Prevalence of metabolic syndrome in patients with psoriasis.

BACKGROUND: Psoriasis is a chronic inflammatory skin disorder in which proinflammatory cytokines including IL-6 and TNF-α increase both locally and systematically. It is thought that chronic inflammation results in metabolic diseases and proinflammatory cytokines give rise to the development of atherogenesis, peripheral insulin resistance, hypertension, and type 2 diabetes. Our aim was to investigate the prevalence of metabolic syndrome in patients with psoriasis vulgaris. METHODS: Study consisted of 115 plaque-type psoriasis patients and 140 healthy individuals. Data including body weight, height, waist circumference, body-mass index, and arterial blood pressure were collected. Fasting blood glucose, triglyceride, and HDL levels were determined. International Diabetes Federation Criteria for Metabolic Syndrome and Insulin Resistance were used for evaluating patients with metabolic syndrome and diabetes. RESULTS: Compared to the control group, metabolic syndrome, diabetes mellitus, and hypertension were found to be higher in psoriasis patients. Metabolic syndrome was increased by 3-folds in psoriasis patients and was more prevalent in women than in men. It was determined that the prevalence of metabolic syndrome was higher in psoriasis patients after the age of 40. Metabolic syndrome was not related to smoking, severity of psoriasis, and duration of disease. CONCLUSIONS: Our findings suggest that psoriasis preconditions occurrence of a group of diseases such as diabetes mellitus, hypertension, and metabolic syndrome. For this reason, patients with psoriasis should be treated early and they should be followed with respect to metabolic diseases.

Autologous whole blood and autologous serum injections are equally effective as placebo injections in reducing disease activity in patients with chronic spontaneous urticaria: a placebo controlled, randomized, single-blind study.

BACKGROUND: Recent demonstration of circulating anti-IgG antibodies towards IgE and its receptor (FcϵRI) has led to an interest in inducing tolerance to circulating histamine-releasing factors with autologous blood injections as a treatment option in chronic spontaneous urticaria (CU). The aim of the study was to assess the efficacy of autologous whole blood (AWB) and autologous serum (AS) injections in patients with CU compared to placebo. METHODS: A total of 88 CU patients with (+) autologous serum skin test (ASST) (59) and (-) ASST (29) were randomized into three parallel subgroups and were treated with weekly injections of AWB, AS or placebo for 10 weeks. Clinical assessments included urticaria activity score (UAS) and dermatology life quality index. RESULTS: In ASST (+) patients, the percentages of patients with >30% improvement in UAS and DLQI were 85% and 90% in AWB group, 65% and 65% in AS group and 79% and 90% in placebo group, respectively. In ASST (-) patients, these figures were 67% and 89% in the AWB group, 80% and 80% in the AS group and 60% and 70% in the placebo group. The intergroup difference for complete subsidence was not statistically significant. CONCLUSIONS: Even though we could not show a better efficacy than placebo, autohemotherapy resulted in a marked decrease in disease activity and improvement in quality of life scores in CU patients.

Primary cutaneous follicle center lymphoma responsive to interferon alfa-2a.

Follicular lymphoma is the most common type of primary cutaneous B-cell lymphomas with a predilection for the scalp, forehead, and trunk. Herein we report a case of primary cutaneous follicle center lymphoma on the scalp of 72-year-old female. The diagnosis was made histopathologically, confirming the presence of centrocytes and centroblasts. Complete resolution was achieved following administration of subcutaneous interferon α-2a at a dose of 4.5 × 106 IU three times weekly for 3 months.

Cutaneous CD4+/CD56+ hematodermic neoplasm.

CD4+/CD56+ hematodermic neoplasm, formerly known as blastic NK cell lymphoma, is a rare and aggressive neoplasm with a high incidence of cutaneous involvement, risk of leukemic dissemination and poor prognosis. The characteristic features are expression of the T helper inducer cell marker CD4 and the NK-cell marker CD56 in the absence of other T cell or NKcell specific markers. Because of the rarity of this disease, we describe a 48 year old woman suffering from CD4+/CD56+ hematodermic neoplasm on her cheek without leukemic infiltration.

An unusual vascular tumor: verrucous hemangioma.

Verrucous hemangioma is an uncommon capillary or cavernous hemangioma with reactive epidermal changes of hyperkeratosis, acanthosis, and papillomatosis. These growths are usually located on the lower extremities and involvement is generally unilateral. A diagnosis of verrucous hemangioma should be considered in lesions especially with a hyperkeratotic nodular appearance located on the lower extremities.

Periumbilical perforating pseudoxanthoma elasticum.

A 58-year-old, gravida 6, obese woman presented with a pruritic yellowish plaque around the umbilicus, which first appeared about 3 years ago. She also had flat yellow papules on the axilla and neck. After a burn from a heating device, a few perforating papules and a violaceous hue occurred on the plaque. Histological examination revealed pathological elastic fibers with a keratotic plug and perforation in the deep dermis, which was consistent with perforating pseudoxanthoma elasticum. This case indicates that perforating pseudoxanthoma elasticum, a variant of hereditary pseudoxanthoma elasticum may perforate due to mechanical factors.

Multiple warty dyskeratomas on the scalp.

Warty dyskeratoma is usually characterized by solitary papules or nodules which reveal acantholytic dyskeratosis histopathologically. Warty dyskeratoma most commonly presents as a single lesion, but there are a few case reports of patients with multiple lesions. Herein we report a female patient presenting with multiple verrucous papules on the scalp diagnosed clinically and histopathologically as warty dyskeratoma.

Reticulate acropigmentation of Kitamura: report of a familial case.

Reticulate Acropigmentation of Kitamura (RAPK) was first described in Japan and most cases reported have been in patients of Asian ethnic groups. Angulated, slightly atrophic, hyperpigmented macules that are arranged in a reticulate pattern are typically found on the dorsal hands and feet. The condition is inherited in an autosomal dominant fashion and skin changes begin to develop during childhood. We report RAPK in a mother and daughter who are from a non-Asian ethnic group.