[Intestinal strongyloidiasis in a psoriasis patient with diabetes]. / Psöriyazis ve Diyabetes Mellitus Tanili Hastada Intestinal Strongyloidosis.

This case study underlined the importance of parasitological examination before starting immunosuppressive treatment since a heavy burden of strongyloidiasis could lead to fatal infections. It represents the first strongyloidiasis from a patient with psoriasis and diabetes mellitus in this country. In the case, 59 years old female subject had psoriasis for six years and during the treatment with topical corticosteroid and anti-psorial medication, psoriatic lesions flared up. The patient had constipation and foul smelling stool complaints. Blood tests showed an increase in eosinophil and a decrease of vitamin B12 level. Stool examination indicated the presence of abundant amount of S. stercoralis larvae. The patient was given albendazole for two weeks. After treatment, the symptoms decreased and S. stercoralis larvae were not detected in stool. In this case, it was emphasized that the clinicians planning immunosuppressive regimens should bear in mind that parasitic examination could be present in the subjects.

[Clinical and functional disorders of the stomach-in patients with psoriasis in the presence of chronic opisthorchiasis].

OBJECTIVE: to study the clinical and functional status of the stompach in patients with psoriasis in the presence of chronic opisthorchiasis (CO). Subjects and methods. Ninety patients with psoriasis concurrent with CO (a study group (Group 1)), 70 with psoriasis (a comparison group (Group 2)), 70 with CO (Group 3), and 30 healthy individuals were examined. All the patients underwent fractional gastric secretory studies and esophagogastroduodenoscopy (EGDS). RESULTS: The study group showed a reduction in stimulated hydrochloric acid output (4.25+/-0.38 mmol/hour), which was significantly less than that in Groups 2 and 3 and healthy individuals [5.87+/-0.51 (p<0.001); 6.86+/-0.59 (p<0.05), and 10.73+/-0.84 mmnol/hour (p<0.001), respectively]. In the study group, stimulated pepsin output (4.87+/-0.49 mmol/hour) was also significantly less than that in the other groups. Reduced basal hydrochloric acid output was found in 65.5% of the study group patients, whose number was significantly larger than that in the comparison group [44.3% (p<0.05)] and its stimulated output was less in 80 and 62.9% in the study and comparison groups, respectively (p < 0.05). A reduction in pepsin output in the basal secretion phase was revealed in 57.8 and 37.1% of the patients in the study and comparison groups, respectively (p<0.05) while that in the stimulated phase was in 63.3 and 34.3% (p<0.001). Thus, gastric secretory function in psoriatic patients is characterized by reduced hydrochloric acid and pepsin outputs and it is more impaired in patients with mixed pathology, which necessitates anthelmintic therapy in this category of patients.

[The clinical and functional state of the liver in patients with psoriasis in the presence of chronic opisthorchiasis].

OBJECTIVE: to study the clinical and functional state of the liver in patients with psoriasis concurrent with chronic opisthorchiasis (CO). SUBJECTS AND METHODS: Twenty-eight patients with psoriasis concurrent with CO, 15 patients with CO, 15 patients with the enlarged liver, and 15 healthy individuals were examined. Serum biochemical study and ultrasonography of the liver and gallbladder were used. RESULTS AND DISCUSSION: The patients with comorbidity were found to have hepatomegaly with syndromes of cytolysis, cholestasis, and mesenchymal inflammation of more degrees than those from Groups 2 and 3. CONCLUSION: The found clinical and functional liver changes in patients with psoriasis concurrent with CO make it necessary to perform anthelmintic therapy in this category of patients.

[Gastric secretory function in psoriatic patients with chronic opistorchosis before and after antihelminthic therapy].

The aim of the work was to study secretory function of the stomach in psoriatic patients with chronic opistorchosis (CO) before and after antihelminthic therapy. It included 90 such patients, 70 with psoriasis alone, 70 with CO, and 30 healthy subjects. All patients were examined by oesophagogastroduodenoscopy. Fractional gastric secretion was measured. The secretory function of the stomach was most seriously disturbed in psoriatic patients with CO. It did not further deteriorate after antihelminthic therapy. The disturbance was associated with reduced hydrochloric acid and pepsin levels which confirms the necessity of antihelminthic therapy.

Echinococcosis: a possible etiology in psoriatic disease.

We aimed to investigate seroprevalence of Echinococcus granulosus in patients with psoriasis to determine a possible etiologic role, since both echinococcosis and psoriasis are defined as T cell-mediated diseases. Forty psoriatic patients and 50 age- and sex-matched control subjects were included in the study. IgG-specific ELISA was used to determine seropositivity. E. granulosus-specific IgG antibodies were found to be positive in 17/40 (42.5%) of the patients with psoriasis and in 11/50 (22%) of the control subjects (p = 0.008). Our results suggest that echinococcosis might be one of the causative pathogens in the etiopathogenesis of psoriasis in highly endemic regions.

Reactive arthritis, psoriasiform lesions and protein loosing enteropathy secondary to Strongyloidiasis.

Reactive arthritis is associated with demonstrable infection at a distant site without evidence of sepsis at the affected joint(s). We present a rare case reactive arthritis where no bacterial or chlamydial infections could be established, rather larvae of Strongyloides stercoralis could be demonstrated in the stool and duodenal biopsy. Reactive arthritis, psoriasiform lesions and malabsorption with hypoproteinaemia, responded to successful treatment with antihelminthic drugs. Early recognition and adequate treatment for gastrointestinal infections and infestations before complications is important.

House dust mite antigen exposure of patients with atopic dermatitis of psoriasis.

We studied the amount of house dust antigen in the beds of 55 patients with atopic dermatitis, eleven patients with psoriasis and ten healthy volunteers using a commercial ELISA which can determine the amount of antigen from Dermatophagoides pteronyssinus, D. farinae and D. microseras expressed as nanogram (ng) antigen per gram of house dust. The World Health Organization has indicated that 10,000 ng house dust mite antigen per gram house dust can elicit an asthma attack in IgE-sensitized patients with asthma bronchiale. There are no recommendations for patients with atopic eczema. We observed no statistical significant differences between each group concerning the amount of house dust found in the beds or the amount of house dust mite antigen. However, there were very wide variations. Twenty-seven percent (15/55) of patients with atopic dermatitis and 27% (3/11) of psoriasis patients had levels of house dust mite antigen above 10,000 ng per gram of house dust compared with healthy volunteers (1/10). Half of the patients had a type I allergy to house dust mite antigen using prick tests. This group had a total serum IgE of 2,034 kU/I (median value) compared to 301 kU/I in the group without type I allergy to house dust mite antigen (p < 0.01). The exposure to house dust mite antigen was similar in the two groups. We conclude that only 1/4 of patients with atopic dermatitis are exposed to high levels of house dust mite antigen in their bed environment equal to what is found for patients with another scaling disorder (psoriasis). Patients who have an increased serum IgE have significantly increased type I allergy to house dust mite antigen even though their exposure is not different from patients with low IgE.