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J. Clin. Med. 2019, 8(4), 521; https://doi.org/10.3390/jcm8040521

Systemic Sclerosis Is Linked to Psoriasis and May Impact on Patients’ Survival: A Large Cohort Study

1
Department of Medicine B and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat-Gan 5265601, Israel
2
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
3
Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds LS7 4SA, UK
4
Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy
5
Department of Dermatology, Case Western Reserve University, Cleveland, OH 44124, USA
6
Young Dermatologists Italian Network, Centro Studi GISED, 24122 Bergamo, Italy
7
Chief Physician’s Office, Clalit Health Services, Tel-Aviv 6997801, Israel
8
Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84101, Israel
*
Authors to whom correspondence should be addressed.
Equally contributed as last authors.
Received: 6 February 2019 / Revised: 2 April 2019 / Accepted: 8 April 2019 / Published: 16 April 2019
(This article belongs to the Special Issue Advanced Analytical Methods in Clinical Diagnosis and Therapy)
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Abstract

Although skin manifestations are quite common in systemic sclerosis (SSc), a link between SSc and psoriasis (PsO) has been poorly investigated. We assessed the Clalit medical database in a cohort study to compare the prevalence of PsO between SSc-patients and SSc-free controls. We also evaluated the SSc-related autoantibodies’ role in the co-existence of the two conditions. Survival analysis was performed using both univariate (Kaplan–Meier, log-rank test) and multivariate (Cox proportional-hazards technique) analyses. Our cohort of 2,431 SSc-patients was age- and gender-matched with 12,710 controls (case-control match 1:5.2). There were 150 (1.2%) cases of PsO among controls and 47 (1.9%) among SSc-patients (p = 0.0027). A SSc diagnosis was an independent risk factor for PsO with an odds ratio (OR) of 2.16 (95%CI 1.38–3.39, p = 0.0008). Among SSc-patients, 98.6% with PsO were antinuclear antibodies (ANA)-negative. In terms of survival, the mortality rate in SSc-patients with PsO was lower than SSc without PsO (14.9% vs. 26%, p < 0.0001). At the multivariate-analysis, SSc-patients with PsO compared to SSc-patients without PsO had an OR for death of 0.44 (95%CI 0.19–0.99, p < 0.05). SSc is independently associated with PsO. The cases with concurrent PsO and SSc are almost exclusively ANA-negative and may exhibit a better survival. View Full-Text
Keywords: psoriasis; systemic sclerosis; scleroderma; big data; massive data mining; nation-wide survey psoriasis; systemic sclerosis; scleroderma; big data; massive data mining; nation-wide survey
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Watad, A.; Bragazzi, N.L.; McGonagle, D.; Damiani, G.; Comaneshter, D.; Cohen, A.; Amital, H. Systemic Sclerosis Is Linked to Psoriasis and May Impact on Patients’ Survival: A Large Cohort Study. J. Clin. Med. 2019, 8, 521.

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