Psoriasis in autoimmune polyendocrine syndrome type I: A possible complication or a non-endocrine minor component.
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Date
2015-03
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Abstract
Introduction: Autoimmune polyendocrine syndrome type I (APS I) is an autosomal recessive
systemic autoimmune disorder, affecting primarily endocrine glands, in which chronic
mucocutaneous candidiasis is an early and prominent manifestation. We describe the rare
occurrence of unstable psoriasis (with onset of pustular lesions) in a case of APS I without
mucocutaneous candidiasis. A patient presenting with unstable psoriasis (with onset of
pustular lesions) was detected to have persistent hypocalcemia which led to the diagnosis of
hypoparathyroidism. Subsequently he was found to have hypergonadotrophic hypogonadism,
primary adrenal insuffi ciency (compensated), and coeliac disease, thus confi rming the
diagnosis of APS I. Psoriasis is very rarely reported in APS I, possibly due to the protective
effect of antibodies to Th17 cytokines, which are responsible for the occurrence of candidiasis
in this syndrome. However, psoriasis could occur in APS I patients without mucocutaneous
candidiasis, who lack these antibodies. In our patient, possible factors aggravating psoriasis
include hypocalcemia due to hypoparathyroidism as well as coeliac disease via anti-tissue
transglutaminase antibodies. However, defi ning psoriasis as a possible minor component
of APS I would require further studies of the autoimmune regulator (AIRE) gene functions.
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Keywords
Autoimmune polyendocrine syndrome I, candidiasis, psoriasis
Citation
Poojary Shital Amin, Lodha Nikita, Gupta Nikita. Psoriasis in autoimmune polyendocrine syndrome type I: A possible complication or a non-endocrine minor component. Indian Journal of Dermatology, Venereology and Leprology. 2015 Mar-Apr; 81(2): 166-169.