Cardiovascular Comorbidities in Patients with Psoriasis: Risk Profile Including Carotide Ultrasonography Assessed in Hospital-based Case Control Study

Psoriasis is a chronic inflammatory disease and its comorbidities have attracted serious interest in recent years. The evidence that psoriasis is associated with systemic inflammation and significantly higher incidence of cardiovascular risk factors was already described. The results of published studies are highly variable, the conclusions are ambiguous and further epidemiological studies are needed for validation of published data. Therefore, we initiated a project aimed at identifying the carriership of cardiovascular risk factors including early stages of atherosclerosis that represent important comorbidities in patients with psoriasis. We carried out a hospital-based case-control study. 189 patients with chronic plaque psoriasis were enrolled as cases. The group consisted of 378 patients with other skin diseases complying with the same restriction criteria were recruited to the study as the controls. All participants underwent physical examination, blood tests, measuring of blood pressure, waist circumference. Furthermore, in the subset of 117 cases and controls (matched 1:2) with no history of cardiovascular disease we evaluated the intima-media thickness (cIMT). The results show higher prevalence of hypertension, hyperlipidaemia, waist circumference, weight, BMI and CRP level in patients with psoriasis than in controls. These parameters have been clearly demonstrated as risk factors for the development of cardiovascular diseases. The associations among psoriasis and diastolic blood pressure, BMI value and LDL cholesterol are statistically significant in the binary data logistic model as well. cIMT in patients  compared to controls was not significant.</p

Cardiovascular Comorbidities in Patients with Psoriasis: Risk Profile Including Carotide Ultrasonography Assessed in Hospital-based Case Control Study

Psoriasis is a chronic inflammatory disease and its comorbidities have attracted serious interest in recent years. The evidence that psoriasis is associated with systemic inflammation and significantly higher incidence of cardiovascular risk factors was already described. The results of published studies are highly variable, the conclusions are ambiguous and further epidemiological studies are needed for validation of published data. Therefore, we initiated a project aimed at identifying the carriership of cardiovascular risk factors including early stages of atherosclerosis that represent important comorbidities in patients with psoriasis. We carried out a hospital-based case-control study. 189 patients with chronic plaque psoriasis were enrolled as cases. The group consisted of 378 patients with other skin diseases complying with the same restriction criteria were recruited to the study as the controls. All participants underwent physical examination, blood tests, measuring of blood pressure, waist circumference. Furthermore, in the subset of 117 cases and controls (matched 1:2) with no history of cardiovascular disease we evaluated the intima-media thickness (cIMT). The results show higher prevalence of hypertension, hyperlipidaemia, waist circumference, weight, BMI and CRP level in patients with psoriasis than in controls. These parameters have been clearly demonstrated as risk factors for the development of cardiovascular diseases. The associations among psoriasis and diastolic blood pressure, BMI value and LDL cholesterol are statistically significant in the binary data logistic model as well. cIMT in patients  compared to controls was not significant.</p

An International Multi-center Study on Self-assessed and Family Quality of Life in Children with Atopic Dermatitis

Atopic dermatitis (AD) is a common childhood chronic inflammatory skin condition that greatly affects the quality of life (QoL) of affected children and their families. The aim of our study was to assess QoL and family QoL of children with AD from 4 different countries and then compare the data, evaluating the effects of AD severity and age of children. Data on the Children’s Dermatology Life Quality Index (CDLQI) and the Dermatitis Family Impact (DFI) questionnaires and the SCORAD index of 167 AD children 5-16 years old from Ukraine, Czech Republic, Singapore, and Italy was used for the study. SCORAD correlated with the CDLQI in all 4 countries and with DFI in all countries except Singapore. Only in Czech children did the CDLQI correlate with their age. No significant correlations between age and DFI results were found. AD symptoms and expenditures related to AD were highly scored in all countries. Impact of AD on friendship and relations between family members were among the lower scored items, and family problems did not increase proportionately with duration of AD in any of the four countries. Self-assessed health-related QoL of children with AD in our study correlated better in most cases with disease severity than family QoL results. Parents of school children with AD were generally less stressed, tired, and exhausted than parents of preschool children. These data together with results showing that duration of AD in children does not affect relations between parents and other family members is optimistic news for families with children with AD who did not recover until adolescence.</p

Hepato-Splenic and Lipid Profile Abnormalities – Do They Exist in Children Affected with Vitiligo?

Autoimmune disturbances and metabolic abnormalities observedin vitiligo, a disease of still unclear etiology, may provide evidence onthe systemic nature of the disease. The aim of the study was to assess functionaland morphological parameters of the liver and spleen, as well as thelipid profile in vitiligo-affected children, in order to ascertain whether anymetabolic abnormalities or structural changes in these organs accompaniedthe course of vitiligo. The study included 34 patients with vitiligo hospitalizedat the Department of Dermatology at the Medical University of Lublin and acontrol group of 35 healthy individuals, aged 7-15 years. Children with the activephase of vitiligo and at least 6 month history of vitiligo lesions were studied.Ultrasound examination of the liver and spleen enabled assessment of thesize and parenchyma of the organs. Liver and spleen functions were assessedby means of the following additional examinations: blood test, transaminases,protein electrophoresis, lipid profile, autoantibodies, and HCV antibodies. Thesize of the liver was not significantly different in the vitiligo and control groups.The ultrasonographic pictures of the spleen revealed no abnormalities in organsize and structure. The concentration of HDL-cholesterol was significantlylower, whereas the concentration of LDL-cholesterol was significantly higherin patients with vitiligo than in healthy controls. The value of the LDL/HDL ratiowas significantly higher in vitiligo patients. The results of our study indicatelipid disturbances in vitiligo-affected children. Since no structural and functionalabnormalities in the liver and spleen were found, it seems likely thatlipid disturbances in vitiligo may result from disturbed metabolic processes inthe adipose tissue as well as from oxidative stress

Dysbiosis of Skin Microbiota in Psoriatic Patients: Co-occurrence of Fungal and Bacterial Communities

Psoriasis is a chronic inflammatory skin disease, whose pathogenesis involves dysregulated interplay among immune cells, keratinocytes and environmental triggers, including microbiota. Bacterial and fungal dysbiosis has been recently associated with several chronic immune-mediated diseases including psoriasis. In this comprehensive study, we investigated how different sampling sites and methods reflect the uncovered skin microbiota composition. After establishing the most suitable approach, we further examined correlations between bacteria and fungi on the psoriatic skin. We compared microbiota composition determined in the same sample by sequencing two distinct hypervariable regions of the 16S rRNA gene. We showed that using the V3V4 region led to higher species richness and evenness than using the V1V2 region. In particular, genera, such as Staphylococcus and Micrococcus were more abundant when using the V3V4 region, while Planococcaceae, on the other hand, were detected only by the V1V2 region. We performed a detailed analysis of skin microbiota composition of psoriatic lesions, unaffected psoriatic skin, and healthy control skin from the back and elbow. Only a few discriminative features were uncovered, mostly specific for the sampling site or method (swab, scraping, or biopsy). Swabs from psoriatic lesions on the back and the elbow were associated with increased abundance of Brevibacterium and Kocuria palustris and Gordonia, respectively. In the same samples from psoriatic lesions, we found a significantly higher abundance of the fungus Malassezia restricta on the back, while Malassezia sympodialis dominated the elbow mycobiota. In psoriatic elbow skin, we found significant correlation between occurrence of Kocuria, Lactobacillus, and Streptococcus with Saccharomyces, which was not observed in healthy skin. For the first time, we showed here a psoriasis-specific correlation between fungal and bacterial species, suggesting a link between competition for niche occupancy and psoriasis. However, it still remains to be elucidated whether observed microbial shift and specific inter-kingdom relationship pattern are of primary etiological significance or secondary to the disease

Prevalence vysoce rizikové DNA a mRNA lidského papilomaviru a její souvislost s abnormální anální cytologií v české kohortě screeningu mužského análního karcinomu

Screening análního karcinomu (AC) je oprávněný u vysoce rizikových populací, zejména HIV pozitivních mužů, kteří mají sex s muži (MSM). Testování HR-HPV by mohlo zlepšit účinnost cytologicky založeného screeningu AC, jako při screeningu biologicky analogické rakoviny děložního čípku. Specifičnost testování HR-HPV je ovlivněna prevalencí infekce HR-HPV ve vyšetřované populaci. Hlášená anální HR-HPV DNA prevalence v MSM je vysoká, ale HR-HPV mRNA odráží spíše dlouhodobé infekce a je specifičtější pro léze vysokého stupně. Nebyla však publikována žádná data o prevalenci HR-HPV DNA a mRNA v české screeningové populaci AC.Anal cancer (AC) screening is justified in high-risk populations, particularly HIV-positive men having sex with men (MSM). HR-HPV testing could improve the efficiency of cytologically based screening of AC, as in the screening of biologically analogical cervical cancer. The specificity of HR-HPV testing is influenced by the prevalence of HR-HPV infection in the screened population. Reported anal HR-HPV DNA prevalence in MSM is high, but HR-HPV mRNA reflects rather long-term infections and is more specific for high-grade lesions. However, no data were published about HR-HPV DNA and mRNA prevalence in the Czech AC screening population

A pilot study on the incidence of severe photosensitivity reactions leading to hospitalization linked to topical ketoprofen and other medications in selected European regions.

The aim of this study was to assess the prevalence of exposure to topical nonsteroidal anti-inflammatory drugs (NSAIDs), particularly ketoprofen, in a convenience sample of the population, to obtain estimates of the incidence of severe photosensitivity leading to hospitalization, and to assess causative factors in three catchment areas: the Paris metropolitan area, the Lombardy region (Italy) and the Prague area. All cases of severe photosensitivity not explained by underlying conditions and admitted to hospitals in the selected areas were included in the study. Controls were patients consecutively admitted to hospitals, in the same areas, for an acute condition or for an elective procedure not suspected of being related to medication use. From October 2012 to September 2013, 920 controls were recruited (median age 44 years, 50.8% females); 8 severe photosensitivity cases were reported in the population aged 18-74 years of the 3 geographical areas during the 1-year surveillance period, corresponding to an incidence rate of 4.81 cases per 10 million person-years (95% confidence interval - CI, 2.07-9.48). Six controls reported 1-month exposure to topical ketoprofen, with an estimated prevalence of 0.65% (95% CI, 0.24-1.42). The population attributable risk for severe photosensitivity reactions linked to ketoprofen was 11.92% (95% CI, -0.12-52.99). This study was conducted in selected European areas and showed that the incidence of severe photosensitivity reactions leading to hospitalization as well as the exposure rate to topical ketoprofen were low. Among topical NSAIDs, topical ketoprofen was the leading cause of photosensitivity reactions but accounted for a limited number of hospitalized cases. Probably most of the relevant reactions were managed in the outpatient setting and a community based case-control study is advisable