Skin Conditions Linked to Stroke, Fibromyalgia

The field of neurology is intertwined with several fields of medicine, but with a few exceptions, it's not every day the worlds of neurology and dermatology collide—unless you bite your tongue when comparing reimbursement rates or on-call schedules. However, a study published in the May 21st online edition of the Journal of Investigative Dermatology found that "patients with psoriasis, particularly if severe, have an increased risk of stroke that is not explained by major stroke risk factors identified in routine medical care."

Researchers performed a population-based cohort study of patients seen by general practitioners participating in the General Practice Research Database in the United Kingdom between 1987 and 2002. They defined mild psoriasis as "any patient with a diagnostic code of psoriasis, but no history of systemic therapy." Severe psoriasis, meanwhile, was defined as "any patient with a diagnostic code of psoriasis and a history of systemic therapy consistent with severe psoriasis." The unexposed group consisted of patients with no history of a psoriasis diagnostic code. When amended for major risk factors for stroke, both mild (hazard ratio (HR) 1.06, 95% confidence interval (CI) 1.0-1.1) and severe (1.43, 95% CI 1.1-1.9) psoriasis were independent risk factors for stroke. "The excess risk of stroke attributable to psoriasis in patients with mild and severe disease was one in 4,115 per year and one in 530 per year, respectively," the authors write.

In light of suggestions that chronic urticaria may be mediated by peripheral cutaneous nerve fiber dysfunction, researchers investigated the relationship between the skin condition and fibromyalgia syndrome (Acta Dermato-Venereologica, 89(4): 389-392). They evaluated 126 patients with chronic urticaria and found that over 70 percent had fibromyalgia syndrome. Just 16 percent of controls had fibromyalgia—higher than estimates for the general population. Researchers concluded that chronic urticaria may, "be viewed in many patients, as a consequence of fibromyalgia syndrome; in fact, skin neuropathy (fibromyalgia syndrome) may trigger neurogenic skin inflammation (chronic urticaria)."