Psoriasis vulgaris does not adversely influence the quality of sleep.

AIM: Sleep could be severely affected in psoriasis because of skin symptoms and psychological repercussions of the disease. The aim of this study was to investigate the influence of psoriasis on sleep. METHODS: A total of 202 patients with psoriasis and 202 healthy volunteers have completed a self-rated questionnaire, the Pittsburgh Sleep Quality Index, which assesses sleep quality and disturbances over a 1-month time interval. The severity of the dermatoses has been evaluated utilizing the PASI score. RESULTS: In psoriatic patients the Pittsburgh Sleep Quality Index resulted between 0 and 17 (5.56±3.93), in the controls between 0 and 18 (5.13±4.16). No statistically significant correlation was observed between the score of Pittsburgh Sleep Quality Index and PASI. The anti-psoriatic therapy, while causing a marked improvement of lesions and itching, does not affect the quality of sleep. CONCLUSION: Although literature indicated that psoriasis negatively affects the quality of sleep, in this study this correlation was not observed.

Detection of DNA of Chlamydophila psittaci in subjects with psoriasis: a casual or a causal link?

BACKGROUND: Recent evidence indicates that subclinical infection by Chlamydophila psittaci occurs in a significant percentage of patients with chronic inflammatory polyarthritis, including psoriatic arthritis. OBJECTIVE: To assess the prevalence of Chlamydiae infection in a large cohort of well-characterized patients with psoriasis. METHODS: The presence of a subclinical C. psittaci infection was investigated in 64 patients with psoriasis, including 12 patients with psoriatic arthritis. Two hundred and twenty-five healthy controls were also investigated. The presence of infection was assessed in peripheral blood mononuclear cells using several polymerase chain reaction protocols, targeting different regions of the bacterial genome. The DNA of other species (Chlamydophila pneumoniae and Chlamydia trachomatis) was also investigated. RESULTS: Chlamydophila psittaci infection was observed in a significantly higher percentage of patients with psoriasis (11/64, 17%) compared with healthy controls (1/225, 0.4%) (odds ratio 46.49, 95% confidence interval 5.87-368.03; P < 0.0001). No differences in age, sex or disease duration were noticed between positive and negative patients, but the majority of the positive patients were on immunomodulatory treatments. CONCLUSION: Chlamydophila psittaci may be an infectious trigger possibly involved in the pathogenesis of psoriasis.

Response of cutaneous microcirculation to treatment with mometasone furoate in patients with psoriasis.

BACKGROUND: In patients with psoriasis, videocapillaroscopy has been used to visualize the typical modifications in the microcirculatory architecture. AIM: To evaluate the modifications of the superficial capillary bed in a psoriatic plaque and healthy perilesional skin during treatment with a topical steroid. METHODS: In total, 24 patients affected with psoriasis vulgaris were enrolled. Each patient was instructed to apply mometasone furoate cream 0.1% once daily to a selected psoriatic lesion for 12 weeks. At baseline (T0) and after 4 (T1), 8 (T2) and 12 (T3) weeks, clinical and capillaroscopic examination was made of the psoriatic plaque and the surrounding skin. RESULTS: At the end of the study, the diameters of dilated and convoluted capillaries in the psoriatic plaque were significantly reduced (baseline, 69.2 microm; after 12 weeks, 29.3 microm; P < 0.0001) in all subjects. A marked clinical improvement was also noted (plaque score: baseline, 7.4; after 12 weeks, 0.5; P < 0.0001). The perilesional skin also showed improvement in capillaroscopic alterations, even if the drug had not been applied to those areas. Of the 24 patients, 12 were clinically healed at the end of the treatment period, although the capillaroscopic picture returned to normal in only 2 of them. CONCLUSIONS: Mometasone furoate cream proved to be effective in reducing the clinical and capillaroscopic alterations of the psoriatic plaque, but there was no association between clinical improvement and microcirculatory alterations noted. The action of mometasone furoate action on the microcirculation was not limited only to the area of application, but also extended to the surrounding areas.

[Scrofuloderma. a clinical case]. / Scrofuloderma. Un caso clinico.

Scrofuloderma is a form of colliquative cutaneous tuberculosis resulting from the spread of an underlying focus, generally represented by lymphnodes; osteoarticular tubercular locations or epididimus locations can also lead to ulcerative cutaneous involvement. We report the case of a female patient aged 12 who had been in Italy for 15 days following her arrival from Marocco. In the left clavicular region she presented an ulcerated lesion with palpable lymphnodes on the corresponding side of the neck. Histopathological examination of one of the involved lymphnodes suggested a mycobacteriosis; differential diagnosis was carried out between MAIS (M. avium, M. intracellulare, M. scrofulaceum) group mycobacteria infection and tuberculosis. Bacteriological research in the lymphnode of alcohol-acid resistant bacilli gave a negative result, while cultural examination and protein chain reaction pointed to M. tuberculosis. The patient was subjected to combined treatment based on rifampycin, isoniazide, etambutolol and pyrazinamide. At the present time, tuberculosis is an important public health problem in developing countries. In western countries such as the United Kingdom, which have been open to immigration for a longer time, scrofuloderma is present with higher prevalence in immigrants from Asia and Africa; in these immigrant populations, this tubercular form involves a wide age segment between the ages of 10 and 50. In the autochthonous population the highest incidence is in subjects aged more than 50. In Italy too, extra-communitary immigration has also contributed, with a delay compared to other western countries, to bring tuberculosis back into the public eye after a period of decades during which it was wrongly considered to have disappeared.