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Psoriasis is an illness that causes inflammation leading to reddening and flaky skin. On some occasions it can also affect joints.

The skin cells generally develop from the deepest layers and rise slowly to the surface of the skin replacing the dead cells. This is known as cell renovation and generally takes around a month. However, in the case of psoriasis, this cell renovation can take place in as little as four days.

 

When this happens it causes thick plates of skin to be stored on the surface, causing flaky skin and reddening, leading to pain and itchiness. Psoriasis is often found on the elbows, knees, other parts of the legs, scalp, lower back, face, palms of the hand and soles of the feet. It may occasionally appear also on other areas such as the finger nails.

In Spain, psoriasis affects around 2% of the population and appears mainly between the ages of 15 and 35, although it also appears in children and the elderly.

Psoriasis begins in the immune system, primarily in a type of white cell present in the blood called lymphocyte T. These lymphocyte T cells help protect us against infection and disease. In the case of Psoriasis the lymphocyte T cells are activated without cause, leading to a response from other parts of the immune system. This generates swelling and the rapid replacement of skin cells. Sufferers from this condition generally experience periodic increases and decreases in their symptoms.

A range of studies have revealed that coeliacs are at greater risk of suffering from psoriasis than the general population. These patients also often have high levels of IgA and/or IgG antigliadin, and 42% of these patients have abnormally high levels of inflammatory cells, predominately mononuclear cells in the intestine.

Skin lesions in coeliacs with psoriasis are generally resistant to conventional treatment, often improving 3 to 6 months on a gluten-free diet, regardless of whether there is an increase in the quantity of inflammatory intestinal cells. The mechanisms, probably due to the association of both entities, are as yet unknown, but a number of hypotheses have been proposed:

  • The modification in the intestinal permeability present in both entities could be a cause of the relationship between them.
  • Lymphocytes T CD4+ would playa n interesting role in the physio-pathogeny of both developments. They are heightened in the blood of patients with psoriasis and it is coeliacs whose adaptive immune response is measured in the intestine.  
  • In patients with the coeliac illness, a reduction in vitamin D levels are often observed. This comes as a result of malabsorption syndrome. This lack of vitamin D is believed to be connected with the outbreak of cutaneous lesions in psoriasis. Vitamin D and its derivatives (calcipotriol, tacalcitol) are recommended for many of these patients because of the anti- proliferative and immune-regulator results, often giving improvements in skin lesions.

The authors of the research state that any associations between psoriasis and the coeliac condition remain unproven and more research is needed in this area. Nevertheless, it was clear from the results that a gluten-free diet led to improvements in cutaneous lesions.

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