Investigation of dermatology Dicle University polyclinic psoriasis patients diagnosed with migraine frequency

Psoriasis, a disease seen in 1-3% of the population and thought to be a disease limited to skin in the past, is accepted now as a chronic systemic inflammatory disease with many comorbidities. The occurrence of comorbidities, which are very common in patients with psoriasis, has been explained by an increased inflammatory effect. In recent studies, the prevalence of migraine as well as comorbidities known in psoriasis has been increased. NO, TNF-alpha and adipokines (leptin and adiponectin) have important roles in the pathogenesis of both diseases. In this prospective study, we aimed to investigate the prevalence of migraine in patients with psoriasis. One hundred sixty three patients who were admitted to Dicle University Faculty of Medicine Department of Skin and Venereal Diseases between November 2017 and May 2018 and confirmed to have psöriasis by biopsy were included in the study. Clinical and demographic findings, history of headache, presence of additional disease, presence of migraine, type of migraine, number of monthly attacks, factors triggering psoriasis (sports, stress, sleep disorder, drug use), factors triggering migraine were recorded. All patients with psoriasis who applied to our dermatology clinic and had headache were consulted to the neurology department. Patients diagnosed with migraine according to the criteria established by the International Headache Society (IHS) in 2013 were recorded. Migraine type, number of monthly attacks and factors triggering migraine were also recorded. Data were evaluated with SPSS 18.0 program and analyzed with x² (ChiSquare) statistical method. Of the 163 patients included in the study, 84 were male and 79 were female. The mean age was found to be 34.67 ± 17.07 in the female patients and 36,07 ± 15,13 in the male patients. The disease duration ranged from 3 months to 32 years. When psoriasis patients were evaluated in terms of clinical subtypes, plaque type psoriasis was detected in 129 (79.1%) of 163 patients. The least detected subtype was localized pustular psoriasis (0.6%). 78 patients had mild and 72 patients had moderate psoriasis. Since PASI could not be calculated in 13 patients, the severity of the disease could not been interpreted. Of the 163 patients diagnosed with psoriasis, 52 had headache (32.9%). Migraine was diagnosed in 14 patients (8.5%). Eleven of these 14 patients (78.5%) had migraine without aura and 3 (21.4%) had migraine with aura. The rate of migraine with/without aura was 0.27. Thirteen (92.8%) of the patients with migraine were female and 1 (7.1%) was male. When evaluated according to gender, the frequency of migraine was similar to literature in women. In males, it was found to be lower than in the literature. The mean age of the patients without migraine was 36,14 ± 16,3 and the mean age of the patients with migraine was 27,43 ± 10,8. When comorbidities were evaluated, the most common comorbidity was obesity (29 patients). When the patients with and without migraine were compared in terms of obesity, 2 patients with migraine (14.2%) and 29 patients (19.4%) without migraine had obesity and this difference was not statistically significant (p = 0.67). Of the 14 patients with migraine, 3 (21.4%) had migraine with aura and 11 (78.5%) had migraine without aura. Patients with PASI<10 and patients with PASI> 10 were compared for migraine frequency. There was no statistically significant difference between the severity of migraine and disease severity (p = 0.68). PsA was detected in 15 of 163 psoriasis patients. In our study, the rate of PsA was 7,14% in patients with migraine and 9,3% in without migraine patients. There was no statistically significant difference between patients with and without migraine in terms of PsA (p = 0.84). Data from different geographic regions have shown that migraine frequency increases in patients with psoriasis and it has been suggested that migraine may be a comorbid condition. In our study, the frequency of migraine was not significantly higher in psoriasis patients. This may be related to the low number of patients in our study. Although the prevalence of migraine in psoriasis patients was not found to be increased in our study, it should be kept in mind that migraine may accompany psoriasis. We suggest that all psoriasis patients with headache should be evaluated with neurological examination for early diagnosis and screening, and multidisciplinary approach should be considered for patients with migraine. Furthermore, we believe that more comprehensive studies involving more patients are needed. Key words: Demographic features, Comorbidity, Migraine, Psoriasis