Psoriatic uveitis: a distinct clinical entity?
OBJECTIVE
To describe the clinical characteristics of uveitis occurring in patients with psoriasis and to compare them with patients with idiopathic anterior uveitis and HLA-B27-associated anterior uveitis.


METHODS
Case-control study.


METHODS
The charts of 36 patients with a diagnosis of uveitis and psoriasis visiting the Immunology and Uveitis Service at the Massachusetts Eye and Ear Infirmary between January 2000 and December 2001 were reviewed. Clinical characteristics, therapy, and outcomes of uveitis were compared with 30 randomly selected patients with either idiopathic anterior uveitis or with HLA-B27-associated anterior uveitis.


RESULTS
The mean age at presentation for uveitis was significantly higher in patients with psoriasis compared with nonpsoriatic groups (44.6 years in HLA-B27-psoriatic patients vs 35.9 years in HLA-B27- nonpsoriatic patients, P = .034; 52.7 years in HLA-B27+ psoriatic vs 35.7 years in HLA-B27+ nonpsoriatic patients, P = .001). Uveitis in patients with psoriasis also tended to be bilateral (62%) and prolonged (11.2 weeks). HLA-B27+ patients with psoriasis required supplemental therapy with oral nonsteroidal anti-inflammatory drugs (95% confidence interval [CI] 1.41 to 5.36, P = .003) for anterior uveitis more often than did the HLA-B27+ nonpsoriatic group. Patients with psoriasis and uveitis who were HLA-B27+ required oral NSAIDs (95% CI 1.51 to 9.79, P = .001) for anterior uveitis more often than did HLA-B27- psoriatic patients.


CONCLUSIONS
Uveitis in patients with psoriasis may have distinguishing clinical features. Further epidemiologic studies are required to determine the strength of association between psoriasis without arthritis but with uveitis.
Durrani
Khayyam
K
Immunology and Uveitis Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114, USA.
Foster
C Stephen
CS
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D015796:HLA-B27 Antigen / Q000032:analysis; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014606:Uveitis, Anterior / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D015796:HLA-B27 Antigen; D008727:Methotrexate