Leishmaniasis is a parasitic infection classified into Old World and New World species of sandfly vectors, classically Phlebotomus and Lutzomyia, respectively. 1 Old World leishmaniasis, seen in the Eastern hemisphere, typically manifests as cutaneous and visceral disease. New World leishmaniasis, arising in Latin and South America, results in cutaneous, mucocutaneous, and visceral disease. The incidence of
Psoriasis is associated with multiple co-morbid medical conditions. The purpose of this study is to evaluate the relationships between psoriasis and cardiovascular disease, psoriatic arthritis, mental health conditions, and immune-mediated diseases, respectively. A literature search was performed during the study period January 1, 2015 to December 18, 2018. Of 2499 records identified, 28 met our criteria selection and were included in this review. Based on these findings, the relationships between psoriasis and these multiple comorbid disease conditions are discussed. Psoriasis is associated with cardiovascular disease, and chronic inflammation likely plays a major role in this relationship. Treatment of psoriasis improves underlying inflammation and TNF inhibitor therapy may provide a protective effect against risk of MACE for patients with psoriasis, which would ultimately promote better health outcomes for these patients. Additionally, psoriatic arthritis is a common comorbid condition associated with psoriasis that can lead to permanent disability. Early treatment is imperative to help prevent complications of psoriatic arthritis. Autoimmune diseases have also been reported to be associated with psoriasis, which may suggest that the pathogenesis of psoriasis may involve autoimmune mechanisms. Moreover, it is important to address and treat comorbid psychiatric conditions among patients with psoriasis, including depression, suicidal behavior, and suicidal ideation. Early recognition and treatment of comorbid disease conditions is important to consider when developing the treatment plan and overall management of patients with psoriasis to help improve the quality of life for these patients.
Central Centrifugal Cicatricial Alopecia (CCCA) is a scarring alopecia most common in black women. Its presentation follows a seemingly genetic pattern affecting clusters of women within a family. A study that aimed to elucidate the genetic basis for CCCA found an increased incidence of mutations and decreased expression of PID3, a gene that encodes for peptidyl arginine deiminase type 3, essential for the formation of a normal hair shaft, in scalp samples of patients with CCCA (1). Of note, PID3 is one of three genes implicated in uncombable hair syndrome, a disorder where the hair shaft appears triangular or heart shaped in cross section when viewed under scanning electron microscopy (SEM) (2). It is unclear if CCCA represents a hair shaft disorder and there have been no studies assessing the hair shafts of patients with CCCA. Our study aimed to investigate differences in features of the hair shaft in regard to cross-sectional shape, area, aspect ratio and circularity. The measure of circularity gives numerical information on the shape in cross section with a measure of 1.0 representing a perfect circle and 0.8 representing an oval shape. Hair samples were obtained from the vertex and occipital scalp of CCCA and age matched controls using a gentle pull technique targeting telogen hairs. Images of the hair samples were taken under SEM, and analysis and measurements were obtained using ImageJ software. This study will help elucidate the role hair shaft differences play in the pathogenesis of CCCA.
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