Prevalence of Metabolic Syndrome in Patients with Psoriasis

Background. Psoriasis is a chronic inflammatory skin disorder in which proinflammatory cytokines including IL-6 and TNF-α increase both locally and systematically. It is thought that chronic inflammation results in metabolic diseases and proinflammatory cytokines give rise to the development of atherogenesis, peripheral insulin resistance, hypertension, and type 2 diabetes. Our aim was to investigate the prevalence of metabolic syndrome in patients with psoriasis vulgaris. Methods. Study consisted of 115 plaque-type psoriasis patients and 140 healthy individuals. Data including body weight, height, waist circumference, body-mass index, and arterial blood pressure were collected. Fasting blood glucose, triglyceride, and HDL levels were determined. International Diabetes Federation Criteria for Metabolic Syndrome and Insulin Resistance were used for evaluating patients with metabolic syndrome and diabetes. Results. Compared to the control group, metabolic syndrome, diabetes mellitus, and hypertension were found to be higher in psoriasis patients. Metabolic syndrome was increased by 3-folds in psoriasis patients and was more prevalent in women than in men. It was determined that the prevalence of metabolic syndrome was higher in psoriasis patients after the age of 40. Metabolic syndrome was not related to smoking, severity of psoriasis, and duration of disease. Conclusions. Our findings suggest that psoriasis preconditions occurrence of a group of diseases such as diabetes mellitus, hypertension, and metabolic syndrome. For this reason, patients with psoriasis should be treated early and they should be followed with respect to metabolic diseases

Adherence to systemic therapy in patients with psoriasis during the COVID-19 pandemic: A multicenter study

Background: Adherence to treatment is important in chronic dermatological diseases. There are limited data regarding the adherence to treatment in patients with psoriasis during the COVID-19 pandemic. Aims: We aimed to determine the rates of adherence to systemic treatments in patients with psoriasis and to identify the causes of non-adherence during the COVID-19 pandemic. Methods: We conducted a cross-sectional multicenter study from May 2021 to August 2021. A questionnaire including items regarding sociodemographic characteristics of the patients, disease-related characteristics, and treatment-related characteristics were filled out by the physicians. The Psoriasis Area Severity Index (PASI), Hospital Anxiety, and Depression Scale, and the Dermatology Life Quality Index were calculated. The rate of adherence and non-adherence to treatment and reasons for non-adherence to treatment were examined. Results: A total of 342 patients with psoriasis were included (182 male/160 female) in the study. The mean age of the patients was 45.9 ± 14.2 years. The average duration of psoriasis was 192 ± 134.7 months. While the rate of adherence to treatment was 57.6%, the rate of non-adherence to treatment was 42.4%. There were no significant differences with respect to adherence to treatment in comparison with oral and injection-therapy groups. The most frequent reasons for non-adherence to treatment were inability to go to the hospital (19.2%), concern about the COVID-19 infection (16.3%), discontinuation of the treatment by the doctor (13.7%), inability to reach the doctor (7.3%), and inability to have access to the medication (7.3%). Conclusion: Adherence to oral and injection therapies was fairly high among our patients with psoriasis during the COVID-19 pandemic. Psoriasis severity and duration of medication use had a negative impact on adherence to treatment

A rare case of neurocutaneous disorders of the newborn: Incontinentia pigmenti

Incontinentia Pigmenti (IP) is a rare X-linked dominant disorder which is mostly lethal for males. It effects hair, teeth, nails, eyes and central nervous system along with skin. A twelve day old female patient was referred to the dermatology departmant due to skin eruptions that began the day before. There was a widespread erythema and many papuls and vesicles were seen on the eryhematous skin in linear sequence. Spongiosis with eosinophilia and necrotic keratinocytes were seen on histopathologic examination. The patient was diagnosed with incontinentia pigmenti. Vesicles and bullous eruption are rarely seen in newborns. The physcians should not avoid histopathologic examination especially in females. Since incontinentia pigmenti is a rare but multisystemic disorder, early diagnosis is crucial

Nineteen-year retrospective evaluation of pemphigus in a single dermatology centre in Istanbul, Turkey

WOS: 000519592400024Introduction: Pemphigus is an autoimmune intra-epidermal bullous disease of the skin and mucosae. Aim: To retrospectively evaluate the course, prognosis and clinical features of pemphigus. Material and methods: The files of 196 pemphigus patients admitted to our clinic between December 1995 and December 2014 were collected and analysed. Results: The male to female ratio among patients was 1 : 1.88. Pemphigus vulgaris (PV) was the most common clinical variant observed in 175 (89.3%) of the patients, followed by pemphigus foliaceus (PF) in 14 (7.1%) of the patients. The mean patient age at disease onset was 50 years. PV presented itself as skin lesions in 55 (31.4%) of the patients and as oral mucosa lesions in 120 (68.6%) of the patients. Complete remission and treatment withdrawal were obtained in 112 (57.1%) of the patients, for a mean period of 2.91 +/- 2.66 years (range: 4 months to 13 years). The mortality rate was 6%, and relapse occurred in 16 (14.3%) of the patients for a mean relapse period of 2.15 +/- 1.88 years (range: 6 months to 7 years). Mucocutaneous pemphigus (MCP) was the major clinical pattern observed in 96 (49%) of the patients. Conclusions: Within our study population, pemphigus predominately affected females, and the most common clinical variant was PV, a subtype that frequently occurs in middle-aged individuals. MCP was the most common clinical pattern. Although MCP and higher doses of corticosteroids were needed to control pemphigus, they did not seem to influence the prognosis

The multidisciplinary evaluation of dermatosis seen after Van earthquake

Objective: In this study, we aimed to evaluate the patients with dermatological diseases those were observed and treated and the referred to the hospital for dermatosis by the dermatologists, family physicians, plastic surgeons and orthopedists that worked in 10 day rescue mission in Van region. Methods: Totally 380 patients (139 female, 241 male) with dermatological problems referred to Van Region Hospital were evaluated by orthopedists, family physicians, plastic surgeons and dermatologists between 12-23 November 2011. Patients were divided into two groups; Group A consisted of patients whose complaints started before the earthquake and group B consisted of patients whose complaints started after the earthquake. The two groups were compared for dermatological diseases. Results: Totally 380 patients (139 female, 241 male) were evaluated. There were 151 and 229 patients in Group A and B, respectively. The mean age of patients was 30 ± 18 and 28 ± 17 in Group A and B, respectively. The most observed dermatological diseases in group A were erythemasquamose diseases (% 27.1) (eczema, mycosis fungoides, xeroderma, atopic dermatitis, seborrheic dermatitis, figured erythema), and in group B were bacterial infections (%27.5). Conclusion: Nonhygienic conditions (snow, cold, mud) leads to bacterial skin infection and traumatic skin lacerations. Helps those made arbitrarily may cause tent fires which giving rise to physical dermatosis

The cientificWorldJOURNAL Research Article Prevalence of Metabolic Syndrome in Patients with Psoriasis

Background. Psoriasis is a chronic inflammatory skin disorder in which proinflammatory cytokines including IL-6 and TNF-α increase both locally and systematically. It is thought that chronic inflammation results in metabolic diseases and proinflammatory cytokines give rise to the development of atherogenesis, peripheral insulin resistance, hypertension, and type 2 diabetes. Our aim was to investigate the prevalence of metabolic syndrome in patients with psoriasis vulgaris. Methods. Study consisted of 115 plaquetype psoriasis patients and 140 healthy individuals. Data including body weight, height, waist circumference, body-mass index, and arterial blood pressure were collected. Fasting blood glucose, triglyceride, and HDL levels were determined. International Diabetes Federation Criteria for Metabolic Syndrome and Insulin Resistance were used for evaluating patients with metabolic syndrome and diabetes. Results. Compared to the control group, metabolic syndrome, diabetes mellitus, and hypertension were found to be higher in psoriasis patients. Metabolic syndrome was increased by 3-folds in psoriasis patients and was more prevalent in women than in men. It was determined that the prevalence of metabolic syndrome was higher in psoriasis patients after the age of 40. Metabolic syndrome was not related to smoking, severity of psoriasis, and duration of disease. Conclusions. Our findings suggest that psoriasis preconditions occurrence of a group of diseases such as diabetes mellitus, hypertension, and metabolic syndrome. For this reason, patients with psoriasis should be treated early and they should be followed with respect to metabolic diseases

Acute Generalized Exanthematous Pustulosis Induced by Etanercept: Another Dermatologic Adverse Effect

Acute generalized exanthematous pustulosis (AGEP) is a skin eruption that is primarily drug induced and characterized by the formation of numerous acute and sterile pustules on an erythematous background as mentioned by Weinblatt et al. (1999). We present a case of AGEP, following administration of etanercept, an antitumour necrosis factor alpha (TNF-α) antibody, in a patient with psoriasis. Recognition of this reaction pattern is important given the frequent reliance on etanercept in treating psoriasis

The co-occurrence of lichen sclerosus et atrophicus and celiac disease

A 53-year-old female patient was admitted to our clinic for generalized hypo/hyper-pigmented, partially firm and sclerotic plaques with undefined borders. As the skin biopsy taken from the lesion was compatible with lichen sclerosus et atrophicus (LSA), the patient was treated with ultraviolet A1 (UVA1) treatment. Upon follow-up, she developed abdominal pain and diarrhea. Further investigation (including endoscopic and laboratory tests) showed signs consistent with celiac disease. After 30 sessions of UVA1 treatment, the skin lesions partially regressed. We present this case because the co-occurrence of LSA and celiac disease is very rare

Mitotically Active Plexiform Fibrohistiocytic Tumor

Plexiform fibrohistiocytic tumor is an intermediate malignant tumor situated in superficial soft tissues. It affects children and young adults. The tumor is most commonly located on upper extremities, whereas involvement of back region is rare. Mitotic activity is generally low (~3/10 HPF). It is rare, but it can exhibit aggressive behavior, so total excision with clear surgical margins and long-term followup is necessary to detect local recurrence and metastases. We report a child with a solid mass on back region which was found to be a mitotically active plexiform fibrohistiocytic tumor (6/10 HPF) after excision. Plexiform fibrohistiocytic tumor (PFT) is a mesenchymal neoplasm of children, adolescents, and young adults. It is characterized by fibrohistiocytic cytomorphology and multinodular growth pattern. Clinically it is usually a slow-growing mass of upper extremities with frequent local recurrence and rare regional lymphatic and systemic metastasis (Fletcher et al. (2002), Enzinger and Zhang (1988), Remstein et al. (1999))