title: Psoriasis beyond the skin surface: a pilot study on the ocular involvement.
abstract: The ocular involvement in psoriasis is not a completely well-known problem. The ophthalmologic involvement occurs in about 10 % of patients, particularly in case of arthropathic or pustular psoriasis. Ocular lesions are more common in males, and they often occur during psoriasis exacerbations. Our study aimed to assess the prevalence and type of ocular involvement in psoriasis, by a comparison between psoriasis and healthy subjects, and if/how a 12-week long systemic immunosuppressive therapy is able to modify them. This study involved thirty-two psoriatic patients and thirty-two healthy subjects. Dermatological evaluation was done using Psoriasis Area and Severity Index, Physician Global Assessment, and Dermatology Life Quality Index (PASI, PGA, and DLQI score). Ophthalmological evaluation included ocular surface involvement (Schirmer, Jones, break-up time--BUT, DR-1 camera), retinal pathologies, and ocular surface disease index. Laboratory investigations including the C-reactive protein (CRP) of all the patients were performed. At baseline, the values of Schirmer, Jones, and BUT tests in the patient group were significantly lower compared to controls; moreover, conjunctival hyperemia was more frequent in psoriatic patients than in healthy subjects. Ocular involvement was more prominent in the subset of psoriatic patients with sebo-psoriasis than in general psoriatic population. A statistically significant correlation was found in sebo-psoriasis between PASI and Schirmer, between PASI and Jones, and between PASI and BUT. On the other hand, the results obtained from DR1 camera showed statistically significant difference between psoriatic and sebo-psoriatic patients at the end of the follow-up. After 12 weeks of treatment, the mean values of PASI, PGA, DLQI, CRP, and BUT showed significant changes in psoriatic patients. Our findings suggest a high rate of ocular involvement in psoriatic patients, emphasizing the need of performing periodic ophthalmological examinations in order to avoid underestimating eye diseases and to allow early diagnosis and treatment of patients.
authors.affiliation: Dermatology Unit, University of Marche, Azienda Ospedaliera Universitaria-Ospedali Riuniti di, Ancona Via Conca 71, 60126, Ancona, Torrette, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Campanati
authors.forename: P
authors.initials: P
authors.lastname: Neri
authors.forename: K
authors.initials: K
authors.lastname: Giuliodori
authors.forename: I
authors.initials: I
authors.lastname: Arapi
authors.forename: G
authors.initials: G
authors.lastname: Carbonari
authors.forename: E
authors.initials: E
authors.lastname: Borioni
authors.forename: C P
authors.initials: CP
authors.lastname: Herbort
authors.forename: C
authors.initials: C
authors.lastname: Mariotti
authors.forename: A
authors.initials: A
authors.lastname: Giovannini
authors.forename: A
authors.initials: A
authors.lastname: Offidani
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D005128:Eye Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D011446:Prospective Studies; D011565:Psoriasis / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D011788:Quality of Life; D012720:Severity of Illness Index
chemical_list: D007166:Immunosuppressive Agents; D002097:C-Reactive Protein