Study of the Visceral Adipose Tissue in a Cohort of Patients with Moderate-Severe Psoriasis Treated with Biological Therapy.

INTRODUCTION: Visceral adipose tissue (VAT) has a greater relationship with the genesis of the metabolic syndrome and the pathology associated with obesity. METHODS: A cross-sectional study of patients with moderate-severe psoriasis in the Psoriasis Unit of the San Cecilio University Hospital in Granada in the period July 1, 2020 - December 31, 2020, was performed. All the patients (n = 110) were receiving biological therapy to control the disease. The variables measured included age, sex, time since diagnosis, weight, height, body mass index (BMI), visceral and total fat, and severity parameters. The visceral fat index was evaluated using a bioimpedance scale, considering a cut-off point for a healthy level < 12. RESULTS: Our sample consisted of 110 patients with a mean age of 47.47 years, with a clear predominance of males (61.7% of patients). After testing for normality using the Kolmogorov-Smirnov test, the Mann-Whitney U test for nonparametric data for independent samples was used, which revealed significant differences between the number of previous treatments and visceral fat (U = -2.235, P = 0.025). No statistically significant differences were found when correlating total fat or visceral fat with BMI. CONCLUSIONS: The results presented lead us to consider if the levels of VAT could be a factor that contributes to some extent to therapeutic refractoriness. The determination of VAT using bioimpedance scales in patients with moderate-severe psoriasis is a valuable method to measure VAT.

Distribution pattern of psoriasis affects sexual function in moderate to severe psoriasis: a prospective case series study.

INTRODUCTION: Psoriasis may significantly impair sexual function. Depression and organic factors appear to play a key role in this relationship. However, beyond genital psoriasis, the importance of the distribution pattern of the disease has not been considered. AIM: To investigate the role of the distribution pattern of psoriasis in sexual dysfunction. METHODS: A prospective case series study was carried out on 133 patients with moderate to severe psoriasis. MAIN OUTCOME MEASURES: The participants completed the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, and the Self-Administered Psoriasis Area and Severity Index. RESULTS: Forty-four women (mean age 42.0 ± 14.1) and 79 men (mean age 47 ± 11.7) were included in the study. Psoriasis lesions on abdomen, genitals, lumbar region, and buttocks in women and chest, genitals, and buttocks in men were associated with an increase in sexual dysfunction. Multivariate logistic regression analysis showed that the involvement of these specific areas may be independent risk factors for sexual dysfunction in patients with moderate to severe psoriasis. CONCLUSIONS: This is the first study identifying body areas other than genitals as potentially related to sexual dysfunction in psoriasis patients. The results suggest that the assessment of sexual dysfunction and the involvement of these body areas should be considered as disease severity criteria when deciding on treatment for psoriasis patients.

Cutaneous Cryptococcus laurentii infection in an immunocompetent child.

Cryptococcus laurentii is an extremely rare human pathogen. We report a case of primary cutaneous cryptococcosis caused by Cryptococcus laurentii in an immunocompetent patient, an 8-year-old child with a solitary lesion on the forearm. It was impossible to determine the source of infection and no predisposing factors were found. Oral treatment with fluconazole was totally successful. A review of the literature showed only three cases of cutaneous infection by Cryptococcus laurentii. All of the cases occurred in immunocompromised patients. To the best of our knowledge, this is the first case of Cryptococcus laurentii in an immunocompetent host.