Coexistência de psoríase e comorbidades relacionadas à síndrome metabólica / Coexistence of psoriasis with metabolic syndrome-related comorbidities

OBJETIVOS: Avaliar a coexistência da psoríase e comorbidades relacionadas à síndrome metabólica, e identificar a associação de características dessa dermatose (gravidade, forma clínica e tipo de tratamento) com essas comorbidades. MÉTODOS: Trata-se de um estudo transversal e descritivo de base hospitalar, envolvendo indivíduos com psoríase em acompanhamento em um ambulatório de referência, de 2014 a 2015, sem restrições para seleção dos mesmos. A análise dos dados, obtidos por meio de questionário, avaliação clínica e exames complementares, foi inicialmente descritiva e, posteriormente, por regressão logística univariada. RESULTADOS: Foram incluídos 59 indivíduos. Destes, 55,9% apresentaram obesidade abdominal, 72,9% hipertensão arterial e 62,7% redução da HDL-c. A presença de psoríase de maior gravidade (Índice de Gravidade da Psoríase por Área − PASI>10) indicou maior chance para a ocorrência de hipertensão arterial, elevação da glicemia e de triglicerídeos; pacientes com forma clínica não vulgar apresentaram maior chance para todas as comorbidades, exceto para elevação de triglicerídeos, e pacientes em uso de medicação sistêmica apresentaram maior chance para ocorrência de obesidade abdominal, elevação da glicemia e de triglicerídeos. CONCLUSÕES: Psoríase e comorbidades relacionadas à síndrome metabólica coexistiram. Possivelmente, as formas clínicas não vulgar, a psoríase grave e o tratamento sistêmico com essas comorbidades estão associadas

OBJECTIVE: To evaluate the coexistence of psoriasis with metabolic syndrome-related comorbidities, and to identify the association of this dermatosis features (severity, clinical presentation and type of treatment) with these comorbidities. METHODS: This is a hospital based, cross-sectional and descriptive study involving individuals with psoriasis attended in a reference outpatient clinic, from 2014 to 2015, with no selection restrictions. Data were obtained through a questionnaire, clinical evaluation and laboratory tests; data analysis was first descriptive and, subsequently, by univariate logistic regression. RESULTS: Fifty-nine subjects were included. Among these, 55.9% had abdominal obesity, 72.9% had arterial hypertension, and 62.7% had decrease in HDL cholesterol. The presence of more severe psoriasis (Psoriasis Area Severity Index - PASI>10) indicated increased odds for the occurrence of arterial hypertension, high blood glucose and triglycerides levels; patients with clinical presentations other than psoriasis vulgaris had increased odds to all comorbidities, except for high triglycerides levels, and patients using systemic medications had increased odds to abdominal obesity, high blood glucose and triglycerides levels. CONCLUSIONS: There was coexistence of psoriasis with metabolic syndrome-related comorbidities. There is possible association of clinical presentations other than psoriasis vulgaris, severe psoriasis and systemic treatment with these comorbidities.

Psoriasis and psoriatic arthritis in Peruvian aborigines: a report from the GRAPPA 2011 annual meeting.

OBJECTIVE: To determine the presence of psoriasis and psoriatic arthritis (PsA) in aboriginal people living in the Andean Mountains of Peru. METHODS: Consecutive patients with psoriasis and PsA attending an arthritis clinic in Juliaca, Puno, Peru, located 3824 m above sea level were examined. The CASPAR (ClASsification of Psoriatic ARthritis) criteria were used for classification of PsA. Diagnosis of psoriasis was confirmed by a dermatologist. RESULTS: Seventeen patients [11 (65%) men and 6 (35%) women] fulfilled classification criteria for PsA; one patient was of European ancestry and is not included in this report. Of the 16 aboriginal patients in this report, 5 were natives of Quechua ancestry and one was native Aymara. At the time of their first clinic visit, no native patient with PsA had a family history of psoriasis or PsA, and all patients exhibited an established disease of long duration and severity. Methotrexate was the drug of choice for all patients; 2 patients are currently receiving biological therapy. CONCLUSION: Contrary to what has been reported in the literature, both psoriasis and PsA are present in aboriginal people from the Andean Mountains of Peru. More studies are needed to further define the phenotype of these disorders, as well as the pathogenetic role of genetic and environmental factors.