HLA-Cw6-positive and HLA-Cw6-negative patients with Psoriasis vulgaris have distinct clinical features.
Psoriasis is associated with HLA-Cw6, and Caucasians who carry this allele have about a 10-fold increased risk of developing psoriasis. We have HLA-C typed 369 patients with familial psoriasis and compared the clinical features of the patients carrying HLA-Cw6 against those carrying other HLA-C types. Some striking clinical differences were observed between the two groups. Patients who are Cw6 positive had a lower age at onset (p=3x10(-7)). Cw6-positive women had an earlier disease onset than Cw6-positive men (p =0.02), but such a difference was not observed for the Cw6-negative patients. The guttate-type onset of psoriasis was mostly confined to this group (p=2x10(-4)) and persistent disseminated guttate-like papules were also predominantly observed in the Cw6-positive patients (p <10(-)4). The Cw6-positive patients also had more extensive plaques on their arms, legs, and trunk (p =0.001), more severe disease (p =0.003), higher incidence of the Koebner's phenomenon (p =0.005), reported more often that their psoriasis got worse during or after throat infections (p =0.02), and more often a favorable response to sunlight (p =0.008) In contrast, dystrophic nail changes were more common in the Cw6-negative patients (p =0.002) and also psoriatic arthritis, although this was not significant (p =0.135). It is concluded that patients with psoriasis have different clinical features depending on whether they are HLA-Cw6 positive or negative.
Gudjónsson
Jóhann E
JE
Department of Immunology, National University Hospital of Iceland, Reykjavik, Iceland.
Kárason
Ari
A
Antonsdóttir
Arna A
AA
Rúnarsdóttir
E Hjaltey
EH
Gulcher
Jeffrey R
JR
Stefánsson
Kári
K
Valdimarsson
Helgi
H
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D015535:Arthritis, Psoriatic / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000209:etiology; D011565:Psoriasis / Q000150:complications / Q000235:genetics / Q000276:immunology* / Q000473:pathology*; D012720:Severity of Illness Index; D012727:Sex Characteristics