This study will determine the prevalence of small bowel lesions suggestive of Crohn's disease
(CD) in patients with moderate to severe plaque psoriasis using capsule endoscopy. The study
also aims to determine if the treatment of psoriasis with adalimumab will have an effect on
the healing of the small bowel for patients who have lesions suggestive of CD.
Patients with psoriasis are at increased risk of developing Crohn's disease (CD), but the
exact prevalence of CD in patients with psoriasis at this time is unknown as many patients
probably have undiagnosed disease as the early signs will often cause no symptoms. CD is
therefore receiving very little attention from dermatologists who are treating patients with
psoriasis. For example, very few dermatologists will actively question patients with
psoriasis about symptoms of CD. This lack of knowledge may induce delays in diagnosis. By the
time the diagnosis is made and patients receive their first treatment, they may already have
significant fibrosis and stenosis of the intestine. Current treatments, including adalimumab,
cannot reverse small bowel anomalies to normal in the presence of fibrosis. Therefore, many
patients with a late diagnosis will still have symptoms or will eventually require surgery
despite good control of the inflammation. Treatment of CD should start as early as possible,
as early treatment has been associated with an increased rate of complete healing. Complete
control of the disease at its early stages may prevent complications.