Bhagyashree B Supekar; Vrutika H Shah; Jayesh Mukhi; Rajesh P Singh
Abstract
Leprosy, just like syphilis, has become a great imitator with its various atypical and unusual presentations. It presents in many diverse ways and can be confused with many infectious and non-infectious forms.It is often misdiagnosed as common disorders like psoriasis, pyoderma, angioedema, pre-vitiligo, ...
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Leprosy, just like syphilis, has become a great imitator with its various atypical and unusual presentations. It presents in many diverse ways and can be confused with many infectious and non-infectious forms.It is often misdiagnosed as common disorders like psoriasis, pyoderma, angioedema, pre-vitiligo, sarcoidosis, and granuloma annulare. Appropriate history-taking with good clinical examination is required to diagnose atypical presentations of leprosy. Early diagnosis along with appropriate treatment is essential to prevent disability and other complications. We outline a case of lepromatous leprosy with an atypical psoriasiform presentation that mimicked psoriasis. Psoriasiform leprosy presents as erythematous plaques of varying sizes and shapes on the extensor regions of trauma-prone sites like the knees, elbows, and buttocks. This condition mimics psoriasis and is diagnosed as leprosy based on the slit skin smear and histopathology with a special Fite-Faraco stain.
Akshay Jain Salecha; Santh Kumar Bellamkonda; Haritha Samanthula; .Sujit Kumar Ponugoti; Anusha Jakkampudi
Abstract
Background: Psoriasis is a prevailing continual inflammatoryaffliction, carrying a considerable risk of cardiac diseases,sometimes even not traceable by conventional predisposingfactors. Detection of subclinical atherosclerosis in psoriasis byultrasonography is beneficial, and it has been solitarily ...
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Background: Psoriasis is a prevailing continual inflammatoryaffliction, carrying a considerable risk of cardiac diseases,sometimes even not traceable by conventional predisposingfactors. Detection of subclinical atherosclerosis in psoriasis byultrasonography is beneficial, and it has been solitarily exploredin carotid arteries. It was found to have a weak predictive value,and so the femoral arteries have now been contemplated. Thisstudy aims to determine subclinical atherosclerosis occurrenceby evaluating the femoral and carotid arteries’ intima-mediathickness (IMT) by ultrasonography in patients with psoriasis.Methods: The study was carried out in the departments ofdermatology and radiology at Dr. Pinnamaneni SiddharthaInstitute of Medical Sciences & Research Foundation for eightmonths. The sample size consisted of 30 chronic plaque psoriasiscases and 30 controls, matched for age and sex. Patients withcomorbidities were excluded. Femoral & carotid arteries wereassessed for IMT by ultrasonography.Results: In our study, the age range was 30–80 years, and a male(56.7%) preponderance was observed in cases and controls. Themean femoral artery and carotid artery IMTs were remarkablygreater in cases than in controls, with P-values < 0.001 and 0.04,respectively. The mean femoral artery IMT was significantly moreelevated (1.4 ± 0.63 mm) than the carotid artery IMT (1.0 ± 0.62mm) in cases (P = 0.01).Conclusion: Ultrasonographic screening of femoral artery IMTenhances the early discernment of subclinical atherosclerosis whencompared with carotid artery IMT. Thereby, it helps in the earlyidentification of cardiovascular disease in patients with psoriasis.Keywords: femoral artery, carotid artery, intima-media thickness,psoriasis, atherosclerosis
Anil Prakash Gosavi; Ravindranath Brahmadeo Chavan; Rahul Narendra Jaiswal; Vijay Deepak Joshi
Abstract
Methotrexate, an anti-psoriatic drug possessing immunoregulatory, antiproliferative, and anti-inflammatory properties,acts by blocking deoxyribonucleic acid and ribonucleic acid synthesis. It acts especially on rapidly dividing bone marrow cells and proliferating epithelia and mucosae. The toxicity of ...
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Methotrexate, an anti-psoriatic drug possessing immunoregulatory, antiproliferative, and anti-inflammatory properties,acts by blocking deoxyribonucleic acid and ribonucleic acid synthesis. It acts especially on rapidly dividing bone marrow cells and proliferating epithelia and mucosae. The toxicity of this double-edged sword occurs due to accidental excessive intake or daily dosing instead of weekly dosing. We report the case of a 31-year-old male with acute methotrexate toxicity presenting with ulcerations over pre-existing psoriatic plaques with foci of bleeding. Oral mucosal involvement in the form of buccal and palatal ulceration was present in the setting of sepsis, pancytopenia, and acute kidney injury. It is worth emphasizing the role of adequate prescription guidelines, patient education, stringent monitoring, early recognition of tell-tale signs of toxicity, timely leucovorin rescue, and the need for strict enforcement of regulations regarding the over-the-counter availability of such drugs, especially in developing countries.
Yalda Nahidi; Bita Kiafar; Zohre Sadeghinejad; Lida Jarahi; Tahmineh Mallakifard
Abstract
Background: Psoriasis is a disease that influences the physical, psychological, and social dimensions of the lives of those affected. We aimed to evaluate the effect of psoriasis disease on the quality of life of patients and their partners.Methods: Forty psoriasis patients were eligible for inclusion ...
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Background: Psoriasis is a disease that influences the physical, psychological, and social dimensions of the lives of those affected. We aimed to evaluate the effect of psoriasis disease on the quality of life of patients and their partners.Methods: Forty psoriasis patients were eligible for inclusion in this study. Each participant’s clinical data were collected, including age, sex, PASI score, history of treatment, family history of the disease, educational level of the patients and their spouse, profession, and history of divorce. The patients and partners completed the Dermatology Life Quality Index (DLQI) and Family Dermatology Life Quality Index (FDLQI) questionnaires, respectively. The results were compared against 40 age and sexmatched healthy individuals and their partners.Results: The mean DLQI score was 11.75 ± 7.25 among patients, and the mean FDLQI score of their partners was 12.20 ± 5.63. There was a significant difference between the patients/partners and the respective control groups in DLQI and FDLQI scores (P < 0.001). There was a significant correlation between disease severity and DLQI/FDLQI scores (P < 0.05). Also, a meaningful relationship was noted between the quality of life of patients and their spouses (r = 0.48, P = 0.001). Besides, the PASI score shared a significant relationship with the DLQI (P = 0.003, r = 0.46) and FDLQI (P = 0.001, r = 0.56) scores.Conclusion: We conclude that psoriasis harms the quality of life of both patients and their families, which deteriorates with an increase in disease severity and PASI scores.
Ravindranath B Chavan; Vasudha A Belgaumkar; Nitika S Deshmukh; Ranjitha Krishnegowda
Abstract
Papulosquamous disorders constitute one of the common pediatric dermatoses. They are a heterogeneous group consisting of psoriasis, eczema, pityriasis rubra pilaris, and other conditions, where the differential diagnoses are close to each other clinically. Moreover, the presentation of the same disease ...
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Papulosquamous disorders constitute one of the common pediatric dermatoses. They are a heterogeneous group consisting of psoriasis, eczema, pityriasis rubra pilaris, and other conditions, where the differential diagnoses are close to each other clinically. Moreover, the presentation of the same disease in children can differ from that occurring in adults. We report two infants with erythematous scaly papules and plaques diagnosed as two different disorders, albeit with a grossly similar appearance. Both these dermatoses are considered to be quite uncommon in infancy and can pose significant challenges in management. These disorders sometimes present with atypical variants, rendering it increasingly difficult to distinguish them. Some of these disorders tend to progress to erythroderma, and the infant may occasionally present directly in the erythrodermic stage, further compounding the conundrum. In such situations, identification of subtle clinical and histopathological clues allows accurate diagnosis, which is imperative for appropriate prognostication and treatment. This article illustrates the importance of histopathology and immunohistochemistry in aiding diagnosis and outlines the management of these disorders while emphasizing the importance of timely intervention in averting inadvertent complications in these young individuals.
Archana Mavoori; Sneha Pamar; Sudha Bala
Abstract
Background: Secukinumab is a fully humanized IL-17A antagonist approved for managing moderate-to-severe plaque psoriasis as well as psoriatic arthritis. This study assessed the speed of action of secukinumab and the improvement in the quality of life in a series of patients.Methods: We aimed to assess ...
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Background: Secukinumab is a fully humanized IL-17A antagonist approved for managing moderate-to-severe plaque psoriasis as well as psoriatic arthritis. This study assessed the speed of action of secukinumab and the improvement in the quality of life in a series of patients.Methods: We aimed to assess changes in the PASI (Psoriasis Area Severity Index) and DLQI (Dermatology Life QualityIndex) following a course of secukinumab injections. Methods: This hospital-based study was conducted in the Department of Dermatology, Venereology and Leprosy of ESIC Medical College & Hospital, Hyderabad, India.Results: Starting from 8 weeks after initiation of treatment with secukinumab 300 mg, a clinically significant response was observed, with progressive reduction of skin disease indices. Twenty-four patients were included in the study, with a mean age of 42 years. The male to female ratio was 15:9. Thirteen (54.16%) patients achieved PASI 75 at eight weeks. At the end of 52 weeks, 20 (83.33%), 15 (62.5%), and 8 (33.33%) patients maintained PASI 75, PASI 90, and PASI 100, respectively.Conclusion: Secukinumab is a highly-efficacious, biologic therapy that provides rapid relief with a relatively favorable safety profile in patients with moderate-severe plaque psoriasis. In addition, secukinumab is a preferred treatment for patients with comorbid psoriatic arthritis or arthralgia symptoms due to its ability to arrest the progression of arthritic disease in the early course.
Narges Alizadeh; Seyyede Zeinab Azimi; Somayeh Hoseinzadeh
Abstract
Background: The relationship between body mass index (BMI) and the severity of psoriasis is of debate. We investigated the relationship between BMI and psoriasis area and severity index (PASI) in Northern Iran. Method: In this prospective, observational descriptive study, 190 patients with chronic plaque-type ...
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Background: The relationship between body mass index (BMI) and the severity of psoriasis is of debate. We investigated the relationship between BMI and psoriasis area and severity index (PASI) in Northern Iran. Method: In this prospective, observational descriptive study, 190 patients with chronic plaque-type psoriasis were included from January 2015 to 2017. None of the patients used systemic therapy for psoriasis during the last month. Results: There was a slight female predominance in our study (n=116; 61.1%). The mean age of our patients was 28.88 ± 18.17 (mean ± standard deviation) years. We found a positive correlation between BMI and PASI in the groups of psoriatic patients who had normal weight or were overweight (r = 0.369, P=0.006 and r=0.287, P=0.019, respectively). In the final logistic regression model, it was shown that in cases with BMI<18.5, the mean PASI score was lower in comparison with those with normal BMI (OR = 0.074, CI: 0.009, 0.636). Conclusion: A relationship between BMI and PASI was only seen in psoriatic patients who had normal weight or were overweight. To reduce the effect of factors such as systemic treatments, it is suggested to evaluate the relationship between BMI and PASI score as soon as the diagnosis of psoriasis is confirmed.
Hiader Kadhim Alrubaye; Khalil Ismail Alhamdi; Jamal Ahmed Abdel Barry; Majid Hameed Alabbood
Abstract
Background: Psoriasis is a chronic, recurrent, inflammatory, and proliferative disease. Previous studies have demonstrated that patients with psoriasis may have an increased risk of developingcoronary artery disease. High serum lipid levels have been suggested in the pathogenesis of this ...
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Background: Psoriasis is a chronic, recurrent, inflammatory, and proliferative disease. Previous studies have demonstrated that patients with psoriasis may have an increased risk of developingcoronary artery disease. High serum lipid levels have been suggested in the pathogenesis of this phenomenon. Accumulating evidence suggests that apolipoprotein B is superior to other lipidparameters in predicting atherosclerotic cardiovascular disease. This study aimed to examine the differences in the lipid profile and apolipoprotein A-I and apolipoprotein B levels between psoriatic patients and healthy subjects.Methods: This was a case-control, cross-sectional study. A total of 93 psoriatic patients and 113 healthy individuals were enrolled. This study was conducted at the outpatient department of dermatology in Alsader Teaching Hospital, Basra, Iraq. The serum level of total cholesterol (TC), triglyceride (TG), very lowdensity lipoprotein cholesterol (VLDL-C), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-I and apolipoprotein B were measured.Results: The psoriatic patients had significantly higher levels of TC, TG, VLDL-C, LDL-C, and apolipoprotein B compared with the control group.Conclusion: Lipid profile values were significantly higher among patients with psoriasis than normal controls. Early screening and treatment of hyperlipidemia in these patients are advisable toprevent atherosclerosis and its complications. Apolipoprotein B may serve as a marker for dyslipidemia and CVD in patients with psoriasis.
Smitha S Prabhu; Sathish Ballambat Pai; Manasa Narayan Kayarkatte
Abstract
Phototherapy is an essential and useful therapeutic procedure wherein the properties of ultraviolet light are used to cure certain dermatological conditions like psoriasis, vitiligo, and atopic dermatitis. This is usually an office-based procedure dependent on the accurate use of sophisticated phototherapy ...
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Phototherapy is an essential and useful therapeutic procedure wherein the properties of ultraviolet light are used to cure certain dermatological conditions like psoriasis, vitiligo, and atopic dermatitis. This is usually an office-based procedure dependent on the accurate use of sophisticated phototherapy units. Since the advent of the COVID-19 pandemic, phototherapy practices were shut down as they were considered as non-essential services. Here, we attempt to analyze how COVID-19 has affected phototherapy and seek to formulate a working guideline for safe phototherapy operations in these taxing circumstances. We used search engines like PubMed, Google Scholar, and Embase to retrieve articles and guidelines regarding phototherapy in dermatology, using the pertinent search terms. There was a paucity of data with only a couple of research letters and guidelines by the British Association of Dermatology and the American Academy of Dermatology, as well as general guidelines issued by the Indian Association of Dermatologists, Venereologists and Leprologists. After a careful study of various modalities of phototherapy and viral inactivation, we collated a set of guiding instructions toward the appropriate utilization of phototherapy amidst the COVID-19 pandemic. Phototherapy is a viable option for selected patients even amidst the COVID-19 pandemic. However, local and national guidelines have to be followed while selecting the patient and operating the phototherapy machine with adequate protective measures for both the patient and the healthcare worker. Home phototherapy units and PUVASOL are good options for those patients who are unable to attend the phototherapy center due to various reasons.
Nitin Joseph; Deepti D’Souza; Matthew Antony Manoj; Shajimon Priya Varsha; Tanya Singh; Archit Gupta; Akshiti Kaushik
Abstract
Background: Psoriasis is an immune-mediated chronic skin disorder. Information regarding its clinic-epidemiological manifestations is limited in parts of Asia. This study was conducted to determine the risk factors, clinical presentation, and management of psoriasis among patients in Mangalore, India. ...
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Background: Psoriasis is an immune-mediated chronic skin disorder. Information regarding its clinic-epidemiological manifestations is limited in parts of Asia. This study was conducted to determine the risk factors, clinical presentation, and management of psoriasis among patients in Mangalore, India. Methods: The medical records of 225 psoriasis patients over the past ten years (from January 2009 till March 2019) were examined by the investigators. Data were collected using a semi-structured form. Results: The mean age at diagnosis of psoriasis was 42.2 ± 16.0 years. Nail psoriasis and psoriatic arthritis (PsA) were present in 66 (29.3%) and 21 (9.3%) patients, respectively. Relapse of psoriasis was seen more among patients with a history of disease exacerbation in winter (P=0.009) or in rainy seasons (P=0.031). Systemic therapy with methotrexate and topical therapy with steroids were used in the management of 52 (23.1%) and 72 (32%) patients, respectively. Phototherapy (n=11) was the most common modality used among the 18 patients with extensive psoriasis. Co-morbidities like diabetes mellitus (P=0.02) and complications like PsA (P=0.008) were associated with greater disease durations among the patients. Conclusion: The proportion of patients with extensive psoriasis was high in the current setting probably because of delayed diagnosis. Awareness about the disease and its clinical manifestations might help in its early identification. Seasonal exacerbation was an important risk factor for psoriasis and it was associated with its relapse. The most common management modalities were topical steroids for psoriasis and phototherapy for extensive psoriasis.
Ladan Esmalian Khamseh; Mehdi Asadi Mofarah; Somayeh Toorani
Abstract
Background: Psoriasis is a chronic autoimmune, complex and progressive disease having various physical, psychological and social consequences. This study aimed to investigate the effect of cognitive behavioral therapy on body image in women with psoriasis. Methods: The research was ...
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Background: Psoriasis is a chronic autoimmune, complex and progressive disease having various physical, psychological and social consequences. This study aimed to investigate the effect of cognitive behavioral therapy on body image in women with psoriasis. Methods: The research was semi-experimental with pre-test and post-test design in both experimental and control groups, and follow-up after 3 months of intervention. The statisticalpopulation included women with psoriasis. A total of 60 patients were selected as available samples and randomly were divided into control and treatment (experiment) groups. The researchtool was the cash’s Body Image Questionnaire (1987) . Data were analyzed by the SPSS 24 software using the repeated measures analysis of variance. Results: Cognitive behavioral therapy guidance reduced the image body anxiety and its two sub-scales in women with psoriasis, and this effect was permanent after three months. Conclusion: Using this therapeutic approach, we can help to reduce the concern of the body image in patients with psoriasis. Conclusion: Using this therapeutic approach, we can help to reduce the concern of the body image in patients with psoriasis.
Hojat Eftekhari; Seyyede Zeinab Azimi; Abbas Darjani; Rana Rafiei; Melika Amookhteh
Abstract
Background: Psoriasis is a chronic disease that may affect patients’ quality of life. We investigated the quality of life (QoL) and its related factors in psoriasis patients. Methods: In this cross-sectional study, 123 patients with psoriasis vulgaris were enrolled, who were at the ...
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Background: Psoriasis is a chronic disease that may affect patients’ quality of life. We investigated the quality of life (QoL) and its related factors in psoriasis patients. Methods: In this cross-sectional study, 123 patients with psoriasis vulgaris were enrolled, who were at the age of 18-55 years. The QoL was assessed by the psoriasis disability index (PDI) questionnaire. The stress associated with psoriasis was evaluated by the psoriasis life stress inventory (PLSI) questionnaire. The severity of the disease (SoD) was measured based on the psoriasis area and severity index (PASI) score. Results: In this study, the mean age of the patients was 40.77 ± 0.73 years, and the mean duration of the disease was 8.7 ± 8.23 years. The average PASI score was 11.06, and the average PDI score was 11.98. The average PDI and PASI scores of smoker patients were significantly more than those of non-smokers (P = 0.017). There was a strong relationship between all parts of QoL and PLSI scores, as well as between PASI and PLSI (P < 0.05). Conclusions: Psoriasis reduced our patients’ quality of life. Thus, it is recommended that the QoL in psoriatic patients be evaluated. Stress management and psychological supporting methods are necessary for these patients.
Robabeh Abedini; Vahideh Lajevardi; Maryam Nasimi; Zahra Hallaji; Mahtab Darvish
Abstract
Background: The role of smoking and alcohol consumption in the pathogenesis of psoriasis is well-known; however, certain published studies have focused on the relationship between substance abuse and psoriasis. The present study was conducted to evaluate the prevalence of tobacco ...
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Background: The role of smoking and alcohol consumption in the pathogenesis of psoriasis is well-known; however, certain published studies have focused on the relationship between substance abuse and psoriasis. The present study was conducted to evaluate the prevalence of tobacco smoking, and substance and alcohol use in patients with psoriasis.Methods: Patients with a definite diagnosis of psoriasis at ages of 15 or more were recruited and general information of patients and their smoking behavior, alcohol consumption and substanceabuse were further collected.Results: 203 patients (103 men and 100 women) with psoriasis were included in this cross-sectional study. There were 76 smokers (37.45%) and 49 patients (24.1%) who consumed alcohol. Smoking, opium and alcohol consumption were significantly higher in men with psoriasis compared with women (P-values = 0.0001, 0.003, 0.002, respectively). Tranquilizer use was higher in married patients (P = 0.002), and those with joint involvements (P = 0.009). Hookah use was considerably high in female psoriatic patients, although not statistically significant (P = 0.37). Moreover, patients older than 40 years, and with nail disease (odds Ratio = 3.8) weremore prone to hookah use.
Conclusion: Our study revealed that the prevalence of smoking, opium and alcohol consumption is higher in men with psoriasis. Moreover, tranquilizer use is higher in married patients, and those with joint involvements. These findings should prompt public health workers to consider the modifiable habitual risk factors in patients with psoriasis.
Taheri Ahmad-Reza; Boroumand Nadia; Ebrahimi Safieh; Hosseini Elias; Roohani Mina; Hashemy Seyed Isaac
Abstract
Background: Psoriasis is a chronic-relapsing inflammatory skin disorder, in whose pathogenesis oxidative stress is suggested to be involved. Among different enzymes that play a role in maintaining the cellular redox balance, we aimed to assess the alteration of glutathione peroxidase (GPX) activity in ...
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Background: Psoriasis is a chronic-relapsing inflammatory skin disorder, in whose pathogenesis oxidative stress is suggested to be involved. Among different enzymes that play a role in maintaining the cellular redox balance, we aimed to assess the alteration of glutathione peroxidase (GPX) activity in cutaneous lesions and its correlation with the disease severity, firstly, to support the possible candidacy of this enzyme for future topical therapeutic regimens, and secondly, to move forward in understanding the etiology of the disease and the pathogenic mechanisms involved in cutaneous lesions so as to pave the way for further investigations. Methods: The clinical severity of disease was determined according to Psoriasis Area and Severity Index (PASI) scoring system. The level of GPX activity in the skin biopsies from 20 psoriatic patients was measured using Cayman’s glutathione peroxidase assay kit, and its association with disease severity was assessed in each patient. Results: Tissue GPX activity was significantly higher in patients with mild psoriasis (149.02 ± 24.213 nmol/min/ml) compared to patients with moderate psoriasis (120.58±21.038 nmol/min/ ml) (p-value < 0.05). There was a significant negative correlation between the activity of GPX and each PASI-associated criterion, including redness, scaling and thickness. Among all the criteria of PASI, scaling was independently correlated with the activity of GPX (p-value < 0.05). Conclusion: The reduced activity of GPX in dermal lesions might be associated with the disease pathogenesis, having a valuable role in diagnosis and therapy.
Namazi Nastaran; Helali Maryam; Pishgahi Mehdi; Ketabi Yasaman
Volume 20, Issue 4 , 2017, , Pages 113-117
Abstract
Background: Psoriasis is a prevalent chronic T cell mediated inflammatory skin disorder. Recent studies have reported an increase in the incidence of arrhythmia in psoriasis patients who run an excessive risk of metabolic syndrome and cardiovascular diseases. P-wave dispersion (PWD) and duration are ...
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Background: Psoriasis is a prevalent chronic T cell mediated inflammatory skin disorder. Recent studies have reported an increase in the incidence of arrhythmia in psoriasis patients who run an excessive risk of metabolic syndrome and cardiovascular diseases. P-wave dispersion (PWD) and duration are important electrocardiographic (ECG) markers employed to anticipate the risk of atrial arrhythmias. The objective of this research was to investigate the risk of atrial arrhythmia by measuring PWD, and maximum and minimum p-wave duration in psoriasis patients without known cardio metabolic risk factors.Materials and Methods: ECG was evaluated in Sixty-five adult patients with psoriasis and sixty-five age-, gender- and BMImatched healthy individuals.Results: Maximum P-wave duration (P max) and PWD were significantly higher in patients compare with the controls.Conclusion: It seems that psoriasis patients run a higher risk of developing atrial arrhythmia even following the adjustment of cardio metabolic risk factors.
Dastgheib Ladan; Saki Nasrin; Heiran Alireza; Kardeh Bahareh; Saki Mohammad Reza
Volume 20, Issue 3 , 2017, , Pages 79-83
Abstract
Background: Psoriasis is a chronic autoimmune skin disorder with relapsing erythematous scaling plaques and joint or nail involvement. A greater occurrence of other autoimmune diseases has been reported in these patients. Additionally, their family members are more likely to be diagnosed with psoriasis. ...
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Background: Psoriasis is a chronic autoimmune skin disorder with relapsing erythematous scaling plaques and joint or nail involvement. A greater occurrence of other autoimmune diseases has been reported in these patients. Additionally, their family members are more likely to be diagnosed with psoriasis. The aimof this study is to assess the prevalence of certain autoimmune diseases in first degree relatives of patients with psoriasis compared with a control group. Methods: In this cross-sectional study we used a questionnaire to compare the frequency of type 1 diabetes, autoimmune thyroid disease, vitiligo, lupus erythematosus, multiple sclerosis, ulcerative colitis, Crohn’s disease, and rheumatoid arthritis in first degree relatives of 109 pathologically confirmed psoriasiscases with the first degree relatives of 109 age-sex matched controls. R programming language (version 3.3.1 for Windows) and the rattle graphical user interface (GUI) package were applied for statistical analysis. A P-value?0.05 was considered to be statistically significant. Results: We compared 955 first degree relatives of psoriatic patients with 934 family members of the controls. There was significantly greater total autoimmune diseases [odds ratio (OR): 2.74, 95% confidence interval (CI): 1.95-3.87, P<0.001), particularly psoriasis (OR: 38.66, 95% CI: 5.3-282.19, P<.0001), in first degree relatives of psoriatic patients compared to family members of the control group. Regardless of gender, autoimmune thyroid disease was more prevalent among first degree relatives of psoriatic patients (OR: 2.81, 95% CI: 1.36-5.83, P=.0066). No statistically significant difference was found regarding type 1 diabetes, rheumatoid arthritis, multiple sclerosis, vitiligo, Crohn’s disease, and ulcerative colitis. Conclusion: First degree relatives of patients with psoriasis had significantly higher autoimmune diseases. This finding was particularly noticed for psoriasis and autoimmune thyroid disease.
Abedini Robabeh; Lajevardi Vahideh; Hallaji Zahra; Khodashenas Zohre; Zafar Fatemeh; Nasimi Maryam
Volume 19, Issue 4 , 2016, , Pages 113-118
Abstract
Background: Psoriasis is a chronic skin disorder that can significantly affect a patient’s quality of life (QoL). The goal of this study was to determine the QoL in patients with psoriasis and to investigate the correlation between the QoL, demographic data, and clinical severity of psoriasis.Methods: ...
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Background: Psoriasis is a chronic skin disorder that can significantly affect a patient’s quality of life (QoL). The goal of this study was to determine the QoL in patients with psoriasis and to investigate the correlation between the QoL, demographic data, and clinical severity of psoriasis.Methods: This prospective, cross-sectional study was conducted from April 2014 to January 2015. One hundred patients with plaque type psoriasis from the Phototherapy Clinic of Razi Hospital, Tehran, Iran were selected and asked to complete questionnaires. The Psoriasis Area Severity Index (PASI) to measure the severity of psoriasis, and the Dermatology Life Quality Index (DLQI) was used for the assessment of the quality of life.Results: The total DLQI score of the all participants was between 0 and 29 with a mean score of 10.6 ± 6.4. The DLQI scores ranged from “very large” to “extremely large” in 45% of the patients. The mean score was 9.2 ± 6.6 in the male group and 12.1 ± 5.9 in the female group, which showed a statically significant difference (P=0.02). Other variables associated with an impaired QoL were age (P=0.002) and PASI (P=0.01). The impact on QoL was higher in younger patients, and in patients with higher PASI scores.Conclusion: In conclusion, although psoriasis is a benign disorder, this study confirms our initial hypothesis that psoriasis significantly impairs the QoL, which is more pronounced in younger patients, women, and patients with a more severe disease (higher PASI scores).
Shahidi-Dadras Mohammad; Abdollahimajd Fahimeh; Younespour Shima; Nikvar Mohammad
Volume 19, Issue 4 , 2016, , Pages 119-124
Abstract
Background: Psoriasis is a chronic disease with multiple biochemical and vascular abnormalities. Several studies have evaluated circulating levels of vascular endothelial growth factor (VEGF) in psoriasis, but none of them evaluated it after reaching a PASI-75 response, as a practical treatment goal. ...
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Background: Psoriasis is a chronic disease with multiple biochemical and vascular abnormalities. Several studies have evaluated circulating levels of vascular endothelial growth factor (VEGF) in psoriasis, but none of them evaluated it after reaching a PASI-75 response, as a practical treatment goal. The aim of this study was to evaluate serum levels of VEGF in moderate to severe psoriatic patients before and after treatment compared with healthy controls.Methods: This study was approved by the Ethics Committee of Shahid Beheshti University of Medical Sciences. Fifty-eight patients with moderate- severe psoriasis and 60 age-and gender-matched healthy controls were recruited to this study. Serum VEGF levels (pg/ml) of both groups were measured. We used Psoriasis Area and Severity Index (PASI) scoring to assess disease activity in patients. According to the disease severity, the patients received proper treatment. When they reached a PASI-75 response, serum VEGF levels were measured once more.Results: In our study, the median serum VEGF level was significantly higher in psoriatic patients (before and after treatment) as compared to healthy controls. Moreover, patients showed a significant reduction in their serum VEGF levels after reaching PASI-75. The median time of therapeutic effect (reaching a PASI- 75 response) was four months. Furthermore, our study showed a significant correlation between the serum VEGF level and age, BMI, PASI, and disease duration (P
Zahra Hallaji; Vahideh Lajevardi; Robabeh Abedini; Amir Soleymani; Azadeh Goodarzi; Mehrnaz Salehi-Taleghani; Sara Beygi
Volume 19, Issue 4 , 2016, , Pages 125-130
Abstract
Background: The prevalence of non-alcoholic fatty liver disease is higher in patients with psoriasis than in the normal population. Serum leptin levels are higher in patients with psoriasis and in patients with non-alcoholic fatty liver. The purpose of this study was to determine the serum levels of ...
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Background: The prevalence of non-alcoholic fatty liver disease is higher in patients with psoriasis than in the normal population. Serum leptin levels are higher in patients with psoriasis and in patients with non-alcoholic fatty liver. The purpose of this study was to determine the serum levels of leptin in psoriatic patients with and without non-alcoholic fatty liver.Methods: This cross-sectional study was conducted at Razi Dermatology Hospital, Tehran, Iran in 2013. A total of 50 patients with psoriasis were enrolled in the study. Fatty liver grade was assessed via ultrasonography and serum leptin levels were measured using the ELISA method.Results: Ten patients had normal livers and 40 had fatty livers with different grades. The median serum leptin level was significantly higher in psoriatic patients with fatty liver (11.75ng/mL) in comparison to those without fatty liver (2.80 ng/ml). Moreover, there was a direct correlation between the leptin level and the grade of fatty liver.Conclusion: serum leptin can be elevated in the course of psoriasis and may have a role in the pathogenesis of non-alcoholic fatty liver disease and other metabolic co morbidities in psoriatic patients.
Wiwanitkit Viroj
Volume 19, Issue 2 , 2016, , Pages 65-65
Abstract
The recent report, “Serum prolactin level in psoriasis”, is very interesting 1. Ghiasi et al. concluded that “it seems that while intracutaneous prolactin may contribute to the pathogenesis of psoriasis, the probable role of pituitary-produced circulating prolactin in the disease process ...
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The recent report, “Serum prolactin level in psoriasis”, is very interesting 1. Ghiasi et al. concluded that “it seems that while intracutaneous prolactin may contribute to the pathogenesis of psoriasis, the probable role of pituitary-produced circulating prolactin in the disease process needs further investigation .” There are some concerns on this report. First, although Ghiasi et al. have studied serum prolactin, they based their conclusion on intracutaneous prolactin. The serum prolactin is not the same as intracutaneous prolactin. The serum prolactin can be affected by several physiological and pathological factors. In fertile females, variations of baseline serum prolactin can be expected. Indeed, for psoriasis, there are previous reports on prolactin with controversial results. The difference in baseline pathophysiological conditions of psoriatic patients can be a good explanation for the different findings on prolactin levels in patients.
Gheisari Mehdi; Golfeshan Atefe
Volume 18, Issue 4 , 2015, , Pages 182-183
Abstract
Psoriasis is a common chronic inflammatory skin disease. The most common form of psoriasis is characterized by sharply demarcated, scaly, erythematous plaques. The face is an unusual site for psoriasis. Herein, we report a 43-year-old woman with facial psoriasis that was developed after remission–induction ...
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Psoriasis is a common chronic inflammatory skin disease. The most common form of psoriasis is characterized by sharply demarcated, scaly, erythematous plaques. The face is an unusual site for psoriasis. Herein, we report a 43-year-old woman with facial psoriasis that was developed after remission–induction chemotherapy for acute leukemia with high dose cytarabine/daunorubicin.
Dadras Mohammad Shahidi; Golfeshan Atefe; Younespour Shima
Volume 18, Issue 2 , 2015, , Pages 51-55
Abstract
Background: It seems that there are similar associated diseases in psoriasis and Lewis (b) negative phenotypes such as diabetesmellitus, cardiovascular events, and metabolic syndrome. Therefore, we decided to evaluate the frequency of Lewis henotypes in patients with chronic plaque type psoriasis. A ...
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Background: It seems that there are similar associated diseases in psoriasis and Lewis (b) negative phenotypes such as diabetesmellitus, cardiovascular events, and metabolic syndrome. Therefore, we decided to evaluate the frequency of Lewis henotypes in patients with chronic plaque type psoriasis. A limited number of studies have been previously conducted in this regard.Methods: Fifty patients and 100 age and gender matched control subjects were selected as the study population. Two milliliter of venous blood was collected from each subject to find out the Lewis phenotype and in subjects with the Le (a-b-) henotype, saliva was collected to determine the secretory status. All individuals with the Le (a-b-) phenotype were typed as non-secretor in their saliva by the hemagglutination inhibition assay; therefore, in this study, Lewis (b) positive individuals were considered as secretor and Lewis (b) negative as non-secretor phenotypes.Results: There was a significant difference in the secretory status or Lewis phenotypes between the two groups. ABH on-secretory status Le (a-b-) and Le (a+b-) together or Lewis b negative phenotypes were found in 78% (39 of 50) of the patients and 26% (26 out of 100) of the healthy controls (P
Ghiasi Maryam; Hallaji Zahra; Narimani Shaban Ali
Volume 18, Issue 1 , 2015, , Pages 6-9
Abstract
Background: Psoriasis is a chronic immune-mediated skin diseasewith a genetic predisposition. Prolactin may contribute to psoriasispathogenesis. However, there has been a debate over the serumlevel of prolactin in psoriatic patients. The aim of this study was todescribe the role of serum prolactin in ...
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Background: Psoriasis is a chronic immune-mediated skin diseasewith a genetic predisposition. Prolactin may contribute to psoriasispathogenesis. However, there has been a debate over the serumlevel of prolactin in psoriatic patients. The aim of this study was todescribe the role of serum prolactin in the pathogenesis of psoriasisMethod: The serum prolactin level was measured in 45 patientswith psoriasis and in 45 sex- and age-matched healthy individualsusing radioimmunoassay.Result: The mean serum prolactin concentration was not differentbetween psoriatic patients and healthy controls (320 ± 179.38 vs.318.18 ± 191.78 mIU/L, respectively P = 0.95). There was no sexandage-related differences in serum prolactin between the twostudy groups. Hyperprolactinemia (serum prolactin >324 mIU/Lin men, and >496 mIU/L for women) was observed in 11 patientswith psoriasis and 12 healthy subjects, which showed no significantdifference between the two groups (P = 0.81). The serum prolactinwas not significantly correlated with the duration of the disease(r = -0.18, P = 0.24) or the PASI score (r = 0.10, P = 0.50).Conclusion: The possible role of pituitary-produced circulatingprolactin in the disease process needs further investigations.
Dadras Mohammad Shahidi; Golfeshan Atefeh; Younespour Shima
Volume 18, Issue 1 , 2015, , Pages 16-19
Abstract
Background: The ABO blood group antigens play a role in thepathophysiology of some diseases and several researches haveinvestigated this relationship in the field of dermatology. In thepresent study, an attempt was made to find the distribution ofblood types in patients with pemphigus vulgaris and chronicplaque ...
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Background: The ABO blood group antigens play a role in thepathophysiology of some diseases and several researches haveinvestigated this relationship in the field of dermatology. In thepresent study, an attempt was made to find the distribution ofblood types in patients with pemphigus vulgaris and chronicplaque type psoriasis.Method: Fifty patients with chronic plaque type psoriasis, 50patients with pemphigus vulgaris and 100 healthy persons ascontrol group, were selected as the study population. ABO bloodgrouping was determined by the cell type tube test method, usingstandard commercial anti/A, anti/B and 5% suspension of redblood cells. Chi square test was used to compare the frequencyof ABO blood groups in patients and control groups.Result: Among the 50 patients with psoriasis, 21 (42%) hadblood group O, 15 (30%) blood group A, 10 (20%) blood groupB and 8 (4%) had blood group AB. Among the 50 patients in thepemphigus group, 22 (44%) had blood group O, 19 (38%) bloodgroup A, 8 (16%) blood group B and 1 (2%) had blood groupAB. The distribution of blood groups in patients with these twodiseases was not significantly different from the control group.Conclusion: Despite some researches, which found associationsbetween blood group antigens and psoriasis or pemphigus, thisstudy did not find any such relationship.
Hussain Sajjad; Hassan Iffat; Majeed Sabiya; Showkat A Bhat; Hinah Altaf; Peerzada Sajad
Volume 17, Issue 4 , 2014, , Pages 117-121
Abstract
Background: Psoriasis is a chronic inflammatory disease of theskin. The etiology of psoriasis is not known exactly. Recently, ithas been suggested that an imbalance in the oxidant- antioxidantstatus due to an increased reactive oxygen species production and/or deficient function of the antioxidant system ...
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Background: Psoriasis is a chronic inflammatory disease of theskin. The etiology of psoriasis is not known exactly. Recently, ithas been suggested that an imbalance in the oxidant- antioxidantstatus due to an increased reactive oxygen species production and/or deficient function of the antioxidant system may be involvedin the pathogenesis of psoriasis. The aim of this study was toevaluate the antioxidant defense status in patients with psoriasisand to look for a correlation, if any, between the antioxidantdefense status and the severity of psoriasis.Method: Sixty patients with psoriasis and an equal number ofage and sex matched healthy controls were enrolled in the study.Plasma levels of malondialdehyde (MDA), reduced glutathione(GSH), and superoxide dismutase (SOD), and antioxidant potential(AOP) were measured in cases as well as controls.Result: Patients with psoriasis were found to have significantlyhigher levels of plasma SOD (P < 0.001) and MDA (P < 0.001)and lower levels of GSH (P < 0.001) than controls. Plasma AOPwas not significantly different between patients and controls(P= 0.822).Conclusion: The results of our study support the hypothesisof an imbalance in the oxidant –antioxidant status in psoriasis,which could contribute to the pathogenesis of psoriasis.
