Psoriasis is a chronic inflammatory disease associated with several
comorbidities. A few decades ago, it was considered an exclusive skin disease
but today it is considered a multisystem disease. It is believed that 73% of
psoriasis patients have at least one comorbidity. Studies have demonstrated the
association of psoriasis with inflammatory bowel disease, uveitis, psychiatric
disorders, metabolic syndrome and its components and cardiovascular diseases.
The systemic inflammatory state seems to be the common denominator for all these
comorbidities. This work aims at presenting a review of the current literature
on some new comorbidities that are associated with psoriasis as osteoporosis,
obstructive sleep apnea and chronic obstructive pulmonary disease. While there
is still controversy, many studies already point to a possible bone involvement
in patients with psoriasis, especially in the male group, generally less
affected by osteoporosis. Psoriasis and chronic obstructive pulmonary disease
present some risk factors in common as obesity, smoking and physical inactivity.
Besides, both diseases are associated with the metabolic syndrome. These factors
could be potential confounders in the association of the two diseases. Further
prospective studies with control of those potential confounders should be
developed in an attempt to establish causality. Existing data in the literature
suggest that there is an association between obstructive sleep apnea and
psoriasis, but studies performed until now have involved few patients and had a
short follow-up period. It is, therefore, premature to assert that there is
indeed a correlation between these two diseases.
The combination of a single-strain Leishmania (Leishmania) amazonensis killed promastigote vaccine with a half dose regimen of antimonial is highly effective for the treatment of ACL.
When eosinophils or neutrophils are found within the epidermis in concert with edema, the pattern is known as eosinophilic or neutrophilic spongiosis. Although eosinophilic spongiosis has been accepted as a clue to the diagnosis of blistering disorders for some time, the fact that either pattern can serve as a clue to the diagnosis of a variety of disorders, including immunobullous diseases, is less widely known. Herein, we review the types of inflammatory skin diseases, including spongiotic dermatitides, subepidermal vesicular dermatitides, intraepidermal vesicular dermatitides, and perivascular or diffuse dermatitides, that display intraepidermal eosinophils and neutrophils. We also review the known mechanisms that explain in part why intraepidermal granulocytes are commonly found in this diverse group of skin diseases.
After resolution of melasma with TC, maintenance therapy over 6 months was successful in preventing relapse in over half of the patients who entered maintenance phase. Prescribing medicines should be adapted to patients based on melasma severity.
An evaluation of 5 laboratory methods for diagnosing American cutaneous leishmaniasis (ACL) was carried out on patients from an endemic area of Brazil. From 164 patients presenting cutaneous lesions, and suspected to have ACL, 133 (81.1%) were confirmed for the disease by Montenegro skin test (MST) and/or parasitologic examination (PE). In both groups of patients, the positivity of polymerase chain reaction (PCR) was similar to that of immunofluorescence assay and enzyme-linked immunosorbent assay, and higher than that of MST and PE (P < .05). In the group of patients suspected to have ACL, PCR presented the same positivity as PE and MST together. No correlation between positivity of the laboratory methods and clinical or epidemiologic aspects was observed. Our data confirmed the value of PCR as an alternative laboratory method for diagnosing ACL, especially for those patients with negative PE and MST.
Palmar BCC not associated with the basal cell nevus syndrome or any other predisposing condition is very rare. Nevertheless, when facing an ulcerated lesion on the palm, BCC should be considered as a diagnostic possibility.
The authors report the case of a 9 year-old female who had bleeding episodes around the mouth after strenuous exercise or prolonged exposure to heat. Characteristically, bleeding occurred right after sweat drops started appearing on the surface of the skin around the mouth. The bleeding episodes ceased spontaneously.
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