The impact of having family history of psoriasis or psoriatic arthritis on psoriatic disease.

OBJECTIVE: Psoriatic arthritis (PsA) has a genetic background. Approximately 40% of patients have a family history of psoriasis or PsA, which may affect disease features. The aim of this study was to assess the effects of family history of psoriasis and PsA on disease phenotypes.

METHODS: The data from 1393 patients recruited in the longitudinal, multicenter Psoriatic Arthritis-International Database (PsArt-ID) were analyzed. The effects of family history of psoriasis and/or PsA on characteristics of psoriasis and PsA were investigated using logistic regression.

RESULTS: Four hundred-forty-four (31.9%) of patients had family history for psoriasis and/or PsA. These patients were more frequently women, had earlier onset of psoriasis, more frequent nail disease, enthesitis, deformities and less frequently achieved minimal disease activity (MDA). Among 444, 335 patients only had psoriasis in their family, 74 had PsA and 35 patients were not clear therefore excluded from further analysis. In multivariate analysis, family history of psoriasis was associated with younger onset of psoriasis (OR: 0.976) and presence of enthesitis (OR: 1.931) whereas family history of PsA was associated with lower risk of plaque psoriasis (OR: 0.417) and higher risk for deformities (OR: 2.557). Family history of PsA vs psoriasis had increased risk for deformities (OR: 2.143) and lower risk for plaque psoriasis (OR: 0.324).

CONCLUSIONS: Family history of psoriasis and PsA has impacts on skin phenotypes, musculoskeletal features and disease severity. The link between family history of psoriasis/PsA and pustular/plaque phenotypes may point out to a different genetic background and pathogenic mechanisms in these subsets. This article is protected by copyright. All rights reserved.