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2.
An Bras Dermatol ; 94(6): 691-697, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31789271

RESUMO

BACKGROUND: Different strategies have been proposed for the cardiovascular risk management of patients with psoriasis. OBJECTIVE: To estimate the cardiovascular risk and evaluate two cardiovascular prevention strategies in patients with psoriasis, analyzing which proportion of patients would be candidates to receive statin therapy. METHODS: A retrospective cohort was selected from a secondary database. All patients >18 years with psoriasis without cardiovascular disease or lipid-lowering treatment were included. The atherosclerotic cardiovascular disease calculator (2018 American College of Cardiology/American Heart Association guidelines) and the Systematic Coronary Risk Evaluation risk calculator (2016 European Society of Cardiology/European Society of Atherosclerosis guidelines) were calculated. The SCORE risk value was adjusted by a multiplication factor of 1.5. The recommendations for the indication of statins suggested by both guidelines were analyzed. RESULTS: A total of 892 patients (mean age 59.9±16.5 years, 54.5% women) were included. The median atherosclerotic cardiovascular disease calculator and Systematic Coronary Risk Evaluation values were 13.4% (IQR 6.1-27.0%) and 1.9% (IQR 0.4-5.2), respectively. According to the atherosclerotic cardiovascular disease calculator, 20.1%, 11.0%, 32.9%, and 36.4% of the population was classified at low, borderline, moderate, or high risk. Applying the Systematic Coronary Risk Evaluation, 26.5%, 42.9%, 20.8%, and 9.8% of patients were stratified as having low, moderate, high, or very high risk, respectively. The proportion of subjects with statin indication was similar using both strategies: 60.1% and 60.9% for the 2018 American College of Cardiology/American Heart Association and 2016 European Society of Cardiology/European Society of Atherosclerosis guidelines, respectively. STUDY LIMITATIONS: This was a secondary database study. Data on the severity of psoriasis and pharmacological treatments were not included in the analysis. CONCLUSION: This population with psoriasis was mostly classified at moderate-high risk and the statin therapy indication was similar when applying the two strategies evaluated.


Assuntos
Anticolesterolemiantes/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Psoríase/prevenção & controle , Adulto , Idoso , Doenças Cardiovasculares/etiologia , Colesterol/sangue , Complicações do Diabetes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Psoríase/complicações , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Triglicerídeos/sangue
3.
Medicine (Baltimore) ; 98(50): e17917, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852063

RESUMO

OBJECTIVE: Psoriasis is a chronic inflammatory disease that affects the skin, joints, and nails. To investigate the efficacy of sonoelastographic evaluation for assessing nail involvement and severity in psoriasis. MATERIALS AND METHODS: Thirty-one psoriasis patients and 31 healthy control subjects were included in the study. The nail thickness and nail bed thickness of the thumbs of all cases were measured by gray scale ultrasonography. In addition, the values of strain elastography were measured by sonoelastography. RESULTS: Of the participants, 38 were male and 24 were female; the ratio of males and females was equal in both groups. There was no significant difference between the patient and control group in terms of gender and age. In the patient group, the mean duration of illness was 13.87 ±â€Š9.8 years, mean PASI score was 5.53 ±â€Š2.38, and mean NAPSI score was 33.97 ±â€Š37.99. The nail plate thickness and elastography strain ratios were found to be statistically higher in the psoriasis group compared to the control group. There was also significant correlation between elastography strain ratios and nail thickness (P = .014), nail bed thickness (P < .001) and NAPSI scores (P = .01). CONCLUSION: Due to the superiority of ultrasound in real-time imaging of the nail structure and the compatibility of sonographic elastography with clinical scores in the assessment of the nail bed, we believe that it can be used as a complementary method.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Doenças da Unha/diagnóstico , Unhas/diagnóstico por imagem , Psoríase/diagnóstico , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Unha/etiologia , Psoríase/complicações , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto Jovem
4.
Medicine (Baltimore) ; 98(47): e18063, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764836

RESUMO

BACKGROUND: Psoriasis (Pso) is a chronic, recurrent, and inflammatory disease involving genetic and immune factors. Psoriatic arthritis (PsA), accounting for 30% of Pso, is an inflammatory arthropathy. Pso and PsA are associated with increased cardiovascular events (CVEs). Biologic therapies for Pso and PsA are drawing arising attention for its therapeutic effects. Large evidences have shown that biologic agents could lower the risk of CVEs in patients with Pso and PsA. However, not all studies support this point. A systematic review is needed. METHODS: Four databases (PubMed, Web of Science, The Cochrane Library, and EMBASE) will be searched from the inception to July 1st, 2019. Randomized controlled trials and observational studies (including case-control studies and cohort studies) reporting CVEs in patients with Pso and PsA treated with biologic agents will be included. The primary outcome is the incidence of CVEs. The secondary outcome is the incidence of each individually reported cardiovascular event. Study selection, data extraction, and assessment of quality will be conducted independently by 2 reviewers. RevMan5.3.5 software will be used for data synthesis. RESULTS: The results of this study will provide evidence for the effect of biologic agents on the risk of CVEs in patients with Pso and PsA, so as to further provide guidance for clinical management. CONCLUSION: The findings of this study will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42019142778.


Assuntos
Artrite Psoriásica/complicações , Fatores Biológicos/uso terapêutico , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Metanálise como Assunto , Psoríase/complicações , Revisão Sistemática como Assunto , Doenças Cardiovasculares/epidemiologia , Humanos , Estudos Observacionais como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Medição de Risco
5.
Vestn Otorinolaringol ; 84(4): 61-66, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31579061

RESUMO

Here, we performed the comprehensive review of the peer-reviewed literature of the effect of chronic foci of streptococcal infection on the course of skin psoriasis, as well as an assessment of the effectiveness of tonsillectomy on the course of this pathology. A PubMed, Web of Science and Google Scholar search were performed with the keywords 'psoriasis' AND 'tonsillectomy' OR 'tonsillitis' OR 'streptococcal infection'. The reviewers identified and evaluated 197 reports published prior to August 2018, of which 153 were excluded from further analysis after review of titles and/or abstracts including four duplicate studies from the same authors in the same patient groups. In total, 44 reports were used and included in the review (including original studies, a description of clinical cases, literature reviews). Analysis of the original studies showed that the effectiveness of tonsillectomy in patients with psoriasis is from 11.4 to 78.6%. Among clinical cases, the rate was 20-100%. We did not conduct a meta-analysis and use the statistical methods because of the heterogeneity of the data. Data were analysed using a descriptive approach. Most studies came from Russia, USA, Japan. However, multiple limitations in the studies do not allow final conclusions about the effectiveness of tonsillectomy in patients with psoriasis.


Assuntos
Psoríase , Infecções Estreptocócicas , Tonsilectomia , Tonsilite , Humanos , Psoríase/complicações , Psoríase/cirurgia , Federação Russa , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/cirurgia , Tonsilite/complicações , Tonsilite/cirurgia
6.
J Low Genit Tract Dis ; 23(4): 287-289, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31592977

RESUMO

OBJECTIVES: Group A streptococcus (GAS) vulvitis is rare, mainly reported in association with vaginitis. We examined the clinical features of GAS vulvitis in adults, the presence of other infected sites, and its association with dermatological conditions. MATERIALS AND METHODS: We retrospectively analyzed the medical files and photographs of adult patients with bacteriologically confirmed GAS vulvitis seen at 3 private clinics. Coexisting infected sites, associated dermatological conditions, and bacteriological results for the husbands of 3 patients were examined. RESULTS: Nineteen patients (mean age = 52.2 [range = 23-83] years) with vulvar GAS infections were identified. The vulvar symptoms consisted of pain (11 cases), pruritus (9), burning (4), and discharge (10). The predominant physical feature was bilateral erythema, mainly located on the labia minora and the inner aspect of the labia majora. This erythema was associated with oozing (3), edema (6), or fissures (6). Seventeen patients had an associated vaginal infection, which was asymptomatic in 7 cases; anal infections were present in 9 cases. The following 10 patients had associated dermatological conditions: psoriasis (6), lichen sclerosus (2), Paget disease (1), or vitiligo (1). Two (one each from the throat and penis) of the 3 bacteriological specimens taken from the 3 husbands were GAS positive. CONCLUSIONS: In most adult women, GAS vulvitis is associated with a vaginal infection that may be asymptomatic. A bilateral, oozing, and edematous or fissured erythema involving the vulvar or anovulvar area is suggestive of GAS vulvitis. The association with psoriasis and the benefits of screening household members and sexual partners deserves further attention.


Assuntos
Psoríase/complicações , Infecções Estreptocócicas/patologia , Streptococcus pyogenes/isolamento & purificação , Vulvite/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecções Estreptocócicas/microbiologia , Vulvite/microbiologia , Adulto Jovem
7.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(8): 642-652, oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-185502

RESUMO

La psoriasis es un proceso inflamatorio crónico que se ha asociado con múltiples comorbilidades, especialmente las formas más graves y asociadas a artritis. El estado de inflamación sistémica es, probablemente, la conexión entre todas estas enfermedades concomitantes. Algunos trabajos recientes indican que los pacientes con psoriasis pueden tener mayor riesgo de fracturas patológicas y osteoporosis. Las guías actuales de abordaje de las comorbilidades de la psoriasis no incluyen valoración de la salud del hueso. Por eso, en este artículo nos proponemos revisar la evidencia disponible sobre la relación entre psoriasis y osteoporosis. Repasaremos primero el concepto de osteoporosis, abordaremos también el papel de la vitamina D en el hueso y, por último, proponemos un algoritmo de manejo y tratamiento de la osteoporosis en el paciente con psoriasis


Psoriasis is a chronic inflammatory disease associated with multiple comorbidities, particularly in patients with arthritis or more severe forms of the disease. The link between all these comorbidities is probably systemic inflammation. Several recent studies have indicated that patients with psoriasis may be at an increased risk of pathologic fractures and osteoporosis. Current guidelines on comorbidities in psoriasis do not recommend assessment of bone health. In this article, we review the available evidence on the association between psoriasis and osteoporosis. We first examine the concept of osteoporosis and the role of vitamin D in bone health and then propose an algorithm for managing and treating this condition in patients with psoriasis


Assuntos
Humanos , Osteoporose/epidemiologia , Fatores de Risco , Qualidade de Vida , Psoríase/complicações , Fraturas Ósseas/complicações , Osteoporose/complicações , Densitometria/métodos , Índice de Massa Corporal , Indicadores Básicos de Saúde , Reabsorção Óssea/patologia , Deficiência de Vitamina D/complicações
11.
J Drugs Dermatol ; 18(8): 790-796, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31424709

RESUMO

BACKGROUND: A novel foam formulation of halobetasol propionate, 0.05% (HBP-Foam) has been developed to treat plaque psoriasis in patients who prefer a thermostable topical foam with low application shear that allows for easier coverage over large and/or hirsute areas than existing formulations. OBJECTIVE: To determine the safety and effectiveness of HBP-Foam in subjects with plaque psoriasis. METHODS: Two randomized, double-blind, vehicle-controlled clinical studies were conducted in 560 adult subjects with moderate to severe plaque psoriasis. Subjects applied the assigned test article to all psoriatic plaques twice daily for 14 days. The key efficacy measures were the proportion of subjects with "treatment success," defined as those subjects that achieved a score of 0 (clear) or 1 (almost clear) and at least a two-grade improvement compared to baseline for the Investigator's Global Assessment (IGA) and for the clinical signs of psoriasis (plaque elevation, scaling, and erythema) as well as pruritus. Safety measurements included adverse events and local skin reactions in the treatment area. RESULTS: HBP-Foam was statistically superior to vehicle in achieving "Treatment Success" in 25.3% and 30.7% vs 3.9% and 7.4% (P<0.001) in Studies 1 and 2, respectively. Pruritus scores statistically improved by over 30% in HBP-Foam treated subjects. In addition, these subjects experienced a significant reduction in the clinical signs of psoriasis (plaque elevation, scaling, and erythema). In contrast, in the vehicle groups the decrease in psoriasis-related signs was generally not observed. Safety outcomes were unremarkable and similar in both the HBP-Foam and vehicle treatment groups. CONCLUSIONS: These results demonstrate the safety and effectiveness of HBP-Foam in the treatment of plaque psoriasis. Furthermore, this novel foam formulation has demonstrable for its ease of application over large and/or hairy treatment areas. ClinicalTrials.gov Registration: NCT02742441 NCT02368210


Assuntos
Clobetasol/análogos & derivados , Fármacos Dermatológicos/administração & dosagem , Veículos Farmacêuticos/administração & dosagem , Prurido/tratamento farmacológico , Psoríase/tratamento farmacológico , Vasoconstritores/administração & dosagem , Adulto , Idoso , Clobetasol/administração & dosagem , Clobetasol/efeitos adversos , Fármacos Dermatológicos/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Veículos Farmacêuticos/efeitos adversos , Prurido/diagnóstico , Prurido/etiologia , Psoríase/complicações , Psoríase/diagnóstico , Índice de Gravidade de Doença , Pele , Resultado do Tratamento , Vasoconstritores/efeitos adversos
12.
Medicine (Baltimore) ; 98(31): e16323, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374004

RESUMO

The aim of this study was to conduct a more comprehensive analysis of the association between psoriasis and abnormal lipid metabolism.The case-control study included 222 psoriatic patients and 445 non-psoriatic control patients matched for age and gender. Clinical parameters included age, gender, and body mass index (BMI). Serum lipid levels were recorded and included cholesterol (CHO), triglycerides (TG), low-density lipoprotein (LDL), high density lipoprotein (HDL), phospholipids (PLIP), free fatty acids (FFA), lipoprotein (a) [Lp(a)], and apolipoproteins (apoA1, apoB, and apoE). Statistical analysis was carried out through the IBM Statistical Package for the Social Studies version 23.0.Compared with controls, levels of BMI and the prevalence of obesity were significantly higher in psoriatic patients. The results revealed that when compared to controls, significant elevation of serum TG (P <.001) and Lp(a) (P = .022) was observed. Levels of HDL (P <.001) and apoA1 (P <.001) were significantly lower in psoriatic patients. There was no significant difference in CHO (P = .367), LDL (P = .400), apoB (P = .294), apoE (P = .05), PLIP (P = .931) and FFA (P = .554) between patients and controls. The levels of CHO, TG, PLIP, FFA, and apoE were positively correlated with BMI level.Dyslipidemia was more common in psoriatic patients, compared with non-psoriatic controls.


Assuntos
Dislipidemias/etiologia , Obesidade/etiologia , Psoríase/complicações , Adulto , Idoso , Apolipoproteínas B/análise , Apolipoproteínas B/sangue , Apolipoproteínas E/análise , Apolipoproteínas E/sangue , Índice de Massa Corporal , Estudos de Casos e Controles , China/epidemiologia , LDL-Colesterol/análise , LDL-Colesterol/sangue , Dislipidemias/epidemiologia , Dislipidemias/fisiopatologia , Feminino , Humanos , Lisina Acetiltransferase 5/análise , Lisina Acetiltransferase 5/sangue , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/fisiopatologia , Psoríase/epidemiologia , Psoríase/fisiopatologia
14.
Diabetes Metab Syndr ; 13(2): 1405-1412, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336500

RESUMO

BACKGROUND: Psoriasis is an immune-mediated chronic inflammatory skin disease with unknown etiology. Current findings demonstrate that psoriatic patients are at higher risk of other systemic disorders such as diabetes mellitus. The present study was conducted to evaluate the association between psoriasis and diabetes mellitus. METHOD: The current study was conducted based on preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Using MeSH keywords we searched online databases of PubMed, Scopus, Web of Science, Science Direct, Embase, CINAHL, Cochrane Library, EBSCO and Google scholar search engine and the reference list of the retrieved articles until June 2018. Heterogeneity among studies was assessed using Cochran's Q test and I2 index and the random effects model was used to estimate Odds Ratio (OR) and 95% confidence interval (CI). Data were analyzed using Comprehensive Meta-Analysis (CMA) software version 2. RESULTS: Analysis of 38 eligible studies involving 922870 cases and 12808071 controls suggested the estimated OR to be 1.69 (95% Confidence Interval [CI]: 1.51-1.89; P < 0.001). Subgroup analysis was conducted based on study design and country of study and was significant (test for subgroup differences: P = 0.025 and P < 0.001, respectively). CONCLUSIONS: Our study indicated the significant association between psoriasis and diabetes. Therefore, psoriasis is a systemic disorder and other comorbidities should be considered in the management of patients with psoriasis.


Assuntos
Diabetes Mellitus/etiologia , Psoríase/complicações , Diabetes Mellitus/patologia , Humanos , Prognóstico
15.
J Assoc Physicians India ; 67(4): 29-32, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31309792

RESUMO

Background: Hyperhomocystienemia is a plausible common link between psoriasis and associated co-morbidities. Aim: To assess and compare serum homocystiene levels in 160(M:F 94:66) patients aged 18-70 years with chronic plaque psoriasis of varying severity with or without metabolic syndrome, cardiovascular and thyroid disorders and controls. The 155 controls (M:F 97:58) were healthy volunteers aged between 18 and 66 years. Results: Overall, 123 (76.9%) psoriasis patients with or without co-morbidities and 87 (56.1%) controls had elevated serum homocystiene levels; 23.48±14.37 and 18.74±12.59 (mean±SD) µmol/L, respectively. Eighty-one (58%) patients had associated co-morbidities with mean serum homocystiene levels of 22.65±13.70 µmol/L.The difference between psoriasis patients with or without comorbidities and controls was statistically significant. Conclusions: Hyperhomocystienemia in psoriasis patients with or without comorbidities versus healthy controls suggests its possible dysregulation in psoriasis. The significance of hyperhomocystienemia as an independent risk factor for cardiovascular or other comorbidities in psoriasis patients remains tenuous at best. Well-designed studies will perhaps resolve this issue.


Assuntos
Hiper-Homocisteinemia/epidemiologia , Psoríase/complicações , Psoríase/epidemiologia , Adolescente , Adulto , Idoso , Doenças Cardiovasculares , Comorbidade , Humanos , Síndrome Metabólica , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
16.
Dermatol Online J ; 25(6)2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31329395

RESUMO

A myriad of different phenomena exist in the dermatological literature which are based on the concept of locus minores resistentiae. The most commonly described phenomenon is the Koebner phenomenon, which is classically associated with the emergence of psoriatic lesions post trauma. Warfarin-induced skin necrosis (WISN) is a rare but severe side effect that leads to necrosis of the skin, predominantly on areas with increased subcutaneous fat. The presented case reports on WISN within psoriatic plaques.


Assuntos
Anticoagulantes/efeitos adversos , Psoríase/complicações , Púrpura/induzido quimicamente , Pele/patologia , Varfarina/efeitos adversos , Adulto , Feminino , Humanos , Necrose , Púrpura/complicações , Púrpura/patologia
17.
Georgian Med News ; (290): 96-100, 2019 May.
Artigo em Russo | MEDLINE | ID: mdl-31322523

RESUMO

The article discusses the role of vitamin D in the development of skin pathology - in particular, psoriasis and acne. In some publications the results of vitamin D sufficiency in patients with these diseases are cited, but there is still insufficient information to draw definitive conclusions about the role of vitamin D in their development. The aim of the study was to assess the role of vitamin D in psoriasis and acne development. The case-control study involved 66 people, including 20 patients with psoriasis (group 1), 20 with acne (group 2) and 26 healthy individuals (control group). All participants in the study were determined the level of plasma vitamin 25 (OH)D; in patients with psoriasis PASI index to determine the severity of the disease was calculated. Vitamin 25(OH)D deficiency was detected in a significant majority of patients with skin diseases, and its average plasma level in each group was significantly lower than in the control group. There was a correlation between vitamin 25(OH)D deficiency and psoriasis severity. In patients with psoriasis and acne, vitamin D preparations should be included in the treatment complex to increase the effectiveness of therapy.


Assuntos
Acne Vulgar/sangue , Psoríase/sangue , Deficiência de Vitamina D/sangue , Vitamina D/sangue , Acne Vulgar/complicações , Acne Vulgar/tratamento farmacológico , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Psoríase/complicações , Psoríase/tratamento farmacológico , Índice de Gravidade de Doença , Vitamina D/análogos & derivados , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/tratamento farmacológico , Vitaminas/uso terapêutico
18.
Hautarzt ; 70(8): 581-593, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31172201

RESUMO

BACKGROUND: Foot mycoses, including onychomycoses, are worldwide infectious diseases. As part of a regional survey using randomly selected residents of in Mecklenburg-Western Pomerania, we investigated the impact of dietary habits, the presence of most frequent autoimmune diseases and current smoking on fungal skin infections in order to reveal potential new risk factors to elucidate potential preventive interventions. OBJECTIVES: The identification of potential new factors that influence the development of mycosis was performed in order to derive possible preventive measures. METHODS: In the Study of Health in Pomerania (SHIP) in Mecklengburg-Western Pomerania, 2523 inhabitants were examined for mycotic lesions and asked about nutritional habits, the presence of atopic dermatitis, allergic rhinitis, psoriasis and smoking habits. RESULTS: In all, 8% of probands were diagnosed with mycosis, 6.5% onychomycosis, 3.7% tinea pedis and 0.2% tinea corporis. Psoriasis, allergic rhinitis and atopic dermatitis and frequent consumption of cooked potatoes, oatmeal and corn flakes, cereals, pasta and rice were significantly associated with tinea pedis. Onychomycosis was positively associated with consumption of cooked potatoes. Cigarette consumption proved protective for tinea pedis and dermatophyte colonization. CONCLUSIONS: The autoimmune disorders psoriasis and atopic dermatitis and allergic rhinitis seem to predispose to foot mycosis. Recalcitrant mycosis should raise the question of diets high in carbohydrates. Nicotine abuse seems to protect against skin mycosis and colonization.


Assuntos
Dermatite Atópica/complicações , Comportamento Alimentar , Onicomicose/complicações , Psoríase/complicações , Rinite Alérgica/complicações , Fumar/efeitos adversos , Tinha dos Pés/complicações , Doenças Autoimunes , Dermatite Atópica/epidemiologia , Alemanha/epidemiologia , Humanos , Incidência , Onicomicose/epidemiologia , Psoríase/epidemiologia , Rinite Alérgica/epidemiologia , Tinha dos Pés/epidemiologia
19.
Int J Dermatol ; 58(8): 976-981, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31168791

RESUMO

BACKGROUND: Sleep problems are common in patients with dermatologic disorders. However, it is unknown whether inflammatory skin disorders are associated with more sleep problems than noninflammatory skin disorders. PURPOSE: To determine whether sleep problems occur more frequently in people with inflammatory skin disorders compared to noninflammatory skin disorders. STUDY DESIGN: Observational case-control study. METHODS: Patients with inflammatory skin disorders (psoriasis [n = 17] and chronic eczema [n = 30]) and noninflammatory skin disorders (nonmelanoma skin cancers [NMSC] [n = 31]) were enrolled. Data collection occurred during a single visit. Statistical analysis of questionnaire results between groups utilized inverse propensity score weighted (IPSW) ANOVA and logistic regression models. RESULTS: Groups differed in mean (SD) age (P < 0.001) and itch severity (P < 0.001). Based on IPSW ANOVA models, the inflammatory group had significantly higher fatigue scores (mean [95% CI]; 32.0 [28.4-35.5]) than the noninflammatory group (25.5 [21.6-29.3]; P = 0.017). The inflammatory group odds of insomnia were significantly greater based on two definitions of insomnia, ISI ≥ 15 and PSSQ-I, with odds ratios (95% CI) of 14.4 (2.16-525) and 4.82 (1.45-20.7), respectively. These results were consistent in comparisons between the three groups, with no difference between psoriasis and chronic eczema, but with chronic eczema, significantly more were affected than NMSC. CONCLUSIONS: Patients with inflammatory skin disorders report significantly more fatigue and have higher odds of insomnia compared to patients with noninflammatory skin cancers.


Assuntos
Eczema/complicações , Fadiga/epidemiologia , Psoríase/complicações , Neoplasias Cutâneas/complicações , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adulto , Estudos de Casos e Controles , Doença Crônica , Fadiga/diagnóstico , Fadiga/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de Doença , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/etiologia , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
20.
J Rheumatol Suppl ; 95: 20-27, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31154400

RESUMO

Patients with psoriatic disease have an increased risk of developing cardiovascular (CV) events. Recent advances in imaging and biomarker research provide insights into the underlying mechanisms that link these conditions. Here, we summarize recent work in this field that was presented at the July 2018 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) annual meeting in Toronto, Ontario, Canada. The presentations highlighted recent data about the association between psoriasis and vascular inflammation, the use of coronary angiogram to investigate CV outcomes, new approaches for CV risk stratification, and the shared pathomechanisms of psoriasis and atherosclerosis.


Assuntos
Artrite Psoriásica/complicações , Doenças Cardiovasculares/etiologia , Psoríase/complicações , Feminino , Humanos , Masculino , Medição de Risco
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