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Multiple Sclerosis increases risk of Psoriasis by 1.9X (both associated with low vitamin D) – meta-analysis Oct 2018

Association of Multiple Sclerosis with Psoriasis: A Systematic Review and Meta-Analysis of Observational Studies

American Journal of Clinical Dermatology, pp 1–8; DOI https://doi.org/10.1007/s40257-018-0399-9
Chia-Yu Liu Tao-Hsin Tung Chin-Yu Lee Kuo-Hsuan Chang Shu-Hui Wang Ching-Chi Chi


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.

Editorial on this study

The connection between multiple sclerosis and psoriasis Dermatology Times

  • "Medical specialists should be aware of the risk of developing psoriasis in patients with multiple sclerosis. Because both disorders are attributed to autoimmune mechanisms, we suggest that dermatology specialists may need not only neurology, but also rheumatology consultations. Further laboratory or imaging studies may be necessary for psoriatic patients in whom neurological symptoms appear,"
  • "Previous studies have established strong evidence that Epstein-Barr virus is related to multiple sclerosis, although few studies have investigated the connection between Epstein-Barr virus and psoriasis. Investigators hypothesized that Epstein-Barr virus might induce cutaneous manifestations, as herpes simplex virus does, and these manifestations could result in the immunopathogenesis of psoriasis."

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