Review
Diet and psoriasis, part II: Celiac disease and role of a gluten-free diet

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Patients with psoriasis have been shown to have a higher prevalence of other autoimmune diseases including celiac disease, a condition marked by sensitivity to dietary gluten. A number of studies suggest that psoriasis and celiac disease share common genetic and inflammatory pathways. Here we review the epidemiologic association between psoriasis and celiac disease and perform a meta-analysis to determine whether patients with psoriasis more frequently harbor serologic markers of celiac disease. We also examine whether a gluten-free diet can improve psoriatic skin disease.

Section snippets

Methods

We searched the electronic MEDLINE database via PubMed using search terms “psoriasis” combined with “celiac disease,” “celiac sprue,” and “gluten,” respectively. We limited our search to articles available in English and those published between 1960 and 2012. Manual searches of bibliographies of the articles were also performed to identify additional studies to be included. We focused on population-based studies examining the co-occurrence of psoriasis and celiac disease, investigations of

Population studies

Several studies have found that patients with psoriasis are at increased risk for celiac disease. A retrospective cohort study comparing 25,341 patients with psoriasis with more than 125,000 matched control subjects in the US Southern California Kaiser Permanente database showed an odds ratio of 2.2 for the association of psoriasis with celiac disease.3 Similarly, a case-control study comparing 12,502 patients with psoriasis with 24,285 age- and sex-matched control subjects using an Israeli

Discussion

It is well established that patients with psoriasis are more likely to have concurrent autoimmune diseases, particularly those affecting the gastrointestinal tract such as Crohn's disease and ulcerative colitis.3, 4 Here we document that another such autoimmune disease is celiac disease, with a recent large study showing that patients with psoriasis have 2.2-fold risk of being given a diagnosis of celiac disease compared with matched control subjects.3 We perform a meta-analysis to show that

References (48)

  • P. Humbert et al.

    Intestinal permeability in patients with psoriasis

    J Dermatol Sci

    (1991)
  • C. Cellier et al.

    Severe osteopenia in symptom-free adults with a childhood diagnosis of celiac disease

    Lancet

    (2000)
  • A. Davidson et al.

    Autoimmune diseases

    N Engl J Med

    (2001)
  • C. Cotsapas et al.

    Pervasive sharing of genetic effects in autoimmune disease

    PLoS Genet

    (2011)
  • E. Grodzinsky et al.

    IgA antiendomysium antibodies have a high positive predictive value for celiac disease in asymptomatic patients

    Allergy

    (1994)
  • C.P. Kelly et al.

    Mucosal and systemic IgA anti-gliadin antibody in celiac disease: contrasting patterns of response in serum, saliva, and intestinal secretions

    Dig Dis Sci

    (1991)
  • S. Birkenfeld et al.

    Celiac disease associated with psoriasis

    Br J Dermatol

    (2009)
  • G. Michaelsson et al.

    Patients with psoriasis often have increased serum levels of IgA antibodies to gliadin

    Br J Dermatol

    (1993)
  • S. Akbulut et al.

    Celiac disease-associated antibodies in psoriasis

    Ann Dermatol

    (2013)
  • N. Nagui et al.

    Estimation of (IgA) anti-gliadin, anti-endomysium and tissue transglutaminase in the serum of patients with psoriasis

    Clin Exp Dermatol

    (2011)
  • A. Damasiewicz-Bodzek et al.

    Serologic markers of celiac disease in psoriatic patients

    J Eur Acad Dermatol Venereol

    (2008)
  • S. Singh et al.

    Celiac disease-associated antibodies in patients with psoriasis and correlation with HLA Cw6

    J Clin Lab Anal

    (2010)
  • V. Ojetti et al.

    Malabsorption in psoriatic patients: cause or consequence?

    Scand J Gastroenterol

    (2006)
  • R.J. de Vos et al.

    Is there a relationship between psoriasis and celiac disease?

    J Intern Med

    (1995)
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    Ms Bhatia and Dr Millsop contributed equally to this work.

    Dr Liao is supported in part by grants from the National Institutes of Health (R01AR065174, K08AR057763). Dr Linos is supported by the National Center for Research Resources (KL2RR024130) and Dermatology Foundation.

    Disclosure: Dr Koo is a speaker for AbbVie and Leo. Dr Koo conducts research for Amgen, Janssen, Novartis, Photomedex, Galderma, Pfizer, and Merck. Dr Koo has no stocks, employment, or board memberships with any pharmaceutical company. None of the grants were directly related to this study. Ms Bhatia, Ms Millsop, Ms Debbaneh, Dr Linos, and Dr Liao have no conflicts of interest to declare.

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