The levels of serum pentraxin3, CRP, fetuin-A, and insulin in patients with psoriasis.

OBJECTIVE: The objective of this study was to evaluate the relationship between disease severity and biochemical parameters such as pentraxin3, CRP, fetuin-A, insulin and HOMA-IR levels in patients with psoriasis. PATIENTS AND METHODS: This study included 58 patients with psoriasis and 30 healthy controls admitted to Ankara Numune Teaching and Research Hospital between January 2011-August 2012. Serum pentraxin3, CRP, fetuin-A and insulin concentrations were determined. Also, HOMA-IR values were calculated. RESULTS: The serum values for CRP, insulin, HOMA-IR, pentraxin-3 and fetuin-A in patients with psoriasis were elevated than control subjects (p values=0.002, 0.003, 0.003, 0.006 vs 0.007, respectively). According to the PASI score, patients were divided into three groups, minimal, moderate and severe psoriasis. There were positive correlation between the levels of CRP and insulin, HOMA-IR, PASI score. In addition, PASI score values were positively correlated with insulin, HOMA-IR and fetuin-A levels. CONCLUSIONS: Elevated levels of pentraxin3, CRP, fetuin-A, insulin and HOMA-IR might play a role in the pathogenesis of psoriasis. Higher CRP, fetuin-A, insulin and HOMA-IR concentrations were associated with the severity of the psoriasis.

Efficacy of erythromycin for psoriasis vulgaris.

Psoriasis is characterised by the presence of neutrophil overactivation and overproduction of interleukin (IL)-6 and IL-8 from keratinocytes. It is now clear that macrolide antibiotics have anti-inflammatory effects, such as inhibition of IL-6, IL-8 and tumour necrosis factor-alpha, perhaps by suppressing the transcription factor nuclear factor-kappaB or activator protein-1, and reduction of neutrophil activity. It is thus possible that macrolides might be a candidate for adjunctive treatment of psoriasis. In this study, we investigated the effectiveness of treatment with the macrolide antibiotic, erythromycin, for skin lesions and pruritus of patients with psoriasis. In total, 60 patients with psoriasis, especially pruritic psoriasis, were included. This was an open-label study and the analysis was on an intention-to-treat basis. Oral macrolide antibiotics and topical corticosteroids were given to the study group of 36 patients. The control group (24 patients) were treated only with topical corticosteroids. After a 4-week treatment period, scores on the Psoriasis Area and Severity Index (PASI) at baseline and at the end of the treatment, and the effectiveness in reducing itching were compared within and between both groups. Although there was no statistically significant difference between the baseline mean PASI of the two groups (P=0.81), there was a statistically significant difference between the mean PASI of the two groups at the end of the treatment (P=0.023, 95% confidence interval: - 3.45 to - 0.27). The comparison of the mean difference in PASI yielded a statistically significant difference (P=0.03, 95% confidence interval 0.73-3.55). Our study suggests that macrolides could be used as one of the adjunctive therapies for psoriasis vulgaris.

Penile pyoderma gangrenosum.

Pyoderma gangrenosum is a rare ulcerating inflammatory skin disease. Genital involvement has been rarely reported. We report a 24-year-old man with penile pyoderma gangrenosum who was treated with systemic corticosteroids.

Prevalence of hepatitis C virus antibodies and cryoglobulinemia in patients with leukocytoclastic vasculitis.

BACKGROUND: Several dermatologic manifestations of hepatitis C virus (HCV) infection have been described. The association of HCV infection, essential mixed cryoglobulinemia and leukocytoclastic vasculitis (LV) have been published mainly in case reports. OBJECTIVE: The aim of the present study was to determine the prevalence of HCV infection and cryoglobulinemia in patients with LV. METHODS: Twenty-five cases of LV were tested for anti-HCV antibodies by means of a third-generation enzyme-linked immunosorbent assay, and cryoglobulins were detected by the precipitation method. Thirty healthy volunteers served as control group. RESULTS: Anti-HCV antibodies were detected in 2/25 patients with LV (8%) and none of the control group. Cryoglobulinemia was detected in 1 patient with LV and none in the control group. CONCLUSION: Although no significant difference between patients and the control group was detected, the prevalence of anti-HCV antibodies in LV patients is as high as 8%. Considering this, it seems reasonable to investigate the presence of HCV in unexplained cases of LV.

Itraconazole therapy in lymphocutaneous sporotrichosis: a case report and review of the literature.

A 24-year-old white man had a six-month history of nontender nodules on the dorsal aspect of the right hand. The lesions were diagnosed as lymphocutaneous sporotrichosis based on clinical appearance, histopathologic examinations, and fungal culture. Therapy with itraconazole was started. Considerable improvement was recorded after two months, when all of the lesions diminished in size and were no longer nodular in appearance.