Family History Of Psoriasis Research Articles

Lithium Compound Treatment and Psoriasis

Observations were made of 12 cases of psoriasis that developed and three cases of psoriasis that became exacerbated during treatment with lithium compounds. Only two patients had a family history of psoriasis, and results of a search for increased frequencies of the histocompatibility antigens seen in psoriasis vulgaris were negative. The clinical features were identical to severe psoriasis vulgaris and the diagnosis was confirmed by histologic examination performed in six cases. However, the skin changes disappeared or returned to pretreatment level after withdrawal of lithium compounds. A positive provocation test result was obtained in two cases, the secondary latency time being shorter than the primary. We suggest that the psoriasis was induced or exacerbated by lithium compounds.

Dermatological manifestations in psoriatic arthritis: a follow-up study

Of 227 patients with psoriasis and rheumatic complaints, inflammatory arthritis was present in 168 patients, of whom 95 have been followed up for more than 5 years and 28 had been followed up for more than 10 years. In patients with psoriasis and inflammatory arthritis the majority were women, but in the Distal joint group, males predominated. The skin disease usually began on the arms and was restricted in extent, initially. It usually began before the arthritis. A few cases were apparently precipitated by trauma, but more by psychological factors. The course pursued by the skin lesions was generally favourable. The skin lesions were resistant to treatment in 20% of the patients. Puberty, pregnancy and the menopause had little effect on the skin lesions. Nail lesions were present in 80%, a greater frequency than that seen in uncomplicated psoriasis. These nail lesions began at a later age than the skin lesions, and commonly preceded the development of arthritis. There was a family history of psoriasis in 26% of first-degree relatives. A history of polyarthritis was obtained quite frequently, and of psoriatic arthritis in 3% of patients with Distal arthritis, and 2% of the Indistinguishable group. The arthritis was usually mild in degree. Ankylosing spondylitis occurred in 5% and sacro-iliitis in 19%. The sheep cell agglutination test for rheumatoid factor was negative in the majority of patients. It was positive in 16% and a fluctuating positive result was obtained in 10%.

Psoriatic arthritis. Follow-up study.

227 patients with psoriasis and various forms of arthritis have been kept under review. Psoriasis and inflammatory arthropathy was present in 168 patients, of whom 94 have been followed up for more than 10 years. An arthritis indistinguishable from rheumatoid disease was present in 78%, distal joint arthritis in 16-6%, and deforming arthritis in 4-8%. There was a female predominance in the sex ratio of patients, although males predominated in the distal joint group (male:female 1-5:1). The peak age of onset was between 36 and 45 years, although in the deforming group the arthritis began before the age of 20 three times as commonly as it did in the indistinguishable group. Onset was acute in nearly half of the patients. At onset the distal joints were affected in one-third of the distal joint group. A synchronous onset of skin and joint changes was uncommon. Skin lesions usually preceded the arthritis but occurred after onset in 16%. Apart from in the deforming group, the arthritis was mild, judged by the number of admissions to hospital for treatment of the joint disease, and the time off work. Deterioration clinically and radiographically occurred in only a small portion of the distal joint and indistinguishable groups. Antimalarial drugs have been used in 7 patients, with deterioration of the skin condition in 4. Uveitis occurred particularly in the men of all three groups, but was most frequent in those with deforming arthritis. A family history of psoriasis was obtained in 26% of first-degree relatives and 13% of second-degree relatives. A history of polyarthritis was most common in patients in the deforming group. The sheep cell agglutination test was negative in the majority, but was positive in 16% of the indistinguishable group, fluctuating in a further 10%. A small number of joints only deteriorated radiographically (10% of the distal and indistinguishable groups). The men in the distal group showed greater radiographic changes and more deterioration in the terminal interphalangeal joints of the fingers than the women. Similarly they showed more deterioration of the metatarsophalangeal joints than the women. 18 patients died, one with gastric haemorrhage resulting from treatment of exfoliative psoriasis with immunosuppressive therapy, and 2 from bronchopneumonia thought to be related to immobility caused by the arthritis.

Letter: Subcorneal pustular dermatosis vs pustular psoriasis.

To the Editor.— The two cases of subcorneal pustular dermatosis submitted by Johnson and Cripps 1 appear atypical in features other than youthful age alone. The precipitation of eruptions by infection, systemic toxicity with fever, family history of psoriasis (case 2), lesions involving the face and tongue, and lack of response to dapsone but rapid response to systemically administered steroids are atypical for subcorneal pustular dermatosis of Sneddon and Wilkinson 2,3 but characteristic of pustular psoriasis. Additionally, the biopsy features presented by Johnson and Cripps (their Fig 4) reveal a pustule that is distinctly spongiform with pronounced spongiosis and exocytosis of the underlying Malpighian layer. In subcorneal pustular dermatosis, the pustule is superficial, discrete, and nonspongiform with minimal or no spongiosis of the underlying epidermis. 2,3 Johnson and Cripps have considered but rejected the diagnosis of pustular psoriasis in favor of subcorneal pustular dermatosis; I submit that the diagnosis of

Congenital Psoriasis

Three unrelated patients with psoriasis present since birth did not have a family history of psoriasis. The oldest of the three developed crippling psoriatic arthritis before the age of 13. The child who is now eight years old has continued to have severe psoriasis. The infant who is at present under 1 year of age has psoriatic lesions that are being controlled with topical application of steroid cream.

Congenital psoriasis: report of three cases

Three unrelated patients with psoriasis present since birth did not have a family history of psoriasis. The oldest of the three developed crippling psoriatic arthritis before the age of 13. The child who is now eight years old has continued to have severe psoriasis. The infant who is at present under 1 year of age has psoriatic lesions that are being controlled with topical application of steroid cream.