The Incidence and Prevalence of Uveitis in Psoriasis: A Systematic Review and Meta-Analysis

Abstract

Background The systemic effects and comorbidities of psoriasis include ocular disorders, such as uveitis. Patients with psoriatic arthritis in particular have been demonstrated to have an elevated risk for developing uveitis. Presently, the risk of uveitis in psoriasis has yet to be fully elucidated and this systematic review seeks to address this gap. Objective To examine the prevalence and incidence of uveitis in psoriasis patients compared to non-psoriasis patients. Methods We conducted a systematic review search on MEDLINE, Embase, and CENTRAL electronic databases with no lower limit on year of publication. Results Fourteen articles met our inclusion criteria, with a total of 234 143 psoriasis subjects. Two studies found that participants with severe psoriasis were at a greater risk of uveitis than those with mild psoriasis. A random-effects meta-analysis of the 3 studies, which reported risk of incidence of uveitis in psoriasis patients compared to non-psoriasis controls, found a pooled risk ratio of 1.29 (95% CI, 1.10-1.51), indicating an increased risk of uveitis in psoriasis. Three studies compared risk of uveitis in psoriatic arthritis with psoriasis-only participants, all finding that psoriatic arthritis was associated with a greater risk of uveitis. Conclusions In summary, our findings suggest that psoriasis is associated with an increased risk of uveitis, with or without psoriatic arthritis.

The potency of common proinflammatory cytokines measurement for revealing the risk and severity of anxiety and depression in psoriasis patients

“…The present study discovered that anxiety and depression were enhanced in psoriasis patients compared to HCs. It could be argued that compared with healthy individuals, psoriasis patients were more likely to suffer comorbidities and the body appearance damaged, which decreased the quality of life and social activities of psoriasis patients, 3 , 4 , 6 , 22 thus the prevalence of anxiety and depression was increased in psoriasis patients by contrast with HCs. Additionally, the inflammation status was generally higher in psoriasis patients; meanwhile, inflammation outbreaks were linked with the prevalence of anxiety and depression 13 ; therefore, anxiety and depression were aggravated in psoriasis patients.…”

“… 1 , 2 Although certain progress has been made in the treatment of psoriasis, this disease still cannot be completely cured and often leads to many complications, such as psoriatic arthritis, cardiovascular disease, metabolic syndrome, uveitis, etc. 3 , 4 , 5 , 6 In addition to these complications, the body appearance of the psoriasis patient is also affected 7 , 8 ; all of these factors contribute to a huge psychological burden (such as anxiety and depression) on the psoriasis patients, which causes difficulties in rehabilitation and even leads to suicide. 9 , 10 , 11 Therefore, it is necessary to explore potential factors that participate in the pathology of anxiety and depression, which might be helpful for attribution therapy and thereby improve the clinical outcomes of psoriasis patients.…”

“…Psoriasis is an inflammatory skin disease mediated by immunity, which has a high incidence and prevalence worldwide 1,2 . Although certain progress has been made in the treatment of psoriasis, this disease still cannot be completely cured and often leads to many complications, such as psoriatic arthritis, cardiovascular disease, metabolic syndrome, uveitis, etc 3–6 . In addition to these complications, the body appearance of the psoriasis patient is also affected 7,8 ; all of these factors contribute to a huge psychological burden (such as anxiety and depression) on the psoriasis patients, which causes difficulties in rehabilitation and even leads to suicide 9–11 .…”

“…(1) the HADS score for estimating anxiety and depression was a self-assessed questionnaire, which might exist an assessment bias;(2) although the linkage of proinflammatory cytokines with anxiety and depression was revealed, the detailed mechanism of these proinflammatory cytokines underlying anxiety and depression in psoriasis patients remained unclear; (3) using psoriatic tissues as samples might be more representative; subsequent studies could make improvements based on this consideration; (4) the pathogenesis of proinflammatory cytokines for regulating anxiety and depression might be different from other autoimmune diseases, further studies could take this into account and investigate the specific mechanisms; (5) some intermediate products, such as indoleamine 2,3-dioxygenase and serotonin were interacted with proinflammatory cytokines to regulate anxiety and depression; therefore, it was meaningful to detect these intermediate products as well; this could be the direction of further studies;(6) this study only assessed anxiety and depression after enrollment; further studies could explore the longitudinal changes in anxiety and depression by multiple points evaluation in psoriasis patients;(7) the linkage of proinflammatory cytokines with anxiety and depression in patients with other autoimmune diseases needed to be further explored;(8) this study revealed the linkage between proinflammatory cytokines and treatment modalities; however, whether the proinflammatory cytokines caused by treatments would further lead to anxiety and depression remained unclear; further studies could explore the linkage based on this consideration; (9) the treatments would directly modulate the levels of proinflammatory cytokines; therefore, this study evaluated the linkage between proinflammatory cytokines and treatment modalities; however, whether this regulation would further regulate anxiety and depression needed to be further explored.In summary, TNFα, IL-17A, and IL-23 increments might reflect anabatic anxiety and depression in psoriasis patients. This finding indicates the potential value of proinflammatory cytokines F I G U R E 5 TNFα, IL-17A, and IL-23, and their combination for estimating anxiety and depression in psoriasis patients.…”

Uveitis in Juvenile Psoriatic Arthritis: Still So Much To Learn

“…Studies involving predominantly adult patients report a significant association between the incidence of uveitis and psoriasis, the risk of which is greatest in patients with severe PsA. 1,2 The literature on uveitis in children focuses mainly on risk factors for the more common forms of juvenile idiopathic arthritis ( JIA) associated with uveitis and antinuclear antibody (ANA) positivity. 3,4 Information on juvenile PsA-associated uveitis ( JPsA-U) is scarce, with detailed ophthalmic findings restricted to small case series.…”