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Abstract
Background Familial Mediterranean fever (FMF) is a periodic fever syndrome caused by MEFV mutations. FMF may be associated with psoriasis in some cases. Previous study has shown that psoriasis was more common in the relatives of FMF patients [1].
Objectives We aimed to investigate the prevalence of psoriasis among FMF patients and their relatives.
Methods FMF patients followed at Hacettepe University Adult and Pediatric Rheumatology Departments between January and August 2016 were consecutively enrolled to this study. Demographic data, clinical manifestations, laboratory data and MEFV variant analysis were documented by medical file screening and face-to-face interview. The presence of psoriasis and psoriatic arthritis in patients and their relatives (first [Mother, father, children]-second [Brothers, grandchildren, grandfather and grandmother]-third degree [Nephew, uncle, maternal uncle, aunt, paternal aunt] relatives) and drug use history were also questioned. The patients were accepted to have psoriasis if the diagnosis was made by a dermatologist.
Results 351 FMF patients (177 adults; 174 children) were included in this study (Table). 70.1% of adult patients were female, 29.9% were male. 53.4% of pediatric patients were female, 46.6% were male. The median age (min-max) of the adult patients was 35 (19–63), while the median age of the pediatric patient group was 10 (2–18). The onset age of symptom was 12 (0–39) in the adult group and 3 (1–14) in the pediatric group. The median age at diagnosis was 25 (2–52) in the adult group and 5 (1–18) in the pediatric group. Thirteen (3.7%) patients had psoriasis. Psoriasis was more common in adult patients than pediatric patients (p=0.02). Psoriasis was present in 22 (12.4%) of adult patients' and 9 (5.2%) of pediatric patients' relatives (p=0.023). The frequency of psoriasis in one or more relatives of all FMF patients was found to be 8.8%.
Conclusions IL-1 has an essential role for signaling early T helper 17 (Th17) differentiation and Ashida et al have shown the presence of Th17 cells in the upper dermis of psoriasis-like lesions in a patient with FMF [2]. We may speculate that high IL-1 in FMF may cause Th17 activation and stimulation of keratinocytes; and this may be the reason for higher frequency of psoriasis in FMF patients. Thirteen (3.7%) patients had psoriasis; more common than the normal population (0.40%) (p<0.0001). FMF increases the likelihood of psoriasis in relatives of FMF patient. Thus, FMF patients should be questioned and carefully examined for psoriasis lesions and psoriasis family history.
References
Barut, K., et al., Inceased frequency of psoriasis in the families of the children with familial Mediterranean fever. Clin Exp Rheumatol, 2016. 34(6 Suppl 102): p. S137.
Ashida, M., et al., Psoriasis-like lesions in a patient with familial Mediterranean fever. J Dermatol, 2016. 43(3): p. 314–7.
References
Disclosure of Interest None declared