Q&A: Can salicylate sensitivity cause psoriasis?

Can psoriasis be triggered by aspirin sensitivity or salicylates in food and the environment? This video may answer your question.

While there are plenty of salicylate sensitive cases on eczema, I was unable to find supporting research on psoriasis vulgaris (plaque psoriasis). This video covers two cases of general pustular psoriasis (GPP) in a child whose trigger was aspirin, and another child with GPP that was triggered by environmental salicylates, mostly from salicylates in birch trees and pollen. Both children recovered well once the triggers were removed. In the case of the second child, he was so sensitive, it was recommended that he avoid foods and cosmetics high in salicylates.

Resources

  • Kelly-Sell M, Gudjonsson JE. 2016. Overview of Psoriasis. In: Therapy for Severe Psoriasis. Elsevier. p. 1–15. Accessbile from: https://www.sciencedirect.com/topics/medicine-and-dentistry/psoriasis-vulgaris
    Clearly states that Psoriasis vulgaris is the most common type of psoriasis and is also called plaque psoriasis.
     
  • Shelley WB. 1964. Birch pollen and aspirin psoriasis: A study in salicylate hypersensitivity. JAMA. 189(13). doi:10.1001/jama.1964.03070130005001. http://dx.doi.org/10.1001/jama.1964.03070130005001.
    Abstract: Generalized pustular psoriasis, reportedly due to an exquisite hypersensitivity to salicylates of tree, shrub, and medical origin, was observed in a six-year-old child. In an effort to account for the explosive appearance of the eruption each April he spent in the eastern Pennsylvania mountains, sweet birch (Betula lenta) pollen was incriminated as the exciting agent since the tree produces large quantities of methyl salicylate (sweet birch oil). The biochemistry of the pharmacopeia as well as of plant life reveal many sources of salicylate.

    This study is one of the earliest research articles linking sensitivity to salicylates in the environment, food and cosmetics to allergy-like reactions. Besides recommending the child stay out of the pollen-filled air during spring in Pennslyvania and avoid aspirin, this paper includes a list of plants, foods, and cosmetics to also avoid.
     
  • Zelickson BD, Muller SA. 1991. Generalized pustular psoriasis in childhood. Report of thirteen cases. J Am Acad Dermatol. 24(2 Pt 1):186–194.
    doi:10.1016/0190-9622(91)70025-w. http://dx.doi.org/10.1016/0190-9622(91)70025-w.
    Abstract: Generalized pustular psoriasis is rare in children. Less than 100 cases have been reported. We describe 13 children with this type of psoriasis. Seven had acute onset of widespread sterile pustules coalescing into lakes of pus with subsequent exfoliation (the Zumbusch pattern). This usually occurred in infancy and was difficult to control; recurrences developed several times per year. Three had the subacute benign annular pattern. They tended to be older and often had resolution within several years. Three had a mixed pattern with Zumbusch flares preceded by an annular or acral pattern. Most patients had an eruption preceding the generalized pustular psoriasis and often had precipitating factors. Generally, generalized pustular psoriasis has little serious chronic morbidity. The condition in most patients was well controlled with topical therapy. Systemic steroids were not helpful. 

    1 our of 12 reports revealed that aspirin was a trigger for GPP. Once removed (and other triggers) the patient did not have recurring flare-ups. Besides this child, 4 children reported tar as a trigger.

Transcript

00:00
Welcome to low-sal-life. I’m Sarah. It’s been a long time since I’ve done any videos. And I am also a little bit behind an email. So I thought that I would answer one email today in the video. And maybe you can see a little bit of my thought process. So sometimes I get questions, and I don’t know the answers, but I can always do my own due diligence to see if I can find any information on it. So that’s what happened with this one. Hello, I hope you’re doing well. I’m suffering from psoriasis and would like to know if it is somehow related to salicylate? That’s a really great question. I do know that a lot of people including myself, my mother had eczema.

00:43
I know eczema, a lot of people suffer with eczema. And I actually don’t know anybody with psoriasis in the low-sal community that has it. So that’s one reason I wanted to do this video because if you have psoriasis and you’re salicylates sensitive, please put in the comments or email me so that I can add that as a symptom for the About Salicylates page that we have. So what I’d like to say is what I ended up doing is – I do research. I look up like salicylate… or I usually look up like psoriasis, and aspirin. And so those will usually come up with a pretty solid bit of information. And then I can refine it a little bit more. One of the issues with this question is that there are a ton of different types of, or not a ton, but there’s more than one type of psoriasis. So it wasn’t specific. So I will answer this. And I have here two papers that talk about a particular type of psoriasis, and how it was aspirin induced. And one of them actually talks about how it’s induced by not only by drugs, but also environmental and food issues. So we’ll just look at that. We’re going to keep it really short today. So we’ll we’ll go with that. The nice thing about …Well, one not one nice thing about if you attempt to do a salicylate diet to see if it affects your psoriasis, you might get close but it might not like hit the nail on the head. So with

02:18
a low-sal diet, you end up usually cutting out a whole bunch of processed foods. You cut out a lot of fragrances you caught out a lot of the cosmetics and cleaners that end up you know that may have other chemicals that might be contributing to your psoriasis. You know, a lot of things contribute to psoriasis. And it’s it’s hard. I’ve been with a lot of I have a lot of friends and I’ve had partners that have had psoriasis. And it is not. It’s It’s terrible. So if you’re in that boat, I am sorry, I hope that you can get to the bottom of it. So there are a couple of different types of psoriasis. The most common is psoriasis vulgaris and that’s the one that creates plaque psoriasis. It’s very similar… So my husband has had both psoriasis and eczema. And when he was talking to his doctor, he was like, Well wait, I’ve already been diagnosed with psoriasis. Why are you diagnosing this with eczema? And this doctor kind of casually said, Well, it kind of depends on the place. So psoriasis has a tendency to like be in the scalp or like on elbows or kind of more on like sturdy like knees and sturdier skin where eczema, it will be kind of more in like the folds. So you’re talking to the inside elbow. I’ve had it on my eyelids. I’ve had it on my inside of my fingers. And I don’t know if there’s more to diagnosing the diagnosis, but that might be a good distinguishing factor for some.

03:51
Okay, so that’s plaque psoriasis, psoriasis vulgaris, I did find two studies that had generalized pustular psoriasis. So we’ll call it GPP. And this one study was done alonh. Oh, this one here was more recent 1990. This is a report of 13 cases. And the reason why this is an interesting study was because GPP is not usually found in children. And so they were particularly interested and they had a research cohort of 13 kids, and out of them, they ended up finding out what their triggers were for psoriasis. So psoriasis, eczema, migraines, these are all chronic conditions, and there’s usually a lot of things that go into it, right? So if you can figure out like what the triggers are, you know, it’s not that this one item causes the condition is that it it’s a trigger. So if you can figure out how to eliminate the triggers and manage them a little bit better, then you can manage your condition a lot better. So they followed these kids around for a long time and they found out that certain

05:00
Kids had certain triggers. So out of one of the kids, one out of the 13, there were actually 12 reports here. I think maybe one kid dropped out. But one out of the 12 kids had aspirin as a GPP trigger. And they followed that child for 19 years, so into adulthood. And once they figured that out, they were in much better, much better shape, eliminating that. And then there was also this other one, I brought this up with the birch pollen. Birch pollen has salicylates in it. And so I brought that up in a former video in springtime. This here is a study from 1964 with a kid that lived in Pennsylvania. So the study is called birch pollen and aspirin psoriasis. A study in salicylate hypersensitivity This is an interesting case and is one of the earliest cases of somebody actually having aspirin sensitivity outside of just taking like an oral medication. So this study is about a kid who had a really bad time and almost died twice. So what ended up happening to him, it was the 60s he was a kid, he was playing outside, he lived in Pennsylvania, he’d go and climb trees, and play outside and everything. And when he was in Pennsylvania, for two springs, he lived also in Ohio, like during some other springs, so it was only the two for Pennsylvania that he ended up getting sick. He ended up with general pustular psoriasis on his hand and all over his body. He spent like two months in the hospital for his first trip. And I think his second trip was much shorter, but also pretty severe. So what they ended up doing was when they realized is that he was probably reacting to both touching birch trees and then also inhaling the pollen. And that was probably what was his outbreak for psoriasis. He never really had another time that he ended up with this except for when he was in Pennsylvania.

07:06
Unfortunately for him, it it was really popular that when kids came with infections, infections, bacterial infections, his skin and everything, by the time he made it to the hospital and fever, so they give him an aspirin. And then he ended up getting worse. And so what they ended up doing was putting him in a climate-controlled room that did not basically like a bubble more or less, so that he could be shielded from the pollen, and also from the temperature fluctuations. And they stopped giving him aspirin and he got way better. But they didn’t know what actually triggered – what triggered it. They didn’t think that it had to do with the pollen or the birch trees at that point. So he ended up leaving, went to Ohio came back a different spring back to Pennsylvania. And then he you know, same month ended up with the same situation. So they figured out that it was more than just the aspirin and like a normal case of psoriasis. And they ended up linking it up eventually with aspirin and with the pollen and birch trees. So it’s kind of interesting, but I wanted to share both of those.

08:21
Both of these articles, as usual, I have the citations in the description down below. And then I always make like a little blog article that talks about the significance of these two articles. So I think that’s it for now. That is the end of everything I know about psoriasis and salicylates. Yes, it can cause general pustular psoriasis, I don’t know if it causes psoriasis vulgaris, you guys if you have that you might know if that’s a trigger for it. Leave in the comments below or email me and then I can add it. I’m thinking about making a little anecdotes place where people can say, oh yeah, I had I had this and low sal diet helped tremendously. So that’s all I got for today. See you guys later. Bye

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