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Updated: Jun 24, 2025
Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
Published on: March 1, 2024
Clinical implications for the association of psoriasis and multiple sclerosis: an observational study
Giuseppina Miele1, Maddalena Sparaco1, Elisabetta Maida1
1Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy.
Background:
Multiple sclerosis (MS) and psoriasis (PsO) are distinct chronic autoimmune conditions with varying impacts on patients' lives. While the co-occurrence of MS and PsO has been reported, the underlying pathogenic link remains unclear. This study aimed to investigate the prevalence of PsO in a MS outpatient clinic population and explore the potential interplay between these conditions.
Methods:
316 MS patients who had at least one visit at our MS center in the last year, were selected from our outpatient MS Clinic electronic database and were e-mailed in August 2023 and inquired about a previous diagnosis of PsO. Demographic and MS history data were retrospectively gathered for two groups: MS patients without and with PsO. Information about MS phenotype, Expanded Disability Status Scale (EDSS) score at the diagnosis and at last follow-up, disease modifying therapy (DMT) were collected retrospectively from our MS data set. PsO diagnosis was confirmed by an experienced dermatologist and severity was assessed with the Psoriasis Area and Severity Index (PASI).
Results:
Among 253 respondents, 5.85% reported a PsO diagnosis that was confirmed after the dermatological evaluation Among patients with psoriasis 66.67% had progressive course of MS (p = 0.032) and the onset of PsO typically occurred after MS diagnosis. 9 out 15 patients had a PASI score of 0 and 6 are currently undergoing treatment with an anti-CD20 therapy. Notably, a subset of our patients were on anti-CD20 therapy and did not experience a worsening of dermatological symptoms.
Discussion And Conclusion:
The prevalence of PsO in our outpatient MS population aligns with previous studies. Treatment approaches should be tailored to individual patient needs, emphasizing collaboration between neurologists and dermatologists. Medications like dimethyl fumarate, effective in both conditions, could be considered. The data from our study also suggest that anti-CD20 therapy may be a viable option for some patients with concurrent MS and mild PsO, without a significant worsening of dermatological symptoms. Further research is needed to elucidate the complex relationship between MS and PsO and to develop more effective therapeutic strategies for patients with both conditions.
Insights
The prevalence of psoriasis in multiple sclerosis patients is consistent with prior research. Anti-CD20 therapy may benefit some patients with both conditions, warranting further investigation.
Area of Science:
- Neurology
- Dermatology
- Immunology
Background:
- Multiple sclerosis (MS) and psoriasis (PsO) are chronic autoimmune diseases with distinct pathologies.
- The co-occurrence of MS and PsO has been observed, but the underlying pathogenic mechanisms remain unclear.
- Investigating the prevalence of PsO in an MS patient cohort is crucial for understanding potential disease interrelations.
Purpose of the Study:
- To determine the prevalence of psoriasis (PsO) within a multiple sclerosis (MS) outpatient clinic population.
- To explore the potential interplay and clinical characteristics of patients with co-occurring MS and PsO.
- To evaluate the impact of treatments, including anti-CD20 therapy, on patients with both MS and PsO.
Main Methods:
- Retrospective analysis of 316 MS patients from an outpatient clinic database.
- Inquiry regarding prior PsO diagnosis via email, with confirmation by a dermatologist.
- Collection of demographic, MS phenotype, Expanded Disability Status Scale (EDSS), and disease-modifying therapy (DMT) data.
Main Results:
- A confirmed PsO diagnosis was reported by 5.85% of the 253 respondents.
- A significant association was found between PsO and a progressive MS course (p = 0.032).
- Onset of PsO typically occurred after MS diagnosis, and some patients on anti-CD20 therapy showed no worsening of dermatological symptoms.
Conclusions:
- The prevalence of PsO in this MS cohort is comparable to previous studies.
- Collaborative care between neurologists and dermatologists is recommended for tailored treatment strategies.
- Anti-CD20 therapy may be a potential treatment option for select patients with concurrent MS and mild PsO, requiring further research.
