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Gan TS, Ghazali NI, Voo SYM, Low DE, Tang JJ, Kiing JW, Muniandy P, Tey KE, Wong KW, Mohamad N, Tan WC, Selvarajah L, Ramalingam R, Ng FY, Lee CS, Raja T, Abdul Rahim NS, Tang MM, Robinson S. Clinical characteristics, management, and quality of life of psoriasis patients with coexistent lupus erythematosus: Data from the Malaysian Psoriasis Registry. Int J Rheum Dis 2023; 26:327-336. [PMID: 36382593 DOI: 10.1111/1756-185x.14492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/08/2022] [Accepted: 10/28/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe the clinical characteristics, management and quality of life of psoriasis patients with and without coexistent lupus erythematosus (LE). METHODS This retrospective cross-sectional study uses data from the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018. RESULTS Of 21 735 psoriasis patients, 34 (0.16%) had coexistent LE. The male to female ratio among psoriasis patients with coexistent LE was 1:5.8 versus 1.3:1 in patients with psoriasis but without LE. Nearly 70% presented with LE preceding psoriasis. Psoriasis patients with LE had an earlier age of psoriasis onset (27.56 ± 11.51 versus 33.31 ± 16.94 years, P = 0.006), a higher rate of psoriatic arthropathy (26.5% versus 13.0%, P = 0.02), and a significantly greater impairment of quality of life (Dermatology Quality of Life Index >10; 57.6% versus 40.3%, P = 0.04) compared with psoriasis patients without LE. The majority (87.5%) had systemic LE. The incidences of lupus nephritis (72.7% versus 40%) and hematological abnormalities (50% versus 20%) were higher among patients with LE preceding psoriasis compared with those with psoriasis preceding LE. Antinuclear antibody and double-stranded DNA were positive in 59.4% and 28.1% of psoriasis patients with LE, respectively. Hydroxychloroquine triggered the onset of psoriasis in 7 (24.1%) patients. Patients with LE were more likely to receive systemic treatment for psoriasis compared with those without LE (30.3% versus 14.2%, P = 0.008). CONCLUSIONS Psoriasis patients with coexistent LE were uncommon, displayed a female preponderance, were more likely to have joint involvement, and had greater quality of life impairment than those without LE. LE preceded psoriasis in most of these patients, and systemic LE was the most common subtype.
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Affiliation(s)
- Teck Sheng Gan
- Department of Dermatology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | | | | | - Dyoi-E Low
- Department of Dermatology, Hospital Serdang, Kajang, Malaysia
| | - Jyh Jong Tang
- Department of Dermatology, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia
| | - Jiu Wen Kiing
- Department of Dermatology, Hospital Umum Sarawak, Kuching, Malaysia
| | - Pubalan Muniandy
- Department of Dermatology, Hospital Umum Sarawak, Kuching, Malaysia
| | - Kwee Eng Tey
- Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | - Kit Wan Wong
- Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | - Norazura Mohamad
- Department of Dermatology, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia
| | - Wooi Chiang Tan
- Department of Dermatology, Hospital Pulau Pinang, Georgetown, Malaysia
| | - Latha Selvarajah
- Department of Dermatology, Hospital Sultan Ismail, Johor Bharu, Malaysia
| | | | - Fei Yin Ng
- Department of Dermatology, Hospital Tengku Ampuan Rahimah, Klang, Malaysia
| | - Choon Sian Lee
- Department of Dermatology, Hospital Melaka, Melaka, Malaysia
| | - Teeba Raja
- Department of Dermatology, Hospital Selayang, Batu Caves, Malaysia
| | | | - Min Moon Tang
- Department of Dermatology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Suganthy Robinson
- Department of Dermatology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
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García-Arpa M, Flores-Terry MA, Ramos-Rodríguez C, Franco-Muñoz M, González-Ruiz L, Ramírez-Huaranga MA. Cutaneous lupus erythematosus, morphea profunda and psoriasis: A case report. REUMATOLOGIA CLINICA 2020; 16:180-182. [PMID: 29625815 DOI: 10.1016/j.reuma.2018.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 01/23/2018] [Accepted: 02/07/2018] [Indexed: 06/08/2023]
Abstract
Psoriasis is a common inflammatory dermatosis that may be associated with a number of diseases. Recent studies provide evidence that there is a greater frequency of autoimmune diseases, but association with autoimmune connective tissue diseases is uncommon. The coexistence of psoriasis and lupus erythematosus is rare. Besides, the occurrence of morphea has rarely been reported in patients with lupus or psoriasis. We report a woman with cutaneous lupus and morphea profunda associated with psoriasis, with an excellent response to methotrexate, and review the literature.
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Affiliation(s)
- Mónica García-Arpa
- Servicio de Dermatología, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
| | - Miguel A Flores-Terry
- Servicio de Dermatología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Claudia Ramos-Rodríguez
- Servicio de Anatomía Patológica, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Monserrat Franco-Muñoz
- Servicio de Dermatología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Lucía González-Ruiz
- Servicio de Dermatología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
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Jamil A, Goh S, Nor N, Cader R, Shaharir S. Exacerbation of systemic lupus erythematosus in a patient with concomitant chronic plaque psoriasis treated with ustekinumab. Indian J Dermatol Venereol Leprol 2020; 86:68-70. [DOI: 10.4103/ijdvl.ijdvl_961_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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4
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Company-Quiroga J, Alique-García S, Romero-Maté A. Current Insights Into The Management Of Discoid Lupus Erythematosus. Clin Cosmet Investig Dermatol 2019; 12:721-732. [PMID: 31632120 PMCID: PMC6781736 DOI: 10.2147/ccid.s184824] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/18/2019] [Indexed: 12/18/2022]
Abstract
Discoid lupus erythematosus is the most disfiguring and common presentation of chronic cutaneous lupus erythematosus. Although most patients will respond to lifestyle measures and topical treatment, a non-negligible number of patients will require systemic and physical therapy, either alone or in combination. We performed a review of the available evidence on the discoid lupus erythematosus treatment. Lifestyle measures and topical treatment (corticosteroids and topical calcineurin inhibitors) remain the therapeutic strategies with the highest evidence level. Within systemic treatment approaches, antimalarial drugs are still the first-line therapy, while other systemic and physical therapies have highly variable evidence. Hence, we propose a therapeutic algorithm based on the strength of recommendations of the different treatment modalities, focusing on the refractory disease.
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Rodríguez-Jiménez P, Chicharro P, Godoy A, Llamas-Velasco M, García M, Daudén E. No evidence for induction of autoantibodies or autoimmunity during treatment of psoriasis with ustekinumab. Br J Dermatol 2017; 177:862-863. [PMID: 28508387 DOI: 10.1111/bjd.15654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P Rodríguez-Jiménez
- Department of Dermatology, Instituto de Investigación Sanitaria Princesa (IIS-IP), Hospital Universitario la Princesa, Madrid, Spain
| | - P Chicharro
- Department of Dermatology, Instituto de Investigación Sanitaria Princesa (IIS-IP), Hospital Universitario la Princesa, Madrid, Spain
| | - A Godoy
- Department of Dermatology, Hospital Universitario Puerta del Sur de Móstoles, Madrid, Spain
| | - M Llamas-Velasco
- Department of Dermatology, Instituto de Investigación Sanitaria Princesa (IIS-IP), Hospital Universitario la Princesa, Madrid, Spain
| | - M García
- Department of Immunology, Instituto de Investigación Sanitaria Princesa (IIS-IP), Hospital Universitario la Princesa, Madrid, Spain
| | - E Daudén
- Department of Dermatology, Instituto de Investigación Sanitaria Princesa (IIS-IP), Hospital Universitario la Princesa, Madrid, Spain
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Prieto-Barrios M, Castellanos-González M, Velasco-Tamariz V, Burillo-Martínez S, Morales-Raya C, Ortiz-Romero P, Rivera-Diaz R. Two poles of the Th 17-cell-mediated disease spectrum: Analysis of a case series of 21 patients with concomitant lupus erythematosus and psoriasis. J Eur Acad Dermatol Venereol 2016; 31:e233-e236. [DOI: 10.1111/jdv.13986] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. Prieto-Barrios
- Department of Dermatology; Hospital Universitario 12 de Octubre; Madrid Spain
| | | | - V. Velasco-Tamariz
- Department of Dermatology; Hospital Universitario 12 de Octubre; Madrid Spain
| | - S. Burillo-Martínez
- Department of Dermatology; Hospital Universitario 12 de Octubre; Madrid Spain
| | - C. Morales-Raya
- Department of Dermatology; Hospital Universitario 12 de Octubre; Madrid Spain
| | - P. Ortiz-Romero
- Department of Dermatology; Hospital Universitario 12 de Octubre; Madrid Spain
| | - R. Rivera-Diaz
- Department of Dermatology; Hospital Universitario 12 de Octubre; Madrid Spain
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