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1.
An. bras. dermatol ; 97(1): 63-74, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1360091

ABSTRACT

Abstract Generalized pustular psoriasis (von Zumbusch) is a rare and acute eruption characterized by multiple sterile pustules over an erythematous and edematous background, eventually associated with psoriasis vulgaris. Classically, it manifests as a potentially severe systemic picture and demands prompt diagnosis and intervention. The duration of each flare-up and intervals between the pustular episodes is extremely variable. Recently, genetic abnormalities have been identified mainly in the familial and early variants of this disease. The therapeutic arsenal is limited; however, new drugs being evaluated aim to control both pustular flare-ups and disease recurrences.


Subject(s)
Humans , Psoriasis/diagnosis , Psoriasis/drug therapy , Skin Diseases, Vesiculobullous , Exanthema , Acute Disease , Chronic Disease
4.
Medwave ; 20(8): e8021, 2020.
Article in Spanish | LILACS | ID: biblio-1128609

ABSTRACT

Un hombre de 44 años, previamente sano, consultó por poliartralgias asimétricas de características inflamatorias de tres meses de evolución, que comprometió pequeñas y grandes articulaciones. Poco tiempo después desarrolló pústulas periungueales sobre una base eritematosa y degeneración progresiva de la lámina ungueal del pulgar izquierdo, limitando severamente su funcionalidad. Destacó al examen físico la presencia de placas eritemato-escamosas y pustulosas bien delimitadas en el primer y tercer dedo de la mano izquierda con onicodistrofia severa, que fue un aspecto clave para establecer el diagnóstico de acrodermatitis continua de Hallopeau. Adicionalmente, se observaron otros hallazgos del espectro psoriático: parches eritematosos en el escroto, placas eritemato-escamosas con costras hemorrágicas en ambas rodillas y dactilitis. Se confirmó histológicamente el diagnóstico de psoriasis inversa, psoriasis en placas y psoriasis pustular, respectivamente y con los criterios de Classification Criteria for Psoriatic Arthritis, CASPAR, el diagnóstico de artritis psoriática.


A 44-year-old man, previously healthy, consulted for a three-month history of asymmetrical polyarthralgia with inflammatory features involving small and large joints. A few days later, he developed erythema covered by pustules in the nail folds and progressive degeneration of the nail plate of the left thumb, with severe functional limitation. The physical exam showed well-defined erythematous scaly and pustular plaques in the first and third fingers of the left hand, with severe onychodystrophy, which was a key aspect in the diagnosis of acrodermatitis continua of Hallopeau. Other signs of the psoriatic spectrum were observed: erythematous patches of the scrotum, erythematous scaly plaques with hemorrhagic crusts on both knees, and dactylitis. The diagnosis of inverse psoriasis, plaque psoriasis, and pustular psoriasis, respectively, were confirmed by histopathology and, with the CASPAR criteria, psoriatic arthritis. This case is of particular dermatological interest due to the variety of psoriatic manifestations recognized in a single patient and because of the poorly described association between acrodermatitis continua of Hallopeau with psoriatic arthritis.


Subject(s)
Humans , Male , Adult , Psoriasis/diagnosis , Acrodermatitis/diagnosis , Arthritis, Psoriatic/diagnosis , Psoriasis/pathology , Acrodermatitis/pathology , Arthritis, Psoriatic/pathology
5.
Rev. fac. cienc. méd. (Impr.) ; 16(1): 34-44, ene.-jun. 2019. graf
Article in Spanish | LILACS | ID: biblio-1024435

ABSTRACT

La psoriasis es una enfermedad que afecta al 2% de la población mundial. Es una enfermedad inflamatoria crónica manifestada en la piel con predisposición familiar, pero de causa desconocida. Objetivo:establecer la importancia de la nutrición y estilos de vida en personas que padecen esta enfermedad. Material y métodos: para la revisión de la bibliografía, se realizó una búsqueda en: PubMed, Lilacs, SciELO, Elsevier y otras en idioma inglés, portugués y español. Es importante la nutrición y los estilos de vida en esta enfermedad, sin embargo existen vacíos en el conocimiento que se relacionan a través de investigaciones que permiten un abordaje adecuado. Conclusión: los cambios en los estilos de vida son indispensables en las personas con esta enfermedad y se hace énfasis en dieta adecuada basada en los principios de la nutrición, que es fundamental en el tratamiento de la misma...(AU)


Subject(s)
Humans , Psoriasis/diagnosis , Nutritional Sciences , Healthy Lifestyle , Metabolic Syndrome
6.
An. bras. dermatol ; 94(2,supl.1): 76-107, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1011088

ABSTRACT

Abstract: Psoriasis is a chronic inflammatory disease that affects 1.3% of the Brazilian population. The most common clinical manifestations are erythematous, scaling lesions that affect both genders and can occur on any anatomical site, preferentially involving the knees, elbows, scalp and genitals. Besides the impact on the quality of life, the systemic nature of the disease makes psoriasis an independent risk factor for cardiovascular disease, especially in young patients with severe disease. By an initiative of the Brazilian Society of Dermatology, dermatologists with renowned clinical experience in the management of psoriasis were invited to form a work group that, in a partnership with the Brazilian Medical Association, dedicated themselves to create the Plaque Psoriasis Diagnostic and Treatment Guidelines. The relevant issues for the diagnosis (evaluation of severity and comorbidities) and treatment of plaque psoriasis were defined. The issues generated a search strategy in the Medline-PubMed database up to July 2018. Subsequently, the answers to the questions of the recommendations were devised, and each reference selected presented the respective level of recommendation and strength of scientific evidence. The final recommendations for making up the final text were worded by the coordinators.


Subject(s)
Humans , Male , Female , Psoriasis/diagnosis , Psoriasis/therapy , Phototherapy/methods , Psoriasis/epidemiology , Societies, Medical , Time Factors , Vitamin D/analysis , Severity of Illness Index , Brazil , Comorbidity , Anthralin/therapeutic use , Methotrexate/therapeutic use , Cyclosporine/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Dermatologic Agents/therapeutic use , Dermatology , Drug Combinations , Calcineurin Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use
7.
An. bras. dermatol ; 94(2): 224-226, Mar.-Apr. 2019. graf
Article in English | LILACS | ID: biblio-1001141

ABSTRACT

Abstract Psoriasis has been associated with various autoimmune diseases, however, its relation to bullous diseases is infrequent. Of these, bullous pemphigoid appears as the main associated entity, even though both conditions differ considerably in demographic and clinical aspects. We report the case of a 42-year-old female patient, with long-standing psoriasis who consulted due to the exacerbation of psoriatic plaques associated with generalized bullous lesions on the skin and oral mucosa, with one-week duration. With clinical signs and histopathological findings compatible with bullous pemphigoid associated with psoriasis, we decided to treat her with methotrexate 10mg a week. The patient had an excellent response after two months of treatment.


Subject(s)
Humans , Adult , Psoriasis/drug therapy , Methotrexate/therapeutic use , Pemphigoid, Bullous/drug therapy , Dermatologic Agents/therapeutic use , Psoriasis/complications , Psoriasis/diagnosis , Pemphigoid, Bullous/complications , Pemphigoid, Bullous/diagnosis , Treatment Outcome , Fluorescent Antibody Technique, Direct
9.
An. bras. dermatol ; 93(6): 813-818, Nov.-Dec. 2018. tab
Article in English | LILACS | ID: biblio-973641

ABSTRACT

Abstract: Background: The Simplified Psoriasis Index is a tool that assesses the current severity, psychosocial impact, past history and interventions in patients with psoriasis through separate components. Two versions are available, one in which the current severity of the disease is evaluated by the patient themselves and another by the physician. Objectives: Translate the Simplified Psoriasis Index into Brazilian Portuguese and verify its validity. Methods: The study was conducted in two stages; the first stage was the translation of the instrument; the second stage was the instrument's validation. Results: We evaluated 62 patients from Complexo Hospitalar Santa Casa de Porto Alegre and Hospital Universitário de Brasília. The Simplified Psoriasis Index translated into Portuguese showed high internal consistency (Cronbach test 0.68). Study limitations: Some individuals, because of poor education, might not understand some questions of the Simplified Psoriasis Index. Conclusions: The Brazilian Portuguese version of the Simplified Psoriasis Index was validated for our population and can be recommended as a reliable instrument to assess the patients with psoriasis.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Psoriasis/diagnosis , Psoriasis/classification , Translations , Severity of Illness Index , Brazil , Predictive Value of Tests , Surveys and Questionnaires , Reproducibility of Results , Sensitivity and Specificity , Cultural Characteristics , Language
10.
An. bras. dermatol ; 93(3): 447-448, May-June 2018. graf
Article in English | LILACS | ID: biblio-949876

ABSTRACT

Abstract: Tinea manuum is a dermatophytosis which is often mistaken for other keratodermas, especially palmar psoriasis and chronic hand eczema. We report the use of dermoscopy as a diagnostic aid in a case of tinea manuum. The dermoscopic clue turned out to be the presence of whitish scaling located mainly in the furrows. This aspect has never been seen in other keratodermas and therefore can be considered as a useful finding to assist in the recognition of tinea manuum.


Subject(s)
Humans , Female , Middle Aged , Tinea/diagnostic imaging , Dermoscopy , Hand Dermatoses/diagnostic imaging , Psoriasis/diagnosis , Diagnosis, Differential , Eczema/diagnosis
11.
Rev. chil. dermatol ; 34(4): 126-129, 2018. ilus
Article in Spanish | LILACS | ID: biblio-1117625

ABSTRACT

La Histiocitosis de Células de Langerhans (HCL) es una neoplasia mieloide de las células dendríticas Langerhans (CDL), caracterizada por acúmulos de células dendríticas mieloides CD207+. Corresponden a un espectro de enfermedades, desde sólo cutáneas a variantes multiorgánicas. El objetivo de este reporte es describir el caso clínico de un paciente pediátrico, con diagnóstico de Histiocitosis de Células de Langerhans, enfatizando el algoritmo clínico. Paciente masculino de 1 año y 5 meses, con antecedentes de otorrea persistente, refractaria a tratamiento, de un año de evolución. Consulta en policlínico de dermatología por "dermatitis severa" desde hace 1 año. Al examen físico se constatan lesiones tipo dermatitis seborreica generalizadas en tronco y cuero cabelludo, intertrigo fisurado, pápulas eritemato-costrosas plantares con petequias y pus en conducto auditivo externo bilateral. Presenta Hemoglobina 9,5 mg/dl, Hematocrito31,9%, leucocitos 12.400, linfocitos 33,3%, plaquetas 920.000, VHS 27. Subpoblaciones linfocitarias: CD3: 34,7%, C4: 22,7%, CD8: 9,7%, CD19:47,8%. HTLV negativo, VIH negativo. Acaro-test negativo. Dermatopatología: Denso infiltrado de células linfomonocíticas en dermis papilar, con ensanchamiento de estas y gran epidermotropismo, con abundante citoplasma eosinófilo con núcleos arriñonados, CD1a y langerina positivo. Recomendamos elevar la sospecha diagnóstica ante un cuadro de dermatitis seborreica generalizada que esta fuera del rango etario característico y en casos de dermatitis refractarias, donde a pesar de un adecuado tratamiento médico, el paciente persiste comprometido.


Langerhans Cell Histiocytosis (HCL) is a myeloid neoplasm of Langerhans dendritic cells (CDL), characterized by accumulations of myeloid dendritic cells CD207 +. They correspond to a spectrum of diseases, from cutaneous to multi-organ variants. The objective of this report is to describe the clinical case of a pediatric patient with diagnosis of, emphasizing the clinical algorithm. Male patient,1 year and 5 months old, with a history of refractory persistent otorrhea, consulted because of long term severe dermatitis. Physical examination revealed generalized seborrheic dermatitis lesions on the trunk and scalp, cleft intertrigo, plantar erythematous-crusted papules with petechiae, and pus in the external auditory canal. Laboratory findings showed: Hemoglobin 9.5 mg / dl, Hematocrit: 31.9%, leukocytes: 12,400, lymphocytes 33.3%, platelets: 920,000, HSV 27. Lymphocyte subpopulations: CD3: 34.7%, C4: 22.7%, CD8: 9.7%, CD19: 47.8%. HTLV negative, HIV negative. Scabies Negative. Dermatopathology: Dense infiltrate of lymphomonocytic cells in the papillary dermis with widening of the papilla and large epidermotropism, cells show abundant eosinophilic cytoplasm with "kidney nuclei", CD1a and langerin were positive. We recommend elevating the diagnostic suspicion in the face of a generalized seborrheic dermatitis that is outside the characteristic age range and in cases of refractory dermatitis, where the patient persists compromised.


Subject(s)
Male , Infant , Histiocytosis, Langerhans-Cell/complications , Dermatitis, Seborrheic/diagnosis , Dermatitis, Seborrheic/etiology , Pityriasis Rubra Pilaris/diagnosis , Psoriasis/diagnosis , Langerhans Cells/pathology , Dermatitis, Atopic/diagnosis , Diagnosis, Differential
12.
Rev. méd. hondur ; 85(3/4): 103-107, jul.-dic. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-970191

ABSTRACT

Antecedentes: La psoriasis es una enfermedad inmune crónica con manifestaciones dermatológicas y articulares. Puede presentarse a cualquier edad pero ocurre con mayor frecuencia en dos picos: 20-30 años y 50-60 años. Tiene un componente genético fuerte porque aproximadamente el 30% de los pacientes tienen un familiar de primer grado con la enfermedad, y sus hijos pueden de-sarrollar artritis psoriásica sin alteraciones cutáneas. El paciente experimenta pocos periodos de remisión espontanea.Caso clínico: Mujer de 39 años, ama de casa del casco rural de Tela, diagnosticada con psoriasis hace 7 años. Acude a consulta en buen estado general sin secuelas psicológicas, con lesión en placa localizada en codo derecho con área afectada del 4% y eritrodermia psoriásica que cubre la totalidad del abdomen en un 9% de la supericie corporal. Reiere mejoría con los productos naturales. Actualmente con sobrepeso (27 IMC) y con hipertensión sistólica aislada (140/82 mmHg) sugerente de ateroesclerosis. Discusión: Se deben tomar en cuenta los aspectos psico-sociales y metabólicos que afectan la calidad de vida de estos pacientes, para tratarlos de forma inte-gral con un grupo multidisciplinario. El médico general puede manejar la psoriasis en casos concretos como las placas localizadas ≤ 5% del BSA, en los cuales el tratamiento indicado es tópico con corticoesteroides de alta potencia como primera línea. Para todo lo demás, el paciente con psoriasis debe ser evaluado por un dermatólogo.


Subject(s)
Humans , Female , Adult , Psoriasis/diagnosis , Skin Diseases/complications , Adrenal Cortex Hormones/pharmacology , Dermatitis, Exfoliative/complications
13.
An. bras. dermatol ; 92(5): 682-685, Sept.-Oct. 2017. tab, graf
Article in English | LILACS | ID: biblio-887043

ABSTRACT

Abstract: Inflammatory linear verrucous epidermal nevus and linear psoriasis are sometimes hard to differentiate clinically and pathologically. Although immunohistochemical expression of keratin 10 (K10), K16, Ki-67, and involucrin may be useful for differentiating both entities, these results have been reported in only a few cases. We collected data from 8 patients with inflammatory linear verrucous epidermal nevus, 11 with psoriasis vulgaris, and 8 healthy controls and evaluated immunohistochemical expression of Ki-67, K16, involucrin, and filaggrin among them. Ki-67 and K16 overexpression was similar in inflammatory linear verrucous epidermal nevus and psoriasis vulgaris compared with normal skin. Although staining for involucrin showed discontinuous expression in parakeratotic regions in 4 inflammatory linear verrucous epidermal nevus cases, it was continuous in the other 4 cases and in all psoriasis vulgaris cases. Filaggrin expression was present in hyperkeratotic regions but scarce in parakeratotic areas in both inflammatory linear verrucous epidermal nevus and psoriasis vulgaris. The immunostaining pattern of Ki-67, K16, involucrin, and filaggrin may be insufficient to discriminate inflammatory linear verrucous epidermal nevus from psoriasis vulgaris.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Protein Precursors/analysis , Psoriasis/diagnosis , Ki-67 Antigen/analysis , Keratin-16/analysis , Nevus, Sebaceous of Jadassohn/diagnosis , Intermediate Filament Proteins/analysis , Psoriasis/pathology , Immunohistochemistry , Biomarkers/analysis , Case-Control Studies , Diagnosis, Differential , Nevus, Sebaceous of Jadassohn/pathology
14.
An. bras. dermatol ; 92(3): 319-322, May-June 2017. tab
Article in English | LILACS | ID: biblio-886975

ABSTRACT

Abstract Background: Von Zumbusch type of generalized pustular psoriasis is a rare variant of psoriasis in children. It can occur in patients with or without psoriasis vulgaris. Objective: The aim of the study was to discuss the precipitating factors, clinical manifestations, laboratory data and therapy of von Zumbusch type of generalized pustular psoriasis in children from southwestern China and to improve the diagnosis and treatment level. Methods: A retrospective analysis was conducted for inpatients aged 14 years old or less with von Zumbusch type of generalized pustular psoriasis in our department from 2005 to 2014. Results: A total of 26 patients were included, of whom four (15.38%) had previous history of psoriasis vulgaris and one (3.85%) had previous history of psoriasis arthropathica. Mean onset age was 6.90 years. Gender distribution was equivalent. Incidence of the disease in summer and autumn was higher than that in winter and spring. Nineteen (73.08%) cases were triggered by infection, two (7.69%) cases were caused by sudden discontinuation of systemic use of corticosteroid. Twenty-four (92.31%) cases had concomitant fever. The initial lesion manifested as non-follicular sterile pustules on erythema. Sixteen patients responded well to acitretin, 11 to Tripterygium wilfordii Hook F (TwHF), two to cyclosporine, and one to methotrexate. Study limitations: This study is a retrospective one and the number of cases is small. CONCLUSION: Von Zumbusch type of generalized pustular psoriasis is a rare disease in children, infection is the most common precipitating factor, acitretin is the first-line therapy, traditional Chinese medicine TwHF also can be used.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Psoriasis/diagnosis , Psoriasis/drug therapy , Psoriasis/classification , Psoriasis/etiology , China , Methotrexate/therapeutic use , Retrospective Studies , Cyclosporine/therapeutic use , Acitretin/therapeutic use
15.
An. bras. dermatol ; 91(5): 664-666, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-827756

ABSTRACT

Abstract: Generalized pustular psoriasis, or psoriasis of von Zumbusch, is an acute and severe clinical form of psoriasis, which usually occurs in patients with psoriasis undergoing aggravating factors. In this work, we report the case of a female patient, 70 years old, who developed generalized pustular psoriasis symptoms while reducing the dose of oral corticosteroids, improperly introduced for the treatment of alleged acute generalized exanthematous pustulosis. The differential diagnosis of generalized pustular psoriasis should be made with other pustular dermatoses, such as subcorneal pustulosis, IgA pemphigus and especially with acute generalized exanthematous pustulosis. Personal history of psoriasis and histopathological findings with psoriasiform changes and subcorneal pustule favored the diagnosis. She was treated with acitretin 30 mg / day, progressing to complete regression of the lesions.


Subject(s)
Humans , Female , Aged , Psoriasis/etiology , Steroids/administration & dosage , Prednisone/administration & dosage , Psoriasis/diagnosis , Psoriasis/drug therapy , Acitretin/therapeutic use , Dose-Response Relationship, Drug , Keratolytic Agents/therapeutic use
17.
Bogotá; s.n; 2016. 103 p. tab, graf.
Thesis in Spanish | LILACS, MTYCI | ID: biblio-879455

ABSTRACT

La psoriasis es una enfermedad dermatológica principalmente inmunitaria que se puede desencadenar por diferentes factores, esta patología es de gran importancia médica ya que compromete la calidad de vida de la persona. La psoriasis es una enfermedad que puede tener dificultad en el enfoque diagnóstico por los casos atípicos de su presentación y puede ser confundida con otras patologías. El estudio de la semiología homeopática tiene su complejidad al traducir lo que el paciente expresa en su propio lenguaje al lenguaje homeopático y más específicamente al lenguaje del Repertorio. Ante esto se necesita un conocimiento claro de los síntomas tanto subjetivos como objetivos de la psoriasis. También surgen dificultades al estudiar aisladamente los síntomas, pues ellos forman parte de una totalidad y la mayoría de las veces se asocian e interrelacionan armónicamente dando una imagen coherente, un perfil definido. En este trabajo se presenta una revisión sistemática de la literatura, de tipo cualitativo, narrativo y documental realizado a partir de la búsqueda de síntomas en el repertorio Syntesis asociados con la psoriasis, así como la revisión de las materias médicas de Boericke, Kent, Lathoud, Vannier y Vijnovsky; haciendo énfasis en la condición clínica en estudio. Finalmente se presenta la repertorizacion de un caso de psoriasis


Subject(s)
Humans , Diagnoses in Homeopathy , Homeopathic Semiology , Psoriasis/diagnosis , Homeopathic Repertory , Complementary Therapies
18.
Rev. Soc. Peru. Med. Interna ; 28(3): 121-131, jul.-sept.2015. tab, graf
Article in Spanish | LILACS, LIPECS | ID: lil-786555

ABSTRACT

Determinar las características clínico-epidemiológicas de los pacientes con psoriasis y su frecuencia de asociación con insulinorresistencia en el servicio de Dermatología del Hospital Nacional Guillermo Almenara lrigoyen. METODOLOGÍA. Estudio analítico, transversal, en el que se evaluaron 147 pacientes con diagnóstico clínico y/o patológico de psoriasis que fueron atendidos durante los meses de diciembre del 2011 a mayo del 2012, a quienes se les entrevisto y evaluó para obtener datos clínicos referentes a su enfermedad y se les realizo mediciones de PASI, DLQI y glicemia e insulina séricas en ayunas con 10 cual se obtuvo el índice HOMA de cada uno. Las variables fueron finalmente analizadas en el programa estadístico SPSS versión 12.0 para Windows. RESULTADOS. De Los 147 evaluados, 70 % fueron varones, con una edad promedio de 56,9 años, 90 % provenían de Lima capital, 72 % eran casados y 58 % presentaban fototipo IV, la edad de inicio de enfermedad promedio fue de 41,4 años, la forma vulgar 0 en placas fue la más frecuente con 89 % de presentación seguida de la forma gutata (8%), La comorbilidad más frecuente fue la dislipidemia, 20,4 % presentaron artritis psoriática, según los criterios aplicados, 71 % presentaron psoriasis grave; 78 % presentaban alguna forma de sobrepeso u obesidad; 46 % de pacientes psoriáticos presentaron insulinorresistencia y se encontró un incremento del riesgo de presentar insulinorresistencia en psoriáticos graves, con un OR de 4,4 (IC 95%: 1,3-14,9 p = 0,02). En cuanto al tratamiento, 97 % utilizaron alguno tópico y el tratamiento sistémico más usado fue la acitretina. CONCLUSIONES. Las características clínicas y epidemiológicas halladas en los pacientes con psoriasis son comparables a las de otros estudios latinoamericanos. Los pacientes con psoriasis grave tienen mayor probabilidad de presentar insulinorresistencia...


To determine clinical and epidemiological characteristics of patients with the diagnosis of psoriasis and its association to insulin resistance in dermatology service of the Hospital Nacional Guillermo Almenara Irigoyen. METHODS. A transversal, analytic study was performed in 147 psoriatic patients between December 2011 and May 2012. We obtained clinical data, also PASI, DLQI tests and fast glycemia and insulin laboratory tests, in order to calculate HOMA-IR index. RESULTS. 70% were males, mean age was 56,9 years-old, 90 % came from Lima, 58 % were phototype IV, 41, 4 years was the mean start of disease age, psoriasis in plaques was the most frequent type (89 %)followed by gutata type (8 %), dyslipidemia was the most frequent comorbidity, psoriatic arthritis was present in 20,4 %, 7 J % have a severe form of psoriasis, 97 % used topical therapy and acitretin was the most frequent systemic therapy. Seventy eight percent were overweight or obese people, 46 % had insulin resistance, there was a higher insulin resistance risk in severe psoriatic (OR: 4,4, Cl 95%;1,3-14,9 p = 0,02). CONCLUSIONS. Clinical and epidemiological characteristics in this group of Peruvian psoriatic patients are similar to the other Latin american countries. Severe psoriatic patients have higher risk of insulin resistance...


Subject(s)
Humans , Psoriasis , Psoriasis/complications , Psoriasis/diagnosis , Psoriasis/pathology , Insulin Resistance , Cross-Sectional Studies
20.
Indian J Dermatol Venereol Leprol ; 2015 Mar-Apr; 81(2): 166-169
Article in English | IMSEAR | ID: sea-158271

ABSTRACT

Introduction: Autoimmune polyendocrine syndrome type I (APS I) is an autosomal recessive systemic autoimmune disorder, affecting primarily endocrine glands, in which chronic mucocutaneous candidiasis is an early and prominent manifestation. We describe the rare occurrence of unstable psoriasis (with onset of pustular lesions) in a case of APS I without mucocutaneous candidiasis. A patient presenting with unstable psoriasis (with onset of pustular lesions) was detected to have persistent hypocalcemia which led to the diagnosis of hypoparathyroidism. Subsequently he was found to have hypergonadotrophic hypogonadism, primary adrenal insuffi ciency (compensated), and coeliac disease, thus confi rming the diagnosis of APS I. Psoriasis is very rarely reported in APS I, possibly due to the protective effect of antibodies to Th17 cytokines, which are responsible for the occurrence of candidiasis in this syndrome. However, psoriasis could occur in APS I patients without mucocutaneous candidiasis, who lack these antibodies. In our patient, possible factors aggravating psoriasis include hypocalcemia due to hypoparathyroidism as well as coeliac disease via anti-tissue transglutaminase antibodies. However, defi ning psoriasis as a possible minor component of APS I would require further studies of the autoimmune regulator (AIRE) gene functions.


Subject(s)
Adult , Candidiasis/complications , Humans , Male , Polyendocrinopathies, Autoimmune/classification , Polyendocrinopathies, Autoimmune/complications , Psoriasis/diagnosis , Psoriasis/etiology
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