ABSTRACT
Psoriasis, a chronic inflammatory skin condition, and metabolic disorders, such as obesity, diabetes, and dyslipidemia, have long been recognized as distinct clinical entities. However, emerging evidence suggests a complex bidirectional relationship between these seemingly unrelated conditions. Psoriasis is characterized by an accelerated skin cell turnover, resulting in the formation of erythematous plaques with silvery scales. Metabolic disorders, on the other hand, encompass a range of conditions associated with abnormal metabolic processes, including insulin resistance, dyslipidemia, and chronic low-grade inflammation. It is intriguing to note that psoriasis is commonly associated with several metabolic comorbidities, with a higher prevalence observed in individuals with obesity, type 2 diabetes, and metabolic syndrome. Mounting evidence suggests that chronic inflammation plays a pivotal role in both psoriasis and metabolic disorders. Shared inflammatory mediators, such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP), have been implicated in the pathogenesis of both conditions. Moreover, adipose tissue-derived hormones, known as adipokines, including leptin and adiponectin, exert modulatory effects on immune responses and may contribute to the link between psoriasis and metabolic abnormalities. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search across databases identified 16 eligible studies (1975-2023), totaling 6,623,379 participants. Inclusion criteria encompassed peer-reviewed observational studies focusing on adults and specified outcomes. Data extraction, quality assessment (Newcastle-Ottawa scale (NOS)), meta-analyses, and heterogeneity evaluations were conducted using rigorous methods. Psoriasis displayed a significant association with diabetes mellitus (DM, 18% increased incidence), hypertension (HTN, 35%), hyperlipidemia (19%), and obesity (25%). Substantial heterogeneity was observed in meta-analyses, particularly for DM. The NOS indicated varied study quality, with some studies categorized as a high or moderate risk of bias.
ABSTRACT
Kaposi sarcoma is relatively common after solid organ transplantation, but very rare after hematopoietic stem cell transplant (HSCT). Here we are reporting a rare case of Kaposi sarcoma in a child after HSCT. An 11-year-old boy with Fanconi anemia was treated by haploidentical HSCT from his father. Three weeks after transplantation, the patient developed severe graft-versus-host disease (GVHD) which was treated by immunosuppressive therapy and extracorporeal photopheresis. Approximately 6.5 months after HSCT, the patient had asymptomatic nodular skin lesions over the scalp, chest, and face. Histopathological examination showed typical findings of Kaposi sarcoma. Later, additional lesions in the liver and oral cavity were confirmed. Liver biopsy was positive for HHV-8 antibodies. The patient was continued on Sirolimus which was already being used for the treatment of GVHD. Cutaneous lesions were also treated with topical timolol 0.5% ophthalmic solution. Within six months, cutaneous and mucous membrane lesions were completely resolved. Follow-up abdominal ultrasound and MRI showed the disappearance of the hepatic lesion.
ABSTRACT
Interleukin-12 RB1 (IL12RB1) deficiency falls under the Mendelian susceptibility to mycobacterial disease. It is a rare genetic disease with autosomal recessive inheritance. It is characterized by recurrent infections with otherwise weak bacteria, such as mycobacteria and Salmonella. Often, when encountering a maculopapular eruption, a drug-related cause comes to mind. However, we report a case of IL12RB1 deficiency presenting with a maculopapular eruption, proven by a skin biopsy to be leukocytoclastic vasculitis. The patient was given antibiotics, which improved her skin lesions. Vasculitis should be considered in the differential diagnosis in patients with IL12RB1 deficiency presenting with a cutaneous eruption.
ABSTRACT
BACKGROUND/OBJECTIVES: Acne vulgaris (AV) is the common form of acne, characterized by a polymorphic eruption of inflammatory non-papules, pustules, nodules, blackheads, and whiteheads. Acne was eighth among the top 10 disorders in terms of prevalence in 2010. The objective of this study was to see if there was any association between acne vulgaris and BMI in the young adult population. METHODS: This is a single-center retrospective study conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Adult patients diagnosed with acne vulgaris from January 2017 to June 2022 were enrolled. The estimated sample size was reached using consecutive, non-probability sampling. RESULTS: A total of 596 participants were selected as a match to the criteria of the research objectives. Of the participants, slightly more than half were males (52.5%) and the rest were females (47.5%). There was a nearly equal number of cases and controls, around 48.7% of the patients had acne while the rest did not. The majority were of the age group 18 to 19 years followed by 22 to 23 years (25.2%). A majority had a normal BMI of 18.5 to 24.9 (40.4%). A significant difference was found between the means of the BMI of the participants who had acne and those who did not (p<0.05). Conclusion: No significant association was found between age group, gender, BMI, and acne. To fully comprehend how dietary factors affect the severity of acne, more studies are required.
