281 © 2021 Indian Dermatology Online Journal | Published by Wolters Kluwer - Medknow
Introduction
Recent times have seen a sudden and
justifiable interest in relating Periodontitis
with a number of systemic conditions with
the aim of improving understanding and
overall patient care. However, in the midst
of potentially lucrative associations it does
become something of a caveat that to prove
an association may make one lose sight of
the quality of evidence supporting these
claims. Psoriasis has been reported to have
an association with Periodontitis, however,
a meta‑analysis on the subject seemed to
suggest otherwise in light of the evidence
available on the matter.
[1,2]
Psoriasis is a
chronic skin disease of unknown etiology
presenting on the skin of affected people
as erythematous scaly plaques, particularly
on the extensor surfaces of knees and
elbows, scalp, buttocks, and lower back.
[3,4]
In addition to the skin, it affects the joints
Address for correspondence:
Dr. Shipra Gupta,
Unit of Periodontics, Oral
Health Sciences Centre,
Postgraduate Institute of
Medical Education and
Research (PGIMER),
Chandigarh, India.
E‑mail: shipra1472@gmail.com
Access this article online
Website: www.idoj.in
DOI: 10.4103/idoj.IDOJ_445_20
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Abstract
Objectives: Psoriasis is a common, chronic, non‑communicable skin disease with no clear etiology
or cure. Periodontitis is a chronic inflammatory condition which is now known to significantly
influence various systemic diseases as an established risk factor. This study aimed at comparatively
evaluating the periodontal status of Psoriatic patients vis. a vis. that of age and gender matched
systemically healthy volunteers. An attempt was also made to explore a possible association, if any,
amongst the two diseases. Materials and Methods: Forty two residents of Chandigarh, suffering
from Psoriasis and attending the Psoriasis Clinic of Department of Dermatology & Venereology,
Post Graduate Institute of Medical Education & Research, Chandigarh were recruited over a period
of 10 months (Case group) and their periodontal status was compared with forty two age and gender
matched systemically healthy volunteers (Control group) randomly selected from the Out Patient
Department of Periodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences & Hospital,
Panjab University, India . Their serum IL‑33 levels were evaluated and compared in an attempt
to identify an underlying common pathological pathway. Results: The periodontal status was
comparable in the two groups in terms of the debris index (p = 0.932), calculus index (p = 0.088),
plaque index (p = 0.097), and mean clinical attachment loss (p = 0.401). A higher bleeding points
index was recorded amongst healthy individuals as compared to the Psoriasis group, the difference
being statistically significant (p = 0.001). The mean number of teeth were more in the Psoriasis
group as compared to the healthy group (p=0.034). IL 33 levels were also not significantly
different (p = 0.491). Conclusion: Contrary to currently available evidence in literature, the study
did not find a statistically significant association between Psoriasis and Inflammatory Periodontal
Disease.
Keywords: Association, inflammation, periodontal disease, periodontitis, psoriasis
Psoriasis and Periodontitis: Exploring an association or lack thereof
Brief Report
Shipra Gupta,
Sunil Dogra
1
,
Gurparkash Singh
Chahal
2
,
Savita Prashar
3
,
Angadveer Pal
Singh
2
,
Mili Gupta
3
Unit of Periodontics, Oral
Health Sciences Centre,
Postgraduate Institute of
Medical Education and
Research,
1
Department of
Dermatology and Venereology,
Postgraduate Institute of
Medical Education and
Research, Departments of
2
Periodontics and
3
Biochemistry,
Dr. Harvansh Singh Judge
Institute of Dental Sciences and
Hospital, Panjab University,
Chandigarh, India
How to cite this article: Gupta S, Dogra S, Chahal GS,
Prashar S, Singh AP, Gupta M. Psoriasis and
periodontitis: Exploring an association or lack thereof.
Indian Dermatol Online J 2021;12:281-4.
Received: 10-Jun-2020. Revised: 07-Aug-2020.
Accepted: 13-Sep-2020. Published: 22-Feb-2021.
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of the spine and other joints, known as
psoriatic arthritis.
Periodontal diseases are caused by
microbial plaque, are chronic in nature, and
no longer thought to be a localized entity
but one which significantly influence the
systemic condition of an individual. They
present clinically as destruction of tissues
and bone surrounding the teeth, leading to
mobility and finally tooth loss. The World
Health Organization (WHO) Global Report
on Psoriasis, Geneva 2016 acknowledges
the association between Periodontal
disease and increased risk for Psoriasis.
[1]
Association between the two diseases may
be due to common underlying pathological
pathways.
In periodontal diseases, IL‑33 has
an osteoclastogenic role by inducing
osteoclast differentiation and increased
production of bone resorption factors (c‑Src