Individuals with psoriasis have double the odds of having celiac disease (CD) versus individuals without psoriasis, according to a research letter published online Feb. 9 in the Journal of the American Academy of Dermatology.

Marina Z. Joel, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues examined the association between psoriasis and CD using data from 316,166 adults participating in the All of Us Research Program.

The researchers found that of the 6,476 patients with psoriasis, 1.65 percent had CD versus 0.49 percent of the 309,690 patients without psoriasis. There were significant differences in age (mean, 61.4 versus 54.0 years), race (69.1 versus 47.8 percent white), body mass index (BMI; mean, 31.0 versus 29.8 kg/m²), smoking (46.0 versus 39.4 percent), and autoimmune disease (22.6 versus 6.4 percent) for participants with psoriasis versus those without psoriasis. After adjusting for age, sex, race/ethnicity, smoking status, autoimmune diseases linked to psoriasis and CD (systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, type 1 diabetes mellitus, autoimmune thyroiditis, vitiligo, and alopecia areata), and BMI in the model, psoriasis remained significantly associated with CD (odds ratio, 2.05).

"While the pathophysiologic mechanism behind the association between psoriasis and CD is unclear, several explanations have been proposed. Genome-wide association studies have found that many susceptibility loci for psoriasis overlap with those for CD. Because both psoriasis and CD are T-cell driven disorders, there could be shared immunogenic mechanisms between the two," the authors write. "Further studies are required to better understand the pathophysiologic mechanisms linking psoriasis and CD."

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