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1.
Artigo em Russo | MEDLINE | ID: mdl-33591657

RESUMO

The psoriasis is chronic inflammatory dermatitis that is accompanied by severe damage of skin and musculoskeletal system and affects functions of other organs and systems. The epidemiological data concerning prevalence and morbidity of psoriasis all over the world varies significantly. The article presents comparative characteristic of approaches to monitoring and evaluation of psoriasis morbidity in the Russian Federation and in the countries of the European region. The differences were revealed such as absence both of indices to evaluate quality of life of patients with psoriasis and specific population epidemiological studies in national system of monitoring and evaluation of the Russian Federation.


Assuntos
Psoríase , Qualidade de Vida , Humanos , Morbidade , Prevalência , Psoríase/epidemiologia , Federação Russa/epidemiologia
2.
Medicine (Baltimore) ; 100(6): e24217, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578523

RESUMO

BACKGROUND: We aim to study the treatment of psoriasis vulgaris with moving cupping. METHODS: We will search PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wanfang Database, and Chinese Biomedical Literature Database of randomized controlled trials beginning from their inception to August 2020. The primary outcomes are that PASI score and clinical effective rate will be the main outcome indicators. Additional outcome is The Quality of life index score and safety assessment will be considered a secondary outcome. Two independent authors will based on the Cochrane system evaluation manual 5.1.0 version of RCT bias risk assessment tool to evaluate the risk of bias among the final included studies. And we will use the RevMan 5.3 software to analysis data. RESULTS: This study will provide an assessment of the current state of moving cupping for the psoriasis vulgaris, aiming to show the efficacy and safety of this treatment. CONCLUSION: This study will provide evidence to judge whether moving cupping is an effective therapy for psoriasis vulgaris. INPLASY REGISTRATION NUMBER: INPLASY2020120061.


Assuntos
Ventosaterapia/métodos , Medicina Tradicional Chinesa/métodos , Psoríase/terapia , China/epidemiologia , Ventosaterapia/efeitos adversos , Feminino , Humanos , Masculino , Medicina Tradicional Chinesa/efeitos adversos , Psoríase/epidemiologia , Psoríase/patologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Segurança , Resultado do Tratamento
3.
JAMA Netw Open ; 4(2): e2034074, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33599771

RESUMO

Importance: The adoption of alternative fractionated radiotherapy regimens for the treatment of patients with cancer and comorbid collagen vascular disease (CVD) is controversial among oncologists because of concerns about potentially severe toxic effects; however, the association between fractionated radiotherapy and toxic effects in the modern era has not been well studied. Objective: To compare acute and late toxic effects among patients with cancer and comorbid CVD who received dose-fractionated radiotherapy. Design, Setting, and Participants: This retrospective cohort study examined 197 adult patients with cancer and CVD who received radiotherapy at a single-institution tertiary academic center over a 12-year period (February 1, 2007, to April 30, 2019), with a median follow-up of 23 months (range, 0-108 months). Data were analyzed from February 1 to August 31, 2020. Exposures: Three dose-fractionated radiotherapy regimens: conventional fractionation (CF; ≤2 Gy per fraction), moderate hypofractionation (MH; >2 Gy to <5 Gy per fraction), and ultrahypofractionation (UH; ≥5 Gy per fraction). Main Outcomes and Measures: The main outcomes were the incidence and severity of acute and late radiotherapy-associated toxic effects, which were assessed separately by dose-fractionation regimen. Toxic effects occurring within 90 days after radiotherapy completion were considered acute, and toxic effects occurring after that 90-day period were considered late. Secondary goals were to identify covariates associated with toxic effects and to characterize the incidence of CVD symptom flares (defined as worsening clinical symptoms and/or worsening results [transient or permanent] on associated blood tests compared with baseline, as documented by managing physicians) after radiotherapy. Results: Of 197 patients with cancer and comorbid CVD (mean [SD] age, 69 [12] years; 134 women [68.0%]; and 149 White participants [75.6%]), 80 patients (40.6%) received CF radiotherapy, 55 patients (27.9%) received MH radiotherapy, and 62 patients (31.5%) received UH radiotherapy. The most common CVD diagnoses were rheumatoid arthritis (74 patients [37.6%]), psoriasis (54 patients [27.4%]), systemic lupus erythematosus (34 patients [17.3%]), and scleroderma (8 patients [4.1%]). The most common radiotherapy sites were the breast (48 patients [24.4%]), thorax (25 patients [12.7%]), central nervous system (24 patients [12.2%]), and prostate (23 patients [11.7%]). Data on acute toxic effects were available for 188 patients (95.4%) and missing for 9 patients (4.6%). Data on late toxic effects were available for 142 patients (72.1%) and missing for 55 patients (27.9%). Over 12 years, the unadjusted incidences of severe acute toxic effects associated with CF, MH, and UH radiotherapy were 5.4% (95% CI, 0.3%-10.5%), 7.4% (95% CI, 0.4%-14.4%), and 1.7% (95% CI, 0%-5.0%), respectively. The incidences of severe late toxic effects associated with CF, MH, and UH radiotherapy were 8.3% (95% CI, 1.3%-15.3%), 0%, and 2.2% (95% CI, 0%-6.4%), respectively. No significant associations were found between severe acute or late toxic effects by dose fractionation regimen. In the multivariable analysis, MH radiotherapy was associated with a lower likelihood of developing late toxic effects (odds ratio [OR], 0.21; 95% CI, 0.05-0.83; P = .03) compared with CF radiotherapy. Those who received UH radiotherapy had a lower likelihood of experiencing late toxic effects (OR, 0.22; 95% CI, 0.04-1.21; P = .08). A total of 19 of 80 patients (23.8%), 15 of 55 patients (27.3%), and 10 of 62 patients (16.1%) experienced CVD symptom flares after receiving CF, MH, and UH radiotherapy, respectively (P = .33). Conclusions and Relevance: In this study, the incidences of unadjusted severe toxic effects over 12 years were less than 10% and were not significantly associated with dose fractionation. When clinically indicated, patients with cancer and comorbid CVD may not require immediate exclusion from the receipt of currently used hypofractionated radiotherapy regimens.


Assuntos
Doenças do Tecido Conjuntivo/epidemiologia , Neoplasias/radioterapia , Lesões por Radiação/epidemiologia , Radioterapia/métodos , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/epidemiologia , Neoplasias da Mama/radioterapia , Comorbidade , Fracionamento da Dose de Radiação , Feminino , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Incidência , Neoplasias Pulmonares/radioterapia , Lúpus Eritematoso Sistêmico/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias da Próstata/radioterapia , Psoríase/epidemiologia , Hipofracionamento da Dose de Radiação , Lesões por Radiação/etiologia , Radioterapia/efeitos adversos , Estudos Retrospectivos , Escleroderma Sistêmico/epidemiologia
4.
Rev Med Suisse ; 17(723): 184-187, 2021 Jan 27.
Artigo em Francês | MEDLINE | ID: mdl-33507657

RESUMO

Atopic dermatitis and psoriasis are two diseases that are thought to be distinct from each other, both clinically as well as pathogenetically. Substantial progress has been made in their treatment through the introduction of targeted therapies, blocking key steps in the respective pathogenetic pathways. Interestingly, introduction of a specific therapy for one of these diseases can occasionally trigger onset of the other. This observation helps to better understand the pathophysiology of both diseases and directly impacts their management.


Assuntos
Dermatite Atópica , Psoríase , Dermatite Atópica/epidemiologia , Dermatite Atópica/terapia , Eczema , Humanos , Psoríase/epidemiologia , Psoríase/terapia
5.
J Allergy Clin Immunol ; 147(3): 857-869.e7, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33485957

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is commonly associated with skin manifestations, and may also exacerbate existing skin diseases, yet the relationship between COVID-19 and skin diseases remains unclear. OBJECTIVE: By investigating this relationship through a multiomics approach, we sought to ascertain whether patients with skin conditions are more susceptible to COVID-19. METHODS: We conducted an epidemiological study and then compared gene expression across 9 different inflammatory skin conditions and severe acute respiratory syndrome coronavirus 2-infected bronchial epithelial cell lines, and then performed a genome-wide association study transdisease meta-analysis between COVID-19 susceptibility and 2 skin diseases (psoriasis and atopic dermatitis). RESULTS: Skin conditions, including psoriasis and atopic dermatitis, increase the risk of COVID-19 (odds ratio, 1.55; P = 1.4 × 10-9) but decrease the risk of mechanical ventilation (odds ratio, 0.22; P = 8.5 × 10-5). We observed significant overlap in gene expression between the infected normal bronchial epithelial cells and inflammatory skin diseases, such as psoriasis and atopic dermatitis. For genes that are commonly induced in both the severe acute respiratory syndrome coronavirus 2 infection and skin diseases, there are 4 S100 family members located in the epidermal differentiation complex, and we also identified the "IL-17 signaling pathway" (P = 4.9 × 10-77) as one of the most significantly enriched pathways. Furthermore, a shared genome-wide significant locus in the epidermal differentiation complex was identified between psoriasis and severe acute respiratory syndrome coronavirus 2 infection, with the lead marker being a significant expression quantitative trait locus for S100A12 (P = 3.3 × 10-7). CONCLUSIONS: Together our findings suggest association between inflammatory skin conditions and higher risk of COVID-19, but with less severe course, and highlight shared components involved in anti-COVID-19 immune response.


Assuntos
Dermatite Atópica , Regulação da Expressão Gênica , Predisposição Genética para Doença , Psoríase , Locos de Características Quantitativas , Proteína S100A12 , /metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , /genética , Linhagem Celular , Dermatite Atópica/epidemiologia , Dermatite Atópica/genética , Dermatite Atópica/metabolismo , Feminino , Estudo de Associação Genômica Ampla , Genômica , Humanos , Masculino , Pessoa de Meia-Idade , Psoríase/epidemiologia , Psoríase/genética , Psoríase/metabolismo , Fatores de Risco , Proteína S100A12/biossíntese , Proteína S100A12/genética , Pele/metabolismo , Pele/virologia
6.
Dermatol Ther ; 34(1): e14691, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33351215

RESUMO

There is widespread concern about treatment of psoriasis in COVID-19 pandemic. We aimed to evaluate the epidemiological data, clinical characteristics, treatment features of the psoriasis patients during the pandemic period. We conducted a study in dermatology clinics of seven different tertiary centers. All adult psoriasis patients who were followed up between 11 March 2020 and 28 June 2020, were phone called or questioned in their visit to their follow-up clinics. A semistructured questionnaire was applied and patients' demographics and disease characteristics were recorded. Of 1322 patients, 52.4% were male, and 47.6% were female. According to the questionnaire responses, 964 (72.9%) of these patients could not communicate with their physician during this period, remained 358 (27.1%) patients contacted the physician by phone, email, or hospital visit. From the patients diagnosed as probable/confirmed COVID-19, 14 were female, and 9 were male. Nine of 23 (39.1%) patients were using biologic treatment. There was no statistically significant difference in terms of hospitalization from COVID-19 between the patients using biologics (n = 9) and those who did not (n = 14) (P = 1.00). No mortality was observed among them. Obesity, smoking, age, and accompanying psoriatic arthritis were not among the risk factors affecting the frequency of COVID-19. We only encountered an increased risk in diabetic patients. Also, an exacerbation of psoriasis was observed with the infection. No difference was found in patients with psoriasis in terms of COVID-19 infection in patients who use biologics and those who don't.


Assuntos
Psoríase , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Psoríase/diagnóstico , Psoríase/epidemiologia , Psoríase/etiologia , Psoríase/terapia
7.
Dermatol Ther ; 34(1): e14700, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33369063

RESUMO

There are few studies on how patients with psoriasis who are on biologic therapy are affected by the COVID-19 pandemic. We analyzed the impact of the COVID-19 pandemic on patients with psoriasis receiving biologic therapy, patients' current status at a single center in Turkey. A total of 133 patients (mean age; 44.6 ± 13.5 years) were on maintenance biological treatment for moderate-to-severe psoriasis during the pandemic. A standardized questionnaire was administered by phone interviews to determine patients' perceptions, attitudes, and adherence to therapy and identify the frequency of COVID-19 infection, psoriasis status, and new comorbidities during the pandemic. All patients had been receiving a biological agent including ustekinumab, etanercept, adalimumab, secukinumab, infliximab, ixekizumab, or certolizumab pegol. Ninety-one patients (68.4%) had at least one comorbid condition, including psoriatic arthritis (35.3%), hypertension (19.5%), diabetes mellitus (16.5%), obesity, coronary artery disease, and dyslipidemia. During the first 3 months of the pandemic, 52 patients (39%) suspended their biological therapies for short (n = 33) or long (n = 19) periods without medical advice for reasons of fear, worry, and anxiety. All but one patient restarted their medications as a result of therapeutic counseling. Five patients reported suspicious symptoms, but only one had PCR-confirmed COVID-19. Our findings suggest that biologic treatment for moderate-to-severe psoriasis would not pose an additional risk for COVID-19 infection and its life-threatening complications, even in the presence of a high frequency of cardiometabolic comorbidities, provided that all patients are informed and necessary pandemic-directed precautions are well adopted by the patients.


Assuntos
Produtos Biológicos/uso terapêutico , Psoríase , Adulto , Produtos Biológicos/efeitos adversos , Humanos , Pessoa de Meia-Idade , Pandemias , Psoríase/diagnóstico , Psoríase/tratamento farmacológico , Psoríase/epidemiologia , Turquia/epidemiologia
8.
J Affect Disord ; 278: 407-412, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33010565

RESUMO

BACKGROUND: Reports showed that elevated proinflammatory cytokines, as detected in patients with psoriasis, was noted in individuals with major depressive disorder (MDD). Therefore, this study aimed to clarify the association of MDD and prospective incidence of psoriasis in human using a nationwide study. METHOD: This population-based cohort study used the data from the Taiwan National Health Insurance system. 64,486 patients were defined as MDD cohort and 64,486 propensity score matched subjects without MDD were identified as comparison cohort. Each patient was independently tracked for a 5-year study period to assure them for a psoriasis diagnosis after the index date. Stratified Cox proportional hazard models were used to calculate the hazard ratio (HRs) for 5-year psoriasis risk. RESULTS: After adjustments, the HR of psoriasis for MDD patients was 1.32 compared with subjects without MDD. The stratified analyses present that MDD patients had approximately 1.30-fold significantly higher risk of psoriasis than comparison subjects in most subgroups. Furthermore, compared with the matched subjects without MDD, the adjusted HRs of psoriasis in the 2-, 3-, 4- and 5-year study periods were 1.33, 1.32, 1.33 and 1.32, respectively. LIMITATIONS: Several patients with MDD or psoriasis might not include in this study, because of using a medical claims database. CONCLUSIONS: This study provides population-based evidence that MDD is an independent risk factor of developing psoriasis, with an increased risk in the male sex. Additional investigations verifying our findings and exploring possible pathological mechanisms would be of great interest and value to the psychiatric field.


Assuntos
Transtorno Depressivo Maior , Psoríase , Estudos de Coortes , Transtorno Depressivo Maior/epidemiologia , Humanos , Incidência , Masculino , Pontuação de Propensão , Estudos Prospectivos , Psoríase/epidemiologia , Fatores de Risco , Taiwan/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-33322823

RESUMO

Psoriasis is a well-known immune-mediated disease. Its autoimmune pathophysiology is consistent with the immune-mediated systemic vascular hypothesis regarding the pathogenesis of sudden sensorineural hearing loss (SSNHL). The purpose of our study was to investigate whether psoriasis affects the prevalence of SSNHL in all age groups matched by age, sex, income, and region of residence. Korean Health Insurance Review and Assessment Service-National Patient Samples were collected from 2002 to 2013. A 1:4 matched psoriasis group (n = 12,864) and control group (n = 51,456) were selected. The crude (simple) and adjusted (Charlson comorbidity index) hazard ratios (HR) for psoriasis and SSNHL were analyzed using the stratified Cox proportional hazard model. The incidence of SSNHL was significantly higher in the psoriasis group than in the control group (0.5% vs. 0.4%, p = 0.004). Psoriasis increased the risk of SSNHL (adjusted HR = 1.44, 95% confidence interval (CI) = 1.09-1.90, p = 0.010). In the stratification analysis, the incidence of SSNHL was significantly higher in the 30-59-year-old group than other group SSNHL (adjusted HR = 1.50, 95% CI = 1.06-2.12, p = 0.023). In addition, SSNHL occurred significantly more frequently in men with psoriasis (adjusted HR = 1.70, 95% CI = 1.17-2.49, p = 0.006). Psoriasis increased the risk of SSNHL, and SSNHL was more prevalent in between the age of 30-59-year-olds and men with psoriasis.


Assuntos
Perda Auditiva Neurossensorial , Perda Auditiva Súbita , Psoríase , Adulto , Estudos de Casos e Controles , Feminino , Seguimentos , Perda Auditiva Neurossensorial/epidemiologia , Perda Auditiva Súbita/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Psoríase/epidemiologia , Fatores de Risco
10.
Medicine (Baltimore) ; 99(46): e22410, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181639

RESUMO

Despite the enormous burden on patients with severe psoriasis, their utilization of medical care is not well understood in Korea.To compare the characteristics and treatment patterns of psoriasis patients by economic status as well as to examine the factors influencing systemic treatments of psoriasis.We conducted a descriptive cross-sectional study using National Health Insurance sample cohort data in 2015. Psoriasis patients were classified as either the "topical treatment only" or the "systemic treatment" group based on the types of treatment. Patients' economic status was defined by the deciles of health insurance premium, which was determined based on income and assets. Multivariate logistic regression analysis was performed to examine the factors influencing systemic treatments of psoriasis.We identified 6041 psoriasis patients; 39.5% were in the bottom 5 deciles of health insurance premium and 60.5% were in the top 5 deciles. Only 1.9% of the low economic status group and 4.0% of the high economic status group were treated with expensive biologics, although the difference was not statistically significant.Overall, psoriasis patients with higher economic status had a lower likelihood of receiving systemic treatments but had a higher probability of being treated with expensive biologics.


Assuntos
Psoríase/terapia , Fatores Socioeconômicos , Adulto , Estudos Transversais , Feminino , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Seguro Saúde/estatística & dados numéricos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Psoríase/epidemiologia , Qualidade da Assistência à Saúde/normas , Qualidade da Assistência à Saúde/estatística & dados numéricos , República da Coreia/epidemiologia
11.
Ann Agric Environ Med ; 27(3): 335-342, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955211

RESUMO

INTRODUCTION AND OBJECTIVE: Psoriasis isa quite common, chronic and immune-mediated skin disorder. The prevalence of psoriasis differs in various countries, but it is said to affect 2% of the world's population in general. Psoriasis has many different clinical features but all lesions have the same characteristic: erythema, thickening and scale, although other clinical features are also connected, such as psoriatic arthritis, obesity and metabolic syndrome. All of these may lead to conditions impairing the quality of life. This review is an attempt to summarize recent data regarding environmental factors, together with epigenetic markers and processes playing an important role in psoriasis. STATE OF KNOWLEDGE: Many different environmental factors play a role in genetically predisposed patients. This is causes epigenetic alternations which may be a linking part in the whole process. Many studies have indicated a connection between psoriasis and various genes and antigens. The presence of HLA-Cw6 is common as well a strong link between its presence and the onset of psoriasis being observed. The main alternations are DNA methylation, histone's modifications and the role of microRNA. Excessive reaction is usually not present without a triggering factor. Environmental factors are mostly rated, such as drugs, life style and habits (smoking, alcohol), diet, physical trauma (skin injury provoking Koebner phenomenon), stress, microorganism and infections. CONCLUSIONS: The correlation between pathogenesis of psoriasis and environmental risk factors, together with epigenetic alternations still require more investigation. Education about diet habits, nutrition, weight loss and healthy lifestyle seems to be important during the treatment of psoriasis.


Assuntos
Epigênese Genética , Psoríase/epidemiologia , Psoríase/genética , Meio Ambiente , Humanos , Fatores de Risco
12.
J Assoc Physicians India ; 68(10): 44-46, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32978925

RESUMO

Background: Psoriasis patients are at increased risk of developing metabolic diseases. Proinflammatory cytokines such as IFN-γ, IL-17, IL-23, and TNF-α,IGF that are increased in psoriasis play an important role in the development of diabetes mellitus(DM), hypertension, dyslipidemia, obesity, insulin resistance and their complications. Aims: To study prevalence of insulin resistance (IR) using HOMA-IR index in psoriasis patients and its association with severity of psoriasis. To study prevalence of metabolic diseases, macro and microvascular complications of these diseases in psoriasis. Materials and methods: A hospital based case control study was conducted involving 102 psoriasis patients and 102 age and sex matched controls. All patients were analysed for the presence of metabolic diseases and their complications. Results: Mean age of cases was 38.41±16.37 years. Majority of cases(58.8%) as well as controls (55.9%) were males. Prevalence of hypertension, prediabetes, DM, raised TG, low HDL, MetS and IR was 46.1%, 28.4%, 27.5%, 42.2%, 31.4%, 31.4% and 48% respectively in cases as compared to 26.5%, 13.7%, 11.8%, 24.3%, 16.7%, 10.8% and 26.5% respectively in controls. However there was no significant difference in obesity (29.4% vs 21.6%, p=0.2024) and LDL among the cases and controls(14.7 %vs 10.8%,p= 0.4). Prevalence of all the metabolic disorders except LDL was significantly higher in cases as compared to that in controls. Prominent complications noted were retinopathy, neuropathy and CVD. With increased psoriasis severity insulin resistance increased. Conclusion: There is a positive correlation of psoriasis with IR and it is associated with increased risk of metabolic diseases and their complications.


Assuntos
Resistência à Insulina , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/etiologia , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Psoríase/complicações , Psoríase/epidemiologia , Adulto , Estudos de Casos e Controles , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
13.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(4): 449-455, 2020 Apr 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879071

RESUMO

By searching the database of CNKI, Wanfang and PubMed, the prevalence and risk factors of atopic dermatitis, psoriasis, acne, and urticaria were relatively more investigated, which were the skin diseases of more concern in the current epidemiological study of skin diseases. Three national epidemiologic surveys reported that the prevalence of atopic dermatitis increased from 0.69% in 1998, to 3.07% in 2002, and 12.94% in 2014, respectively. The prevalence of psoriasis increased from 0.123% in 1984 to 0.47% in 2009 according to 2 national surveys. The prevalence of acne was 8.1% in a national investigation in 2008. Representative national prevalence data of urticaria is not available. Risk factors for these skin diseases are distinct. Atopic dermatitis, psoriasis, and urticaria are more related to environment and mental stress, while acne is more related to skin type and dietary factors. Owing to the heterogeneities in diagnostic methods used in the dermatoepidemiologic surveys (some of the diagnoses were self-reported) and a lack of follow ups, the reliability of data remained questionable, and the comparability across the surveys was difficult. As a result, it is necessary to conduct population-based cohort studies on skin diseases in China.


Assuntos
Acne Vulgar/epidemiologia , Dermatite Atópica , Psoríase/epidemiologia , Urticária , China/epidemiologia , Humanos , Prevalência , Reprodutibilidade dos Testes , Fatores de Risco
14.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(7): 804-811, 2020 Jul 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879084

RESUMO

OBJECTIVES: Psoriasis is a chronic inflammatory skin disease that affects adults and children. The most common subtype is psoriasis vulgaris. This article analyzes the characteristics and clinical features of children with psoriasis vulgaris to strengthen the understanding, treatment, and management for children with psoriasis. METHODS: A total of 208 children with psoriasis vulgaris, who were first admitted to the Department of Dermatology, Xiangya Hospital, Central South University from October 2012 to December 2018, were retrospectively analyzed. Their clinical characteristics, results of laboratory examination, treatment options and efficacy were summarized. RESULTS: The age of the 208 children with psoriasis vulgaris was (11.19±3.97) years old, the peak incidence was 12 years old, the disease duration was (27.46±31.30) months, and the male-female ratio was 1∶0.96. The most common site of the first attack was the scalp (37.98%), followed by the trunk (26.44%) and the limbs (22.12%). The causes leading to exacerbation were more common in infections and diets. There were 33 patients (15.87%) with a family history of psoriasis, showing the higher score of Psoriasis Area and Severity Index (PASI) and the higher Dermatological Quality of Life Index (DLQI) (both P<0.05). In all patients, 29 cases (13.94%) were overweight, 19 cases (9.14%) were obese, and the rate of overweight and obesity in children with psoriasis vulgaris was higher than that of normal children in China. In the laboratory test, the serum levels of 25-hydroxyvitamin D (25-OH-VD) were decreased in most patients (47.5%), and the serum 25-OH-VD levels were found to be moderately negatively correlated with PASI score (P<0.05). The score of DLQI in the patient was 5.56±3.57, the score of PASI was 7.25±6.83, and they were positively correlated (r=0.409, P<0.001). In most patients (72.11%), the severity of the disease was mild to moderate. Their treatment was often dominated by topical drugs and Chinese patent medicine (65.67%). Retinoids showed a good effect on children. Cyclosporine and methotrexate were effective in more severe cases. CONCLUSIONS: Children with psoriasis vulgaris are mainly caused by infection and diet. Patients with family history have more serious illness, lower quality of life, and are more likely to have metabolic abnormalities such as overweight and obesity. The serum 25-OH-VD levels in children with psoriasis vulgaris are negatively correlated with the score of PASI.


Assuntos
Obesidade Pediátrica , Psoríase/epidemiologia , Adolescente , Adulto , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Qualidade de Vida , Estudos Retrospectivos , Índice de Gravidade de Doença
15.
PLoS One ; 15(8): e0237267, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785291

RESUMO

BACKGROUND: Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors. METHODS AND FINDINGS: This was a non-interventional, cross-sectional study, conducted in 18 Italian University and/or hospital centers with psoriasis-specialized units. Questionnaires evaluating demographic and socioeconomic characteristics were administered to participants. Overall, 1880 consecutive patients affected by mild-to-severe psoriasis were recruited. Univariate and multivariable logistic regression analyses of systemic therapy prescription, with a special focus on biologics, accounting for the above mentioned characteristics were performed. Our analysis showed that all analyzed patients' characteristics were significantly associated with biological therapy compared to non-biological systemic one. Particularly, women were less likely to receive biologics than men (OR = 0.66; 95% CI, 0.57-0.77). Elderly patients (≥65 years) and subjects with a BMI ≥30 had lower odds to receive biologics respect to adults (≥35-64 years) (OR = 0.33; 95% CI, 0.25-0.40), and subjects with BMI≥25<30 (OR = 0.64; 95% CI, 0.53-0.77), respectively. Northern and Southern patients were both less likely to receive biologics than Central patients (OR = 0.75; 95% CI, 0.63-0.89, and OR = 0.56; 95% CI,0.47-0.68, respectively). Lower economic profile and never reading books were both associated with decreased odds of receiving biological therapy. CONCLUSIONS: This study shows that sex, age, comorbidities, and socioeconomic characteristics influence the prescription of systemic treatments in psoriasis, highlighting that there are still unmet needs influencing the therapeutic decision-making process that have to be addressed.


Assuntos
Anticorpos/uso terapêutico , Psoríase/tratamento farmacológico , Psoríase/epidemiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Fatores Socioeconômicos , Adulto Jovem
16.
PLoS One ; 15(8): e0237598, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790787

RESUMO

BACKGROUND: Obesity is a leading comorbidity in psoriatic disease, including both psoriasis (PsO) and psoriatic arthritis (PsA), and is associated with adverse metabolic and cardiovascular (CV) outcomes. Anthropometric parameters, such as weight, body mass index (BMI) and waist-to-hip ratio, have been extensively reported in psoriatic disease. However, the associations of body composition and fat distribution with psoriasis have not yet been fully defined. OBJECTIVES: To identify whether patients with psoriatic disease, including psoriatic arthritis, have altered body composition compared with the general population, and to review existing modalities for the assessment of body composition. METHODS: Electronic searches of the literature were conducted in PubMed, Medline (Ovid®), Embase (Ovid®), Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar. Titles and abstracts were reviewed by two authors independently against a set of prespecified inclusion/exclusion criteria. The research question was answered with a systematic literature review and results were summarized narratively. RESULTS: Twenty-five full text articles met the inclusion criteria and were included in the final narrative analysis. The studies were of heterogeneous design and used a range of objective measures to assess body composition, including simple anthropometric measures, bioimpedance analysis (BIA), dual energy X-ray absorptiometry (DXA) and computed tomography (CT). Few studies met all the quality assessment criteria. Clinical heterogeneity prevented meta-analysis. CONCLUSIONS: Patients with psoriatic disease reveal defined body composition changes that are independent of obesity and the customary metabolic syndrome, including higher overall body fat, visceral fat and sarcopenia. These findings emphasize that patients with psoriatic disease should be screened for abnormal adipose effects beyond their weight and body mass index (BMI). Our findings show that the last decade has seen an exciting expansion of research interest in the development and validation of new modalities for the assessment of body composition. There is no consensus on the optimal assessment method of body composition for this diverse group; hence there is a need for validation of existing modalities and standardization of assessment tools.


Assuntos
Adiposidade , Composição Corporal , Índice de Massa Corporal , Obesidade/fisiopatologia , Psoríase/epidemiologia , Comorbidade , Humanos
17.
PLoS One ; 15(7): e0235091, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32609733

RESUMO

Genital psoriasis affects 2-5% of psoriasis patients; generalised plaque or intertriginous psoriasis also affects the genital area in 29-40% of cases. Anogenital psoriasis has been associated with significant quality of life impairments, but little is known about specific patient needs/treatment goals. This study aimed to examine the overall and sex-related disease burden, patient needs and treatment benefits in patients with anogenital psoriasis, compared to patients with psoriasis not affecting the anal/genital areas. Within the cross-sectional nationwide survey, 2,009 participants were consecutively recruited in 157 randomly assigned German dermatology practices and clinics, according to the following inclusion criteria aged 18 years or over; diagnosis of psoriasis vulgaris; ability to answer the questionnaires; and written informed consent. Based on a high-resolution grid on the topical distribution of psoriasis, two groups were formed: anogenital psoriasis (n = 622) and comparison group (n = 1,303). Clinical severity was assessed by the Psoriasis Area and Severity Index (PASI). Patients completed the EuroQoL visual analogue scale (EQ VAS), the Dermatology Life Quality Index (DLQI), and the Patient Benefit Index (PBI). Patients with anogenital psoriasis had higher PASI (13.0±10.6 vs. 8.9±7.6, P < 0.001) and more DLQI impairments (8.9±6.9 vs. 7.0±6.2, P = 0.002) than controls. At the item-level, they also reported more sex-related DLQI impairments (DLQI-i9: 0.5±0.8 vs. 0.3±0.7, P < 0.001) and treatment needs (PBI-i17: 2.2±1.8 vs. 1.9±1.8, P = 0.001). A great percentage of missing/not-relevant responses was found for sex-related items (23.3-41.9%). These results suggest that the assessment of sex-related impairments and treatment needs should be prioritised in patients with anogenital psoriasis. Questionnaires may be used as a less uncomfortable way for patients to discuss their genital lesions and sexual function during healthcare visits. However, the great percentage of missing/not-relevant responses to sex-related items calls for in-depth assessments and effective patient-physician communication regarding these sensitive topics.


Assuntos
Assistência Centrada no Paciente , Psoríase/patologia , Adolescente , Adulto , Idoso , Canal Anal/patologia , Estudos Transversais , Feminino , Genitália/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Psoríase/epidemiologia , Qualidade de Vida , Índice de Gravidade de Doença , Fatores Sexuais , Adulto Jovem
19.
Medicine (Baltimore) ; 99(24): e20632, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32541501

RESUMO

BACKGROUND: In the current literature, studies assessing the role of Helicobacter pylori (HP) infection in psoriasis have reported conflicting data. Therefore, we investigated the association between HP infection and psoriasis using a nationwide population-based longitudinal cohort study. METHODS: We identified 41,539 patients with HP infection and 83,078 matched controls between 2000 and 2013 from the Longitudinal Health Insurance Research Database of the National Health Insurance Research Database in Taiwan. Propensity score analysis was used to match age, sex, comorbidities, and medical visits at a ratio of 1:2. Multiple Cox regression analysis was used to estimate the adjusted hazard ratio of psoriasis. Furthermore, sensitivity tests and a stratified analysis were conducted. RESULTS: The incidence rates of psoriasis did not differ significantly between the HP and control cohorts (4.58 vs 4.20 per 100,000 person-months, crude relative risk: 1.092, 95% confidence interval: 0.917-1.302). After multivariate adjustment, no significant difference in psoriasis risk was observed in patients with HP infection (adjusted hazard ratio: 1.081, 95% confidence interval: 0.907-1.288). Risk of psoriasis was significantly higher in men and the elderly, and in those with diabetes, hyperlipidemia, chronic obstructive pulmonary disease, or tuberculosis. Stratified analysis also confirmed that HP infection was not correlated with an increased risk of psoriasis based on follow-up duration, sex, and age. CONCLUSION: This retrospective population-based longitudinal cohort study, conducted in Taiwan, found no association between HP infection and risk of psoriasis. Further research may be warranted.


Assuntos
Infecções por Helicobacter/complicações , Helicobacter pylori , Psoríase/complicações , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Psoríase/epidemiologia , Medição de Risco , Taiwan/epidemiologia
20.
Dermatol Ther ; 33(4): e13757, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32495952

RESUMO

The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in a paradigm shift in disease management. Since immunosuppression may cause increased susceptibility to COVID-19, there is uncertainty as to whether systemically treated nail psoriasis patients are at increased infection risk. While specific data on nail psoriasis treatments and COVID-19 is lacking, we present clinical trial data on rates of upper respiratory infections, nasopharyngitis, viral infection, pneumonia and overall infections. Some systemic medications and biologics are associated with increased in infections risk compared to placebo in clinical trials. However, this data should be regarded cautiously since clinical trials on nail psoriasis, particularly controlled studies, are lacking. Our recommendations may be helpful in guiding physicians managing nail psoriasis patients during the COVID-19 pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Doenças da Unha/terapia , Pandemias , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Psoríase/terapia , Humanos , Doenças da Unha/epidemiologia , Psoríase/epidemiologia
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