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Emma C, Vesela P, Kay P, Huseyin H, Alison H, Mara S, Floriana DA, Sara C. Psoriasiform dermatitis following ocrelizumab in relapsing-remitting multiple sclerosis: Case report and literature review. Mult Scler 2024; 30:893-897. [PMID: 38385208 DOI: 10.1177/13524585241232277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
We present a case of a 30-year-old man with relapsing-remitting multiple sclerosis who developed psoriasiform dermatitis following his second course of ocrelizumab. This resolved with topical therapies and discontinuation of treatment. Cases of psoriasiform rashes have been increasingly reported in the use of ocrelizumab and are possibly due to B-cell (CD20) depletion and T-cell overregulation. Nevertheless, skin-related adverse reactions are not yet considered in the risk management plans of anti-CD20 treatments in multiple sclerosis.
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Affiliation(s)
- Callanan Emma
- Department of Neurology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
| | - Petkova Vesela
- Department of Neurology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
| | - Polly Kay
- Department of Neurology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
| | - Huseyin Huseyin
- Department of Neurology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
| | - Hassett Alison
- Department of Neurology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
| | - Sittampalam Mara
- Department of Neurology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
| | - De Angelis Floriana
- Department of Neurology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
- Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Collorone Sara
- Department of Neurology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
- Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
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Zhou H, Qi Y, Xu Y, Qi X, Qi H. Reverse causation between multiple sclerosis and psoriasis: a genetic correlation and Mendelian randomization study. Sci Rep 2024; 14:8845. [PMID: 38632254 PMCID: PMC11024188 DOI: 10.1038/s41598-024-58182-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024] Open
Abstract
Observational studies have found a potential bidirectional positive association between multiple sclerosis and psoriasis, but these studies are susceptible to confounding factors. We examined the directionality of causation using Mendelian randomization and estimated the genetic correlation using the linkage disequilibrium score. We performed Mendelian randomization analysis using large-scale genome-wide association studies datasets from the International Multiple Sclerosis Genetics Consortium (IMSGC, 115,803 individuals of European ancestry) and FinnGen (252,323 individuals of European ancestry). We selected several Mendelian randomization methods including causal analysis using summary effect (CAUSE), inverse variance-weighted (IVW), and pleiotropy-robust methods. According to CAUSE and IVW the genetic liability to MS reduces the risk of psoriasis (CAUSE odds ratio [OR] 0.93, p = 0.045; IVW OR 0.93, p = 2.51 × 10-20), and vice versa (CAUSE OR 0.72, p = 0.001; IVW OR 0.71, p = 4.80 × 10-26). Pleiotropy-robust methods show the same results, with all p-values < 0.05. The linkage disequilibrium score showed no genetic correlation between psoriasis and MS (rg = - 0.071, p = 0.2852). In summary, there is genetic evidence that MS reduces the risk of psoriasis, and vice versa.
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Affiliation(s)
- Hao Zhou
- Peking University Shenzhen Hospital Clinical College, Anhui Medical University, Shenzhen, 518036, China
- The Fifth Clinical Medical College, Anhui Medical University, Hefei, 230000, China
- Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Yajie Qi
- Peking University Shenzhen Hospital Clinical College, Anhui Medical University, Shenzhen, 518036, China
- The Fifth Clinical Medical College, Anhui Medical University, Hefei, 230000, China
- Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Yingxin Xu
- Peking University Shenzhen Hospital Clinical College, Anhui Medical University, Shenzhen, 518036, China
- The Fifth Clinical Medical College, Anhui Medical University, Hefei, 230000, China
- Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Xiaoyi Qi
- Medical College, Shantou University, Shantou, 515000, China
| | - Hui Qi
- Peking University Shenzhen Hospital Clinical College, Anhui Medical University, Shenzhen, 518036, China.
- The Fifth Clinical Medical College, Anhui Medical University, Hefei, 230000, China.
- Peking University Shenzhen Hospital, Shenzhen, 518036, China.
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Porwal MH, Patel D, Maynard M, Obeidat AZ. Disproportional increase in psoriasis reports in association with B cell depleting therapies in patients with multiple sclerosis. Mult Scler Relat Disord 2022; 63:103832. [PMID: 35512502 DOI: 10.1016/j.msard.2022.103832] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/14/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Some pathways involved in the pathogenesis of psoriasis share similarities with processes involved in multiple sclerosis (MS) pathogenesis. However, the association between MS and psoriasis is poorly understood. Since disease-modifying therapies for MS have various targets, it may be possible that the occurrence of psoriasis varies by drug. OBJECTIVE To analyze the frequency of psoriasis reports in patients treated with various disease-modifying therapies for MS. METHODS Data was collected using the FDA Adverse Event Reporting System (FAERS) and OpenFDA database between January 2009 and June 2020. The study analyzed total reports of psoriasis out of total reports in the "Skin and Subcutaneous Tissue Disorders" category for each drug and explored age, sex distribution, and report source. OpenFDA data was used to perform statistical analyses including reporting odds ratios (ROR) and information components. RESULTS The study identified 517 psoriasis reports of 45,547 total skin and subcutaneous tissue disorders (1.13%) in FAERS. The highest proportions of reports in this study were associated with rituximab, ocrelizumab, and interferon beta 1a. The lowest proportion of reports were associated with glatiramer acetate, alemtuzumab, dimethyl fumarate and teriflunomide. Reports of other autoimmune skin disorders were minimal (29 vitiligo, 33 pemphigoid, and 7 pemphigus). Patients primarily drove reports for most DMTs versus healthcare providers. The proportion of reports from female patients were the highest for each DMT except alemtuzumab. OpenFDA query retrieved 302 total reports of psoriasis. Significantly increased reporting odds ratios (RORs, 95% confidence interval) of psoriasis were noted for rituximab (7.14, 3.92-13.00), ocrelizumab (3.79, 2.74-5.23), and fingolimod (1.33, 1.01-1.76). Significantly decreased RORs were noted for natalizumab (0.53, 0.36-0.80), glatiramer acetate (0.58, 0.35-0.96), and dimethyl fumarate (0.71, 0.53-0.94). CONCLUSION There are frequent reports of psoriasis in MS patients treated with various DMTs. However, reports and RORs were disproportionally high in association with B cell depleting therapies. Further research is required to determine if certain DMTs may serve as better options for individuals affected by, or at high-risk for developing psoriasis.
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Berkovich R, Yakupova A, Eskenazi J, Carlson NG, Steinman L. Improvement of Comorbid Psoriasis in Patients With MS Treated With Natalizumab. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2021; 8:8/2/e961. [PMID: 33589543 PMCID: PMC8057059 DOI: 10.1212/nxi.0000000000000961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/08/2020] [Indexed: 12/01/2022]
Abstract
Objective To present observations on administration of natalizumab to 18 patients with the comorbid MS and psoriasis, who represented a full subset of patients with such comorbidity within the patient records available. Methods A retrospective analysis of patient records was performed. Patient histories were gathered and included date of diagnosis of MS and psoriasis, MS disease-modifying therapies (DMTs), Expanded Disability Status Scale (EDSS), reason for DMT switch, and effects on MS and psoriasis status. Results On initiation of natalizumab, all 18 patients had a complete cessation of MS disease activity (within 2–8 months) with significant patient-reported improvement of psoriasis (within 1–5 months). This improvement was independent of previous MS therapy and led to 15 of 18 patients needing no additional treatment for MS and psoriasis (remaining 3 patients continued to use topical treatments for psoriasis). Conclusions In this cohort of 18 patients with comorbid MS and psoriasis, beneficial results on both diseases were observed after initiation of therapy with natalizumab.
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Affiliation(s)
- Regina Berkovich
- From the LA County and University of Southern California General Hospital and Clinic (R.B.), Los Angeles; Kazan State Medical University (A.Y.), Russia; UCLA (J.E.), Los Angeles, CA; GRECC, VA Salt Lake, University of Utah (N.C.), Salt Lake City; and Stanford University (L.S.), Palo Alto, CA.
| | - Aida Yakupova
- From the LA County and University of Southern California General Hospital and Clinic (R.B.), Los Angeles; Kazan State Medical University (A.Y.), Russia; UCLA (J.E.), Los Angeles, CA; GRECC, VA Salt Lake, University of Utah (N.C.), Salt Lake City; and Stanford University (L.S.), Palo Alto, CA
| | - Jonathan Eskenazi
- From the LA County and University of Southern California General Hospital and Clinic (R.B.), Los Angeles; Kazan State Medical University (A.Y.), Russia; UCLA (J.E.), Los Angeles, CA; GRECC, VA Salt Lake, University of Utah (N.C.), Salt Lake City; and Stanford University (L.S.), Palo Alto, CA
| | - Noel G Carlson
- From the LA County and University of Southern California General Hospital and Clinic (R.B.), Los Angeles; Kazan State Medical University (A.Y.), Russia; UCLA (J.E.), Los Angeles, CA; GRECC, VA Salt Lake, University of Utah (N.C.), Salt Lake City; and Stanford University (L.S.), Palo Alto, CA
| | - Lawrence Steinman
- From the LA County and University of Southern California General Hospital and Clinic (R.B.), Los Angeles; Kazan State Medical University (A.Y.), Russia; UCLA (J.E.), Los Angeles, CA; GRECC, VA Salt Lake, University of Utah (N.C.), Salt Lake City; and Stanford University (L.S.), Palo Alto, CA
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Silfvast-Kaiser AS, Homan KB, Mansouri B. A narrative review of psoriasis and multiple sclerosis: links and risks. PSORIASIS (AUCKLAND, N.Z.) 2019; 9:81-90. [PMID: 31687363 PMCID: PMC6709810 DOI: 10.2147/ptt.s186637] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
Abstract
The association of psoriasis (PsO) with other autoimmune and autoinflammatory diseases has long been a topic of interest. Although previous studies have attempted to clarify the specific relationship between PsO and multiple sclerosis (MS), it remains obscure, with limited and conflicting evidence regarding a link between the two entities. Herein, we review the etiology, pathogenesis, and treatment of each disease and present the available literature to-date regarding a possible relationship between PsO and MS. We conclude that further study is necessary to discern whether there may be a significant relationship between PsO and MS. In the meantime, clinicians may find it appropriate to screen for MS in patients with PsO, allowing for timely referral to a neurologist should it be necessary.
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Affiliation(s)
| | - Katie B Homan
- Department of Dermatology, Baylor Scott and White Medical Center, Temple, TX, USA
| | - Bobbak Mansouri
- Austin Institute for Clinical Research, Pflugerville, TX, USA
- Sanova Dermatology – Pflugerville, Pflugerville, TX, USA
- U.S. Dermatology Partners - Tyler, TX, USA
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Association of Multiple Sclerosis with Psoriasis: A Systematic Review and Meta-Analysis of Observational Studies. Am J Clin Dermatol 2019; 20:201-208. [PMID: 30361954 DOI: 10.1007/s40257-018-0399-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous studies have reported the occurrence of psoriasis together with multiple sclerosis (MS). Although similar predisposing genes and pathomechanisms have been hypothesized, the relationship between the two remains obscure. OBJECTIVE The aim of this systematic review and meta-analysis was to investigate the association between psoriasis and MS. METHODS We searched MEDLINE, Embase, and CENTRAL in July 2018 for case-control, cross-sectional, or cohort studies that examined either the odds or risk of psoriasis in subjects with multiple sclerosis. The risk of bias of included studies was assessed using the Newcastle-Ottawa Scale. A random-effects model meta-analysis was used to calculate the odds ratio (OR) for case-control/cross-sectional studies and hazard ratio (HR) for cohort studies. RESULTS We included 10 publications that reported a total of 11 studies (5 case-control, 4 cross-sectional and 2 cohort studies). The case-control and cross-sectional studies included 18,456 MS patients and 870,149 controls, while the two cohort studies involved 25,187 MS patients and 227,225 controls in total. Three studies were rated with a high risk of bias in comparability, non-response rate, and selection of controls. MS was associated with increased odds (OR 1.29; 95% confidence interval [CI] 1.14-1.45) and risk for psoriasis (HR 1.92; 95% CI 1.32-2.80). CONCLUSION Patients with MS display both increased prevalence and incidence of psoriasis.
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Lambrianides S, Kinnis E, Leonidou E, Pantzaris M. Does Natalizumab Induce or Aggravate Psoriasis? A Case Study and Review of the Literature. Case Rep Neurol 2018; 10:286-291. [PMID: 30323758 PMCID: PMC6180259 DOI: 10.1159/000492891] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/14/2018] [Indexed: 01/04/2023] Open
Abstract
Psoriasis is a relatively common immune-mediated chronic inflammatory skin disease. It is well known that interferon-beta, a drug used in the management of relapsing-remitting multiple sclerosis, could exacerbate or induce de novo psoriasis. There is limited evidence in the literature based only on case reports that natalizumab could induce or aggravate psoriasis. In this case study, we present a 33-year-old patient who developed plaque psoriasis during natalizumab treatment.
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Affiliation(s)
| | - Evgenios Kinnis
- The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Eleni Leonidou
- The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
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Affiliation(s)
- U. Gieler
- Department of Dermatology; Giessen Germany
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9
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Abstract
Background: The development of biologic agents directed against distinct cytokines and receptors has advanced the therapeutic options available for psoriasis patients. Evidence from preclinical studies suggests that IL-17 may contribute to the pathogenesis of psoriasis. Objective: The objective was to review the safety and efficacy profile for each IL-17 inhibitor by evaluating phase III clinical trial data. Methods: We reviewed the results of phase III clinical trials for the IL-17 inhibitors secukinumab, ixekizumab, and brodalumab. Results: At week 12, the proportion of patients reaching Psoriasis Area and Severity Index (PASI 75) was above 60% for the most efficacious dose of each agent with favorable and comparable safety profiles. The most commonly reported adverse events were nasopharyngitis, headache, and upper respiratory tract infection. Conclusions: The clinical improvement among psoriasis patients on IL-17 inhibitors is similar or superior to the improvement seen with commercially produced biologic agents available accompanied by a favorable short-term safety profile. The results of the phase III trials indicate that IL-17 inhibitors are effective therapeutic options for psoriasis patients.
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Affiliation(s)
- Mina Amin
- School of Medicine , University of California, Riverside , Riverside , CA , USA
| | - Kavita Darji
- School of Medicine , Saint Louis University , St. Louis , MO , USA
| | - Daniel J No
- School of Medicine , Loma Linda University , Loma Linda , CA , USA
| | - Tina Bhutani
- Department of Dermatology , University of California , San Francisco , CA , USA
| | - Jashin J Wu
- Department of Dermatology , Kaiser Permanente Los Angeles Medical Center , Los Angeles , CA , USA
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Miron G, Gurevich M, Baum S, Achiron A, Barzilai A. Psoriasis comorbidity affects multiple sclerosis neurological progression: a retrospective case - control analysis. J Eur Acad Dermatol Venereol 2017; 31:2055-2061. [DOI: 10.1111/jdv.14403] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 06/02/2017] [Indexed: 12/17/2022]
Affiliation(s)
- G. Miron
- Multiple Sclerosis Center; Sheba Medical Center; Ramat Gan Israel
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - M. Gurevich
- Multiple Sclerosis Center; Sheba Medical Center; Ramat Gan Israel
| | - S. Baum
- Department of Dermatology; Sheba Medical Center; Ramat Gan Israel
| | - A. Achiron
- Multiple Sclerosis Center; Sheba Medical Center; Ramat Gan Israel
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - A. Barzilai
- Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
- Department of Dermatology; Sheba Medical Center; Ramat Gan Israel
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Prosperini L, Pontecorvo S. Dimethyl fumarate in the management of multiple sclerosis: appropriate patient selection and special considerations. Ther Clin Risk Manag 2016; 12:339-50. [PMID: 27042079 PMCID: PMC4780395 DOI: 10.2147/tcrm.s85099] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Delayed-release dimethyl fumarate (DMF), also known as gastroresistant DMF, is the most recently approved oral disease-modifying treatment (DMT) for relapsing multiple sclerosis. Two randomized clinical trials (Determination of the Efficacy and Safety of Oral Fumarate in Relapsing-Remitting MS [DEFINE] and Comparator and an Oral Fumarate in Relapsing-Remitting Multiple Sclerosis [CONFIRM]) demonstrated significant efficacy in reducing relapse rate and radiological signs of disease activity, as seen on magnetic resonance imaging. The DEFINE study also indicated a significant effect of DMF on disability worsening, while the low incidence of confirmed disability worsening in the CONFIRM trial rendered an insignificant reduction among the DMF-treated groups when compared to placebo. DMF also demonstrated a good safety profile and acceptable tolerability, since the most common side effects (gastrointestinal events and flushing reactions) are usually transient and mild to moderate in severity. Here, we discuss the place in therapy of DMF for individuals with relapsing multiple sclerosis, providing a tentative therapeutic algorithm to manage newly diagnosed patients and those who do not adequately respond to self-injectable DMTs. Literature data supporting the potential role of DMF as a first-line therapy are presented. The possibility of using DMF as switching treatment or even as an add-on strategy in patients with breakthrough disease despite self-injectable DMTs will also be discussed. Lastly, we argue about the role of DMF as an exit strategy from natalizumab-treated patients who are considered at risk for developing multifocal progressive leukoencephalopathy.
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Affiliation(s)
- Luca Prosperini
- Department of Neurology and Psychiatry, Sapienza University, Rome, Italy
| | - Simona Pontecorvo
- Department of Neurology and Psychiatry, Sapienza University, Rome, Italy
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Egeberg A, Mallbris L, Gislason GH, Skov L, Hansen PR. Risk of Multiple Sclerosis in Patients with Psoriasis: A Danish Nationwide Cohort Study. J Invest Dermatol 2016; 136:93-8. [DOI: 10.1038/jid.2015.350] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/08/2015] [Accepted: 08/19/2015] [Indexed: 01/28/2023]
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Zecca C, Caporro M, Adami M, Mainetti C, Gobbi C. Fumaric acid esters in psoriasis and multiple sclerosis. Clin Exp Dermatol 2014; 39:488-91. [DOI: 10.1111/ced.12326] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2013] [Indexed: 11/30/2022]
Affiliation(s)
- C. Zecca
- Department of Neurology; Neurocenter of Southern Switzerland; Ospedale Regionale; Lugano Switzerland
| | - M. Caporro
- Department of Neurology; Neurocenter of Southern Switzerland; Ospedale Regionale; Lugano Switzerland
| | - M. Adami
- Department of Neurology; Neurocenter of Southern Switzerland; Ospedale Regionale; Lugano Switzerland
| | - C. Mainetti
- Department of Dermatology; Ospedale Regionale Bellinzona e Valli; Bellinzona Switzerland
| | - C. Gobbi
- Department of Neurology; Neurocenter of Southern Switzerland; Ospedale Regionale; Lugano Switzerland
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Fellner A, Dano M, Regev K, Mosek A, Karni A. Multiple sclerosis is associated with psoriasis. A case–control study. J Neurol Sci 2014; 338:226-8. [DOI: 10.1016/j.jns.2014.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Revised: 11/25/2013] [Accepted: 01/02/2014] [Indexed: 12/27/2022]
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Al-Hashel JY, Ahmed SF, Alexnader KJ, Ahmed W. Cerebral venous thrombosis in a patient with clinically isolated spinal cord syndrome. Case Rep Neurol Med 2013; 2013:364869. [PMID: 24000313 PMCID: PMC3755436 DOI: 10.1155/2013/364869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/29/2013] [Indexed: 11/17/2022] Open
Abstract
Background. The association between cerebral venous thrombosis (CVT) and multiple sclerosis (MS) has already been reported in patients with clinically definite MS in relation to intravenous methylprednisolone (IVMP) or previously performed lumbar puncture (LP). Case Summery. We report a 29-year-old Indian female who presented with a clinically isolated spinal cord syndrome according to the revised 2010 McDonald Criteria. She developed CVT after a lumbar puncture and two days of finishing the course of IVMP. Conclusion. We conclude that the sequence of doing lumbar puncture followed by high-dose IVMP may increase the risk of CVT. A prophylactic anticoagulation may be indicated in this setting.
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Affiliation(s)
- Jasem Yousef Al-Hashel
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
- Kuwait University, P.O. Box 24923, 13110 Safat, Kuwait
| | - Samar Farouk Ahmed
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
- Minia University, P.O. Box 61519, Minia City, Minia 61111, Egypt
| | - K. J. Alexnader
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
| | - Walaa Ahmed
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
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Psoriasis during natalizumab treatment for multiple sclerosis. J Neurol 2012; 259:2758-60. [PMID: 23096069 DOI: 10.1007/s00415-012-6713-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 10/09/2012] [Accepted: 10/10/2012] [Indexed: 10/27/2022]
Abstract
Beta-interferon therapy is known to trigger psoriasis, but this effect has not been previously reported for other multiple sclerosis treatments, such as natalizumab. The following is a case report. A 31-year-old woman affected by psoriasis and relapsing-remitting multiple sclerosis suffered a severe worsening of psoriasis symptoms during natalizumab treatment and acquired a drug-resistant course. This case suggests that aggravation of psoriasis might be a rare side effect of natalizumab, and that clinicians should be aware of the possibility of paradoxical activation of autoimmune diseases during its treatment.
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Roshanisefat H, Bahmanyar S, Hillert J, Olsson T, Montgomery S. Shared genetic factors may not explain the raised risk of comorbid inflammatory diseases in multiple sclerosis. Mult Scler 2012; 18:1430-6. [PMID: 22419672 DOI: 10.1177/1352458512438240] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Comorbid inflammatory conditions in multiple sclerosis (MS) patients suggest shared risks with MS. OBJECTIVE To estimate if the risk of immune-mediated disease in MS patients and their parents is increased. METHODS Swedish register data were analysed using Cox regression to estimate immune-mediated disease risk among 11284 fathers and 12006 mothers of MS patients, compared with 123158 fathers and 129409 mothers of index subjects without MS. Similar analyses were conducted among 20276 index subjects with MS and 203951 without. RESULTS Parents of patients with MS did not have a significantly altered immune-mediated disease risk. Patients with MS had a consistently raised risk for several immune-mediated diseases: ulcerative colitis, Crohn's disease, type 1 diabetes, psoriasis, polyarthritis nodosa and pemphigoid. The risk was more pronounced for diseases diagnosed subsequent to MS onset. CONCLUSION The increased occurrence of other immune-mediated diseases in MS patients may not be due to shared genetic factors and surveillance bias is likely to be the main or possibly the entire explanation. If not entirely explained by surveillance bias, a modestly raised occurrence of comorbid diseases may be due to shared environmental risks or factors related to MS disease characteristics.
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Affiliation(s)
- H Roshanisefat
- Department of Neurology, Karolinska University Hospital Huddinge, Sweden.
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Foulkes AC, Grindlay DJC, Griffiths CEM, Warren RB. What’s new in psoriasis? An analysis of guidelines and systematic reviews published in 2009-2010. Clin Exp Dermatol 2011; 36:585-9; quiz 588-9. [DOI: 10.1111/j.1365-2230.2011.04108.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Current World Literature. Curr Opin Neurol 2011; 24:300-7. [DOI: 10.1097/wco.0b013e328347b40e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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