title: Psoriasis and polycystic ovary syndrome: a new link in different phenotypes.
abstract: OBJECTIVE
  Women affected by PCOS and psoriasis are more likely to have insulin-resistance, hyperinsulinemia, reduced HDL cholesterol levels and a more severe degree of skin disease than those with psoriasis alone. The mechanism underlying this association between PCOS and psoriasis is currently unknown. The aim of the present study was to evaluate the features of psoriasis and the psoriasis severity scores in the different PCOS phenotypes and in age and body mass index (BMI)-matched psoriatic control patients.
  
  
  METHODS
  A cross-sectional study was performed on 150 psoriatic patients: 94 PCOS and 56 age- and BMI-matched controls. PCOS patients were diagnosed and divided into four phenotypes according to Rotterdam criteria: A - patients with complete phenotype with hyperandrogenism (H) plus oligoamenorrhea (O) plus polycystic ovary (PCO) on ultrasound examination; B - patients with H plus O (without PCO); C - patients with H plus PCO (ovulatory phenotype); D - patients with O plus PCO (without H). The patient's Psoriasis Area and Severity Index (PASI) as well as the Physician's Global Assessment (PGA) were calculated. A PASI score ≥10 was correlated with common indicator of severe disease. A PGA ≥4 was considered as a condition of moderate to severe disease.
  
  
  RESULTS
  Among the four phenotypes investigated, the group with complete phenotype (H plus O plus PCO) had a higher prevalence of patients with patient's PASI ≥10 compared to controls (Odds Ratio (OR) 4.71, 95% confidence intervals (CI) 1.59-13.95). The group with O plus PCO had a higher prevalence of patients with PGA ≥4 compared to controls (OR 26.79, 95% CI 3.40-211.02) while the ovulatory group had a lower prevalence of patients with PGA ≥4 (OR 0.06, 95% CI 0.01-0.51).
  
  
  CONCLUSIONS
  The ovulatory phenotype displays a milder psoriasis form than other phenotypes while the phenotypes with oligoamenorrhea presented higher severity scores of disease than other phenotypes and control group.
authors.affiliation: Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: morofrancy@gmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Moro
authors.affiliation: Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Tropea
authors.affiliation: Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Scarinci
authors.affiliation: Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Alex
authors.initials: A
authors.lastname: Federico
authors.affiliation: Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: De Simone
authors.affiliation: Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Caldarola
authors.affiliation: Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Leoncini
authors.affiliation: Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Boccia
authors.affiliation: Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lanzone
authors.affiliation: Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Apa
mesh_terms: D000328:Adult; D000367:Age Factors; D000858:Anovulation / Q000209:etiology*; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology; D009839:Oligomenorrhea / Q000209:etiology; D010044:Outpatient Clinics, Hospital; D050177:Overweight / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000503:physiopathology*; D015995:Prevalence; D011565:Psoriasis / Q000150:complications / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012384:Rome / Q000453:epidemiology; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Hyperandrogenism; Oligoamenorrhea; PCOS; Phenotypes; Psoriasis