Serum angiotensin converting enzyme in patients with psoriasis

Controversial data concerning the elevation of serum angiotensin-converting enzyme in psoriasis are reported in the literature. In order to verify whether this abnormality exists in Iranian patients, we performed this study. Serum angiotensin-converting enzyme level was measured in 40 psoriatics. According to clinical forms of psoriasis, patients were further divided into three groups: common plaque type [n=24], pustular psoriasis [n=10] and erythrodermic psoriasis [n=6]. Serum angiotensin-converting enzyme shows some increase in patients with psoriasis; the greatest increase in serum angiotensinconverting enzyme level was observed in patients with erythrodermic psoriasis. Our results suggest that angiotensin-converting enzyme may have a role in the aetiopathogenesis of psoriasis but further studies are warranted to evaluate the possible role of this enzyme in psoriasis

Staphylococcus aureus carriage in patients with psoriasis

The aggravating role of Staphylococcus aureus is well known in atopic dermatitis but has not yet been proven in psoriasis. The role of Staphylococcus aureus superantigens is emphasized in the initiation, maintenance and complications of psoriasis. We investigated the frequency of nasal, axillary, and perineal carriage of Staphylococcus aureus [SA] in patients with psoriasis and its possible influence on the severity of the disease. One hundred patients with the clinical diagnosis of psoriasis participated in the study. Cultures of the bacterial flora were obtained from the right and left axilla and nasal nares and perineum, inoculated on standard bacterial medium [blood agar], and incubated at 37°C degrees for 48 h. One hundred patients with the clinical diagnosis of psoriasis [42% female and 58% male] comprised the study group. Mean age of the patients was 41.1 +/- 17.1 years. About 42% of the patients carried S. aureus; of these, 32% were from the nose, 13% from axilla, and 11% from the perineum. Three patients were carriers in all 3 sites. There was no significant difference in the severity of the disease between the carriers and non-carriers measured by the psoriasis area and severity index [PASI] score. According to our findings, S.aureus carriage in psoriasis had no significant influence on disease severity. It might be relevant for a subgroup of patients only when superantigen productions are found

Does short-term low-dose methotrexate treatment affect homocysteine blood level in patients with psoriasis?

An elevated homocysteine level is an independent risk factor for cardiovascular disorders. Psoriatic patients have an increased risk of cardiovascular diseases; In addition, hyperhomocysteinemia is a complication of methotrexate treatment. We undertook a study to evaluate the plasma levels of homocysteine, vitamin B12 and folate in patients with psoriasis before and after short-term low-dose methotrexate treatment. Twenty six patients with psoriasis were recruited. The plasma levels of homocysteine, vitamin B12 and folate were evaluated before and 8 weeks after methotrexate therapy [in the peak of methotrexate effect]. No significant difference was found between the plasma profile of homocysteine, vitamin B12 and folate before and after methotrexate treatment. In the short-term treatment of psoriasis, methotrexate does not increase homocysteine level

Case: multiple painful nodules on the back

A 43-year-old middle-eastern woman was visited with a 15-year history of multiple painful cutaneous nodules on her back. The first lesion appeared on her back when she was 28 years old. As she aged, the lesions became larger, more numerous, and more painful with cold or physical contact. Her medical history was not significant. The patient's medications included naproxen, calcium-D, and vitamins. Her family history was notable as her brother had developed similar cutaneous lesions. Physical examination revealed more than 30 pinkish papules, measuring up to 1 cm in diameter, in a grouped arrangement on her back [Figure 1]. The complete blood cell count, serum chemistry profile, and serum erythropoietin levels were within normal limits. Abdominal ultrasonography was normal. A skin biopsy specimen was obtained from a nodule on her back [Figure 2]

case of lipomembranous panniculitis associated with rheumatoid arthritis

Lipomembranous panniculitis is a special type of fat necrosis which has been associated with several clinical conditions, mainly chronic venous insufficiency and connective tissue disorders such as lupus profundus, morphea, systemic sclerosis, and dermatomyositis .We report a 50 year old woman with known rheumatoid arthritis who presented with a painful indurated erythematous plaque on her right leg. Histologic examination demonstrated cystic areas of fat necrosis lined by wavy eosinophilic hyaline membrane with convoluted projections of the membrane into the cysts. This finding is diagnostic of lipomembranous panniculitis. To our knowledge, this is the first report on lipomembranous panniculitis associated with rheumatoid arthritis

Interplay among antioxidants and oxidants in psoriasis

The etiology of psoriasis, a chronic inflammatory skin disease, has not been elucidated. However, Oxidant / antioxidant imbalance is suspected. The aim of this study was to evaluate oxidant / antioxidant status in psoriatic patients. Forty two psoriatic patients and 42 age and sex matched controls were recruited for this study. Serum total antioxidant capacity [TAC], oxidized light density lipoprotein [Ox-LDL] and malondialdehyde [MDA] levels were determined. A statistically significant increase in the serum level of MDA was found between patients and controls. No significant difference was found in the serum levels of other parameters in the two groups. Our results supported the hypothesis of an imbalance between oxidants and antioxidants in psoriasis and pointed to the probability of an increased risk of cardiovascular diseases in psoriatic patients

Adult Case of Hydroa Vacciniforme

Hydroa vacciniforme [HV] is a rare acquired photodermatosis, usually with onset in childhood and characterized by vesicles, crust and scar formation that follow exposure to sunlight.Vacciniform scars of face and dorsa of the hands are common features but oral ulcer and eye signs also rarely occur. It usually resolves before adult age. A rare manifestation of the disease would be persistence until adult age which is presented in this report

Case: erosive nodule on the vulval skin

A 64-year-old Iranian woman presented with a genital erosive skin lesion that she had noticed from two years ago. On physical examination, a 20 to 25 millimeter purplish lesion was observed on the vulval skin [Figure 1]. The indurated lesion showed a small central erosion measuring 3 to 5 mm. Inguinal lymph nodules were not palpable. A skin biopsy specimen was obtained from the eroded lesion [Figure 2]