ileo-ano-pouch 1, ileostomy 2) and 97 CD (58 M, median age 45, range 18–79; median duration 10yrs, range 1–45; CD colitis 7, ileo-colitis 20, ileitis 25, neo-terminal ileum 40, ileostomy 2, jejunum 1). Non-IBD C included 35 patients (19M, median age 48, range 18–67). Among the 152 IBD patients, psoriasis was detected in 34 (22%; 20 CD, 14 UC). In IBD, age and IBD duration was comparable in patients with or without psoriasis (median: 51 range 23–72 vs 44 range 18–80; p = n.s.; median: 7 range 1–45 vs 9 range 1–40; p = n.s.; unpaired T test). Mild psoriasis was detected in a higher proportion of IBD patients (32/34; 94%) than non-IBD C (22/35; 64%; p < 0.001, T test). Differently from non-IBD C, no IBD pts showed nail psoriasis (9/35; 25% vs 0/34, 0%; p < 0.001, T test). Scalp psoriasis and sebopsoriasis were the more common phenotype in IBD (12/34; 35%), followed by palmo-plantar psoriasis (5/34; 15%) and inverse psoriasis (5/34; 15%). Psoriatic arthritis was detected in 5/35 (15%) non-IBD-C and in 3/34 (9%) IBD (p = n.s.). In 4/34 (12%) IBD patients, psoriasis was observed after anti-TNFs (palmo-palmar 3, sebo­psoriasis 1).

Conclusion

Specific phenotypes of psoriasis may be associated with IBD.