Clinical characteristics of psoriatic patients with latent tuberculosis infection

Eur J Dermatol. 2020 Apr 16. doi: 10.1684/ejd.2020.3757. Online ahead of print.

Abstract

Background: Psoriasis is an immune-mediated inflammatory disease in which imbalance of the immunological response may be associated with disease severity and comorbidities. Latent tuberculosis infection (LTBI) is a growing concern for treatment of psoriasis, as the use of biologics has recently increased.

Objectives: To investigate the clinical and immunological influence of LTBI on the features of psoriasis.

Materials and methods: We conducted a retrospective analysis of 300 patients with psoriasis using clinical information, including severity, comorbidities, and presence of LTBI. Serum cytokine levels were measured for immunological analysis.

Results: The prevalence of psoriatic arthritis (p = 0.001) and nail psoriasis (p = 0.014) in patients with LTBI was significantly higher than in those without LTBI, although other data including the Psoriasis Area Severity Index showed no association. The serum levels of interleukin (IL)-6, IL-8, and IL-23A in the LTBI-positive group were higher than those in the LTBI-negative group (p = 0.014, p = 0.025, and p = 0.004, respectively).

Conclusion: LTBI may be a risk factor for the development of psoriatic arthritis during chronic inflammatory conditions induced by tuberculosis infection.

Keywords: latent tuberculosis; psoriasis; psoriatic arthritis.