HLA-Cw6-Positive and HLA-Cw6-Negative Patients with Psoriasis Vulgaris have Distinct Clinical Features

• Published in: Journal of investigative dermatology Vol. 118; no. 2; pp. 362 - 365
• Main Authors: Guðjónsson, Jóhann E., Valdimarsson, Helgi, Kárason, Ari, Antonsdóttir, Arna A., Hjaltey Rúnarsdóttir, E., Gulcher, Jeffrey R., Stefánsson, Kári
• Format: Journal Article
• Language: English
• Published: Danvers, MA Elsevier Inc 01.02.2002; Nature Publishing; Elsevier Limited
• Subjects: Adolescent; Adult; Age of Onset; Aged; Arthritis, Psoriatic - immunology; Biological and medical sciences; Child; Child, Preschool; clinical features; Cohort Studies; Dermatology; Female; HLA-Cw6; Humans; Infant; Male; Medical sciences; Middle Aged; Nail Diseases - etiology; psoriasis; Psoriasis - complications; Psoriasis - genetics; Psoriasis - immunology; Psoriasis - pathology; Psoriasis. Parapsoriasis. Lichen; Severity of Illness Index; Sex Characteristics; HLA-Cw6; psoriasis; clinical features; age of onset; Human; Symptomatology; HLA-System; Skin disease; Age of onset; Psoriasis
• ISSN: 0022-202X; 1523-1747
• DOI: 10.1046/j.0022-202x.2001.01656.x

Psoriasis is associated with HLA-Cw6, and Caucasians who carry this allele have about a 10-fold increased risk of developing psoriasis. We have HLA-C typed 369 patients with familial psoriasis and compared the clinical features of the patients carrying HLA-Cw6 against those carrying other HLA-C types. Some striking clinical differences were observed between the two groups. Patients who are Cw6 positive had a lower age at onset (p=3×10-7). Cw6-positive women had an earlier disease onset than Cw6-positive men (p =0.02), but such a difference was not observed for the Cw6-negative patients. The guttate-type onset of psoriasis was mostly confined to this group (p=2×10-4) and persistent disseminated guttate-like papules were also predominantly observed in the Cw6-positive patients (p <10-4). The Cw6-positive patients also had more extensive plaques on their arms, legs, and trunk (p =0.001), more severe disease (p =0.003), higher incidence of the Koebner's phenomenon (p =0.005), reported more often that their psoriasis got worse during or after throat infections (p =0.02), and more often a favorable response to sunlight (p =0.008) In contrast, dystrophic nail changes were more common in the Cw6-negative patients (p =0.002) and also psoriatic arthritis, although this was not significant (p =0.135). It is concluded that patients with psoriasis have different clinical features depending on whether they are HLA-Cw6 positive or negative.