High prevalence of non-alcoholic fatty liver disease among hidradenitis suppurativa patients independent of classic metabolic risk factors.

BACKGROUND: Some chronic inflammatory skin diseases, such as psoriasis, have been associated with an increased prevalence of non-alcoholic fatty liver disease (NAFLD). Nevertheless, this prevalence in hidradenitis suppurativa (HS) has not been assessed to date. OBJECTIVES: To determine the prevalence of NAFLD in patients with HS and the risk factors associated with this disorder. METHODS: This case-control study enrolled 70 HS patients and 150 age- and gender-matched controls who were evaluated by hepatic ultrasonography (US) and transient elastography (TE) after excluding other secondary causes of chronic liver disease. The diagnosis of NAFLD was established if US and/or TE were altered. RESULTS: The prevalence of NAFLD was significantly increased in patients with HS compared to controls (72.9% vs. 24.7%: P < 0.001). In the multivariable regression model adjusted for age, sex and classic metabolic risk factors for NAFLD, HS was significantly and independently associated with the presence of NAFLD [OR 7.75 confidence interval (CI) 2.54-23.64; P < 0.001]. CONCLUSIONS: Our results show a high prevalence of NAFLD in HS patients independent of classic metabolic risk factors. Therefore, we suggest HS patients to be evaluated for NAFLD and managed accordingly.

Use of positron emission tomography (PET) for the diagnosis of large-vessel vasculitis / Utilización de la tomografía por emisión de positrones (PET) para el diagnóstico de vasculitis de vaso grande

The term vasculitis encompasses a heterogeneous group of diseases that share the presence of inflammatory infiltrates in the vascular wall. The diagnosis of large-vessel vasculitis is often a challenge because the presenting clinical features are nonspecific in many cases and they are often shared by different types of autoimmune and inflammatory diseases including other systemic vasculitides. Moreover, the pathogenesis of large-vessel vasculitis is not fully understood. Nevertheless, the advent of new imaging techniques has constituted a major breakthrough to establish an early diagnosis and a promising tool to monitor the follow-up of patients with largevessel vasculitis. This is the case of the molecular imaging with the combination of positron emission tomography with computed tomography (PET/CT) using different radiotracers, especially the 18F-fluordeoxyglucose (18F-FDG). In this review we have focused on the contribution of 18F-FDG PET in the diagnosis of large-vessel vasculitis (AU)

El término vasculitis engloba un heterogéneo grupo de enfermedades que tienen en común la presencia de un infiltrado inflamatorio en la pared vascular. El diagnóstico de las vasculitis de vaso grande es a menudo dificultoso debido a que pueden comenzar con una sintomatología inespecífica que también puede aparecer en otros tipos de enfermedades autoinmunes e inflamatorias, incluyendo otras vasculitis sistémicas. Además, la patogenia de las vasculitis de vaso grande no se conoce en su totalidad. Sin embargo, el desarrollo de nuevas técnicas de imagen constituye un gran avance para establecer un diagnóstico precoz y son una herramienta prometedora para el seguimiento de las vasculitis de vaso grande. Este es el caso de la imagen molecular obtenida de la combinación de la tomografía por emisión de positrones con la tomografía computarizada (PET/TAC) utilizando diferentes radiotrazadores, especialmente la 18F- fluordeoxiglucosa (18F-FDG). En esta revisión nos hemos centrado en la contribución del 18F-FDG PET en el diagnóstico de las vasculitis de vaso grande (AU)

Use of positron emission tomography (PET) for the diagnosis of large-vessel vasculitis.

The term vasculitis encompasses a heterogeneous group of diseases that share the presence of inflammatory infiltrates in the vascular wall. The diagnosis of large-vessel vasculitis is often a challenge because the presenting clinical features are nonspecific in many cases and they are often shared by different types of autoimmune and inflammatory diseases including other systemic vasculitides. Moreover, the pathogenesis of large-vessel vasculitis is not fully understood. Nevertheless, the advent of new imaging techniques has constituted a major breakthrough to establish an early diagnosis and a promising tool to monitor the follow-up of patients with largevessel vasculitis. This is the case of the molecular imaging with the combination of positron emission tomography with computed tomography (PET/CT) using different radiotracers, especially the (18)F-fluordeoxyglucose ((18)F-FDG). In this review we have focused on the contribution of (18)F-FDG PET in the diagnosis of large-vessel vasculitis.

Psoriasis: una enfermedad cutánea relacionada con riesgo cardiovascular elevado / Psoriasis: a Skin Disease Associated With Increased Cardiovascular Risk

La psoriasis y la artritis psoriásica se asocian con un mayor riesgo de eventos cardiovasculares y de mortalidad cardiovascular. Además de los factores clásicos de aterosclerosis, la gravedad de la afección cutánea influye en el aumento del riesgo cardiovascular en estos pacientes. En ambos procesos se observa la presencia de disfunción endotelial y un grosor aumentado de la íntima-media de la arteria carótida, como expresión de enfermedad cardiovascular subclínica. El tratamiento activo de la enfermedad y el manejo de los factores de riesgo cardiovascular clásicos son fundamentales para disminuir la morbilidad cardiovascular en estos pacientes. El establecimiento de guías clínicas para el manejo del riesgo cardiovascular abrirá, en el futuro, un nuevo abordaje clínico integral del paciente con psoriasis y la artritis psoriásica (AU)

Psoriasis and psoriatic arthritis are associated with increased risk of cardiovascular events and cardiovascular mortality. Alongside classic risk factors such as atherosclerosis, the severity of psoriatic skin disease also influences cardiovascular risk in these patients. In both cases, endothelial dysfunction and increased intima-media thickness in the carotid artery are indicators of subclinical cardiovascular disease. Active treatment of the psoriasis and management of traditional cardiovascular risk factors are essential in order to reduce cardiovascular morbidity in these patients. Clinical practice guidelines on the management of cardiovascular risk will define a new integrated approach to the care of patients with psoriasis and psoriatic arthritis (AU)

Psoriasis: a skin disease associated with increased cardiovascular risk.

Psoriasis and psoriatic arthritis are associated with increased risk of cardiovascular events and cardiovascular mortality. Alongside classic risk factors such as atherosclerosis, the severity of psoriatic skin disease also influences cardiovascular risk in these patients. In both cases, endothelial dysfunction and increased intima-media thickness in the carotid artery are indicators of subclinical cardiovascular disease. Active treatment of the psoriasis and management of traditional cardiovascular risk factors are essential in order to reduce cardiovascular morbidity in these patients. Clinical practice guidelines on the management of cardiovascular risk will define a new integrated approach to the care of patients with psoriasis and psoriatic arthritis.

Manifestaciones cutáneas del trastorno mieloproliferativo transitorio asociado a síndrome de Down / Cutaneous manifestations of transitory myeloproliferative disorder associated with Down syndrome

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Placa verrugosa persistente en dedo de mano / Persistent wart plaque on finger

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Bronchiolitis obliterans and IgA nephropathy. A new cause of pulmonary-renal syndrome.

IgA nephropathy is a common form of glomerulonephritis, classically manifested by asymptomatic hematuria. Although the exact pathophysiologic mechanism is still unknown, renal damage has been related to mesangial deposition of IgA-containing immune complexes. In recent years, some lung diseases have been associated with IgA nephropathy, including pulmonary hemorrhage and sarcoidosis. We report a patient with idiopathic bronchiolitis obliterans who developed a rapidly progressive glomerulonephritis due to IgA deposits. Extensive deposits of IgA were also found in the lungs, thus suggesting a pathogenetic role for IgA in tissue injury at both organ levels. To our knowledge this association has not been previously described in the literature.

Henoch-Schönlein purpura as clinical presentation of a myelodysplastic syndrome.

Small-vessel vasculitis may be a paraneoplastic syndrome. It may be associated with haematologic malignancies and less frequently with solid tumors. We describe a patient with myelodysplastic syndrome presenting as Henoch-Schönlein Purpura. To our knowledge this association has not previously reported.

Metastatic arthropathy report of two cases and review of the literature.

Metastatic arthropathy has been rarely reported as a manifestation of solid tumors. It is characterized by a monoarticular involvement and is frequently the first feature of the malignant process; therefore, it may pose a diagnostic challenge. We report two new cases of metastatic carcinomatous arthritis: a patient with right-knee monoarthritis as a presenting feature of pancreatic carcinoma and another one with right-elbow monoarthritis, preceded by constitutional and pulmonary symptoms, secondary to metastasis of undifferentiated carcinoma. We also review the literature for well documented cases of metastatic arthropathy secondary to solid tumors. Metastatic arthropathy indicates a poor prognosis because of a wide spread of the tumor when it is diagnosed. We emphasize the need for increasing awareness of cancer as a cause of monoarthritis.

Primary acute torsion of the vermiform appendix.

A case of primary acute appendiceal torsion in a 6-year-old boy with symptoms suggestive of acute appendicitis is presented. The appendix was abnormally long, measuring 13.5 cm in length. Although appendicitis is the most common intra-abdominal surgical emergency, there are few descriptions of primary acute appendiceal torsion, a rare cause of an acute abdomen. A review of the English language literature disclosed 19 reports, including the present, with 11 pediatric cases. The site of torsion occurs most frequently 1 cm or more from the appendiceal base. Rotation varies from 270 degrees to 1080 degrees with a mean of 580 degrees. The direction of the rotation is more frequently anticlockwise. Appendix is most commonly described as lying free or pelvic. In children the mean age is 9.1 years, the range 3-16 years, and the male-to-female ratio 4.5:1.