ABSTRACT
Recent studies have found that psoriasis is linked to a higher rate of obesity, and that obesity itself is a risk factor for the development of psoriasis. There are two recent reports of chronic severe psoriasis improving with weight loss after Roux-en-Y gastric bypass surgery. We have observed two patients with body mass indices greater than 50 kg/m(2) who had marked improvement in their psoriasis after gastric bypass surgery. The common link between psoriasis and obesity may be a state of chronic inflammation, including elevated levels of T helper 1 (TH-1) cytokines such as tumor necrosis factor. More recent research has shown that the appetite suppressant leptin is also elevated in patients with psoriasis and obesity, and that levels decrease with weight loss. We conclude that weight loss may be a useful adjunctive therapy for obese patients with psoriasis.
Subject(s)
Gastric Bypass/methods , Obesity, Morbid/surgery , Psoriasis/diagnosis , Adult , Body Mass Index , Female , Follow-Up Studies , Humans , Obesity, Morbid/complications , Obesity, Morbid/diagnosis , Psoriasis/complications , Psoriasis/drug therapy , Severity of Illness Index , Treatment Outcome , Weight LossABSTRACT
Sorafenib is an oral multikinase inhibitor used in the treatment of renal cell carcinoma. As with single kinase inhibitors, cutaneous adverse events have been reported with sorafenib, specifically a hand-foot reaction complicated by hyperkeratosis. The authors highlight the case of a 51-year-old Caucasian woman treated for metastatic renal cell carcinoma who presented with well-defined tender erythematous callosities of the fingers and feet, following a dosage increase of sorafenib. A dose reduction decreased the symptoms, but the hyperkeratosis persisted. This adverse response may represent a novel event differing from traditional hand-foot syndrome.
