Psoriasis and uveitis: a literature review.

Psoriasis is a systemic, chronic, immunologically mediated disease, with significant genetic and environmental influences. It affects from 1 to 3% of the world population. Recently, the relation between psoriasis and different comorbidities, particularly metabolic syndrome, has become extremely relevant. Uveitis is characterized by a process of intraocular inflammation resulting from various causes. Considering psoriasis and uveitis as immune-mediated diseases, this study aims to evaluate the possible association of psoriasis and/or psoriatic arthritis with uveitis and its subtypes. Few studies have evaluated the association of uveitis and psoriasis without joint involvement. It seems that psoriasis without arthropathy is not a risk factor for the development of uveitis. Uveitis tends to develop more frequently in patients with arthropathy or pustular psoriasis than in patients with other forms of psoriasis. Ophthalmic examination should be performed periodically in patients with psoriasis and uveitis. If ophthalmopathy is diagnosed, the patient should receive adequate treatment with anti-inflammatory drugs or immunomodulators to prevent vision loss.

Psoriasis and uveitis: a literature review / Psoríase e uveíte: uma revisão da literatura

Psoriasis is a systemic, chronic, immunologically mediated disease, with significant genetic and environmental influences. It affects from 1 to 3% of the world population. Recently, the relation between psoriasis and different comorbidities, particularly metabolic syndrome, has become extremely relevant. Uveitis is characterized by a process of intraocular inflammation resulting from various causes. Considering psoriasis and uveitis as immune-mediated diseases, this study aims to evaluate the possible association of psoriasis and/or psoriatic arthritis with uveitis and its subtypes. Few studies have evaluated the association of uveitis and psoriasis without joint involvement. It seems that psoriasis without arthropathy is not a risk factor for the development of uveitis. Uveitis tends to develop more frequently in patients with arthropathy or pustular psoriasis than in patients with other forms of psoriasis. Ophthalmic examination should be performed periodically in patients with psoriasis and uveitis. If ophthalmopathy is diagnosed, the patient should receive adequate treatment with anti-inflammatory drugs or immunomodulators to prevent vision loss.

Psoríase é uma doença sistêmica, crônica, imunologicamente mediada, com importante influência genética e ambiental, que afeta 1 à 3% da população mundial. Nos últimos anos, a relação da psoríase com diferentes comorbidades, em especial a síndrome metabólica, tornou-se extremamente relevante. A uveíte é caracterizada por um processo de inflamação intra-ocular resultante de várias causas. Considerando a psoríase e a uveíte como doenças imunologicamente mediadas, o presente trabalho visa avaliar a possível associação da psoríase e/ou artrite psoriática com a uveíte e seus subtipos. Poucos são os estudos que avaliam a associação de uveíte e psoríase sem comprometimento articular. Parece que a psoríase sem artropatia não seria um fator de risco para desenvolvimento de uveíte. A uveíte tende a desenvolver mais frequentemente em pacientes com artropatia ou psoríase pustulosa que em outras formas de psoríase. Avaliação oftalmológica deve ser feita periodicamente em pacientes com psoríase, proporcionando ao paciente um diagnóstico precoce da oftalmopatia e a instituição de tratamento adequado com anti-inflamatórios não hormonais ou drogas imunomoduladoras, no intuito de evitar a perda da visão nos pacientes com psoríase e uveíte.

Psoríase pustulosa da infância: relato de caso / Childhood pustular psoriasis: case report

A psoríase pustulosa generalizada é tipo raro de psoríase descrita pela primeira vez, em 1910, por Von Zumbusch. A psoríase pustulosa generalizada na criança tende a ter um curso mais benigno que no adulto, entretanto, em sua forma grave, pode por em risco a vida do paciente. Talvez, pela raridade da doença, nenhuma opção terapêutica se mostrou consistentemente eficaz e segura até o momento. Relatos isolados sugerem ser o retinoide a droga de escolha nesses casos, porém trata-se de fármaco que, na primeira infância, traz mais dificuldades no manejo. Relata-se exemplo dessa rara doença em lactente, quadro extenso e grave, com resposta satisfatória ao uso de dapsona, com boa tolerabilidade.

Generalized pustulous psoriasis is a rare type of psoriasis first described in 1910 by Von Zumbusch. This disease tends to have a more benign development in children when compared to its development in adults. However, in its serious form it may represent a risk to the patient's life. Maybe, due to being such a rare disease no therapeutic option has so far consistently proved to be both effective and safe. Isolated reports suggest that retinoid is the best choice of drug in these cases. However, it is difficult to manage this drug in early infancy. The present report describes a serious case of this rare disease in an infant with a satisfactory response and good tolerance to the use of dapsone.

Childhood pustular psoriasis: case report.

Generalized pustulous psoriasis is a rare type of psoriasis first described in 1910 by Von Zumbusch. This disease tends to have a more benign development in children when compared to its development in adults. However, in its serious form it may represent a risk to the patient's life. Maybe, due to being such a rare disease no therapeutic option has so far consistently proved to be both effective and safe. Isolated reports suggest that retinoid is the best choice of drug in these cases. However, it is difficult to manage this drug in early infancy. The present report describes a serious case of this rare disease in an infant with a satisfactory response and good tolerance to the use of dapsone.

Manifestations of the human T-cell lymphotropic virus type I infection in childhood and adolescence

OBJETIVOS: Revisão da literatura sobre doenças relacionadas à infecção pelo vírus linfotrópico de células T humanas (HTLV-I) na infância e adolescência, focalizando clínica, diagnóstico, patogênese, evolução e tratamento. FONTES DOS DADOS: Literatura médica dos últimos 20 anos utilizando PubMed e MEDLINE e livros médicos especializados, com ênfase na dermatite infecciosa associada ao HTLV-I (DIH), na forma infanto-juvenil da mielopatia associada ao HTLV/paraparesia espástica tropical (HAM/TSP), na leucemia/linfoma de células T do adulto (ATL) e na uveíte associada ao HTLV-I. Palavras-chave usadas na pesquisa: dermatite infecciosa associada ao HTLV-I, mielopatia associada ao HTLV/paraparesia espástica tropical, leucemia/linfoma de células T do adulto, uveíte associada ao HTLV-I. SíNTESE DOS ACHADOS: A DIH é uma dermatite crônica, recidivante e infectada da infância que sempre envolve o couro cabeludo e que pode evoluir para HAM/TSP e ATL. A HAM/TSP é uma mielopatia crônica e incapacitante do adulto. Há 17 casos infanto-juvenis de HAM/TSP bem documentados na literatura, 12 dos quais em pacientes com DIH. Ao contrário da doença no adulto, essa forma é rapidamente progressiva. A ATL é uma leucemia/linfoma T do adulto, geralmente fatal. De 24 casos infanto-juvenis de ATL da literatura, 11 foram diagnosticados no Brasil. CONCLUSÕES: Essas doenças devem ser mais freqüentes na infância e adolescência do que indica a literatura. É aconselhável fazer sorologia para o HTLV-I em crianças e adolescentes com eczema crônico e recidivante, com sintomas e sinais de mielopatia ou com diagnóstico de leucemia/linfoma de células T. É importante que os pediatras saibam reconhecer as manifestações pediátricas dessa infecção para diagnosticá-las corretamente, propiciando aos pacientes orientação e tratamento adequados.

OBJECTIVES: To review the literature on diseases linked with infection by human T-cell lymphotropic virus type I (HTLV-I) in childhood and adolescence, with focus on clinical aspects, diagnosis, pathogenesis, progression and treatment. SOURCES: Medical literature published during the last 20 years identified using PubMed and MEDLINE and from specialized medical books, with emphasis on infective dermatitis associated with HTLV-I (IDH), on the juvenile form of HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP), on adult T-cell leukemia/lymphoma (ATL) and on HTLV-I-associated uveitis. Keywords used to search databases were: HTLV-I-associated infective dermatitis, HTLV-I-associated myelopathy/tropical spastic paraparesis, adult T-cell leukemia/lymphoma, HTLV-I-associated uveitis. SUMMARY OF THE FINDINGS: IDH is a chronic, relapsing and infected dermatitis of childhood which always involves the scalp and which may progress to HAM/TSP and ATL. HAM/TSP is a chronic and incapacitating myelopathy of adults. There are 17 well-documented cases of HAM/TSP in children and adolescents in the literature, 12 of whom are patients with IDH. In contrast with the adult form of the disease, the juvenile form is rapid and progressive. ATL is a type of T-cell leukemia/lymphoma that affects adults and is generally fatal. Eleven of the 24 published reports of ATL in children and adolescents were diagnosed in Brazil. CONCLUSIONS: These diseases are likely to be more common in childhood and adolescence than the literature would suggest. It is advisable that serological testing be performed for HTLV-I in children and adolescents suffering from chronic and relapsing eczema, with signs and symptoms of myelopathy or with a diagnosis of T-cell leukemia/lymphoma. It is important that pediatricians know how to recognize the pediatric manifestations of this infection in order to correctly diagnose them and offer their patients appropriate guidance and treatment.