Increased expression of microRNA-155 in peripheral blood mononuclear cells from psoriasis patients is related to disease activity.

BACKGROUND: MicroRNAs (miRNAs) gene expression regulators are altered in psoriasis suggesting their role in the pathogenesis. OBJECTIVE: To study expression changes of inflammation and toll-like receptor (TLR)-related miRNAs, miRNA-155, let-7i, miRNA-21, miRNA-146a and miRNA-223 in peripheral mononuclear cells (PBMCs) and miRNA-21, miRNA-146a and miRNA-223 in plasma, from chronic plaque-type psoriasis patients who were treatment-naive or had undergone a washout period (n = 11). MiRNAs were evaluated at baseline and after 11 (9-12) months [median (25th-75th percentile range)] of methotrexate (MTX) or topical (betamethasone plus calcipotriene) treatment. METHODS: MiRNA expression was analysed with quantitative real-time reverse transcription-polymerase chain reaction. Matched controls were studied. RESULTS: Psoriasis patients presented, at baseline, increased expression of miRNA-155, let-7i, miRNA-146a, miRNA-21 and miRNA-223 in PBMCs, plus miRNA-21, miRNA-146a and miRNA-223 in plasma. Receiver-operator characteristic (ROC) curve analysis and area under the curve (AUC) showed that expression of these miRNAs have the potential to distinguish between psoriasis and controls. At baseline, miRNA-155 expression in PBMCs correlated with Psoriasis Area Severity Index (PASI) [12 (8-14)] (Spearman r: 0.7140, P < 0.05) suggesting a role in psoriasis. After MTX or topical treatment, reduction in PASI was observed [87.5% (75-100)]; miRNA-155 expression in PBMCs decreased; plasma miRNA-21, miRNA-146a and miRNA-223 were down-regulated. ROC analysis showed that miRNA-155 expression in PBMCs from psoriasis patients have the potential to distinguish between patients' samples at baseline and after treatment (AUC: 0.942, sensitivity: 0.91; specificity: 0.91 values; maximum likelihood ratio =10). After treatment, miRNA-146a expression in PBMCs increased; miRNA-155/miRNA-146a ratio decreased, suggestive of a regulatory feedback; let-7i expression decreased; miRNA-21 and miRNA-223 remained elevated. CONCLUSION: In this exploratory study, psoriasis patients presented increased expression of miRNA-155 in PBMCs that correlated with PASI and decreased with disease remission. MiRNA-21, miRNA-146a and miRNA-223 in PBMCs and plasma were increased at baseline and differentially modulated, underscoring different roles of TLR-related miRNAs in psoriasis.

FR. Hemangiomas infantiles y B-bloqueantes. Cuándo, cómo y por qué / Infantile hemangioma and B-blockers: When, how, and why?

No disponible

Mastocitos y alopecia cicatricial: ¿hay una clara relación fisiopatológica? / Mast cells and scarring alopecia: Is there a clear pathophysiological relationship?

No disponible

Eritema multiforme: descripción de casos y variantes fenotípicas / Erythema multiforme: Description of cases and phenotypic variants

No disponible

Elevated prevalence of Type D (distressed) personality in moderate to severe psoriasis is associated with mood status and quality of life impairment: a comparative pilot study.

BACKGROUND: Psoriasis may imply a remarkable psychological impairment, which can influence patient's personality. The Type D personality is defined by the combination of social inhibition and negative affectivity. Furthermore, Type D personality has been associated with impaired health-related quality of life (HRQOL) and increased cardiovascular risk, both facts being associated with moderate to severe psoriasis. OBJECTIVES: To explore the prevalence of Type D personality in moderate to severe psoriasis patients; To analyse the relationship between Type D personality and the most common physical and psychological comorbidities in moderate to severe psoriasis and To explore the impact of Type D personality on HRQOL. METHODS: A prospective comparative study matched to age and sex. Eighty patients with moderate to severe psoriasis and 80 healthy volunteers were included in the study. The participants completed the DS14 test, the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, the SF-36 and the Psoriasis Disability Index. RESULTS: The prevalence of Type D personality was higher in patients with moderate to severe psoriasis as compared to healthy volunteers: 38.7% vs. 23.7%, P < 0.001. Psoriasis patients with Type D personality had a 3.2-fold risk of anxiety when compared to patients without Type D personality; odds ratio 3.2 (1.3-8.83 P = 0.01). Type D personality was significantly associated with an impaired general, sexual and psoriasis-related HRQOL (P < 0.01). CONCLUSION: Because Type D personality could represent a frequent type of personality among individuals with moderate to severe psoriasis, it could serve as a 'marker' of more psychologically vulnerable patients, probably related to dysfunctional coping strategies. The Type D personality could represent a profile more frequently encountered among patients with psoriasis, and might therefore help identify subjects physiologically more vulnerable to disease, most likely due to inadequate adaptation mechanisms.

Sexual dysfunction in psoriasis: a systematic review.

BACKGROUND: Psoriasis has been associated with numerous psychological disorders such as low self-esteem, depression, anxiety, sexual dysfunction or suicidal ideation. Recently, there has been a progressive increase in studies examining the impact of psoriasis on sexual function. This alteration seems to be considerable and can cause significant changes in quality of life. OBJECTIVE: The aim of this study was to elaborate recommendations for psoriasis and sexual function supported by a systematic review, to facilitate the application of new scientific findings into clinical practice and to serve as a basis for conducting future research. METHODS: We performed a systematic review of the available studies on psoriasis and sexual dysfunction. RESULTS: Scientific evidence shows that psoriasis patients have a higher risk of sexual dysfunction as compared to the general population. The risk of erectile dysfunction is also higher in psoriasis patients. The risk factors associated with sexual dysfunction in psoriasis patients are disease severity, female gender, psoriatic arthritis and age.

Alteraciones en los niveles de expresión del microARN-33 en plasma de pacientes con psoriasis / Abnormal Levels of Expression of Plasma MicroRNA-33 in Patients With Psoriasis

INTRODUCCIÓN Y OBJETIVOS: Se han identificado microARN (miARN) circulantes implicados en la regulación postranscripcional de genes del metabolismo de lípidos (miARN-33) y de la función vascular y angiogénesis (miARN-126). El objetivo de este estudio exploratorio ha sido evaluar los niveles plasmáticos de miARN-33 y miARN-126 en pacientes con psoriasis en placas y su relación con parámetros clínicos. MATERIAL Y MÉTODOS: Se estudiaron once pacientes con psoriasis en placas (PASI [mediana] [25 - 75% percentil] 13 [9-14] y BSA 12 [11-15]) y un grupo pareado en edad y sexo de 11 controles sanos. Se analizaron factores de riesgo cardiovascular y la ateromatosis carotídea subclínica. Los miARN plasmáticos se evaluaron mediante la reacción en cadena de la polimerasa cuantitativa a tiempo real (qRT-PCR). RESULTADOS: La media del grosor de la íntima carotídea (GIM) estaba aumentada en pacientes (0,57 mm [0,54-0,61], n = 11) respecto a controles (0,50 mm [0,48-0,54], datos disponibles n = 9) (test Mann-Whitney, p = 0,0055). La expresión de miARN-33 en pacientes (5,34 [3,12-7,96], n = 11) estaba significativamente aumentada respecto a controles (2,33 [1,71-2,84], n = 7; solo se pudo detectar en 7 de 11) (test de Wilcoxon signed Rank, p = 0,0049). No se observaron diferencias en los niveles de miARN-126 entre pacientes y controles. En pacientes se observó una correlación positiva entre miARN-33 e insulina (r = 0,7289, p = 0,0109, n = 11); y una correlación negativa entre miARN-126 y GIM (r = -0,6181, p = 0,0426, n = 11). CONCLUSIÓN: Los pacientes con psoriasis presentaban niveles plasmáticos aumentados de miARN-33 (metabolismo de lípidos y glucosa), que se correlacionaban con los niveles de insulina. La valoración de miARN-33 circulante puede contribuir al conocimiento de las alteraciones inflamatorias sistémicas en psoriasis

INTRODUCTION AND OBJECTIVES: Circulating microRNAs (miRNA) are involved in the posttranscriptional regulation of genes associated with lipid metabolism (miRNA-33) and vascular function and angiogenesis (miRNA-126). The objective of this exploratory study was to measure plasma levels of miRNA-33 and miRNA-126 in patients with plaque psoriasis and evaluate their association with clinical parameters. MATERIAL AND METHODS: We studied 11 patients with plaque psoriasis. The median Psoriasis Area Severity Index (PASI) was 13 (interquartile range [IQR], 9-14) and body surface area involvement was 12 (IQR, 11-15). Eleven healthy controls matched for age and sex were also included. We analyzed cardiovascular risk factors and subclinical carotid atheromatosis. Plasma miRNAs were evaluated using quantitative real-time polymerase chain reaction. RESULTS: Carotid intima-media thickness was greater in patients (0.57 mm; IQR, 0.54-0.61; n = 11) than in controls (0.50 mm; IQR, 0.48-0.54; data available for 9 controls) (P = 0.0055, Mann-Whitney). Expression of miRNA-33 in patients (5.34; IQR, 3.12-7.96; n = 11) was significantly higher than in controls (2.33; IRQ, 1.71-2.84; only detected in 7 of 11 controls) (P = 0.0049, Wilcoxon signed rank). No differences in miRNA-126 levels were observed between patients and controls. In patients (n = 11), we observed a positive correlation between miRNA-33 and insulin levels (r = 0.7289, P = 0.0109) and a negative correlation between miRNA-126 and carotid intima-media thickness (r = -0.6181, P = 0.0426). CONCLUSION: In psoriasis patients plasma levels of lipid and glucose metabolism-related miRNA-33 are increased and correlated with insulin. The study of circulating miRNA-33 in psoriasis may provide new insights about the associated systemic inflammatory abnormalities

Abnormal levels of expression of plasma microRNA-33 in patients with psoriasis.

INTRODUCTION AND OBJECTIVES: Circulating microRNAs (miRNA) are involved in the posttranscriptional regulation of genes associated with lipid metabolism (miRNA-33) and vascular function and angiogenesis (miRNA-126). The objective of this exploratory study was to measure plasma levels of miRNA-33 and miRNA-126 in patients with plaque psoriasis and evaluate their association with clinical parameters. MATERIAL AND METHODS: We studied 11 patients with plaque psoriasis. The median Psoriasis Area Severity Index (PASI) was 13 (interquartile range [IQR], 9-14) and body surface area involvement was 12 (IQR, 11-15). Eleven healthy controls matched for age and sex were also included. We analyzed cardiovascular risk factors and subclinical carotid atheromatosis. Plasma miRNAs were evaluated using quantitative real-time polymerase chain reaction. RESULTS: Carotid intima-media thickness was greater in patients (0.57mm; IQR, 0.54-0.61; n=11) than in controls (0.50mm; IQR, 0.48-0.54; data available for 9 controls) (P=.0055, Mann-Whitney). Expression of miRNA-33 in patients (5.34; IQR, 3.12-7.96; n=11) was significantly higher than in controls (2.33; IQR, 1.71-2.84; only detected in 7 of 11 controls) (P=.0049, Wilcoxon signed rank). No differences in miRNA-126 levels were observed between patients and controls. In patients (n=11), we observed a positive correlation between miRNA-33 and insulin levels (r=0.7289, P=.0109) and a negative correlation between miRNA-126 and carotid intima-media thickness (r=-0.6181, P=.0426). CONCLUSION: In psoriasis patients plasma levels of lipid and glucose metabolism-related miRNA-33 are increased and correlated with insulin. The study of circulating miRNA-33 in psoriasis may provide new insights about the associated systemic inflammatory abnormalities.

Síndrome papular purpúrico en guante y calcetín asociado a infección por Parvovirus B19 / Papular purpuric syndrome glove and sock associated with Parvovirus B19 infection

El síndrome papular purpúrico en “guante y calcetín” (SPPGC) es una dermatosis rara, aguda, caracterizada por lesiones eritematosas, pruriginosas y papulares en manos y pies, con una distribución en “guante y calcetín”, asociadas a lesiones orales y fiebre. Parvovirus B19 es en la mayoría de los casos el agente causante del síndrome. Presentamos el caso de un paciente adulto con síndrome papular purpúrico con lesiones poco frecuentes, asociado a Parvovirus B19 que fue confirmado mediante estudio serológico (AU)

Papular-purpuric “gloves and socks” syndrome (PPGSS) is a rare acute dermatosis characterized by pruritic erythematous and papular lesions on the hands and feet in a “gloves and socks” distribution associated with oral lesions and fever. Parvovirus B19 has been implicated in most cases as thecause of this syndrome. We present the case of an adult patient with papular purpuric syndrome with uncommon lesions, associated with parvovirusB19. He was confirmed by serology (AU)

Relationship between food intake and cutaneous solar elastosis adjacent to basal cell carcinoma.

BACKGROUND/OBJECTIVE: Studies suggest that diet may influence in skin ageing and skin appearance. However, the effect of diet in the elastotic changes of dermis, which is the main histological sign of ageing, has not been studied previously. The objective was to investigate if the dietary habits influence the dermal elastosis observed in BCCs. MATERIALS AND METHODS: The 136 patients with facial BCCs, who underwent surgery, were interviewed to assess the consumption of fruit, vegetables, fat, red meat, coffee and tea. We reviewed 136 specimens of BCC to identify the presence of solar elastosis. We also analysed clinical variables such as gender, age, phototype and smoking. RESULTS: Severe solar elastosis was found in 22 patients (16%), middle reticular dermis in 37 (27 %) and 77 patients (57%) had abscence or light elastosis. Fat consumption was reported by most of participants from our sample, while fruit and tea consumption was less common. Intakes of fat, vegetables and coffee were not associated with the grade of elastosis whereas Vitamin E and C-rich fruits and tea were correlated with less risk of elastosis. Smokers showed higher grades of elastosis than non-smokers. CONCLUSION: Our study provides evidence that the presence of dermal elastosis and cutaneous ageing may be influenced by the type of food intake: Vitamin E and C-rich fruit and tea are positively associated with less elastosis.

Assessment of incompletely excised basal cell carcinomas in six facial areas: influence of elastosis.

BACKGROUND: Incomplete excision of non-melanoma skin cancer is a clinical indicator of surgical care. With most basal cell carcinomas arising on the face and considering the cosmetic and functional structures involved, it is interesting to identify what are the areas within the face with more likelihood of incomplete excision and the factors implicated. The aim of this study was to identify those areas and possible predictive factors. Six anatomical regions were considered and studied selectively. METHOD: A monocentric study was performed reviewing all facial basal cell carcinomas excised at our center during 2010. Data were analyzed using SPSS software. RESULTS: 202 lesions from 202 subjects were studied. The percentage of incomplete excision was 17.07%. CONCLUSION: Lesions located in the orbitopalpebral and auricular areas and those with moderate to severe grade of associated elastosis are more likely to be incompletely excised. Wider surgical margins are observed in frontal, malar and labial areas which are distant from functional structures. The following tumor features were found to be a risk factor for incomplete resection: morpheic or superficial histology, large lesions (>20 mm) and thick lesions (>6 mm).

Vessel resistance to blood flow in the nailfold in patients with psoriasis: a prospective case-control echo Doppler-based study.

BACKGROUND: Psoriasis is a disease in which endothelial cells seem to play an important pathogenic role. No report published to date has examined nail vascularity in patients with psoriasis. OBJECTIVES: To evaluate the vascularity in the nails of patients with psoriasis treated with classic and biologic therapies for comparison with disease-free controls, and to evaluate whether there are differences in nail vascularity among patients with and without nail involvement. METHODS: We performed a prospective study with two cohorts comprising 23 patients with moderate-to-severe psoriasis and 23 controls without psoriasis. We measured the nailfold vessel resistance index (NVRI) in each subgroup. RESULTS: We found significant differences in the NVRI between patients and controls (P<0·001). Among patients with psoriasis, those with nail involvement showed a higher mean±SD NVRI (0·58±0·10) than those without (0·52±0·45). CONCLUSIONS: Psoriasis decreases the blood flow in nails, suggesting that this skin disease confers an independent risk for microvascular changes. This outcome may be associated with greater risk of nail-related signs.

Estudio de las consultas extraoficiales en un hospital de tercer nivel / Analysis of Unofficial Consultations in a Tertiary-Level Hospital

Introducción: Los dermatólogos somos demandados a diario, en nuestro centro de trabajo, por pacientes sin cita reglada (acompañantes de pacientes, médicos de otras especialidades, trabajadores del centro, etc.). Objetivos: Descripción de los pacientes demandantes, los motivos de consulta, la gravedad de la patología consultada, la actitud diagnóstico-terapéutica y asistencial de los profesionales demandados. Resultados: El paciente modelo sería una mujer enfermera de mediana edad que consulta por primera vez por una lesión tumoral melanocítica benigna. En general el dermatólogo tomará una actitud terapéutica empírica o informadora y considera que la atención prestada es similar a un paciente con cita reglada. Conclusiones: Las consultas no regladas, aunque suelen ser por patología banal, suponen una carga asistencial en la práctica diaria (AU)

Background: Dermatologists are regularly consulted in their place of work by patients without an official appointment (individuals accompanying other patients, doctors from other specialties, hospital workers, etc). Objectives: To describe the characteristics of consulting patients, reasons for consultation, severity of complaint, diagnostic and therapeutic approach taken, and level of care provided by the consulted professionals. Results: The typical patient would be a middle-aged female nurse consulting for the first time for a benign melanocytic lesion. In general, the dermatologist will take an empirical or informative therapeutic approach and consider the care provided to be similar to that offered to patients with an official appointment. Conclusions: Unofficial appointments, although commonly for trivial complaints, represent an additional workload in daily clinical practice (AU)

Elastorrexis papulosa. Presentación de un caso y claves para el diagnóstico diferencial / Papular Elastorrhexis: A Case Report and Principal Differential Diagnoses

No disponible

[Analysis of unofficial consultations in a tertiary-level hospital]. / Estudio de las consultas extraoficiales en un hospital de tercer nivel.

BACKGROUND: Dermatologists are regularly consulted in their place of work by patients without an official appointment (individuals accompanying other patients, doctors from other specialties, hospital workers, etc). OBJECTIVES: To describe the characteristics of consulting patients, reasons for consultation, severity of complaint, diagnostic and therapeutic approach taken, and level of care provided by the consulted professionals. RESULTS: The typical patient would be a middle-aged female nurse consulting for the first time for a benign melanocytic lesion. In general, the dermatologist will take an empirical or informative therapeutic approach and consider the care provided to be similar to that offered to patients with an official appointment. CONCLUSIONS: Unofficial appointments, although commonly for trivial complaints, represent an additional workload in daily clinical practice.

Lipid levels in patients with lichen planus: a case-control study.

BACKGROUND: Cardiovascular risk factors have been assessed with some skin diseases such as alopecia and psoriasis. Recently, a case-control study found that lichen planus (LP) was associated with dyslipidaemia in a large series of patients. However, no data were presented about lipid values in patients and controls. OBJECTIVE: The objective of this case-control study was to evaluate lipid levels in men and women with lichen planus and in healthy controls, excluding lichenoid drug eruption and treatment for LP such as systemic corticosteroids, retinoid acid or methotrexate. PATIENTS AND METHODS: This case-control study included 160 patients, 80 with LP (40 men and 40 women) and 80 controls consecutively admitted to the outpatient clinic in Dermatology department of San Cecilio Hospital, Granada, Spain. RESULTS: Patients with LP presented higher significant triglycerides values (145.9 vs. 101.5 mg/dL P = 0.0007), total cholesterol values (197.7 vs. 178.4 mg/dL P = 0.001), LDL-C values (120.8 vs. 100.9 mg/dL P < 0.0001) and lower HDL-C values (55.3 vs. 61.9 mg/dL P = 0.004) vs. controls. Adjusted OR for dyslipidaemia in patients with LP was 3.03 (95% confidence interval: 1.49-6.17, P = 0.002). CONCLUSION: The results obtained in this study indicate an association between LP and dyslipidaemia. Lipid levels screening in men or women with LP may be useful to detect individuals at risk and start preventive treatment against the development of cardiovascular disease.