Scientists have long wondered why those with psoriasis were more likely to also suffer from migraines. It seems that some proinflammatory cytokines found in psoriasis also contribute to vasospasm, meningeal inflammation, and pain pathway hypersensitivity present with migraine sufferers.
Psoriasis vulgaris (PV) and psoriatic arthritis (PsA) are T-lymphocyte-mediated autoimmune disorders characterized by chronic, organ-specific (skin, joints) and systemic inflammation. This latter fact about psoriasis-that it is associated with multiple medical comorbid conditions-has been bolstered by myriad recent studies linking psoriasis with cardiovascular disease (stroke, ischemic heart disease, congestive heart failure, hypertension) and metabolic disorders (dyslipidemia, obesity, insulin resistance, and type 2 diabetes).
Migraine is a common neurovascular condition characterized by intermittent headaches with or without auras. Some of the same proinflammatory cytokines linked to psoriasis (eg, tumor necrosis factor-alpha) may also contribute to the vasospasm, meningeal inflammation, and pain pathway hypersensitivity found in migraine sufferers. Furthermore, persons with migraine—like those with psoriasis—have an elevated risk for such cardiovascular diseases as stroke. But are migraines more prevalent in patients with psoriasis than in those without psoriatic skin or joint diseases?
To address this intriguing question, Egeberg and colleagues used the Danish National Patient Register to gather data from Danish adults (age >18 years) over a 14-year period (n = 5,379,859). This deep pool of data yielded 53,006 cases of mild PV, 6831 cases of severe PV, and 6243 cases of psoriatic arthritis. A comparison of migraine incidence in these three groups compared with the control population generated the following observations:
- Fully adjusted incidence rate ratios for migraine in patients with mild PV, severe PV, and PsA were 1.37, 1.55, and 1.92, respectively;
- The increased risk for migraine seen in patients with psoriasis was severity-dependent (ie, the risk was greater in severe vs mild psoriasis); and
- The psoriasis-associated increased risk was the same for men and women (ie, not sex specific).
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