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Enteropathy in Psoriasis: A Systematic Review of Gastrointestinal Disease Epidemiology and Subclinical Inflammatory and Functional Gut Alterations

  • Psoriasis (J Wu, Section Editor)
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Abstract

Purpose of Review

Psoriasis in an inflammatory skin disorder associated with systemic inflammation. This systematic review summarizes the epidemiology, histology, and function of the gastrointestinal (GI) system in patients with psoriasis.

Recent Findings

Although psoriasis patients are at higher risk for developing inflammatory bowel disease and celiac disease, estimates of their prevalence have varied and it is unclear whether psoriasis patients without GI symptoms may harbor subclinical inflammation.

Summary

In a meta-analysis, the pooled prevalence of Crohn disease, ulcerative colitis (UC), and celiac disease among patients with psoriasis was 0.4, 0.5, and 2%, respectively. The pooled prevalence of psoriasis among patients with Crohn disease was 9.5% and among patients with UC was 6.6%. A significant proportion of psoriasis patients harbor lymphocytic infiltrates in the small and large intestine; 40–50% of the psoriasis patients demonstrate abnormal intestinal absorption based on fecal fat, D-xylose, and lactose tolerance tests. These results suggest that the inflammatory state of psoriasis may in some patients extend to the GI tract.

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Author notes

  1. Isabelle M. Sanchez and Wei Jiang contributed equally to this work.

Authors and Affiliations

  1. Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA

    Isabelle M. Sanchez, Wei Jiang, Eric J. Yang, Rasnik K. Singh, Kristen Beck, Ladan Afifi & Wilson Liao

  2. University of Illinois at Chicago College of Medicine, Chicago, IL, USA

    Isabelle M. Sanchez

  3. Department of Dermatology, Peking University Third Hospital, Beijing, China

    Wei Jiang

  4. Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA

    Eric J. Yang

  5. Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA

    Rasnik K. Singh

  6. Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Claire Liu

  7. University of Miami Miller School of Medicine, Miami, FL, USA

    Ladan Afifi

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  1. Isabelle M. Sanchez
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Correspondence to Wilson Liao.

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IS, WJ, EY, RS, KB, CL, LA declare that they have no conflict of interest.

Wilson Liao has received research funding from AbbVie, Janssen, Novartis, and Pfizer.

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Sanchez, I.M., Jiang, W., Yang, E.J. et al. Enteropathy in Psoriasis: A Systematic Review of Gastrointestinal Disease Epidemiology and Subclinical Inflammatory and Functional Gut Alterations. Curr Derm Rep 7, 59–74 (2018). https://doi.org/10.1007/s13671-018-0213-1

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