Rana Ashwani, Mahajan Vikram K, Chauhan Pushpinder S, Mehta Karaninder S, Sharma Satya Bhushan, Sharma Anuj, Sharma Reena
Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India.
Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India.
Indian Dermatol Online J. 2020 Sep 19;11(5):771-776. doi: 10.4103/idoj.IDOJ_432_19. eCollection 2020 Sep-Oct.
Associations among thyroid dysfunction, thyroid autoimmunity, and clinical features including age, gender, disease duration, and severity of psoriasis is less studied.
To study frequency of thyroid dysfunction and thyroid autoimmunity and examine association among thyroid dysfunction, thyroid autoimmunity, and clinical features including gender, age, duration, and severity of psoriasis.
The medical records of 290 (m:f 2.15:1) patients aged 13-75 years with plaque psoriasis were analyzed for thyroid dysfunction and thyroid autoimmunity. Thyroid dysfunction was defined as 10% variation in any thyroid hormone levels. Thyroid autoimmunity was diagnosed from presence of antithyroid peroxide (anti-TPO) antibodies.
The majority, 57.9% patients, was aged ≥41 years (Type-2 psoriasis) and duration of disease was <5 years in 58.6% patients. Mild and moderate to severe psoriasis was present in 58.3% and 41.7% patients, respectively. Deranged thyroid functions were present in 29 (10%) patients. Hypothyroidism and hyperthyroidism occurred in 5.4% and 2.7% patients, respectively. Anti-TPO antibodies were observed in 13.5% patients; 11had hypothyroidism. There was no statistically significant difference in gender, age, duration, and severity of psoriasis when compared with patients having normal thyroid function tests.
The study suggests possible thyroid dysregulation and thyroid autoimmunity in psoriasis but results need careful interpretation and clinical application. Their significance as standalone risk factor for the chronicity, severity, and relapses in psoriasis or whether thyroid hormone replacement or antithyroid drugs become a useful therapeutic option remains tenuous at best for need of more robust evidence. Retrospective, observational, cross-sectional study design, small number of patients, and lack of controls remain major limitations.
甲状腺功能障碍、甲状腺自身免疫与包括年龄、性别、病程及银屑病严重程度等临床特征之间的关联研究较少。
研究甲状腺功能障碍和甲状腺自身免疫的发生率，并探讨甲状腺功能障碍、甲状腺自身免疫与包括性别、年龄、病程及银屑病严重程度等临床特征之间的关联。
分析290例年龄在13 - 75岁的斑块状银屑病患者（男:女为2.15:1）的病历，以评估甲状腺功能障碍和甲状腺自身免疫情况。甲状腺功能障碍定义为任何甲状腺激素水平有10%的变化。根据抗甲状腺过氧化物酶（抗-TPO）抗体的存在诊断甲状腺自身免疫。
大多数患者（57.9%）年龄≥41岁（2型银屑病），58.6%的患者病程<5年。轻度银屑病患者占58.3%，中度至重度银屑病患者占41.7%。29例（10%）患者存在甲状腺功能紊乱。甲状腺功能减退和甲状腺功能亢进分别发生在5.4%和2.7%的患者中。13.5%的患者检测到抗-TPO抗体；其中11例患有甲状腺功能减退。与甲状腺功能检查正常的患者相比，银屑病患者在性别、年龄、病程和严重程度方面无统计学显著差异。
该研究提示银屑病患者可能存在甲状腺调节异常和甲状腺自身免疫，但研究结果需要谨慎解读和临床应用。它们作为银屑病慢性化、严重程度和复发的独立危险因素的意义，或者甲状腺激素替代或抗甲状腺药物是否成为有用的治疗选择，目前因缺乏更有力的证据而仍不明确。回顾性、观察性、横断面研究设计、患者数量少以及缺乏对照仍是主要局限性。
