Indian Journal of Dermatology
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REVIEW ARTICLE
Year : 2018  |  Volume : 63  |  Issue : 3  |  Page : 193-200

Association between psoriasis and Helicobacter pylori infection: A systematic review and meta-analysis


1 Department of Internal Medicine, Greenfield Family Medicine, Baystate Franklin Medical Center, Greenfield, MA, USA
2 Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago, IL; Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
3 Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Correspondence Address:
Dr. Wai Chung Yong
Department of Internal Medicine, Greenfield Family Medicine, Baystate Franklin Medical Center, 48 Sanderson Street, Greenfield, MA 01301
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijd.IJD_531_17

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Background/Purpose: Helicobacter pylori infection has been suggested as a culprit of various extragastrointestinal (GI) disorders. It is debatable whether H. pylori infection exacerbates or triggers the pathogenesis of psoriasis. This meta-analysis aimed to explore the association between psoriasis and H. pylori infection. Materials and Methods: A comprehensive search of the MEDLINE and EMBASE databases was performed from inception through October 2017. The inclusion criterion was observational studies evaluating the association between psoriasis and H. pylori infection. The pooled odds ratio (OR) of H. pylori infection and their 95% confidence interval (CI) were calculated using a random-effects meta-analysis to compare risk between psoriasis patients and controls. The between-study heterogeneity of effect-size was quantified using the Q statistic and I2. Results: Data were extracted from nine observational studies involving 1546 individuals. Pooled result demonstrated an increased H. pylori infection in psoriasis compared with controls (OR=1.58; 95% CI: 1.02–2.46, P=0.04, I2=64%). Subgroup analysis showed an increased risk of H. pylori infection in psoriasis measured with H. pylori IgG enzyme-linked immunosorbent assay (OR=3.11; 95% CI: 1.85–5.20, P<0.01, I2=10%) but not active infection measured with urea breath test (OR=0.88; 95% CI: 0.61–1.27, P=0.49, I2=0%). Conclusion: This meta-analysis has shown an increased H. pylori infection in patients with psoriasis. H. pylori infection in the past could play a role in the abnormal immunological cascade in the pathogenesis of psoriasis. Further studies to elucidate the inflammatory response in the pathogenesis of psoriasis are warranted.


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