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Psoriasis comorbidities

Christine Fink, Samuel Kilian, Ines Bertlich, Elti Hoxha, Felicitas Bardehle, Alexander Enk, Holger A Haenssle
INTRODUCTION: Psoriasis vulgaris was shown to be an independent factor increasing the risk of several comorbidities such as obesity, diabetes and dyslipidaemia with an increased risk of stroke and myocardial infarction. We hypothesise that early endothelial dysfunction, which plays a crucial role in the pathogenesis of atherosclerosis, may be detected by digital video nailfold capillaroscopy (DVNC) at the level of the dermal capillary microvasculature as a surrogate parameter. Nailfolds represent the only body site allowing for a non-invasive assessment of the capillary microvasculature at a horizontal plane...
August 10, 2018: BMJ Open
Elena Pezzolo, Unal Mutlu, Meike W Vernooij, Emmilia A Dowlatshahi, Paolo Gisondi, Giampiero Girolomoni, Tamar Nijsten, M Arfan Ikram, Marlies Wakkee
BACKGROUND: Based on increased cardio-metabolic comorbidities, inflammation and an overlap in genetics with Alzheimer's disease, psoriasis patients may be at risk for cognitive dysfunction and dementia. OBJECTIVE: To compare cognition, magnetic resonance imaging (MRI)-markers and dementia risk in psoriasis and non-psoriasis participants in the population-based Rotterdam Study. METHODS: We identified 318 psoriatic and 9678 non-psoriatic participants (mean age: 66...
August 6, 2018: Journal of the American Academy of Dermatology
Vladeta Ajdacic-Gross, Laura Bechtiger, Stephanie Rodgers, Mario Müller, Wolfram Kawohl, Roland von Känel, Margot Mutsch, Wulf Rössler, Erich Seifritz, Enrique Castelao, Marie-Pierre F Strippoli, Caroline Vandeleur, Martin Preisig, Peter Howell
AIMS: Associations between stuttering in childhood and a broad spectrum of risk factors, associated factors and comorbidities were examined in two large epidemiological studies. Subtypes of stuttering were then identified based on latent class analysis (LCA). METHODS: Data were from two representative Swiss population samples: PsyCoLaus (N = 4,874, age 35-82 years) and the ZInEP Epidemiology Survey (N = 1,500, age 20-41 years). Associations between stuttering and sociodemographic characteristics, familial aggregation, comorbidity and psychosocial risk / associated factors were investigated in both samples...
2018: PloS One
Marius Rademaker, Karen Agnew, Nicholas Anagnostou, Megan Andrews, Katherine Armour, Christopher Baker, Peter Foley, Kurt Gebauer, Monisha Gupta, Gillian Marshman, Diana Rubel, John Sullivan, Li-Chuen Wong
The Australasian Psoriasis Collaboration has developed a clinical practice narrative with respect to the relationship between psoriasis, its treatment and infection. The cutaneous microbiome of patients with psoriasis is different to those without psoriasis, although the significance of this is unclear. Whilst a wide range of microorganisms has been associated with psoriasis (including β-haemolytic streptococci, Staphylococcus aureus, Porphyromonas gingivalis, Candida albicans, Chlamydia psittaci, human immunodeficiency virus and hepatitis C virus), there is limited evidence that antimicrobial therapy is of direct benefit in preventing flares of psoriasis...
August 5, 2018: Australasian Journal of Dermatology
Nikolai Tsankov, Ivan Grozdev
Psoriasis is a multifaceted disease in terms of its pathophysiological mechanisms, inducing and aggravating factors, clinical types and clinical severity, associated comorbidities and therapeutic modalities. In recent years, an attracting perspective has emerged to identify variants of the disease with their own specific clinical course and management which could stratify the variable spectrum of the disease into different entities (such as palmo-plantar pustulosis). We hypothesize the existence of a unique Tuberculosis-related type of psoriasis that could be managed successfully with rifampicin...
August 2018: Medical Hypotheses
Marco Galluzzo, Simone D'Adamio, Elena Campione, Luca Bianchi, Marina Talamonti
BACKGROUND: Nowadays, even though several biologic therapies are available to treat psoriasis, multidrug-resistant disease continues to be a therapeutic challenge. Combination therapy has therefore become increasingly important. In this context, apremilast, according to its safety profile, could easily be combined with biologics in patients with comorbidities and/or recalcitrant multidrug-resistant psoriasis. OBJECTIVE: Our goal is to share experience from our institution in the observation of a patient with severe chronic plaque psoriasis that was unresponsive to all anti-tumor necrosis factor-α treatment and to an anti-interleukin (IL)-17A drug and only partially responsive to ustekinumab, even in combination with apremilast...
August 3, 2018: Molecular Diagnosis & Therapy
T-Y Tsai, H Yen, Y-C Huang
BACKGROUND: Patients with psoriasis are at increased risk for cardiovascular (CV) comorbidities. Previous studies examined the possible contribution of serum homocysteine, folate and vitamin B12 to CV risks in psoriasis patients but had conflicting conclusions. OBJECTIVES: We aimed to perform a systematic review and meta-analysis of studies on serum homocysteine, folate and vitamin B12 levels in patients with psoriasis. METHODS: Online databases were searched on February 15, 2018 to include studies comparing serum homocysteine, folate and vitamin B12 levels between psoriasis patients and controls...
August 3, 2018: British Journal of Dermatology
Maciej Haberka, Katarzyna Bańska-Kisiel, Beata Bergler-Czop, Małgorzata Biedroń, Ligia Brzezińska-Wcisło, Bogusław Okopień, Zbigniew Gąsior
Introduction Severe psoriasis is a chronic systemic immune-mediated disease associated with increased cardiovascular (CV) risk and several comorbidities. Objectives Our aim was to assess vascular indexes and selected serum biomarkers of increased CV risk in patients with a non-severe psoriasis. Patients and methods The study group included 80 patients with a mild or moderate psoriasis (mean PASI - Psoriasis Area Severity Index 18.6 (10.5)) and the control group included 39 age and BMI-matched individuals. All the patients had a comprehensive clinical assessment with aplanation tonometry (Pulse Wave Velocity, PWV) and a following ultrasound indexes: FMD (Flow Mediated Dilatation), carotid IMT (Intima Media Thickness)...
July 27, 2018: Polish Archives of Internal Medicine
Peter L M Kerkhof, Irina Khamaganova
Cardiology, dermatology, and rheumatology form a fascinating triad. Many skin and joint disorders are associated with cardiovascular comorbidities because they share etiologic elements. Female predominance is often remarkable and likely related to autoimmune pathology. Although studies have shown that X-encoded genes may be involved in the differences in immunity between males and females, other studies have also shown that sex chromosomes are irrelevant and that estrogens and androgens are responsible for the differences...
2018: Advances in Experimental Medicine and Biology
Joseph F Merola, Vivian Herrera, Jacqueline B Palmer
This study assessed the comorbidity burden and direct healthcare costs associated with psoriatic arthritis (PsA). Adults (18-64 years) with ≥ 2 claims for a PsA diagnosis ≥ 30 days apart in the Truven Health MarketScan database (July 2009-June 2014) were selected as the case group. The index date was randomly selected after the first claim for PsA. Controls free of PsA and psoriasis (PsO) in their entire claims history were assigned the same index date and were matched with the cases on age, gender, and geographic region...
July 26, 2018: Clinical Rheumatology
Arianna Zhang, Drew J B Kurtzman, Lourdes M Perez-Chada, Joseph F Merola
Psoriatic arthritis is a common form of inflammatory arthritis that frequently accompanies psoriasis of the skin-up to 30% of patients with psoriasis are affected. Recognition of the clinical features of psoriatic arthritis is critical, as delayed detection and untreated disease may result in irreparable joint injury, impaired physical function, and a significantly reduced quality of life. Recent epidemiologic studies have also supported that psoriatic arthritis is associated with cardiometabolic and cerebrovascular comorbidities, including coronary heart disease, diabetes mellitus, hypertension, dyslipidemia, and cerebrovascular accidents, further highlighting the importance of identifying affected patients...
July 2018: Clinics in Dermatology
Wayne P Gulliver, Shane Randell, Susanne Gulliver, Don Macdonald, Valerie Gregory, Sean Nagle, Olivier Chambenoit
Psoriasis is an inflammatory skin condition affecting 2% to 3% of the population and is associated with several comorbidities, including cardiovascular disease, depression, inflammatory bowel disease, metabolic syndrome, mood disorder, psoriatic arthritis, and weight gain. Psoriasis is treated with a number of topical and systemic therapies, including biologic drugs that directly target proinflammatory cytokines. This cross-sectional retrospective study investigated comorbid conditions reported in the Newfoundland and Labrador psoriasis population, outcomes associated with therapeutic treatment, and use of health care resources...
July 24, 2018: Journal of Cutaneous Medicine and Surgery
Vito Di Lernia, Mohamad Goldust
Psoriasis in elderly patients is considered to be of emerging clinical relevance because of the increase in the aged segment of the population. Psoriasis in such a group raises significant management challenges. There is an age-related immunosuppression, a high frequency of comorbidities, and polypharmacy, which enhances the potential risk of drug interactions or side effects when an additional systemic treatment must be administered. Despite the aging of the general population, clinical studies focusing on treatment of geriatric psoriasis are limited...
August 2018: Expert Opinion on Biological Therapy
Machaon Bonafede, Barbara H Johnson, Neel Shah, David J Harrison, Derek Tang, Bradley S Stolshek
OBJECTIVES: To determine the rate of timely disease-modifying antirheumatic drug (DMARD) initiation in patients newly diagnosed with rheumatoid arthritis (RA), as recommended per a quality measure endorsed by the National Quality Forum. STUDY DESIGN: Retrospective analysis of claims data from the Truven Health MarketScan commercial and Medicare claims databases. METHODS: Patients newly diagnosed with RA were identified in the claims databases...
July 2018: American Journal of Managed Care
Kevin K Wu, April W Armstrong
Psoriasis is a chronic inflammatory skin disease with under-investigated and underappreciated links to psychiatric comorbidities, including anxiety, depression, and suicidality. In this review, we synthesize and discuss the literature investigating the association between psoriasis and three measures of suicidality: suicidal ideation, suicide attempts, and completed suicide. Studies have shown that psoriasis is significantly linked to all three measures of suicidality, but the available data on suicide attempts and completed suicides is limited and less consistent...
July 18, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Shivani B Kaushik, Mark G Lebwohl
Psoriasis is a systemic inflammatory disease associated with increased risk of comorbidities such as psoriatic arthritis, Crohn disease, malignancy, obesity and cardiovascular diseases. All these factors have a significant impact on the decision to use one therapy over another. The past decade has seen a paradigm shift in our understanding of the pathogenesis of psoriasis which has led to identification of new therapeutic targets. Several new drugs have gained FDA approval, expanding the psoriasis armamentarium but still a large number of patients continue to be untreated or undertreated...
July 11, 2018: Journal of the American Academy of Dermatology
R Parisi, R T Webb, C E Kleyn, M J Carr, N Kapur, C E M Griffiths, D M Ashcroft
BACKGROUND: Psychological distress among people with psoriasis may lead to elevated risks of suicide and non-fatal self-harm. OBJECTIVES: To investigate psychiatric comorbidity, psychotropic medication prescribing and risk of suicidality in people with psoriasis. METHODS: A cohort of patients with psoriasis (1998-2014) was delineated using the Clinical Practice Research Datalink, with linkage to Hospital Episode Statistics and Office for National Statistics mortality records...
July 14, 2018: British Journal of Dermatology
Francisco Kerdel, Frank Don
Psoriasis is a chronic, immune-mediated, inflammatory disease that if left untreated can result in prolonged subclinical inflammation that affects a variety of organs, including the heart, liver, kidney, and intestines, as well as joints and muscles. Relatedly, psoriasis significantly increases patients' risks for developing certain comorbidities. Disease progression in psoriasis is unpredictable, and some patients have mild disease that is stable for many years, while in others, mild disease quickly progresses to moderate-to-severe psoriasis...
July 1, 2018: Journal of Drugs in Dermatology: JDD
Sofie Mylle, Lynda Grine, Reinhart Speeckaert, Jo L W Lambert, Nanja van Geel
New promising treatments have been developed for psoriasis that target different parts of the interleukin (IL)-23/IL-17 pathway. This approach is believed to be more disease specific, and sparing the T helper 1 pathway might prevent serious long-term adverse events. Moreover, superior Psoriasis Area and Severity Index improvements are observed, which has redefined treatment goals in psoriasis. The new molecules can be divided into different categories, according to the target: blocking agents can target the upstream cytokine IL-23 or the downstream IL-17...
July 12, 2018: American Journal of Clinical Dermatology
E Dauden, A J Blasco, C Bonanad, R Botella, J M Carrascosa, E González-Parra, E Jodar, B Joven, P Lázaro, A Olveira, J Quintero, R Rivera
BACKGROUND: The association between psoriasis and some diseases has become relevant in recent years. Providing appropriate management of psoriasis from an early stage requires prompt diagnosis and treatment of concomitant diseases and to prevent any potential comorbidity. This approach should consider the adverse events of the drugs used to treat psoriasis potentially related to the onset of comorbidities. OBJECTIVE: To provide the dermatologist with an accurate and friendly tool for systematizing the diagnosis of psoriasis-associated comorbidities, which generally escapes the scope of the dermatology setting, and to facilitate decision-making about the referral and treatment of patients with comorbidities...
July 10, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
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