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Psoriasis and Its Severity Associated with Migraine

A Danish study of more than 5 million people has found a link between psoriasis and migraine that increases with the severity of psoriasis. Both diseases have been associated with increased cardiovascular risk, but little is known about their interplay. To better understand a potential link, researchers reviewed health data on all Danish citizens ages 18 and older from January 1, 1997, to December 31, 2011. Of the more than 5,300,000 individuals, 53,006 had a mild form, 6,831 severe psoriasis, and 6,243 patients had psoriatic arthritis.

Rates of migraine increased as the severity of the skin disorder increased.  The incidence rates per 1,000 person years of new-onset migraine were 3.86 for the entire cohort, 5.25 for patients with mild psoriasis, 6.41 for severe psoriasis, and 9.27 for psoriatic arthritis.

Many individuals consider psoriasis as a common chronic skin disease, but lead author Alexander Egeberg, MD, of the Herlev and Gentofte Hospital in Hellerup, Denmark, explained the disorder has a large inflammatory component and is now understood to be a systemic disease, with the skin reflecting the disease activity. In an interview in, he noted that the inflammatory pathways in psoriasis have also been implicated in several central nervous system diseases, such as depression, uveitis, and multiple sclerosis.  He added that pain generation and sensitization can occur as a result of the pro-inflammatory mediators, which are increased in psoriasis.

One of the most important elements of the study, he said, is that certain forms of migraine are associated with increased risk of stroke, and studies have shown that patients with psoriasis have an increased risk of stroke.

“Focus on migraine in patients with psoriasis, including during cardiovascular risk assessments, may be warranted,” he said.

The authors concluded additional studies are necessary to determine if antipsoriatic treatment affects the association, and whether migraine affects the psoriasis-associated risk of cardiovascular disease.

The study appeared in the Journal of the American Academy of Dermatology.

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