Translation and validation of the Simplified Psoriasis Index (SPI) into Brazilian Portuguese

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.

Clinical features of von Zumbusch type of generalized pustular psoriasis in children: a retrospective study of 26 patients in southwestern China

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.

Psoriasis rupioides: una variante inusual de psoriasis / soriasis: an unusual variant of psoriasis

La psoriasis es una enfermedad cutánea inflamatoria crónica, recidivante, que afecta al 2% de la población. Se clasifica de acuerdo a su apariencia morfológica. Existen formas raras excesivamente hiperqueratósicas, entre ellas la variante rupioides, de la cual se han reportado pocos casos en la literatura. Presentamos un caso clínico de psoriasis rupiodes diseminada con buena respuesta al tratamiento sistémico con acitretin

Psoriasis is a relapsing chronic inflammatory skin disease affecting about 2% of population. It is classified according morphological appearance. There are exceedingly rare hyperkeratotic forms, including rupioid variant, which few cases have been reported in the literature. A case of widespread rupioid psoriasis with good response to systemic treatment with acitretin is presented.

Clinical features and severity of psoriasis: a comparison of facial and nonfacial involvement in Iran

Facial involvement in psoriasis is accomplished with poor prognosis. In this study, clinical features and severity of psoriasis were compared between facial and nonfacial psoriasis involvement groups in Iran. It also evaluated these characteristics in different subtypes of facial psoriasis. One hundred and thirty- eight psoriatic patients having referred to our clinic entered in this cross- sectional study in 2006 - 2007. Medical information, whole body and scalp Psoriasis Area and Severity Index [PASI] scores were obtained. Variables were compared between the facial and nonfacial involvement groups and also in different subtypes of the former including peripherofacial [PF], centrofacial [CF], and mixedfacial [MF]. A P-value of < 0.05 was considered as significant. We found 55.0% facial involvement in Iranian psoriatic patients. MF [52.6%], CF [28.9%], and PF [18.4%], respectively were the common forms of facial involvement. The median whole body and scalp PASI scores, the number of male participants, and tongue involvement were significantly higher in patients with facial involvement. Comparing different subtypes of facial psoriasis, whole body PASI and scalp PASI scores were significantly higher in MF subtype and lower in CF subtype. Despite the least severity in the latter subtype, psoriatic arthritis and geographic tongue were shown to be more common in this subtype. Moreover, relapse history was correlated with PF subtype. Facial involvement in psoriasis had significantly higher whole body and scalp PASI scores in Iran which may be an indication of more severe disease. This difference was more prominent in MF subtype

Terapia Biológica en Psoriasis / Biologic therapy in psoriasis

La psoriasis es una enfermedad inflamatoria crónica, medida inmunológicamente, de etiología desconocida que afecta del 1 al 3 por ciento de la poblalción mundial. Se caracteriza por la Hiperproliferación de queratinositos causada por la estimulación persistente de celulas T por inmunogenos de origen epidermico. Se asocia información dermica y secundariamente hiperplasia epidermica, suceptible de control mediante tratamiento médico prolongado, no curable, con grados diferentes de afectación. Existen múltiples tratamientos como son la terapia tópica, fototerapia y sistémica, con resultados variables. El desarrollo de la biología molecular, la ingeniería genética y biotecnología ha permitido la creación de moléculas dirigidas a etapas específicas de la patogenia de varias enfermedades mediadas por el sistema inmunitario. Estos elementos así obtenidos se denominan productos biológicos, y al uso de estos, terapia biológica. La terapia biológica en pacientes con psoriasis ha mostrado beneficios significativos con perfiles de tolerabilidad y seguridad satisfactorios. La limitación que la terapia biológica presenta dentro de las estrategias de tratamiento es definitivamente, su costo.

Psoriasis is a chronic inflammatory disease, immunologicaly mediated, of unknown etiology, affecting 1 to 3 per cent of the worldÆs population; is characterized by hiperproliferación of keratinocytes, caused by persistent stimulation of T cells by immunogens of epidermal origin, which associates skin inflammation and secondarily epidermal hyperplasia, which could control through prolonged medical treatment, not curable, with varying degrees of involvement. There are multiple treatments such as topical and systemic therapy, with varying results. The development of molecular biology, genetic engineering and biotechnology has enabled the creation of molecules aimed at specific stages of the pathogenesis of several diseases mediated by the immune system. These elements thus obtained are called biological products, and its use biological therapy. Biological therapy in patients with psoriasis has shown significant benefits with profiles of successful safety and tolerability. The restriction that the biological therapy introduced in the treatment strategies is definitely its cost.

Association of HLA class I and class II alleles with psoriasis vulgaris in Turkish population Influence of type I and II psoriasis

To investigate the role of human leukocyte antigen [HLA] in susceptibility to psoriasis vulgaris in the Northeast region of Turkey and to contribute to the data related to HLA and psoriasis. The study included 72 unrelated psoriatic patients [43 men and 29 women; aged 11-76 years] admitted to the Dermatology Department, University Research Hospital, Erzurum, Turkey between April 2002 and November 2003. We studied the distribution of HLA class I and II antigens in patients with psoriasis: 72 patients were divided into 2 groups according to the onset of psoriasis before age 40 years with family history [type I] and onset after age 40 without family history [type II]. The HLA class I and II antigens were analyzed using the PCR-SSP method in 72 patients and in 104 controls. We found an increase in HLA-A30 and A68, B7, Bl3, B57,Cw6, and DRB 107 antigens in psoriatic patients compared with controls. As we compared type I and type II psoriasis with control group, B57, Cw6 and DRB 107 alleles were more significant in patients with type I psoriasis. Our patients with type II psoriasis represented a significant association with the HLA-B13. Our findings along with previous HLA studies on psoriasis vulgaris patients from different racial groups showed that HLA-B57 and DRBI 07 alleles are associated with the disease

Comportamiento clínico epidemiológico de los pacientes con psoriasis atendidos en el centro nacional de dermatología "Dr. Francisco José Gómez Urcuyo" en el péríodo comprendido de abril 2004 a abril 2005 / The patients' epidemic clinical behavior with psoriasis assisted in the national center of dermatology Dr. Francisco José Gómez Urcuyo in the understood péríodo of April 2004 to April 2005

La psoriasis es una dermatosis crónica, recidivantes, que se caracteriza por la presencia de placas eritomnatosas y escamosas que ocasionan alteraciones en la calidad de vida del paciente. No existen datos epidemiológicos nacionales respecto a la psoriasis en Nicaragua. Se hizo un estudio descriptivo de corte transversal acerca del comportamiento clínicoepidemiológico de la psoriasis en el Centro Nacional de Dermatología "Dr. Francisco José Gómes Urcuyo" en el período comprendido de abril del 2004 a abril 2005 con un universo de 284 pacientes diagnósticados con psoriasis que asistieron a consulta externa y al programa de psicodermatosis y para la recolección de la información se elaboró una encuesta con preguntas cerradas y se revisaron expedientes clínicos del departamento de estadística del Hospital donde se lleno la ficha de recolección de la información. De los 284 pacientes estudiados, 162 pertenecian al sexo femenino y 122 al sexo masculino. El grupo etáreo más afectado fue el de 51 años a más. Los principales factores desencadenantes fueron el estrés, alcoholismo, fenómeno isomórfico y las infecciones en menor frecuencia, el 50 porciento de los pacientes encuestados (46) tuvieron antecedentes familiares. El 56.34 por ciento iniciaron su cuadro con psoriasis antes de los 40 años. El índice de severidad y área de psoriasis (PASI) fue de leve a moderado. La topografia más frecuente fue la forma diseminada y predominó la psoriasis en placa. Debemos continuar realizando determinaciones para tener nuestros propios marcadores para conocer el comportamiento real de la psoriasis en Nicaragua. Los resultados se encasillan dentro de los rangos de la epidemiología mundial...

An Inverse Relationship Between Ceramide Synthesis and Clinical Severity in Patients with Psoriasis

Ceramides play major roles in maintaining the epidermal barrier. It has been sus-pected that the depletion of ceramides, associated with disrupted barrier function in the epidermis, leads to the clinical manifestation of dryness and inflammation seen in patients with psoriasis. The aim of the present study was to determine the relation-ship between the level of ceramide synthesis in the epidermis and the clinical severity in patients with psoriasis. Samples from lesional and unlesional epidermis obtained from psoriasis patients were incubated with [14C]serine, an initiator of ceramide syn-thesis. otal ceramide was fractionated using high performance thin layer chromato-graphy, and the radioactivity was measured. The clinical severity of psoriasis was graded according to the psoriasis area and severity index scoring system. The level of ceramide synthesis in the lesional epidermis of patients was significantly lower than that in the unlesional epidermis and bore a negative correlation with the clinical severity of psoriasis. The present results suggest that the decreased level of ceramide synthesis in the epidermis contributes to the clinical severity of psoriasis.

Psoríase / Psoriasis

A psoríase é uma doença inflamatória crônica na qual há hiperproliferaçäo da epiderme, com manifestaçöes clínicas variadas. O tratamento deve ser individualizado, podendo-se usar agentes tópicos ou sistêmicos, isoladamente ou associados.(au)

Psoriasis pustulosa / Pustular psoriasis

En este artículo de revisión se analiza las distintas variedades clínicas de Psoriasis Pustular. La psoriasis pustular se subdivide de acuerdo a la extensión del compromiso y a su localización. Se discuten las características clínicas e histopatológicas de este tipo de psoriasis, con especial atención al diagnóstico diferencial y tratamiento

Psoriasis y metotrexato: 195 enfermos controlados durante 3 años / Psoriasis and methotrexate: 195 patients controlates during 3 years

En 10 años se estudiaron 195 enfermos con psoriasis que hubiesen completado tres años de tratamiento con metotrexato (MTX) a una dosis de 2,5 mg por día durante cinco días de cada semana en tres semanas, dejándose la cuarta para los exámenes clínicos y laboratoriales. No se efectuó punción hepática. No se eligió ni sexo ni edad, cuyo promedio fue de 38 años. No se admitieron los obesos, diabéticos, embarazadas, ni pacientes con análisis de laboratorio de rutina anormales: TGO, TGP, fosfatsa alcalina, uroanálisis y recuento de Addis. En el primer año de tratamiento los análisis se repitieron cada 6 meses, cada 4 meses en el segundo y cada 3 en el tercer año. El resultado del tratamiento considerado como curación ("blanquecimiento") se valoró por el enfermo y el médico. Los pacientes se dividieron en 5 grupos: a) sin ningún tratamiento previo, b) sin corticoides orales o inyectables aunque los hubiera usado en forma epitrópica, c) con corticoides orales y o inyectables y/o locales. A su vez estos grupos fueron considerados, d) en manifestaciones en el cuero cabelludo y e) con manifestaciones en el cuero cabelludo. Tanto los años los mejores resultados se lograron en los psoriácicos vírgenes de tratamiento y los peores en los que usaron corticoesteroides. Igual ocurrió en los que no tenían psoriasis del cuero cabelludo siendo menos favorables los que lo tenían afectado. De los 195 enfermos iniciales terminaron el tercer año de tratamiento 45 pacientes. Las curaciones totales en los cinco grupos fueron: 41,66 por ciento, 21,42 por ciento, 11,39 por ciento, 17,35 por ciento y 12,16 por ciento, respectivamente. No se diagnosticaron cirrosis hepáticas. Los efectos adversos fueron mínimos y se redujeron suspendiendo momentáneamente el tratamiento con MTX

Terapéutica de la psoriasis / Therapy for psoriasis

La psoriasis es una enfermedad de la piel que está caracterizada por su naturaleza crónica con recaídas y una gran variedad de manifestaciones cutáneas. Afecta aproximadamente entre el 1 y 2 por ciento de la población y aparece generalmente en la tercera década de la vida. La patogenia de la enfermedad no se comprende en su totalidad, pero dos mecanismos parecen ser importantes: la proliferación epidérmica y el proceso inflamatorio. Precisamente porque se desconoce la causa, múltiples tratamientos se han propuesto. En este trabajo se realiza una revisión sobre los tratamientos, tanto tópicos como sistémicos, haciendo énfasis en los mecanismos de acción, dosificación, efectos secundarios y las terapias de combinación más efectivas utilizadas para el tratamiento de esta enfermedad

Evaluation of psoralen with solar ultraviolet light (puvasol) and adjunctive topical tar therapy in psoriasis.

Fifty patients having psoriasis were studied with a view to assess the efficacy of 'puvasol' (Oral psoralen with sun-rays exposure) alone and in combination with topical tar therapy and were placed in 2 groups, each group being consisted of 25 patients. At the end of 8 weeks, out of 25 patients (Group 1) receiving 'Puvasol' in combination with topital tar therapy 15 patients (60%) showed complete clearance, marked improvement of lesions were seen in 4 cases (16%) and deterioration in one case (4%). Out of 25 patients (Group I) receiving 'Puvasol' alone 8 cases (32%) showed complete clearance of lesions and 11 patients (44%) showed marked im-provement of lesions. It is found that topical tar therapy when used as an adjunct to 'Puvasol' was more effective than 'Puvasol' alone.

Psoríase e acometimento articular / Psoriasis and articular involvement

Os autores apresentam a avaliaçäo de um grupo de 70 pacientes, com o diagnóstico clínico e histopatológico de psoríase, que foram atendidos conjuntamente pelos Serviços de Dermatologia e Reumatologia da Universidade Federal do Paraná. O estudo mostrou a alta incidência de queixas articulares neste grupo de pacientes (51,4%) e a comprovaçäo de artrite psoriásica em 10% dos casos