Turner Syndrome Increases the Risk of Psoriasis: A Systematic Review and Meta-Analysis

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The aim was to pool data presented in the literature on the incidence and prevalence of psoriasis in girls and women with Turner syndrome. The conclusion was that psoriasis was more incident and prevalent in Turner syndrome than in subjects without this syndrome, named controls.

The manuscript has some major flaws:

No data on the prevalence of psoriasis in girls/women in general in the population is given. No data or figures are given on the frequency of cases in each included study. No data on how many, or the percentage of patients/controls, had psoriasis. Table 1 and Figure 2 include 2 Danish studies based on similar, and probably the same, population. Hence, subjects were counted twice which could increase the power and blur the conclusion. Only unique subjects should be included. The forest plots must be calculated without the Danish register study by Jörgensen et al without controls i.e. NA in Table 1.  Bakalows´ study has another autoimmune patient group as control group, premature ovarian failure without Turner syndrome, and cannot be considered representative as controls. Small and strongly selected groups of girls/women with both Turner syndrome and selected controls, respectively, are seen in the presented study groups.

The authors are probably right in their conclusion, but in order to avoid putting another burden on the patient group with Turner syndrome, the present review and meta-analyses must be more precisely presented.

Minor:

Is there a misprint in Table 1 and the figures after Isochromosome 378 (47)? Percentage? The references could be more updated. For example there is a recent and large controlled study published on Autoimmunde disease in Turner syndrome (Naessen et al JCEM 2024).

Author Response

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Reviewer 2 Report

Comments and Suggestions for Authors

comments in word

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Author Response

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Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Please see the enclosed word file  

Comments for author File: Comments.pdf

Author Response

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Reviewer 2 Report

Comments and Suggestions for Authors

comments in word

Comments for author File: Comments.pdf

Comments on the Quality of English Language

adequate quality of english

Author Response

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Round 3

Reviewer 1 Report

Comments and Suggestions for Authors The manuscript is OK for me now.

Reviewer 2 Report

Comments and Suggestions for Authors

All requested changes have already been made by the authors

Comments on the Quality of English Language adequate quality