BACKGROUNDEmerging epidemiological evidence suggests independent associations between
psoriasis and metabolic syndrome. Objectives: The aim of the study was to
examine the prevalence of metabolic syndrome and its components in patients
with psoriasis, and to assess which factors may predict metabolic syndrome
in these patients.METHODSA hospital-based, cross-sectional study with 244 psoriatic patients and 163
control subjects with skin diseases other than psoriasis was conducted at
the Clinic of Dermatovenerology, Clinical Center of Serbia, Belgrade, from
October 2011 to October 2012. Metabolic syndrome was defined using the
revised National Cholesterol Education Program Adult Treatment Panel III.
Severity of psoriasis was measured by Psoriasis Area and Severity Index and
Body Surface Area.RESULTSThe adjusted odds ratios (ORs) and 95% confidence intervals (CI) for
psoriasis patients vs. non-psoriasis patients were 2.66 (95% CI, 1.58-4.42)
for metabolic syndrome, 3.81 (95% CI, 2.30-6.31) for hypertension, 2.29 (95%
CI, 1.39-3.78) for central obesity, 1.92 (95% CI, 1.08-3.41) for
hyperglycemia, 1.87 (95% CI 1.18-2.96) for low high-density lipoprotein
cholesterol level, and 1.42 (95% CI, 0.87-1.04) for hypertrigliceridemia. We
failed to find any statistically significant association between the
metabolic syndrome and clinical severity of psoriasis. Later onset and
longer duration of psoriasis were predicting factors for metabolic syndrome
in our patients. Study limitations: The cross-sectional design of the study
does not allow us to draw directional causal inferences concerning the
association between psoriasis and metabolic syndrome. Factors such as diet,
alcohol consumption or mental health, which have not been evaluated in this
study, may be confounders in this relation.CONCLUSIONA higher prevalence of metabolic syndrome and its components in patients with
psoriasis than in controls, regardless of disease severity, emphasizes the
need for early treatment and follow-up of all psoriatic patients with
respect to metabolic diseases.
This entity was established 40 years ago, and around 100 patients have been reported worldwide. It is important to be aware of this particular form of pemphigus because clinical presentation, course of the disease and therapeutic approach are different from conventional forms of pemphigus.
Our results support the importance of assessing the quality of life in psoriasis and effects of stress in patients' adjustment to their condition and may have important implications for a psychological stress management approach in the clinical management of psoriasis.
Fox-Fordyce disease (FFD) is characterized by a pruritic eruption of skin-coloured or yellowish papules in areas rich in apocrine glands. The histology comprises dilatation of follicular infundibula with hyperkeratosis, acanthosis, and spongiosis of the infundibular epithelium with perifollicular infiltration of lymphocytes and foamy histiocytes. We treated a 12-year-old girl with FFD with topical pimecrolimus for 12 weeks, this resulted in a complete clearance of lesions. After the therapy, the patient was followed for an additional 19 months without signs of relapse. The effects of pimecrolimus in FFD might imply that an inflammatory process inducing secondary reactive hyperkeratosis could be involved in the pathogenesis of FFD.
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