Association of Behçet disease with psoriasis and psoriatic arthritis

Abstract

Behçet disease (BD) is a debilitating multi-systemic vasculitis with a litany of muco-cutaneous manifestations and potentially lethal complications. Meanwhile, psoriasis (PSO) is a cutaneous and systemic inflammatory disorder marked by hyperplastic epidermis and silvery scales, which may be accompanied by a distinct form of arthropathy called psoriatic arthritis (PsA). While the clinical pictures of these two are quite different, they feature some important similarities, most of which may stem from the autoinflammatory components of BD and PSO. Therefore, the aim of this study was to investigate the prospective link between BD and cutaneous and articular manifestations of psoriasis. BD, PSO, and PsA cohorts were extracted using the National Health Insurance Service of Korea database. Using χ2 tests, prevalence of PSO and PsA with respect to BD status was analysed. Relative to non-BD individuals, those with personal history of BD were nearly three times more likely to be diagnosed with PSO. The adjusted odds ratio (aOR) was 2.36 [95% confidence interval (CI), 1.91–2.93, p < 0.001]. Elevated PSO risk was more pronounced in the male BD cohort (aOR = 1.19, 95% CI 1.16–1.23, p < 0.001). In age-group sub-analysis, individuals over 65 years with PSO were one and a half times more likely to be affected with BD, relative to those under 65. The adjusted OR for the older group was 1.51 (95% CI 1.43–1.59, p < 0.001). BD individuals with “healthy” body weight were significantly less likely to be affected by PSO (aOR = 0.59, 95% CI 0.57–0.62, p < 0.001). On the other hand, there was a correlation between BMI and the risk of BD, with the “moderately obese (30–35 kg/m2)” group having an aOR of 1.24 (95% CI 1.12–1.38, p < 0.001). BD patients were also twice more likely to be associated with PsA (aOR = 2.19, 95% CI 1.42–3.38, p < 0.001). However, in contrast to the case of psoriatic disease itself, females were exposed to a greater risk of developing BD compared to the male PsA cohort (aOR = 2.02, 95% CI 1.88–2.16, p < 0.001). As with PSO, older BD patients were exposed to a significantly higher risk of developing PsA (aOR = 3.13, 95% CI 2.90–3.40, p < 0.001). Behçet disease may place an individual at a significantly increased risk of psoriasis, and still greater hazard of being affected with psoriatic arthritis. This added risk was pronounced in the male cohort, and tended to impact senile population, and this phenomenon may be related with the relatively poor prognosis of BD in males and PSO in older patients.

Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review

“…An association was also confirmed between psoriasis and hearing loss (217), Behcȩt's disease (218), scabies infection (219), and pediatric infection (220).…”

Behçet syndrome: The disturbed balance between anti- (CLEC12A, CLC) and pro-inflammatory (IFI27) gene expressions

“…[39][40][41][42][43][44][45][46][47][48][49][50] It is also well-known that, some of these above-mentioned inflammatory diseases (i.e., inflammatory bowel diseases, psoriasis, and systemic lupus erythematosus) have an intersection with BS. [51][52][53] Similar to CLEC12A , IFI27 is also among the top 10 most differentially ex-pressed genes of the class comparisons (second in M vs. C with an FC: 3.49, second in Ovs. C with an FC: 2.14, and third in V vs. C with an FC: 4.34) (Table 6).…”

Behçet syndrome: The disturbed balance between anti‐ (CLEC12A, CLC) and proinflammatory (IFI27) gene expressions

“… 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 It is also well‐known that, some of these above‐mentioned inflammatory diseases (i.e., inflammatory bowel diseases, psoriasis, and systemic lupus erythematosus) have an intersection with BS. 51 , 52 , 53 Regarding interferons in BS, Belguendouz et al reported an increased in vivo and in vitro production of interferon gamma in active ocular BS patients compared to inactive patients and healthy controls. 54 Additionally in the same study, interferon gamma was shown to induce nitric oxide production in vitro.…”

“…The literature harbors many inflammatory/immunological conditions including inflammatory bowel diseases, psoriasis, systemic lupus erythematosus, Sjögren's syndrome, antiphospholipid syndrome, acute graft‐versus‐host disease, immune thrombocytopenic purpura, Aicardi−Goutieres syndrome, Kikuchi−Fujimoto, and hand, foot, and mouth diseases, in which significant increases in IFI27 expression have been reported 39–50 . It is also well‐known that, some of these above‐mentioned inflammatory diseases (i.e., inflammatory bowel diseases, psoriasis, and systemic lupus erythematosus) have an intersection with BS 51–53 . Regarding interferons in BS, Belguendouz et al reported an increased in vivo and in vitro production of interferon gamma in active ocular BS patients compared to inactive patients and healthy controls 54 .…”