ABSTRACT
BACKGROUND: Psoriasis is associated with increased risk of cardiovascular morbidities, especially in severe cases. Severity of the disease has been known to be associated with higher prevalence of these risk factors. However, in the absence of robust measurements, studies to date relied mostly on treatment spectrum as a proxy for the severity. OBJECTIVE: To evaluate the relationship between psoriasis area and severity index (PASI) and cardiovascular risk factors in Korean patients. METHODS: Presence of diabetes mellitus (DM), hypertension, smoking history was surveyed through questionnaires and serum lipid profile analysis were done after fasting overnight. The severity of psoriasis was assessed using PASI scores: mild, <10; moderate to severe, ≥10. Cardiovascular risk factors such as smoking, hypertension, diabetes and dyslipidemia were compared between the mild group and moderate to severe group. The prevalence of diabetes and hypertension was compared among these two groups of psoriasis patients and the general population based control; age and gender were matched among three groups accordingly prior to analysis. RESULTS: A total of 256 patients with plaque type psoriasis were included. Between mild group and moderate to severe group, significant differences of cardiovascular risk factors including lipid profile were not discovered except in triglyceride level. Comparing to general population, prevalence of diabetes was found significantly higher in psoriasis patients while that of hypertension was similar. CONCLUSION: Our results suggest that among cardiovascular risks, presence of DM and triglyceride level seem to be associated with the presence of psoriasis in Korean psoriasis patients, while other factors may not contribute meaningfully.
Subject(s)
Humans , Diabetes Mellitus , Dyslipidemias , Fasting , Hypertension , Prevalence , Proxy , Psoriasis , Risk Factors , Smoke , Smoking , TriglyceridesABSTRACT
BACKGROUND: Kruppel-like factor 4 (KLF4) is a transcription factor that regulates a diverse array of cellular processes, including development, differentiation, proliferation, and apoptosis. Although its function in keratinocytes has been widely studied, its exact role in psoriasis has not been elucidated. OBJECTIVE: We designed this study to investigate epidermal expression levels of KLF4 and the change in KLF4 expression after treatment in patients with psoriasis. METHODS: We compared the expression levels of KLF4 in the basal, suprabasal, and superficial epidermal layers, in psoriatic lesional, non-lesional, and normal skin, using an immunoreactivity intensity distribution index (IRIDI). In addition, we measured the change in KLF4 expression on the basis of the IRIDI and by reverse transcription polymerase chain reaction (RT-PCR) analysis after treatment. RESULTS: The combined IRIDI scores in psoriatic lesional skin were significantly higher than the scores in both non-lesional and normal skin. The psoriatic epidermis, particularly the suprabasal layer, showed a significantly increased IRIDI score compared to that of non-lesional and normal skin, which was significantly decreased after treatment. RT-PCR analysis exhibited a slight increase in KLF4 mRNA expression level after treatment; however, this increase was not significant. CONCLUSION: These data indicate that KLF4 could regulate epidermal proliferation and differentiation. Moreover, we believe that KLF4 may play an important role in the physiological reaction to counteract abnormal differentiation and proliferation of keratinocytes.
Subject(s)
Humans , Apoptosis , Epidermis , Keratinocytes , Polymerase Chain Reaction , Psoriasis , Reverse Transcription , RNA, Messenger , Skin , Transcription FactorsABSTRACT
BACKGROUND: The age-associated loss of subcutaneous fat with the accumulation of visceral fat consequently leads to several deleterious health outcomes such as dyslipidemia, insulin resistance, and metabolic syndrome. A recent research has shown that acute ultraviolet (UV) irradiation can reduce subcutaneous fat. OBJECTIVE: The purpose of our study is to investigate whether chronic UV radiation can reduce subcutaneous fat, increase visceral fat, and lead to additional metabolic changes. METHODS: We analyzed the abdominal computed tomography images of the 98 subjects attending our health examination center to calculate the amount of subcutaneous fat and visceral fat. Questionnaire surveys were conducted to analyze the degree of daily UV exposure, sunscreen use, and physical activity. Weight, height, blood pressure (BP), liver function test, lipid profiles, and glucose metabolism were also assessed. RESULTS: In the analysis of covariance adjusted for age, sex, and physical activity, the visceral fat amount in the high UV exposure group was significantly higher than that in the low UV exposure group (p=0.043), and the subcutaneous/total fat ratio in the high UV group was significantly lower than that in the low UV group (p=0.048). The high UV group had higher levels of fasting insulin, homeostasis model assessment of insulin resistance, systolic BP, and diastolic BP than the low UV exposure group (p=0.039, 0.012, 0.004, and 0.002, respectively). CONCLUSION: Our results suggest that chronic UV radiation could change body fat distribution and lead to additional changes, including changes in glucose metabolism and BP.
Subject(s)
Blood Pressure , Body Fat Distribution , Cross-Sectional Studies , Dyslipidemias , Fasting , Glucose , Homeostasis , Insulin , Insulin Resistance , Intra-Abdominal Fat , Liver Function Tests , Metabolism , Motor Activity , Subcutaneous Fat , Surveys and QuestionnairesABSTRACT
A 32-year-old man is being presented with a 1-week history of erythematous annular flat plaque with scales on his scalp. He displays only a solitary skin lesion on his scalp without any presence or other histories for other skin lesions or constitutional symptoms. It is difficult to consider the possibilities of syphilis based on such clinical findings. A diagnosis of syphilid is being made on the basis of clinical, serological and histological findings. Herein, we report an interesting case of secondary syphilis which is presented as a solitary annular plaque on the scalp.