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Psoriasis and IgE-mediated allergy: correlation or mutual inhibition?

A prospective cohort study in patients with mild or moderate to severe psoriasis

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Summary

Background

Psoriasis is an autoimmune disease caused by overactivation of TH1 (Type 1 helper cells) and TH17 (T helper 17) cells. Overactivation of TH1 cells inhibits the activity of TH2 cells involved in type 1 allergies, therefore, psoriasis patients might be less affected by type 1 allergies. This study tested if allergies were less frequent in patients with moderate to severe than with mild psoriasis.

Methods

Psoriasis patients at the study site reported possible allergy symptoms and were tested for common allergens by skin prick test and IgE levels. Psoriasis was classified by PASI scores (Psoriasis Area and Severity Index) as mild (PASI <10) or moderate/severe (PASI ≥10). Patients without systemic therapy were assessed separately. Fisher’s exact test was used to test for differences.

Results

A total of 97 patients were included, 21 with mild and 76 with moderate to severe psoriasis. Allergies were found in 27.8%, most commonly against dust mites (23.4%) and grasses (18.1%). Allergies were found in 23.8% of the patients with mild vs. 29.0% allergic patients with moderate to severe psoriasis (P = 0.786). In patients without systemic medication, allergies were found in 21.1% vs. 35.3% (P = 0.463).

Conclusion

Allergy prevalence was not reduced in patients with moderate/severe psoriasis, and generally close to the prevalence in the general Austrian population (24%). The inhibiting effect of psoriasis on type 1 allergies was not confirmed.

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Further Reading

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Acknowledgements

These results were first presented as A. Essl’s thesis [39], supervised by D. Loader and P. Sator. Writing assistance was provided by W. Adlassnig (CW Research and Management GmbH).

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Authors and Affiliations

  1. Hospital Hietzing, Wolkersbergenstraße 1, 1130, Vienna, Austria

    Anna Essl, Robert Feldmann, Andreas Steiner &  Paul Sator

  2. Medical Practice, Privatärztezentrum Döbling, Heiligenstädter Straße 46–48, 1190, Vienna, Austria

    Dagmara Loader

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  1. Anna Essl
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Correspondence to Paul Sator.

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A. Essl, D. Loader, R. Feldmann, A. Steiner, and P. Sator declare that they have no competing interests.

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Essl, A., Loader, D., Feldmann, R. et al. Psoriasis and IgE-mediated allergy: correlation or mutual inhibition?. Wien Klin Wochenschr 133, 997–1003 (2021). https://doi.org/10.1007/s00508-020-01683-0

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