Latent tuberculosis infection in patients with chronic plaque psoriasis: evidence from the Italian Psocare Registry.
The nationwide prevalence of latent tuberculosis infection (LTBI) in Italian patients with psoriasis has never been investigated.



To estimate the nationwide prevalence of LTBI in Italian patients with psoriasis who are candidates for systemic treatment.



Data were obtained from the Psocare Registry on those patients (n = 4946) with age > 18 years, systemic treatment at entry specified and tuberculin skin test (TST) performed according to the Mantoux method. LTBI diagnosis was based on a positive TST result in the absence of any clinical, radiological or microbiological evidence of active tuberculosis.



Latent tuberculosis infection was diagnosed in 8·3% of patients with psoriasis (409 of 4946). The prevalence of LTBI was lower in patients on biologics than in those on conventional systemic treatments, ranging from 4·3% (19 of 444) of patients on adalimumab to 31% (eight of 26) of those on psoralen-ultraviolet A (P < 0·05). Independent factors associated with LTBI were male sex [odds ratio (OR) 1·30, 95% confidence interval (CI) 1·04-1·62; P = 0·02], age over 55 years (OR 2·93, 95% CI 2·18-3·93; P < 0·001) and being entered into a conventional treatment (OR 3·83, 95% CI 3·10-4·74; P < 0·001). Positive history of tuberculosis was seen in 1% of patients (n = 49).



The nationwide prevalence of LTBI in Italian patients with psoriasis candidate to systemic treatment is high, and screening is recommended prior to biological treatment.
Department of Medicine, Section of Dermatology and Venereology, University of Verona, Piazzale A. Stefani 1, I-37126, Verona, Italy.
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Gisondi
GISED Study Centre, Ospedali Riuniti, Bergamo, Italy.
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S
Cazzaniga
Department of Dermatology, University of Rome 'Tor Vergata', Rome, Italy.
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Chimenti
Italian Psoriatic Patient Association (ADIPSO), Rome, Italy.
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M
Maccarone
Laboratory of Cutaneous Physiopathology, San Gallicano Dermatological Institute, Rome, Italy.
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Picardo
Department of Medicine, Section of Dermatology and Venereology, University of Verona, Piazzale A. Stefani 1, I-37126, Verona, Italy.
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Girolomoni
GISED Study Centre, Ospedali Riuniti, Bergamo, Italy.
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L
Naldi
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D001685:Biological Factors / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D055985:Latent Tuberculosis / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011701:PUVA Therapy / Q000706:statistics & numerical data; D015995:Prevalence; D011565:Psoriasis / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D012042:Registries; D012111:Residence Characteristics / Q000706:statistics & numerical data; D017678:Sex Distribution; D014374:Tuberculin Test; D055815:Young Adult
D000995:Antitubercular Agents; D001685:Biological Factors