IADR Abstract Archives
The Associations between Psoriasis and Periodontitis
Objectives: Psoriasis is a chronic, immunologically-mediated, inflammatory skin disease and numerous studies have identified tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), and interleukin 12/23 (IL12/23) as particularly major mediators governing the inflammatory cascade in psoriasis. Periodontitis is a bacteria-caused chronic inflammatory disease. The disease severity is the result of the interactions between pathogens and the host. Activation of monocytes by stimulated T lymphocytes initiates the production of large amounts of inflammatory mediators, such as TNF-α and interleukin 1β(IL-1β), which further stimulate the release of mediators, including MMPs, eventually resulting in soft and hard periodontal tissue destruction. In our clinic, we found most psoriasis patients complained of gum swelling and tooth loss. The aim of this study is to explore the possible associations of the clinical periodontal status and psoriasis severity in psoriasis patients.
Methods: 34 psoriasis patients referred from the outpatient clinic of Department of Dermatology in National Taiwan University Hospital and 32 healthy controls were recruited in this study. Periodontal parameters including probing depth, recession, plaque index, gingival index and teeth number were recorded by a periodontist. 0.5 ml saliva was collected at the same time for analysis of inflammatory cytokines, including TNF-α, IL1, IL-17, IL12 and IFN-γ. The severity of psoriasis was assessed by Psoriasis Area Severity Index (PASI) and Body Surface Area (BSA).
Results: Patients with psoriasis seemed to have more severe periodontal destructions and less remaining teeth, compared with those in the control subjects. We observed a positive correlation between clinical attachment level (CAL) and BSA involvement or PASI score (p=0.049, p=0.075, respectively). The number of remaining teeth was negatively correlated with BSA involvement (p=0.016). Nevertheless, saliva inflammatory cytokines were not associated with BSA involvement or PASI score in psoriasis patients.
Conclusions: The involvement and severity of psoriasis seemed to associate with the extent of periodontal destruction, suggesting a possible association between psoriasis and periodontitis. Further studies are warranted to clarify the mechanism.
Methods: 34 psoriasis patients referred from the outpatient clinic of Department of Dermatology in National Taiwan University Hospital and 32 healthy controls were recruited in this study. Periodontal parameters including probing depth, recession, plaque index, gingival index and teeth number were recorded by a periodontist. 0.5 ml saliva was collected at the same time for analysis of inflammatory cytokines, including TNF-α, IL1, IL-17, IL12 and IFN-γ. The severity of psoriasis was assessed by Psoriasis Area Severity Index (PASI) and Body Surface Area (BSA).
Results: Patients with psoriasis seemed to have more severe periodontal destructions and less remaining teeth, compared with those in the control subjects. We observed a positive correlation between clinical attachment level (CAL) and BSA involvement or PASI score (p=0.049, p=0.075, respectively). The number of remaining teeth was negatively correlated with BSA involvement (p=0.016). Nevertheless, saliva inflammatory cytokines were not associated with BSA involvement or PASI score in psoriasis patients.
Conclusions: The involvement and severity of psoriasis seemed to associate with the extent of periodontal destruction, suggesting a possible association between psoriasis and periodontitis. Further studies are warranted to clarify the mechanism.