Thyroid abnormality in patients with psoriasis: prevalence and association with severity

BACKGROUND

Psoriasis is associated with several comorbidities and its association with thyroid abnormality has been hypothesized.

OBJECTIVE

To assess the prevalence of thyroid abnormality in Brazilian patients with psoriasis and to analyze its association with severity, presence of psoriatic arthritis and immunobiological treatment. Additionally, to compare results with literature as a control.

METHODS

In this observational study, clinical and laboratory data of patients followed from January 2018 to December 2019 were analyzed. Thyroid abnormality was assessed through the current history of thyroid disease and laboratory tests - thyrotropin (TSH), free thyroxine (FT4), antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-TG) antibodies. Patients were classified according to psoriasis severity - Psoriasis Area and Severity Index (PASI), presence of psoriatic arthritis, and current treatment. Subsequently, the results were compared with a control group selected from the literature review.

RESULTS

Of the 250 included patients, 161 were eligible. The prevalence of thyroid abnormality was 28.57% and of hypothyroidism, 14.91%. The mean age was 55 years and the median PASI was 2.2. There was no association between thyroid abnormality and PASI (p=0.8), presence of psoriatic arthritis (p=0.87), or use of immunobiological therapy (p=0.13). The literature control group included 6,227 patients and there was a statistically significant difference for the hypothyroidism variable (p<0.0001).

STUDY LIMITATIONS

Absence of a control group from the same center.

CONCLUSION

This was one of the first Brazilian studies on the prevalence of thyroid abnormality in patients with psoriasis.

Líquen plano da conjuntiva ocular

O líquen plano (LP) é uma doença autoimune, recorrente, de etiologia desconhecida. Pode apresentar associação com distúrbios psíquicos, hipertensão arterial e alcoolismo crônico. Líquen plano ocular (LPO), por sua vez, é uma doença rara, com incidência de 0,22% a 5% em todo o mundo. Afeta principalmente adultos de meia-idade, entre 30-60 anos, e não apresenta predileção de gênero ou raça. O presente relato de caso trata-se de um paciente com LPO isolado com remissão total da lesão após introdução de corticoide sistêmico.