Clinical and genetic differences between pustular psoriasis subtypes.


Journal

The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002

Informations de publication

Date de publication:
03 2019
Historique:
received: 02 02 2018
revised: 14 05 2018
accepted: 15 06 2018
pubmed: 24 7 2018
medline: 17 3 2020
entrez: 24 7 2018
Statut: ppublish

Résumé

The term pustular psoriasis indicates a group of severe skin disorders characterized by eruptions of neutrophil-filled pustules. The disease, which often manifests with concurrent psoriasis vulgaris, can have an acute systemic (generalized pustular psoriasis [GPP]) or chronic localized (palmoplantar pustulosis [PPP] and acrodermatitis continua of Hallopeau [ACH]) presentation. Although mutations have been uncovered in IL36RN and AP1S3, the rarity of the disease has hindered the study of genotype-phenotype correlations. We sought to characterize the clinical and genetic features of pustular psoriasis through the analysis of an extended patient cohort. We ascertained a data set of unprecedented size, including 863 unrelated patients (251 with GPP, 560 with PPP, 28 with ACH, and 24 with multiple diagnoses). We undertook mutation screening in 473 cases. Psoriasis vulgaris concurrence was lowest in PPP (15.8% vs 54.4% in GPP and 46.2% in ACH, P < .0005 for both), whereas the mean age of onset was earliest in GPP (31.0 vs 43.7 years in PPP and 51.8 years in ACH, P < .0001 for both). The percentage of female patients was greater in PPP (77.0%) than in GPP (62.5%; P = 5.8 × 10 The analysis of an unparalleled resource revealed key clinical and genetic differences between patients with PPP and those with GPP.

Sections du résumé

BACKGROUND
The term pustular psoriasis indicates a group of severe skin disorders characterized by eruptions of neutrophil-filled pustules. The disease, which often manifests with concurrent psoriasis vulgaris, can have an acute systemic (generalized pustular psoriasis [GPP]) or chronic localized (palmoplantar pustulosis [PPP] and acrodermatitis continua of Hallopeau [ACH]) presentation. Although mutations have been uncovered in IL36RN and AP1S3, the rarity of the disease has hindered the study of genotype-phenotype correlations.
OBJECTIVE
We sought to characterize the clinical and genetic features of pustular psoriasis through the analysis of an extended patient cohort.
METHODS
We ascertained a data set of unprecedented size, including 863 unrelated patients (251 with GPP, 560 with PPP, 28 with ACH, and 24 with multiple diagnoses). We undertook mutation screening in 473 cases.
RESULTS
Psoriasis vulgaris concurrence was lowest in PPP (15.8% vs 54.4% in GPP and 46.2% in ACH, P < .0005 for both), whereas the mean age of onset was earliest in GPP (31.0 vs 43.7 years in PPP and 51.8 years in ACH, P < .0001 for both). The percentage of female patients was greater in PPP (77.0%) than in GPP (62.5%; P = 5.8 × 10
CONCLUSIONS
The analysis of an unparalleled resource revealed key clinical and genetic differences between patients with PPP and those with GPP.

Identifiants

pubmed: 30036598
pii: S0091-6749(18)31039-X
doi: 10.1016/j.jaci.2018.06.038
pmc: PMC6403101
pii:
doi:

Substances chimiques

AP1S3 protein, human 0
IL36RN protein, human 0
Interleukins 0
Vesicular Transport Proteins 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1021-1026

Subventions

Organisme : Department of Health
ID : EME/13/50/17
Pays : United Kingdom
Organisme : Department of Health
ID : EME 13/50/17
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S003126/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/L011808/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/N005872/1
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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Auteurs

Sophie Twelves (S)

Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, King's College London, London, United Kingdom.

Alshimaa Mostafa (A)

Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; Department of Dermatology, Beni Suef University, Beni Suef, Egypt.

Nick Dand (N)

Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, King's College London, London, United Kingdom.

Elias Burri (E)

Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.

Katalin Farkas (K)

Department of Medical Genetics, University of Szeged, Szeged, Hungary.

Rosemary Wilson (R)

St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom.

Hywel L Cooper (HL)

Portsmouth Dermatology Unit, Portsmouth Hospitals Trust, Portsmouth, United Kingdom.

Alan D Irvine (AD)

Paediatric Dermatology, Our Lady's Children's Hospital Crumlin, and Clinical Medicine, Trinity College Dublin, Dublin, Ireland.

Hazel H Oon (HH)

Department of Dermatology, National Skin Centre, Singapore.

Külli Kingo (K)

Department of Dermatology, University of Tartu, and the Clinic of Dermatology, Tartu University Hospital, Tartu, Estonia.

Sulev Köks (S)

Department of Pathophysiology, University of Tartu, Tartu, Estonia.

Ulrich Mrowietz (U)

Psoriasis Center at the Department of Dermatology, University Medical Center, Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Luis Puig (L)

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Nick Reynolds (N)

Institute of Cellular Medicine, Medical School, Newcastle University and the Department of Dermatology, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.

Eugene Sern-Ting Tan (ES)

Department of Dermatology, National Skin Centre, Singapore.

Adrian Tanew (A)

Department of Dermatology, Medical University of Vienna, Vienna, Austria.

Kaspar Torz (K)

Psoriasis Center at the Department of Dermatology, University Medical Center, Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Hannes Trattner (H)

Department of Dermatology, Medical University of Vienna, Vienna, Austria.

Mark Valentine (M)

Division of Dermatology, University of Washington School of Medicine, Seattle, Wash.

Shyamal Wahie (S)

University Hospital of North Durham and Darlington Memorial Hospital, Darlington, United Kingdom.

Richard B Warren (RB)

Dermatology Centre, Salford Royal Hospital, University of Manchester and the Academic Health Science Centre, Manchester, United Kingdom.

Andrew Wright (A)

St Lukes Hospital, Bradford, and the Centre for Skin Science, University of Bradford, Bradford, United Kingdom.

Zsuzsa Bata-Csörgő (Z)

MTA-SZTE Dermatological Research Group, Szeged, and the Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary.

Marta Szell (M)

MTA-SZTE Dermatological Research Group, Szeged, and the Department of Medical Genetics, University of Szeged, Szeged, Hungary.

Christopher E M Griffiths (CEM)

Dermatology Centre, Salford Royal Hospital, University of Manchester and the Academic Health Science Centre, Manchester, United Kingdom.

A David Burden (AD)

Institute of Infection, Inflammation and Immunity, University of Glasgow, Glasgow, United Kingdom.

Siew-Eng Choon (SE)

Department of Dermatology, Hospital Sultanah Aminah, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor Bahru, Selangor, Malaysia.

Catherine H Smith (CH)

St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom.

Jonathan N Barker (JN)

St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom. Electronic address: jonathan.barker@kcl.ac.uk.

Alexander A Navarini (AA)

Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.

Francesca Capon (F)

Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, King's College London, London, United Kingdom.

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Classifications MeSH