It is well known that several psychiatric disorders may be related to childhood psychological trauma. Recent studies have associated childhood exposure to trauma to some skin diseases. Our study aimed at exploring whether psoriasis is related to the reported positive and negative traumatic life events in different age intervals beginning from early childhood to adulthood. Furthermore, we investigated differences between psoriatics with early and late onset according to traumatic experiences in different age intervals. Also, we investigated the possible correlation of traumatic experiences with the disease severity. One hundred patients with psoriasis and 101 controls (patients with skin conditions considered to be "non-psychosomatic") were enrolled in the study. All participants completed a specific questionnaire measuring traumatic life experiences (Traumatic Antecedents Questionnaire, TAQ). The TAQ assesses positive personal experiences (competence and safety) and negative personal experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas and exposure to alcohol/drugs) from early childhood to adulthood. The severity of psoriasis was estimated according to the Psoriasis Area and Severity Index (PASI), a standardized measuring instrument. The amount of positive experiences did not differ significantly among groups, except for safety scores that were higher in controls compared with both psoriatic groups (early and late onset). On the other side, negative traumatic experiences appeared more frequently in patients with psoriasis during all developmental periods. We found no correlation between severity of psoriasis and traumatic experiences. The present study demonstrates an increased history of childhood and adulthood negative traumatic experiences in patients with psoriasis compared to the control group. Our findings suggest a relationship between retrospectively reported negative traumatic experiences and psoriasis.
Recent data suggest that childhood and adulthood stressors may play a significant role in the development of an autoimmune disease. The present study explores the relationship between psoriatic arthritis (PsA) and positive and negative life events during childhood and adulthood in psoriatic patients. Forty-five patients with psoriatic arthritis and 101 controls (patients with skin conditions considered to be "non-psychosomatic") were enrolled in the study. All participants completed a specific questionnaire measuring traumatic life experiences [Traumatic Antecedents Questionnaire (TAQ)]. The TAQ assesses positive personal experiences (competence and safety) and negative personal experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas and exposure to alcohol/drugs) from early childhood to adulthood. The patients with psoriatic arthritis exhibited lower mean scores of total positive experiences during late childhood (latency) as compared to the control group. Negative experiences during four developmental periods appeared more frequently in patients with psoriatic arthritis than in the controls. The most frequently reported negative experiences were neglect, emotional abuse, physical abuse, sexual abuse, alcohol/drug abuse and other traumas. The present findings add evidence to the relationship between retrospectively reported childhood experiences and psoriatic arthritis. Furthermore, a high amount of reported emotional and physical abuse occurs in patients with psoriatic arthritis during latency and adolescence.
An open, noncomparative study was performed to establish the efficacy of azithromycin in the treatment of early syphilis. Sixteen patients were treated with oral azithromycin: 1g the first day and then 500 mg for the following 8 days. Two patients were excluded from the study, leaving 14 patients for the evaluation of the efficacy. Venereal Disease Research Laboratory (VDRL) negativity was observed in 3 out of 6 patients treated for primary syphilis after 3 months and in all patients after 6 months. Two of 8 patients treated for manifest or early latent secondary syphilis had VDRL negativity after 3 months and 4 patients after 6 months. This study demonstrates that azithromycin is effective in the treatment of early syphilis. Two patients experienced gastrointestinal side effects which did not require treatment interruption.
A 76-year-old housewife presented with multiple erythematous itchy patches on her face and neck along with hair loss, scaling and inflammation in the occipital region of the scalp that had started 2 months ago. The diagnosis of allergic contact dermatitis was made in the first place and therapy with topical corticosteroid creams was recommended.Physical examination revealed multiple erythematous scaly papules and plaques on her face, neck and upper trunk ( Fig. 1). Scalp examination revealed intense inflammation and scaling along with hair loss in the occipital region ( Fig. 2). Direct microscopy of scraping specimens from skin lesions and scalp was positive for fungal hyphae. Woodlight inspection of scalp revealed green fluorescence. Fungal culture on Sabouraud's agar grew Microsporum canis. The patient was successfully treated with oral itraconazole as a pulse therapy for 3 months and 1% clotrimazole cream twice daily.Topical application of steroids may modify the clinical picture showing several atypical forms of tinea including lupus erythematosus, rosacea, contact dermatitis and even erythema migrans [1]. Potent fluorinated steroids seem most likely to produce tinea incognito, however, even steroids of the lowest potency as 1% hydrocortisone cream can modify clinical presentation of tinea [2]. More recently, a few cases of tinea incognito due to use of topical tacrolimus and pimecrolimus were reported in literature [3].The present case highlights the importance of considering a dermatophytosis when clinical presentation of dermatosis is atypical, or in an atypical location for fungal infection given the age of the patient. References 1. Gorani A, Schiera A, Oriani A (2002) Case report. Rosacea-like tinea incognito. Mycoses 45: 135-137 2. Al Aboud KA, Al Hawsawi KA, Alfadley A (2003) Tinea incognito on the hand causing a facial dermatophytid reaction. Acta Derm Venereol 83: 59 3. Crawford KM, Bostrom P, Russ B, Boyd J (2004) Pimecrolimus-induced tinea incognito. Skinmed 3: 352-353
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