DOP066. Psoriasis phenotype in inflammatory bowel disease: a case–control prospective longitudinal study
E. Lolli1, R. Saraceno2, G. Condino1, C. Petruzziello1, M. Ascolani1, S. Onali1, E. Calabrese1, S. Chimenti2, F. Pallone1, L. Biancone1, 1Università di Roma Tor Vergata, Medicina dei sistemi, cattedra di Gastroenterologia, Roma, Italy, 2Dermatology Unit, University of Rome Tor Vergata, Systems Medicine, Rome, Italy
Psoriasis has been associated with Inflammatory Bowel Disease (IBD). However, whether IBD is associated with specific phenotypes of psoriasis is unknown. In a case–control prospective longitudinal study, we aimed to assess the psoriasis phenotype in patients with IBD, when compared with non-IBD control patients (non-IBD C).
From January 2011 to April 2013, dermatological assessment was performed in 188 consecutive IBD patients under follow up. Dermatological assessment was focused in detecting the presence of psoriasis (present/absent) and in defining characteristics of psoriasis (localization, phenotype) including severity (mild/moderate/severe). In order to define psoriasis phenotype, each IBD patient with psoriasis was matched for gender, ethnicity and age (±5 years) with one non-IBD patient with psoriasis, referring to the same University/Hospital. Data were expressed as median and range and differences between groups assessed by the T test.
Dermatological assessment was performed in 188 IBD patients (85 F, age 45.5 yrs, range 18–85; IBD duration 9 yrs, range 1–46). Among these 188 patients, there were 72 UC (35 M, age 47, range 23–85; UC duration 6 yrs, range 1–40; UC extent: distal 26, left 11, extensive 31, ileal pouch 3, ileostomy 1) and 116 CD (69 M, age 44, range 18–80; CD duration 10 yrs, range 1–46; CD colitis 8, ileo-colitis 24, ileitis 34, neo-terminal ileum 45, ileostomy 2, jejunum 1, distal ileum + jejunum 2). Non-IBD C included 50 patients (31 M, age 47, range 18–75). Among the 188 IBD patients, psoriasis was detected in 48 (26%; 28 CD, 20 UC). In the IBD group, the median age and IBD duration were comparable in patients with or without psoriasis (age 50.5 range 23–72 vs 44 range 18–85; IBD duration 8 yrs range 1–45 vs 9 yrs range 1–41; p = ns for both). Mild psoriasis was detected in a higher proportion of IBD patients (40/48; 83%) than non-IBD C (28/50; 56%; p < 0.001). Scalp psoriasis and sebopsoriasis were the more common psoriasis phenotype in IBD (16/48; 33%), followed by inverse psoriasis (7/48; 15%) and by palmo-plantar psoriasis (5/48; 10%). Psoriatic arthritis was detected in 9/50 (18%) non-IBD C and in 4/48 (8%) IBD patients (p = n.s.). In 4/48 (12%) IBD patients, psoriasis developed after anti-TNFs (palmo-palmar 3, sebopsoriasis 1).
Results from a cohort of IBD patients matched with non-IBD control patients suggest that specific phenotypes of psoriasis may be associated with IBD.