Macklis P, et al. Dermatol Online J. 2019;25(7):16.
November 13, 2019
Oral health and hygiene and dietary practices may be associated with the development and severity of psoriasis, according to a study in Dermatology Online Journal.
“The biggest surprise was that frequent consumption of fresh fruit is associated with a lower severity of psoriasis,” Paul Macklis, BS, MS, study author and medical student at The Ohio State University College of Medicine, said in an interview with Healio Dermatology. “While this could potentially be explained by a confounding variable such as fruit consumption being linked to more health-conscious behaviors in general, it does raise the question of whether fruit consumption could be shifting the microbiome to a less inflammatory constituent.”
Macklis and colleagues administered a specially designed questionnaire to 100 patients with psoriasis and 165 adult controls.
“The questionnaire consisted of a series of discrete and Likert scale questions exploring topics such as duration of the patient’s skin condition, patient-reported outcomes, presence of any other autoimmune conditions, previous streptococcal infections, dietary choices and oral hygiene practices supplemented by the validated World Health Organization adult survey for oral hygiene practices,” Macklis said.
Significant predictors for psoriasis included age (OR = 1.03; 95% CI, 1.01-1.05), family history of psoriasis (OR = 5.04; 95% CI, 2.61-9.73), personal history of strep throat (OR = 2.0; 95% CI, 1.08-3.7), personal history of rheumatoid arthritis (OR = 4.18; 95% CI, 1.34-13.06) and oral pain or discomfort within the past 12 months (OR = 1.99; 95% CI, 1.05-3.79).
Moreover, higher BMI scores were associated with more severe psoriasis symptoms based on the product of physician’s global assessment and body surface area (95% CI, 0.01-2.5).
Patients with psoriasis who rated their gum health as poor or very poor had significantly more severe psoriasis symptoms (95% CI, 8.3-133.9). Additionally, those who reported difficulty with speech due to dental problems had a significant increase in psoriasis severity (95% CI, 7.0-91.9).
Patients who said they consumed fresh fruit at least once daily had milder symptoms (95% CI, –107.4 to –13.0).
“These results suggest that clinicians can augment the treatment of psoriasis and potentially improve clinical outcomes by recommending excellent oral health practices, thereby reducing the incidence of dysbiotic changes to their oral microbiome and decreasing their dermatologic symptoms,” Macklis said.
Future studies will explore the correlation between psoriasis and validated dental health evaluations and further evaluation of the microbiome and subsequent dysbiosis within patients with psoriasis, he added. – by Abigail Sutton
Disclosure: Macklis reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.