Psoriasis and Gluten sensitivity

Association of celiac disease with psoriasis has been of recent interest. A significantly higher prevalence of celiac disease is reported in patients with psoriasis compared to controls. An increased incidence of psoriasis in patients with celiac disease too has been noted. A gluten-rich diet, polyunsaturated fatty acids, and alcohol consumption have been implicated often for the severity of psoriasis in a significant number of patients. Long-standing improvement or total remission of psoriasis is reported after diagnosis and its treatment with a gluten-free diet in many patients with severe and/or refractory psoriasis. The concomitant celiac disease was mostly asymptomatic in them. Gluten-free diet is also suggested to improve psoriasis severity even in patients with IgA and/or IgG anti-gliadin antibodies alone without histological evidence of celiac disease. However, the significance of concurrent celiac disease (it also affects 1% of the general population) as a risk factor for the chronicity, severity and relapses in psoriasis needs a careful interpretation as frequency of celiac disease associated antibody positivity remains variable across studies.