Internalized stigma is the adoption of negative attitudes and stereotypes of the society regarding a person's illness. It causes decreased self-esteem and life-satisfaction, increased depression and suicidality, and difficulty in coping with the illness. The primary aim of this study was to investigate the internalized stigma state of psoriatic patients and to identify the factors influencing internalized stigma. The secondary aim was to identify the correlation of internalized stigma with quality of life and perceived health status. This multicentre, cross-sectional study comprised 1485 patients. There was a significant positive correlation between mean values of Psoriasis Internalized Stigma Scale (PISS) and Psoriasis Area and Severity Index, Body Surface Area, Dermatological Life Quality Index and General Health Questionnaire-12 (P < 0.001 in all). Lower percieved health score (P = 0.001), early onset psoriasis (P = 0.016), family history of psoriasis (P = 0.0034), being illiterate (P < 0.001) and lower income level (P < 0.001) were determinants of high PISS scores. Mean PISS values were higher in erythrodermic and generalized pustular psoriasis. Involvement of scalp, face, hand, genitalia and finger nails as well as arthropathic and inverse psoriasis were also related to significantly higher PISS scores (P = 0.001). Our findings imply that psoriatic patients experience high levels of internalized stigma which are associated with psoriasis severity, involvement of visible body parts, genital area, folds or joints, poorer quality of life, negative perceptions of general health and psychological illnesses. Therefore, internalized stigma may be one of the major factors responsible from psychosocial burden of the disease.
Our results have shown that concurrent topical calcipotriol potentiates the efficacy of PUVA in the treatment of vitiligo, and that this combination achieves earlier pigmentation with a lower total UVA dosage.
Bevacizumab is a monoclonal antibody against vascular endothelial growth factor (VEGF), which is used to treat several cancers. Currently, experience with anti-VEGF treatment for psoriasis is limited, and no published reports on this use exist. We describe a patient with metastatic colon cancer and psoriasis who experienced complete remission of psoriasis during treatment with bevacizumab and combination chemotherapy without any other treatment for psoriasis. These data suggest that bevacizumab may be a promising therapeutic agent for the treatment of psoriasis.
ÖzAmaç: Sensorinöral işitme kaybı, otoimmün ve inflamatuvar hastalıkların bir komplikasyonu olarak ortaya çıkabilmektedir. Psoriasis toplumda yaygın olarak görülmesine rağmen, odyolojik bozukluklar ile ilişkisi hakkında literatürdeki bilgiler sınırlıdır ve vestibüler bozukluklarla ilişkisi daha önce araştırılmamıştır. Biz de bu çalışmamızda, psoriasis hastalarında odyovestibüler bozuklukların varlığını ve hastalık parametreleri ile ilişkisini araştırmayı amaçladık. Yöntemler: Altmış bir psoriasis hastası ile yaş ve cinsiyet uyumlu 61 sağlıklı gönüllü çalışmaya dahil edildi. İşitme ve denge bozukluğuna yol açabilecek olası etiyolojik faktörlere sahip olanlar çalışmaya dahil edilmedi. Tüm katılımcılara öncelikle tam bir kulak, burun ve boğaz muayenesi yapıldı. Takiben hastalara ses izolasyonu sağlanmış odyoloji laboratuvarında tam odyolojik tetkik (saf ses odyometri, otoakustik emisyon, stapes refleksi, konuşmayı alma ve ayırt etme eşiği saptanması) ve elektronistagmografi testleri yapıldı. Psoriasis hastalık şiddeti psoriasis alan ve şiddet indeksi, vücut yüzey alanı ve araştırmacının genel değerlendirmesi ile değerlendirildi. Bulgular: Odyometrik testlerde hasta ve kontroller arasında anlamlı farklılık saptandı.Objective: Sensorineural hearing loss can occur as a complication of autoimmune and inflammatory diseases. Although psoriasis is also a chronic inflammatory skin disease characterized by T-cell mediated hyper proliferation of the keratinocytes, the information about the relationship between audiological disorders is limited in the literature and the relationship with vestibular disorders has not been investigated before. In this study, we aimed to investigate the presence of audiovestibular disorders and their relationship with disease parameters. Methods: Sixty-one patients with psoriasis and 61 healthy individuals were included in this prospective cross-sectional study. Those with possible etiologic factors that may lead to hearing and balance disorders were not included in the study. All participants were first performed a full ear, nose and throat examination. Subsequently, full audiological examination (pure audiometry, autoacoustic emission, stapes reflex, detection threshold of speech and discrimination) and electronystagmography tests were performed in the audiology laboratory where sound isolation was provided. Psoriasis severity was assessed by psoriasis area and severity index, body surface area and general evaluation of researcher. Results: There were significant differences between patients and controls in terms of audiovestibular symptoms. According to audiograms, predominant bilateral sensorineural hearing loss was detected in high frequency in psoriasis patients. The vestibular abnormalities in patients with psoriasis were found to be more frequent than those in controls, only saccadic test values were observed as statistically significant. Conclusion: Our study demonstrates that audiovestibular abnormalities are significantly associated with psoriasis. Therefore, patients with psoriasis s...
Terbinafine, an orally active antifungal agent of the allylamine class, is effective in the treatment of dermatophyte onycomycosis. Its pharmacologic and pharmacokinetic properties give strong support to the possibility that intermittent treatment courses may be equally effective in onychomycosis in general. The present randomized and controlled study was carried out to determine whether intermittent therapy with terbinafine was effective in dermatophyte toe-onychomycosis. Sixty patients with mycologically proven toenail dermatophyte onychomycosis were included in the study. Patients were equally allocated to treatment groups in a random manner. Group 1 was given 250 mg/day of terbinafine for 3 months. Group 2 was given 500 mg/day of terbinafine for 7 days during the first week of each month for 3 months. Nails were examined clinically and mycologically at monthly intervals. All patients were followed up for 48 weeks after starting the treatment. Of the patients who entered the study, 24 in Group I and 23 in Group 2 were evaluable for efficacy. At the end of the follow-up period, the cure rate (negative microscopy and culture) was 79.2% in Group 1 and 73.9% in Group 2; this difference was not significant (p: 0.79). The results indicate that intermittent therapy with terbinafine is as effective as 3-month treatment in dermatophyte toe-onychomycosis.
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