Does psoriasis increase the likelihood of headaches?

The headaches, more commonly referred to as pains in the head, are painful sensations that regularly occur in the skull region. They present in various forms characterized by their onset, their location (forehead, side, or entire head), their intensity, and their duration. The most common types of headaches are the tension headaches and the migraines.

• The tension headache in adults usually manifests itself at the end of the day. They are often related to stress, fatigue, psychological tensions and can sometimes be associated with episodes of migraines.

• The migraine episodes result from an increase in abnormal electrical activity at the neuron level. This reaction is influenced by a genetic predisposition and regulated by various environmental factors such as hormones, stress, and dietary habits, including certain foods like chocolate, tobacco, coffee, or alcohol.

Although psoriasis and headaches are two distinct conditions in their own right, it has long been considered that there might be a link between the two conditions. As a result, several studies have been conducted to investigate this potential relationship.

A study has shown that psoriasis, an inflammatory disease, is influenced by a balance of adipokines, proteins secreted by adipose tissue, skewed in favor of "bad" adipokines. High levels of chemerin, for example, lead to the infiltration of immune cells promoting the manifestation of psoriasis.

Another study showed a 47.05% incidence of migraines in patients suffering from psoriasis. Most psoriatic patients with a clinical diagnosis of migraine were found to suffer from psoriatic arthritis (78%). This connection could be explained by a specific adipokine, leptin, which was observed in higher quantities in patients with psoriasis, and hyperleptinemia was also observed in patients with migraines. Hyperleptinemia has the ability to increase the sensitivity of the cortex to spreading cortical depression (CSD), a mechanism suggested to trigger migraine attacks. However, no connection has been demonstrated with psoriasis.

Although these observations may suggest a possible correlation between these two conditions, there is currently no evidence of a biological link between them. These observations remain as facts and require further evidence to definitively establish any correlation between these two diseases.

• WOLK K. & al. Adipokines in psoriasis: An important link between skin inflammation and metabolic alterations. Reviews in Endocrine and Metabolic Disorders (2016).

• CAPO A. & al. Psoriasis and migraine. Journal of the European Academy of Dermatology and Venereology (2017).