Addictive behaviors, cardiovascular and metabolic comorbidities in North African psoriatic patients: case-control study.

We propose to study the epidemiological aspects of North African psoriasis and determine the cardiovascular comorbidities and addictive behaviors associated with psoriasis. This is a North African case-control study which was conducted over a five year period (October 2008 through August 2013), involving 671 psoriatic patients and 1,242 controls identified in various Algerian, Tunisian and Moroccan university hospitals. For each patient, epidemiological characteristic, addictive behaviors, and cardiovascular pathologies associated with psoriasis were noted. Six hundred and seventy one psoriasis patients and 1,242 controls were included in this study. The average age was 47.24 years and the M/F sex-ratio was 1.11 (354 men and 317 women). Statistical analysis showed that psoriasis patients were more likely to develop addictive behaviors than controls (smoking p<10-5 and alcohol consumption: p < 10-5), together with dyslipidemia (30.1% of patients p < 10-5), obesity (23.8% of patients p < 10-4), hypertension (22.3% of patients p < 10-5), diabetes (21.7% of occurrences p < 10-5) and metabolic syndrome (37.4% of patients p<10-5). The relative risk for developing psoriasis was 1.9 in hypertensive patients, 1.7 in diabetic patients, 3.9 in dyslipidemic patients, 1.8 in obese patients, 2.6 in those with metabolic syndrome, 2.1 in smokers and 2.8 in alcoholics. Our work confirms the high incidence of addictive behaviors and of cardiovascular and metabolic comorbidities during the North-African psoriasis, hence the need for a multidisciplinary comprehensive care based on a guideline suited to the characteristics of North-African psoriatic patients.

Metabolic syndrome in Moroccan patients with psoriasis.

BACKGROUND: Several recent reports have shown a significant association between psoriasis and metabolic syndrome (MBS). OBJECTIVE: The goal of this study was to investigate the prevalence of MBS and, in particular, the main factors that determine this syndrome in Moroccan patients with psoriasis. METHODS: A case-control study has included 150 patients with psoriasis and 300 controls matched for age and sex, the MBS was defined according to the International Diabetes Foundation, and the severity of psoriasis was assessed by body surface area. RESULTS: Mild psoriasis was seen in 10.7%, 40.3% had moderate psoriasis, and 49% had severe psoriasis. MBS was higher in cases than in controls with statistical differences (44.7 vs. 2.7%, odds ratio [OR]: 26 CI: [12.4-54.3]; P = 0.000). Abdominal obesity and dyslipidemia were the only metabolic factors significantly related to psoriasis whereas diabetes, hypertension, smoking, alcohol consumption, and cardiovascular diseases were not significant. MBS increases with age in our patients with psoriasis, whereas there was no relationship between MBS and gender. Hypertension (P = 0.007), diabetes (P = 0.003), and increased level of triglycerides (P = 0.05) and high-density lipoprotein cholesterol (P = 0.003) were associated with the severity of psoriasis. CONCLUSION: Metabolic syndrome is an important comorbidity in patients with psoriasis, and vigilance and enhanced screening may be important in this population, especially patients with severe disease.

Pemphigus: use of the Japanese severity index in 56 Moroccan patients.

INTRODUCTION: In pemphigus, there still is no consensus on parameters mesuring clinically the disease severity. The aim of this study is to use the Japanese severity index in Moroccan patients with pemphigus. METHODS: Multicenter prospective study from September 2007 to September 2009 including consecutive patients with confirmed pemphigus. We used the Japenese severity index for pemphigus. For each patient, the score was calculated at diagnosis and at 6 months of follow-up and correlated to type of pemphigus; mean dosage of corticosteroids and clinical statuts at 6 months: dead or not. RESULTS: Fifty six patients were included, 20 men and 36 women, mean age 46.62 ± 15.9 years. At diagnosis, the mean initial score was 7.7 + 2.36; at six months, it was 1.61 + 1.83. The score variation at 6 months and inclusion was 6.19 ± 2.18 for deep pemphigus and 5.43 ± 2.85 for superficial pemphigus (p = 0,3 non significant). At six months, 4 patients were dead: their initial score was 11 + 1.41 while the initial score in the 52 patients was 7.4±2.03 (p = 0,001, significant). Data showed no correlation between initial severity scores and cumulative dosage of corticosteroids at 6 months (Pearson coefficient of correlation 0.144; p = 0.580). CONCLUSION: In this study, initial severity scores for pemphigus were high and decreased at 6 months of treatment. Both deep pemphigus and superficial pemphigus were severe as their score variation was similar. Japenese severity score is useful for Moroccan patients with pemphigus.