Ocular findings in patients with psoriasis

Background Psoriasis is a chronic inflammatory disease affecting skin, nails, and joints. Although there are not many reports in the literature, ocular findings occur in approximately 10% of patients, in mostly those who have psoriatic arthritis. In this study, we aimed to evaluate eye involvement in psoriasis patients. Methods This study was performed on a total of 100 psoriasis patients and a group of 100 healthy individuals. History was taken from all study and control subjects, and dermatological, systemic, and ophthalmological examinations were performed and Schirmer and BUT values were measured. Constant variables were compared using the t‐test, and categorical variables were compared using chi‐square test. Relationship between ocular findings and sex, age, duration of psoriasis, PASI score, presence of psoriatic plaques on the eyelid, nail involvement, and psoriatic arthritis was evaluated using logistic regression analysis. Statistical analyses were performed individually for both right and left eyes. Results The number of ocular findings in both eyes in the patient group was found to be statistically higher than that in the control group. Schirmer and BUT values were statistically lower in the patient group than those in the control group. Conclusions Although results of our study support the necessity of routine ophthalmological examination of psoriasis patients for early diagnosis and treatment, we believe that further studies are required on the etiopathogenesis of ocular involvement in psoriasis patients.     

Ocular changes in patients with psoriasis

Eye involvement in psoriasis is little known to many dermatologists, although psoriasis has been acknowledged as a systemic disease for decades. The ophthalmic complications of psoriasis are numerous and can affect almost any part of the eye. The most common ocular changes in patients with psoriasis, including blepharitis, conjunctivitis, keratitis, iridocyclitis, UV-induced cataracts, uveitis, and birdshot chorioretinitis, have been described in the literature. Recognition of the ocular complications of psoriasis is of significant clinical importance, because various pathogenic mechanisms may contribute to the development of ocular manifestations, including direct eye involvement with psoriatic plaques, psoriasis-related immune-mediated inflammatory processes, and complications of psoriasis treatments.     

Ocular melanomas

The importance of melanomas of the eye and adnexa is that they can be as deadly as the most aggressive cutaneous types, with 15-year mortality rates approaching 50 per cent. Also, treatment may permanently impair the sight. This discussion of melanomas that affect the eye and adnexa commences with the eyelids, proceeds to the conjunctiva, follows with the ocular globe, and includes a consideration of the dysplastic nevus syndrome as it affects the eye.     

Ocular sarcoidosis

Ocular involvement in sarcoidosis is the second most common manifestation of the disease, preceded only by pulmonary abnormalities with hilar adenopathy. Ocular disease is the presenting manifestation in 9% of cases,¹ and 25–50% of patients with systemic sarcoidosis will at some time show ocular involvement.^1–3 Chronic ocular sarcoidosis may correlate with cutaneous lesions in 38% of cases. All patients with suspected sarcoidosis should have a thorough ophthalmologic examination.     

Ocular allergies

Recent developments indicate that ocular allergy is more than an IgE-mediated allergic conjunctivitis. Ocular allergy is a disease affecting the entire ocular surface including conjunctiva, lids, cornea, lacrimal gland and tear film. Besides an IgE-mediated reaction, a complex chronic inflammation is involved in the pathogenesis of many ocular allergies. According to their pathogenesis and clinical picture, ocular allergies are classified into mild forms, such as seasonal and perennial allergic conjunctivitis as well as giant papillary conjunctivitis, and chronic, potentially blinding forms such as atopic keratoconjunctivitis and vernal keratoconjunctivitis. New therapeutics act on the entire inflammatory process or try to modulate the allergic reaction early and specifically. The association with non-ocular allergic symptoms requires an interdisciplinary approach.     

Animal models of psoriasis and pustular psoriasis

Investigation of psoriasis and pustular psoriasis is presently hampered by the lack of appropriate animal models. So far, more than ten models have been developed in mice by spontaneous gene mutations and by gene manipulation. However, none of them has satisfactorily reproduced the clinicopathological and immunopathological phenotypes of these diseases. Xenotransplantation techniques have been used for designing models of psoriasis vulgaris, in which CD4(+) T cells have been shown to play an important role. An ideal model for pustular psoriasis should have an immunological background and fulfill the diagnostic criteria of psoriasis.     

Oral psoriasis

Summary We present a patient with oral lesions consistent with a diagnosis of oral psoriasis and discuss the relationship of oral and skin lesions in psoriasis.     

Naevoid psoriasis

A 6-year-old male child had linear scaly erythematous band on the penis, undersuface of penis, extending to the scrotum since birth. He was diagnosed clinically as well as histopathologically as a case of naevoid psoriasis.     

Infantile psoriasis

Psoriasis is a common inherited papulosquamous dermatosis that may be a diagnostic dilemma, particularly in infants and children. The treatment of children with psoriasis should be handled with caution and tailored according to the child's age, as well as to the extent, distribution, and type of psoriasis.