Antidepressants and the risk of psoriasis induction: A case–control study

Authors

1 Medical Doctor, Isfahan Student Research Committee School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Dermatology, Skin Diseases and Leishmaniasis Research Center School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Psoriasis (PSO) is a common chronic autoimmune skin disease with a significant psycho-socio-economic burden. Some antidepressants (ADs) such as fluoxetine and bupropion can induce or exacerbate PSO. This study aimed to investigate the correlation between ADs history before PSO onset, and the risk of PSO induction, in Isfahan province, Iran.
Materials and Methods: In this case–control study, 80 patients with PSO were selected by non-probability sampling method, and 80 healthy individuals were selected using simple random sampling. They were interviewed and medical information was recorded. Chi-square, Mann–Whitney, and Kruskal–Wallis tests for dichotomous or categorical data, and independent-sample t test for continuous data were used. Statistical significance was taken as P ≤ 0.05.
Results: In this case–control study, a total of 160 individuals, 80 participants in each group, were included. The mean age of the total samples was 44.8 ± 16 years. Forty-three percent of the individuals were women. PSO familial history in the cases was significantly higher than the control group (OR = 11.94, P = 0.001). It was revealed that use of ADs by patients before PSO induction, was greater than the controls (OR = 2.78, P = 0.058).
Conclusions: Past history of ADs in the cases before PSO onset, was higher than the controls, indicating a possible association between ADs and the risk of PSO induction. This study can be effective to pay more attention to the possible complications of ADs and PSO risk factors. Accurate knowledge of PSO risk factors will be useful for better management and morbidity reduction.

Keywords

1.
Michalek IM, Loring B, John SM. A systematic review of worldwide epidemiology of psoriasis. J Eur Acad Dermatology Venereol 2017;31:205-12.  Back to cited text no. 1
    
2.
Parisi R, Symmons DPM, Griffiths CEM, Ashcroft DM. Global epidemiology of psoriasis: A systematic review of incidence and prevalence. J Invest Dermatol 2013;133:377-85.  Back to cited text no. 2
    
3.
Iskandar IY, Parisi R, Griffiths CE, Ashcroft DM. Systematic review examining changes over time and variation in the incidence and prevalence of psoriasis by age and gender. Br J Dermatol 2021;184:243-58.  Back to cited text no. 3
    
4.
Boehncke W-H, Schön MP. Psoriasis. Lancet (London, England) 2015;386:983-94.  Back to cited text no. 4
    
5.
Reich K. The concept of psoriasis as a systemic inflammation: Implications for disease management. J Eur Acad Dermatology Venereol 2012;26:3-11.  Back to cited text no. 5
    
6.
Tsoi LC, Stuart PE, Tian C, Gudjonsson JE, Das S, Zawistowski M, et al. Large scale meta-analysis characterizes genetic architecture for common psoriasis associated variants. Nat Commun 2017;8:1-8.  Back to cited text no. 6
    
7.
Mohd Affandi A, Khan I, Ngah Saaya N. Epidemiology and clinical features of adult patients with psoriasis in Malaysia: 10-year review from the Malaysian psoriasis registry (2007-2016). Dermatol Res Pract 2018;2018.  Back to cited text no. 7
    
8.
Greb JE, Goldminz AM, Elder JT, Lebwohl MG, Gladman DD, Wu JJ, et al. Psoriasis. Nat Rev Dis Prim 2016;2:16082.  Back to cited text no. 8
    
9.
Tokura Y, Mori T, Hino R. Psoriasis and other Th17-mediated skin diseases. J UOEH 2010;32:317-28.  Back to cited text no. 9
    
10.
Egeberg A, Thyssen JP, Wu JJ, Skov L. Psoriasis and depression. Br J Dermatol 2019;180:e12.  Back to cited text no. 10
    
11.
Szczerkowska-Dobosz A. Human leukocyte antigens as psoriasis inheritance and susceptibility markers. Arch Immunol Ther Exp (Warsz) 2005;53:428-33.  Back to cited text no. 11
    
12.
Huynh M, Gupta R, Koo J. Emotional stress as a trigger for inflammatory skin disorders. Semin Cutan Med Surg 2013;32:68-72.  Back to cited text no. 12
    
13.
Bangsgaard N, Engkilde K, Thyssen JP, Linneberg A, Nielsen NH, Menné T, et al. Inverse relationship between contact allergy and psoriasis: Results from a patient- and a population-based study. Br J Dermatol 2009;161:1119-23.  Back to cited text no. 13
    
14.
Wolters M. Diet and psoriasis: Experimental data and clinical evidence. Br J Dermatol 2005;153:706-14.  Back to cited text no. 14
    
15.
Hernandez M, Simms-Cendan J, Zendell K. Guttate psoriasis following streptococcal vulvovaginitis in a five-year-old girl. J Pediatr Adolesc Gynecol 2015;28:e127-9.  Back to cited text no. 15
    
16.
Eyre RW, Krueger GG. Response to injury of skin involved and uninvolved with psoriasis, and its relation to disease activity: Koebner and 'reverse'Koebner reactions. Br J Dermatol 1982;106:153-9.  Back to cited text no. 16
    
17.
Balak DM, Hajdarbegovic E. Drug-induced psoriasis: Clinical perspectives. Psoriasis (Auckland, NZ) 2017;7:87-94.  Back to cited text no. 17
    
18.
Basavaraj KH, Ashok NM, Rashmi R, Praveen TK. The role of drugs in the induction and/or exacerbation of psoriasis. Int J Dermatol 2010;49:1351-61.  Back to cited text no. 18
    
19.
Rongioletti F, Fiorucci C, Parodi A. Psoriasis induced or aggravated by drugs. J Rheumatol Suppl 2009;83:59-61.  Back to cited text no. 19
    
20.
Tsankov N, Angelova I, Kazandjieva J. Drug-induced psoriasis. Am J Clin Dermatol 2000;1:159-65.  Back to cited text no. 20
    
21.
Hemlock C, Rosenthal JS, Winston A. Fluoxetine-induced psoriasis. Ann Pharmacother 1992;26:211-2.  Back to cited text no. 21
    
22.
Lester EB, Cook DL, Frieling GW. Psoriasiform drug eruptions and drugs that flare psoriasis. In Cutaneous Drug Eruptions. London: Springer; 2015. p. 141-55.  Back to cited text no. 22
    
23.
Hong J, Bernstein D. A review of drugs that induce or exacerbate psoriasis. Psoriasis Forum 2012;18a:2-11.  Back to cited text no. 23
    
24.
Cen J, Zhu K, Jin N, Lin A, Cheng H. Effects of drugs known to trigger psoriasis on HaCaT keratinocytes. Yao Xue Xue Bao 2007;42:1041-4.  Back to cited text no. 24
    
25.
Sadatmadani SF, Malakoutikhah Z, Mohaghegh F, Peikar M, Saboktakin M. Nilotinib-induced elephantine psoriasis in a chronic myeloid leukemia patient: A rare case report and literature review. Current Therapeutic Res 2022;96:100676.  Back to cited text no. 25
    
26.
Kaur S, Arora AK, Sekhon JS, Sood N. Nilotinib-induced psoriasis in a patient of chronic myeloid leukemia responding to methotrexate. Indian J Dermatol Venereol Leprol 2015;81:216-8.  Back to cited text no. 26
[PUBMED]  [Full text]  
27.
Nagai T, Karakawa M, Komine M, Muroi K, Ohtsuki M, Ozawa K. Development of psoriasis in a patient with chronic myelogenous leukaemia during nilotinib treatment. Eur J Haematol 2013;91:270-2.  Back to cited text no. 27
    
28.
Tan Pei Lin L, Kwek SK. Onset of psoriasis during therapy with fluoxetine. Gen Hosp Psychiatry 2010;32:446.e9-10.  Back to cited text no. 28
    
29.
Singh PA, Cassel KP, Moscati RM, Eckersley D. Acute generalized erythrodermic pustular psoriasis associated with bupropion/naltrexone (Contrave®). J Emerg Med 2017;52:e111-3.  Back to cited text no. 29
    
30.
Cox NH, Gordon PM, Dodd H. Generalized pustular and erythrodermic psoriasis associated with bupropion treatment. Br J Dermatol 2002;146:1061-3.  Back to cited text no. 30
    
31.
Matos-Pires E, Campos S, Mendes-Bastos P, João A, Fernandes C. Erythrodermic psoriasis induced by bupropion. J Eur Acad Dermatology Venereol 2017;31:e129-30.  Back to cited text no. 31
    
32.
Surovik J, Riddel C, Chon SY. A case of bupropion-induced Stevens-Johnson syndrome with acute psoriatic exacerbation. J Drugs Dermatol 2010;9:1010-2.  Back to cited text no. 32
    
33.
Messiha FS. Fluoxetine: Adverse effects and drug-drug interactions. J Toxicol Clin Toxicol 1993;31:603-30.  Back to cited text no. 33
    
34.
Tzeng YM, Li IH, Kao HH, Shih JH, Yeh CB, Chen YH, et al. Protective effects of anti-depressants against the subsequent development of psoriasis in patients with major depressive disorder: A cohort study. J Affect Disord 2021;281:590-6.  Back to cited text no. 34
    
35.
Zafiriou E, Daponte AI, Siokas V, Tsigalou C, Dardiotis E, Bogdanos DP. Depression and obesity in patients with psoriasis and psoriatic arthritis: Is IL-17-mediated immune dysregulation the connecting link? Front Immunol 2021;12.  Back to cited text no. 35
    
36.
Connor CJ, Liu V, Fiedorowicz JG. Exploring the physiological link between psoriasis and mood disorders. Dermatol Res Pract 2015;2015.  Back to cited text no. 36
    
37.
Lewinson RT, Vallerand IA, Lowerison MW, Parsons LM, Frolkis AD, Kaplan GG, et al. Depression is associated with an increased risk of psoriatic arthritis among patients with psoriasis: A population-based study. J Invest Dermatol 2017;137:828-35.  Back to cited text no. 37
    
38.
Dominguez PL, Han J, Li T, Ascherio A, Qureshi AA. Depression and the risk of psoriasis in US women. J Eur Acad Dermatol Venereol 2013;27:1163-7.  Back to cited text no. 38
    
39.
Nestle FO, Kaplan DH, Barker J. Psoriasis. N Engl J Med 2009;361:496-509.  Back to cited text no. 39
    
40.
Rapp SR, Feldman SR, Exum ML, Fleischer Jr AB, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol 1999;41:401-7.  Back to cited text no. 40
    
41.
Farshchian M, Zamanian A, Farshchian M, Monsef AR, Mahjub H. Serum lipid level in Iranian patients with psoriasis. J Eur Acad Dermatology Venereol 2007;21:802-5.  Back to cited text no. 41
    
42.
Hägg D, Sundström A, Eriksson M, Schmitt-Egenolf M. Severity of psoriasis differs between men and women: A study of the clinical outcome measure psoriasis area and severity index (PASI) in 5438 Swedish register patients. Am J Clin Dermatol 2017;18:583-90.  Back to cited text no. 42
    
43.
White D, O'Shea SJ, Rogers S. Do men have more severe psoriasis than women? J Eur Acad Dermatol Venereol 2011;26:126-7.  Back to cited text no. 43
    
44.
Ashkevari S, Ehsani AH, Ghanbari A, Molaii H, Noormohammadpour P. The frequency of cigarette smoking in patients with psoriasis vulgaris: A comparative study. Tehran Univ Med J 2011;69:260-6.  Back to cited text no. 44
    
45.
Chiriac A, Solovan C, Pinteala T, Chiriac AE, Brzezinski P, Foia L. The relationship between psoriasis and specific professional activities or occupation-induced skin diseases. Shiraz E-Medical J 2014;15:e20591.  Back to cited text no. 45
    
46.
Naldi L, Peli L, Parazzini F, Carrel CF, Psoriasis Study Group of the Italian Group for Epidemiological Research in Dermatology. Family history of psoriasis, stressful life events, and recent infectious disease are risk factors for a first episode of acute guttate psoriasis: Results of a case-control study. J Am Acad Dermatol 2001;44:433-8.  Back to cited text no. 46
    
47.
Dowlatshahi E, Wakkee M, Herings R, Hollestein L, Nijsten T. Increased antidepressant drug exposure in psoriasis patients: A longitudinal population-based cohort study. Acta Dermato Venereol 2013;93:544-50.  Back to cited text no. 47
    
48.
Derme AM, Zanieri F, Campolmi E, Santosuosso U, Betti S, Agnoletti AF, et al. Therapeutic implications of adding the psychotropic drug escitalopram in the treatment of patients suffering from moderate-severe psoriasis and psychiatric comorbidity: A retrospective study. J Eur Acad Dermatology Venereol 2014;28:246-9.  Back to cited text no. 48
    
49.
Younes SF, Bakry OA. Immunohistochemical evaluation of role of serotonin in pathogenesis of psoriasis. J Clin Diagn Res 2016;10:EC05.  Back to cited text no. 49
    
50.
Wardhana M, Windari M, Puspasari N, Suryawati N. Role of serotonin and dopamine in psoriasis: A case-control study. Open Access Maced J Med Sci 2019;7:1138.  Back to cited text no. 50
    
51.
Young MR, Matthews JP. Serotonin regulation of T-cell subpopulations and of macrophage accessory function. Immunology 1995;84:148-52.  Back to cited text no. 51
    
52.
Besser MJ, Ganor Y, Levite M. Dopamine by itself activates either D2, D3 or D1/D5 dopaminergic receptors in normal human T-cells and triggers the selective secretion of either IL-10, TNFα or both. J Neuroimmunol 2005;169:161-71.  Back to cited text no. 52
    
53.
Mori T, Kabashima K, Fukamachi S, Kuroda E, Sakabe J, Kobayashi M, et al. D1-like dopamine receptors antagonist inhibits cutaneous immune reactions mediated by Th2 and mast cells. J Dermatol Sci 2013;71:37-44.  Back to cited text no. 53
    
54.
Parrado AC, Canellada A, Gentile T, Rey-Roldán EB. Dopamine agonists upregulate IL-6 and IL-8 production in human keratinocytes. Neuroimmunomodulation 2012;19:359-66.  Back to cited text no. 54
    
55.
Katzung BG, Trevor AJ. Basic and Clinical Pharmacology. 13th ed. NewYork: Mc Graw Hill; 2015. p. 514-6.  Back to cited text no. 55
    
56.
Kato M, Serretti A. Review and meta-analysis of antidepressant pharmacogenetic findings in major depressive disorder. Mol Psychiatry 2010;15:473-500.  Back to cited text no. 56
    
57.
Ramesh V, Venkatesan V, Ramasamy B. Role of serotonin transporter and receptor gene polymorphisms in treatment response to selective serotonin reuptake inhibitors in major depressive disorder. Hum Psychopharmacol 2022:e2830.  Back to cited text no. 57
    
58.
García-García ML, Tovilla-Zárate CA, Villar-Soto M, Juárez-Rojop IE, González-Castro TB, Genis-Mendoza AD, et al. Fluoxetine modulates the pro-inflammatory process of IL-6, IL-1β and TNF-α levels in individuals with depression: A systematic review and meta-analysis. Psychiatry Res 2022;307:114317.  Back to cited text no. 58
    
59.
Creeden JF, Imami AS, Eby HM, Gillman C, Becker KN, Reigle J, et al. Fluoxetine as an anti-inflammatory therapy in SARS-CoV-2 infection. Biomed Pharmacother 2021;138:111437.  Back to cited text no. 59
    
60.
Hoertel N. Do the selective serotonin reuptake inhibitor antidepressants fluoxetine and fluvoxamine reduce mortality among patients with COVID-19? JAMA Netw Open 2021;4:e2136510.  Back to cited text no. 60