RESUMO
Background and Objectives: Recently, the concept of “psoriatic march” has come to the fore, in which chronic cutaneous inflammation in psoriasis leads to systemic inflammation which, in conjunction with increased oxidative stress, triggers a cascade of events resulting in increased cardiovascular risk in patients with severe psoriasis. We, therefore, decided to study the levels of some biochemical cardiovascular risk markers: lipid peroxidation (malondialdehyde), lipoprotein (a), lipid indices and atherogenic index, in patients with psoriasis and their association with disease severity. Methods: Fortyfive patients with psoriasis and 45 age and gender‑matched healthy controls were included in this cross‑sectional study. Disease severity was assessed by the Psoriasis Area Severity Index (PASI). Serum malondialdehyde, lipoprotein (a) and fasting lipid profile were estimated in all study subjects. Lipoprotein ratios were computed using standard formulae. Atherogenic index was calculated as ratio of lipoprotein (a)/high‑density lipoprotein. Results: In psoriasis, we observed significantly higher levels of malondialdehyde, total cholesterol, low‑density lipoprotein cholesterol, non‑high‑density lipoprotein cholesterol, lipoprotein (a), lipid ratios, atherogenic index and comprehensive lipid tetrad index, compared to controls. These levels were directly proportional to disease severity. Serum levels of malondialdehyde correlated positively with serum lipoprotein (a), comprehensive lipid tetrad index and atherogenic index. Limitations: Different morphological types of psoriasis were not included and follow‑up post‑therapy was not done. A larger sample size would have validated the results further. Conclusion: Our results indicate that psoriasis, especially the severe variants, are associated with increased oxidative stress and dyslipidemia, which correlate positively with atherogenic index and hence, an increased cardiovascular risk.
RESUMO
Background: Even though seborrheic keratoses (SK) have been well characterized clinically and histopathologically, data regarding clinical and dermoscopic correlation of different types of SK are inadequate. Aims: We carried out a study to establish any correlation between the clinical and dermoscopic appearance of SK and its variants. Methods: This was a descriptive study conducted in the Department of Dermatology, a tertiary care institute, from August 2008 to June 2010. Patients with SK were evaluated with respect to age, sex, age of onset, duration, site of lesions, number of lesions, and morphology. Dermoscopy was performed in all cases. Results: A total of 250 cases of SK were recruited. A male-to-female ratio was 1:1.04. The most common age group affected by SK was 60 years and above (40%). The most common clinical variant was common seborrheic keratosis (CSK) (60%). Comedo-like openings (CL) (80%), fissures and ridges (FR) (52%), and sharp demarcation (SD) (83%) were consistent finding on dermoscopy in CSK. Dermatosis papulosa nigra (DPN) and pedunculated seborrheic keratoses (PSK) had characteristic CL and FR in both of them. Fingerprint (FP) (55%) and network-like (NL) (88%) structures were commonly seen in flat SK. Stucco keratoses demonstrated SD (100%) and NL structures (100%). Conclusions: The most common clinical variant of SK was CSK, followed by DPN, PSK, Flat SK, and stucco keratoses. Dermoscopic findings were consistent with those described in the literature.