Sensorineural Hearing Loss Precede the Onset of Psoriasis
Main Author: Samah Allam
Sharjah United Arab Emirates
Al-Qassimi hospital, Emirates Health Services (EHS)
Introduction: Psoriasis (PsO) is a common chronic inflammatory skin disease that may exhibit a variety of clinical manifestations. PsO has also been identified as a multisystem chronic inflammatory disorder associated with multiple comorbidities. A few studies have reported that PsO can also be associated with sensorineural hearing loss (SNHL) since both diseases may share an immune-mediated and systemic inflammatory pathogenesis, yet the clinical significance remains undefined, and the extent of association has not been well defined. Immunologically, it has been explained as an interaction between circulating antibodies and an antigen in the inner ear, or by direct inner ear by activated T cells.
Method(s): We are presenting a case of PsO that was preceded by SNHL.
Result(s): A 62-year-old Iranian male patient. At the age of 20, was diagnosed as a case of Left profound SNHL, right moderately severe to profound SNHL (figure 1). Since then, hearing aids have been used by patients.
At the age of 55, he had been referred from the Ear-Nose-Throat (ENT) clinic to the Rheumatology clinic of Al Kuwait-Dubai (Al-Baraha) hospital with red, itchy, scaly skin rash in the groins, genitalia, and the chest. Moreover, there was pain and swelling of the whole left thumb with redness.
Physical examination showed psoriatic patches over the extensor surface of the forearms, lateral aspects of the thighs, shins and back of the hands. There was swelling of the whole left thumb; sausage shaped (dactylitis), with redness and tenderness.
Blood investigations revealed normal complete blood count, liver function test, renal function test, erythrocyte sedimentation rate; ESR, and C-reactive protein. Rheumatoid factor was negative.
In view of skin psoriasis and thumb dactylitis, He was diagnosed with psoriatic arthritis and PsO.
Methotrexate had been started, and in 2 months review there was remnant redness with little of silvery scales over the right groin (Figure 2) and around the umbilicus (Figure 3), with improvement of the dactylitis (Figure 4).
Conclusion(s): In PsO, SNHL might precede musculoskeletal manifestations.
