Etiological Association Between Psoriasis and Thyroid Diseases

Abstract

Psoriasis is a chronic relapsing/remitting autoimmune disease affecting skin and fingernails. It is associated with many other autoimmune diseases such as rheumatoid arthritis, celiac disease, Crohn's disease, and thyroid diseases. Two important autoimmune thyroid diseases-Hashimoto's thyroiditis (hypothyroidism) and Grave's disease (hyperthyroidism)-affect the body's significant organs such as the brain, muscles, digestive function, and the skin. Although some studies have established the connection between psoriasis and thyroid diseases with autoimmunity, our article provides an in-depth analysis of the connection between these two diseases and other common etiological factors associated with them, along with autoimmunity. We reviewed articles from PubMed using regular keywords and Medical Subject Headings (MeSH) keywords and finalized 45 articles to find an association between these two diseases. These articles showed that this association is more prevalent in obese patients and late-onset psoriasis. Most of the articles showed a positive association, but few articles showed no connection between them. However, there is no concrete explanation to prove the association due to limited research; additional studies are necessary. It requires the attention of both clinicians and researchers to develop a universal drug that will work on both diseases, and also thyroid evaluation could be included in psoriatic patient care so that there is a possibility to decrease cost and efforts while treating these diseases.

Successful guselkumab treatment of a refractory psoriasis patient with Graves’ disease: a case report

“…Previous research suggests that there are several commonalities in the pathophysiology shared between psoriasis and Graves' disease, such as hormones, genetic factors and oxidative stress. 5 Therefore, when the current patient showed poor responses to a variety of treatments, including conventional therapies, Janus kinase inhibitor inhibitors and biologics, her medical team speculated that this was related to the underlying Graves' disease, so she underwent iodine-131 treatment at same time. Finally, her treatment was switched to the IL-23 inhibitor, guselkumab, which resulted in the resolution of her psoriatic lesions.…”

“…2,3 Autoimmune thyroid disease is considered to be closely related to psoriasis, because free thyroxine is increased significantly in psoriatic patients and patients with thyroiditis have more extended disease periods; 4 and in severe psoriasis, there are increased levels of thyroid-stimulating hormone (TSH). 5 Previous studies have demonstrated a link between psoriasis and thyroid illness as well as the involvement of type 1 helper T (Th1) cell cytokines in the pathogenesis of both psoriasis and Graves' disease, which is the most common cause of hyperthyroidism in iodine-replete areas. 5 A previous study indicated that methimazole, the first-line treatment for hyperthyroidism, could alleviate psoriasis through a variety of pathways by lowering the psoriasis area and severity index (PASI) scores of the patients after 6-8 weeks of treatment.…”

“… 5 Previous studies have demonstrated a link between psoriasis and thyroid illness as well as the involvement of type 1 helper T (Th1) cell cytokines in the pathogenesis of both psoriasis and Graves’ disease, which is the most common cause of hyperthyroidism in iodine-replete areas. 5 A previous study indicated that methimazole, the first-line treatment for hyperthyroidism, could alleviate psoriasis through a variety of pathways by lowering the psoriasis area and severity index (PASI) scores of the patients after 6–8 weeks of treatment. 6 These studies provide some evidence that thyroid illness exacerbates the severity of psoriasis.…”

Lėtinis Autoimuninis Tiroiditas Ir Jo Ryšys Su Psoriaze

“…Genetinis polinkis yra reikšmingas psoriazės patogenezėje, tačiau aplinkos veiksniai gali suaktyvinti ligą. Psoriazė yra susijusi su įvairiomis ligomis, įskaitant metabolinį sindromą, cukrinį diabetą, širdies ir kraujagyslių ligas, kitas uždegimines autoimunines ligas, pvz., reumatoidinį artritą, celiakiją, Krono ligą [9]. Daugelis perspektyvinių ir retrospektyvių tyrimų esant skirtingam tiriamųjų skaičiui parodė reikšmingą teigiamą psoriazės ir Hašimoto tiroidito ryšį, kurį patvirtintų: klinikiniai ypatumai (pasireiškimas odoje): pacientams, sergantiems Hašimoto tiroiditu ir kitomis skydliaukės ligomis, dažnai pastebima daugybė odos apraiškų.…”

“…Daugelis perspektyvinių ir retrospektyvių tyrimų esant skirtingam tiriamųjų skaičiui parodė reikšmingą teigiamą psoriazės ir Hašimoto tiroidito ryšį, kurį patvirtintų: klinikiniai ypatumai (pasireiškimas odoje): pacientams, sergantiems Hašimoto tiroiditu ir kitomis skydliaukės ligomis, dažnai pastebima daugybė odos apraiškų. Pavyzdžiui, pacientams, sergantiems psoriaze ir itin sunkiu hipotiroidizmu, buvo pastebėtas reikšmingas odos pažeidimų pagerėjimas normalizavus tiroksino kiekį organizme [9];• keletas patofiziologinių mechanizmų, bendrų psoriazei ir skydliaukės ligoms. Vieną iš svarbiausių vaidmenų atlieka hormonai: skydliaukės hormonai ir jų receptoriai, esantys odoje, yra būtini skatinti odos proliferaciją, veikdami kaip endogeniniai odos uždegimo inhibitoriai bei didindami epidermio augimo veiksnio kiekį (skatina keratinocitų proliferaciją ir diferenciaciją).…”