Dyslipidemia and Hyperglycemia in Psoriatic Inpatients

Background: Psoriasis is a chronic cutaneous T-cell mediated disease, which has been associated with many comorbidities, especially with metabolic disorders such as dyslipidemia, diabetes mellitus, obesity, and metabolic syndrome, many of which are themselves risk factors for other diseases. The goal of this study was to evaluate the presence of dyslipidemia and hyperglycemia in patients with psoriasis. Methods: We compared 48 inpatients with plaque psoriasis aged 29-79, hospitalized between March 2018 and February 2019, to 48 age- and gender-matched controls. We evaluated dyslipidemia and hyperglycemia using enzymatic methods as part of a standard blood test, or medication history indicative of ongoing treatment of dyslipidemia and/or hyperglycemia. Hypertension was evaluated by registering blood pressure greater than 140/90 mmHg or ongoing antihypertensive treatment. Smoking habits were also noted. Results: There were statistically significant differences between psoriasis patients and controls for elevated total cholesterol (p=0,028), elevated LDL (p=0,015), hypertriglyceridemia (p=0,006), and hyperglycemia (p=0,021). The two groups had statistically insignificant differences for lowered HDL (p=0,084), hypertension (p=1), and smoking (p=0,836). Conclusion: Hypertriglyceridemia, hyperglycemia, and elevated LDL cholesterol were more prevalent in the group containing psoriatic patients compared to the control group. This indicates that further investigation of metabolic abnormalities should be conducted in psoriatic patients which could greatly benefit from early treatment of the aforementioned underlying conditions

Necrolytic migratory erythema: complete healing after surgical removal of pancreatic carcinoma

Necrolytic migratory erythema is considered an obligatory cutaneous paraneoplastic sign associated with glucagonoma. Glucagonoma syndrome is defined by the presence of an alpha-cell secreting tumor of the pancreas, elevated levels of glucagon, and a characteristic rash called necrolytic migratory erythema. Although necrolytic migratory erythema is a specific finding in glucagonoma syndrome, it may occur in other settings, unassociated with an alpha-cell pancreatic tumor (pseudoglucagonoma syndrome). The rarity of glucagonoma imposes a challenge, with most patients being diagnosed after a long period of treatment for their skin rash. The main prognostic sign of glucagonoma are the subsequent metastases that come late in the course of the disease. Herein, we present a 55-year-old female patient with a 5-year history of unrecognized cutaneous and systemic manifestations of glucagonoma syndrome. Based on the investigations, the diagnosis of glucagonoma syndrome without metastases was established. After surgical removal of pancreatic carcinoma/glucagonoma, complete healing and a long disease-free period was achieved. Appropriate awareness of the characteristics of necrolytic migratory erythema in physicians/dermatologists often leads to an early diagnosis of glucagonoma syndrome and enhances the chances of a favorable outcome.healing and long disease-free period was achieved. The awareness of physicians/dermatologists of the characteristic necrolytic migratory erythema, often leads to an early diagnosis of glucagonoma syndrome and enhance the chances of a favorable outcome.</p