Onset Of Psoriasis Research Articles

Associations between family history of psoriatic disease and clinical characteristics on patients with psoriatic arthritis: a nationwide study from the Chinese Registry of Psoriatic Arthritis (CREPAR II).

The study aimed to identify clinical characteristics in Chinese patients with psoriatic arthritis (PsA) with or without a family history of psoriasis and/or PsA. Patients with PsA were recruited based on Chinese REgistry of Psoriatic ARthritis (CREPAR) between December 2018 and June 2021. The demographics, clinical information relating to PsA, laboratory variables and comorbidities were collected. The association between family history of psoriatic disease and clinical characteristics on PsA was analysed using logistic regression analysis. Among 1074 eligible patients with PsA, 313 (29.1%) had a family history of psoriasis and/or PsA. Compared with patients without a family history, notably, patients with a family history of psoriasis and/or PsA had an earlier age of onset of psoriasis and PsA, higher proportions of enthesitis and nail involvement, a higher prevalence of positive human leukocyte antigen-B27 (HLA-B27), lower disease activity score 28-erythrocyte sedimentation rate, higher proportions of hyperlipidaemia, lower proportions of hypertension and diabetes. Furthermore, after adjusting for confounding factors, logistic regression analysis demonstrated that a positive family history of psoriasis and/or PsA was associated with more females (OR 1.514, 95% CI 1.088-2.108, p=0.014), earlier age at psoriasis onset (OR 0.971, 95%CI 0.955-0.988, p=0.001), a higher prevalence of HLA-B27 (OR 1.625 95%CI 1.089-2.426, p=0.018), more presence of nail involvement (OR 1.424, 95%CI 1.007-2.013, p=0.046) and enthesitis (OR 1.393, 95%CI 1.005-1.930, p=0.046), a higher proportion of hyperlipidaemia (OR 2.550, 95%CI 1.506-4.317, p=0.001) in PsA patients. This was first nationwide study to characterize patients with and without a family history of psoriatic disease in China. The findings from the present study revealed that family history of psoriasis and/or PsA had greater effects on disease phenotypes of PsA, especially nail disease and enthesitis.

Roles of Infection in Psoriasis.

Psoriasis is a chronic, immune-mediated disorder with cutaneous and systemic manifestations. Genetic predisposition, environmental factors, and immune dysfunction all contribute to the pathogenesis of psoriasis with host-microbe interaction governing the progression of this disease. Emerging evidence has indicated that infection is an environmental trigger for psoriasis and plays multiple roles in its maintenance as evidenced by the frequent association between guttate psoriasis onset and acute streptococcal infection. Different infectious factors act on immune cells to produce inflammatory cytokines that can induce or aggravate psoriasis. In addition to bacterial infections, viral and fungal infections have also been shown to be strongly associated with the onset or exacerbation of psoriasis. Intervention of skin microbiota to treat psoriasis has become a hot research topic. In this review, we summarize the effects of different infectious factors (bacteria, viruses, and fungi) on psoriasis, thereby providing insights into the manipulation of pathogens to allow for the identification of improved therapeutic options for the treatment of this condition.

Dactylitis and Early Onset Psoriasis in Psoriatic Arthritis: Are they Markers of Disease Severity? A Clinical Study.

ObjectivesTo stratify psoriatic arthritis (PsA) patients based on psoriasis (PsO) onset age: early onset psoriasis (EOP) vs. late onset psoriasis (LOP), and to assess if there are differences in disease characteristics, activity/function/impact of the disease, and comorbidity indices.MethodsCross-sectional analysis of a longitudinal PsA cohort. Patients were stratified based on PsO onset age.ResultsOne hundred and sixty PsA patients were enrolled (84 in EOP and 76 in LOP group) in the study. EOP PsA patients seem to have an increased probability to have dactylitis rather than LOP ones, OR 9.64 (3.77–24.6). Comorbidity indices (Rheumatic Disease Comorbidity Index and Charlson Comorbidity Index) were higher in LOP PsA patients, but these data were not confirmed when adjusted by age and sex. There are also differences in the treatment regimen: EOP PsA patients were more frequently treated with anti-interleukin (IL) 17; instead, LOP patients were more frequently treated with non-steroid anti-inflammatory drugs and conventional synthetic disease-modifying anti-rheumatics drugs. There were no differences in the disease activity, function, or impact of the disease.ConclusionsThere are some clinical and therapeutic differences in PsA patients linked to the PsO onset age, namely dactylitis in EOP. Other characteristics found were: a “comorbidities trend” in LOP patients and a more frequent use of anti-IL17 in EOP.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40744-022-00468-3.

Impact of Childhood Onset Psoriasis on Addictive Behaviours, Socioeconomic and Educational Data in Adulthood.

Paediatric psoriasis has been associated with school absenteeism, limitation of physical activities, psychiatric disorders and, in the longer term, with sexual dysfunction and addictions. This raises the hypothesis that childhood onset psoriasis may affect patients' educational development, and further social and professional outcomes. This study evaluated the relationship between childhood onset psoriasis and patients' educational and socioeconomic characteristics, and the development of addictions in adulthood. This cross-sectional ancillary study captured patients' characteristics at baseline in the French PSOBIOTEQ registry. Data in adulthood included: educational (baccalaureate) and socioeconomic (working activity) groups, smoking status (self-reporting of being a current smoker vs past smoker or non-smoker), alcohol consumption (defined as at least 1 glass of alcoholic beverage per day), and living conditions (alone/family/social institutions; child at home). A total of 1,960 patients were included, of whom 26.2% had childhood onset psoriasis. In multivariate analyses, childhood onset psoriasis was associated with smoker status (p = 0.02). No association was observed with educational level, working activity, living conditions, or alcohol consumption. This study provides reassuring data overall with regard to the impact of childhood onset psoriasis on major social outcomes. Evidence for some association with addictive behaviours paves the way for larger prospective studies assessing in depth the social and educational impact of this disease.

New onset of psoriasis following COVID ‐19 vaccination

The cutaneous side effects of COVID‐19 vaccines are being studied and their immunogenicity is most likely linked to the pathophysiology of psoriasis. Although uncommon, several cases of exacerbation and new onset of psoriasis have been reported globally after vaccination. To contribute to the literature on this intriguing topic, we present three cases of de novo psoriasis in adult patients following COVID‐19 vaccination. Our observations and a literature review show that this occurrence is independent of the type and brand of vaccines.

The Effects of Interacting With a Paro Robot After a Stressor in Patients With Psoriasis: A Randomised Pilot Study.

ObjectiveStress can play a role in the onset and exacerbation of psoriasis. Psychological interventions to reduce stress have been shown to improve psychological and psoriasis-related outcomes. This pilot randomised study investigated the feasibility of a brief interaction with a Paro robot to reduce stress and improve skin parameters, after a stressor, in patients with psoriasis.MethodsAround 25 patients with psoriasis participated in a laboratory stress task, before being randomised to either interact with a Paro robot or sit quietly (control condition) for 30 min. Raman spectroscopy and trans-epidermal water loss were measured at baseline, after the stressor and after the intervention as indexes of acute skin changes. Psychological variables, including self-reported stress and affect, were also measured at the three time-points.ResultsNo statistically significant differences between the two conditions were found for any of the outcomes measured. However, effect sizes suggest significance could be possible with a larger sample size. Changes in the psychological and Raman spectroscopy outcomes across the experimental session were found, indicating the feasibility of the procedures.ConclusionThis pilot study showed that a brief interaction with a Paro robot was a feasible intervention for patients with psoriasis, but future trials should broaden the inclusion criteria to try to increase recruitment rates. Studying people who are highly stressed, depressed or who are stress-responders may increase the power of the intervention to show effects using a longer-term intervention.

Prevalence of Tobacco Smoking and Its Association With Disease Severity Among Patients With Psoriasis in China: A Cross-Sectional Study.

IntroductionTobacco smoking is associated with the onset and severity of psoriasis, and understanding the prevalence of tobacco smoking among patients with psoriasis is critical due to its high physical and mental influence and heavy disease burden. However, evidence on the association between tobacco smoking and psoriasis severity is still limited in China.ObjectivesThe objective of this study was to examine the prevalence of tobacco smoking and explore the association between tobacco smoking and diseases severity among patients with psoriasis.MethodsA total of 4,529 patients with psoriasis in 200 selected hospitals were recruited in China between January 2020 and September 2021. Detailed information covering demographic feature, tobacco smoking, and psoriasis history were collected through an electronic questionnaire, and clinical data were extracted from the health information system (HIS). SAS 9.4 was used for data analysis, and a p-value of <0.05 was considered statistically significant.ResultsThe prevalence of tobacco smoking was 30.8%, with 24.6% for current smoking. The average Psoriasis Area and Severity Index (PASI) score for patients with psoriasis was 9.4, with male patients having a higher PASI score than female patients. The odds ratio (OR) of former tobacco smoking prevalence was 1.5 [95% confidence interval (CI): (1.0–2.3)] for PASI score (3.0–7.0), 2.2 for PASI score (7.1–13.0), and 4.2 for PASI score >13, when compared with patients with PASI score < 3.0. Similarly, the OR of current tobacco smoking prevalence was 1.8 [95% CI: (1.5–2.2)] for PASI score (3.0–7.0), 1.9 for PASI score (7.1–13.0), and 3.1 for PASI score >13, when compared with patients with PASI score <3.0. The Spearman correlation analysis indicated that both tobacco smoking intensity and smoking duration were positively correlated with psoriasis severity (p < 0.05).ConclusionThe prevalence of tobacco smoking was high, especially among male patients with psoriasis and those with senior high education. Tobacco smoking was positively associated with psoriasis severity; moreover, both smoking intensity and smoking duration were positively correlated with the severity of psoriasis in a dose-dependent fashion.

Cellular Molecular of Osteopontin in the Pathogenesis of Psoriasis

Psoriasis (PS) is a chronic inflammatory skin disease of complex pathogenesis with genetic predisposition, environmental factors and immunological disturbances. Osteopontin (OPN) is known to enhance Th1 responses, inhibit Th2 ones, and take part in the modulation of Th17 cell lineage. Due to its impact on Th1/Th17 immune responses, several reports have suggested that OPN may be of pathogenic importance in psoriasis. However, the involvement of this OPN in the onset of psoriasis have not been fully elucidated. We investigate the cellular localization of OPN protein expression and histopathological features of psoriasis. The study was conducted on 40 patients affected with plaque psoriasis, 10 healthy volunteers and ER+ breast cancer as a positive control. Severity of PS was assessed using the qualitative assessment and severity index score. Our results showed statistically significant differences in the expression of OPN, between lesional and non lesional skin as well as between non lesional skin and control group (P ≤ 0.05). In addition, there was a significant difference in the expression of OPN, between control and lesional group. We concluded that, OPN expressions and severity of psoriasis showed a strong significant negative correlation and also a moderate significant negative correlation. With this notion we postulate OPN expressions will stimulate the inflammatory response, by generating anti‐OPN antibodies and eventually determining OPN expression will become a useful therapeutic tool in assessing and establishing early detection of PS.

Strong site-specific association of pharyngeal cultures with the onset of psoriatic arthritis and psoriasis, regardless of pathogen.

The objective of this study was to evaluate any association between culture site / culture result / pathogen and incident PsA or psoriasis. Records of all samples sent for culture from a large population during a 3-year period were linked with nationwide registry data on diagnoses and death over a 15-year period. The main outcomes of interest were incident diagnoses of PsA and psoriasis, defined by International Classification of Diseases (ICD) codes. The effect of culture site, culture result (positive vs negative), and pathogen (Streptococcus vs negative culture) on the risk of developing PsA and psoriasis was calculated using Cox proportional hazards models adjusted for age and gender. A total of 313 235 bacterial cultures from 128 982 individuals were analysed. Comparing individuals with pharyngeal cultures to those with urine cultures, the hazard ratio for incident PsA was 8.78 [95% confidence interval (CI) 3.23, 23.91] and for incident psoriasis it was 8.00 (95% CI 5.28, 12.12). Most of the risk was concentrated in the first 50 days after the culture date. Increased risk was also found when comparing individuals with cultures from the pharynx with those with cultures from the nasopharynx and blood. An association with streptococci was not found, neither in the pharynx nor at any other site. A positive bacterial culture from any site was associated with reduced risk for both PsA and psoriasis. There is a strong site-specific association between pharyngeal culture samples and an increased risk of PsA and psoriasis, regardless of the pathogen. This may indicate that the site of infection, rather than the pathogen, is associated with increased risk.

Study on the Correlation between Morphology and Distribution of Common Psoriasis Lesions.

Objective Through the analysis of the morphological distribution of psoriasis lesions, we can study the relationship between psoriasis lesions and age, gender, and course of disease and dialectically look at the location of lesion morphology and the impact of course of disease on it, so as to provide more basis for the treatment of psoriasis. Method Through a questionnaire survey of 512 patients in the dermatology clinic of a well-known traditional Chinese medicine hospital in Jiangsu Province, their symptoms met the diagnostic criteria of psoriasis in Chinese clinical dermatology. The current situation of psoriasis was analyzed by literature analysis, and the collected data were analyzed by general mean analysis, analysis of variance, and descriptive analysis. Result There were some differences in the proportion of male to female in 512 patients. It is possible to conclude that male incidence rate is higher than that of women. It can be deduced from bad habits such as heavy drinking and smoking in male life. Bad habits can reduce male immunity and cause disease. The distribution of skin lesions in different parts shows that the skin is more affected by the outside world, which leads to the repeated attack of psoriasis. The incidence of chest, scalp, and upper arm is also relatively high. There have been similar demonstrations in relevant medical data, which may be related to the vascular density in them. Some substances that induce psoriasis in the dense blood vessels are easy to accumulate here, leading to the pathogenic bacteria to induce the onset of psoriasis. Conclusion By studying the distribution of psoriasis lesions and the correlation between lesions, gender, and disease course, we can improve the dialectical treatment of psoriasis, which has reference significance, and provide a new thinking direction for the treatment system theory of psoriasis.

The Impact of Proinflammatory Cytokines and Imiquimod on GLUT1 in HaCaT Keratinocytes - a Potential Anti-Psoriatic Therapeutic Target?

Glucose metabolism has been proven as an essential process for proliferating keratinocytes, which highlights the importance of glucose transporter-1 (GLUT1) not only in the onset of psoriasis but also in the progression and severity of this inflammation-driven disease. In this study, we attempted to find a connection between proinflammatory cytokines (IL-6, IL-17, IL-23, IL-36, TNF-α), a skin inflammation inducing agent - imiquimod (IMQ) and GLUT1 expression. Human keratinocyte HaCaT cell line was incubated with exogenous cytokines: IL-6, IL-17A, IL-23, IL-36, TNF-α at a final concentration of 100 ng/ml, or with 1 µM of IMQ, for 48 h. Following the stimulation, glucose uptake and GLUT1 expression were evaluated. The activity of GLUT1 was measured in the presence of a selective GLUT1 inhibitor, BAY-876. The expression of GLUT1 was examined by immunofluorescence and quantified by qPCR, Western blotting and densitometry. The results from qPCR analysis showed that the administration of exogenous IL-6, IL-17, IL-23 and IL-36 to HaCaT cells resulted in upregulation of GLUT1-encoding SLC2A1 gene, while TNF-α had no significant effect. The same results were confirmed by immunofluorescence analysis, as the fluorescent intensity of GLUT1 was elevated following cytokine and IMQ stimulation. Western blot and densitometry showed that all examined cytokines, as well as IMQ, increased GLUT1 expression. HaCaT cells displayed an improved intracellular 2-deoxy-D-glucose (2-DG) uptake and GLUT1 activity after stimulation by exogenous cytokines and IMQ. The highest uptake of 2-DG was observed after IL-23 stimulation (1.93x) and the lowest after TNF-α stimulation (1.07x). BAY-876 inhibited the 2-DG uptake compared to control. Our findings suggest that cytokines and IMQ may play a key role in regulating GLUT1 expression in HaCaT cells. We believe that GLUT1 overexpression could potentially be utilized in the targeted treatment of psoriasis.

Understanding the experiences of anger in the onset and progression of psoriasis: A thematic analysis.

Psoriasis is a chronic inflammatory skin condition, which can be affected by stress. Living with psoriasis can trigger negative emotions, which may influence quality of life. The present study explored the lived experiences of people with psoriasis with attention to the potential role of anger in the onset and progression of the chronic skin condition. Semi-structured qualitative interviews were conducted with 12 participants (n=5 females, n=7 males) recruited from an advert on a patient charity social media platform. Data were transcribed and analysed using thematic analysis. Four key themes were identified: (1) anger at the self and others, (2) the impact of anger on psoriasis: angry skin, (3) shared experiences of distress and (4) moving past anger to affirmation. Findings suggest that anger can have a perceived impact on psoriasis through contributing to sensory symptoms and unhelpful coping cycles, and points to a need for enhanced treatment with more psychological support. The findings also highlight the continued stigma which exists for those living with visible skin conditions and how this may sustain anger for those individuals. Future research could usefully focus on developing targeted psychosocial interventions to promote healthy emotional coping.

Chronic Plaque Psoriasis in Poland: Disease Severity, Prevalence of Comorbidities, and Quality of Life.

The epidemiology of psoriasis has not been widely assessed in Polish population so far. This study aimed to investigate psoriasis epidemiological situation by evaluating disease course and severity, management, comorbidities, environmental factors, and knowledge about this disorder among psoriatic patients in Poland. A cross-sectional cohort population-based study enrolled 1080 psoriatic patients and 1200 controls. The mean age of psoriasis onset was 27.6 years; 78.24% had type I psoriasis. Positive family history of psoriasis was reported in 44.81% of patients, whereas itch was reported in vast majority of patients (83.33%). Based on PASI score moderate psoriasis was the most common in studied group (mean 12.63 ± 9.33, range 0–67.2). The DLQI score (12.01 ± 7.41, range 0–30.0) indicated a very large effect of psoriasis on the quality of life. Hypertension was the most prevalent comorbidity (33.80%), followed by obesity (16.85%) and dyslipidemia (11.85%). Stress was the foremost cause of disease exacerbation (66.20%); however, infections (44.07%) and seasonal changes (45.09%) had also an impact on the course of psoriasis. Psoriatic patients were more often smokers (37.59%) vs. general population (27.50%; p < 0.0001). In conclusion, epidemiological studies help clinicians in better disease and patient understanding, which may translate into better management and patient compliance.

A Retrospective, Cross-sectional Hospital-based Study to Determine the Epidemiological, Clinical and Comorbidity Characteristics in Older Adults with Psoriasis

Background: Psoriasis is extensively studied among middle-aged adults, but not many have studied psoriasis in older adults(geriatrics). Objectives: To analyze epidemiological, clinical, comorbidities and therapeutic profile of geriatric psoriasis(GP). Methods: All consenting clinically diagnosed psoriatic patients ≥60 years were divided into two groups: Elderly psoriatic(EP)(60-75 years) and Ultra elderly psoriatic(UP)(&gt;75 years). The dermatologist filled their clinical characteristics’ standardised questionnaire to determine comorbidities, drug interactions profile and compared with age-matched controls using Chi square test. Results: Prevalence of GP is 14.5%(Average age:68 years; Sex ratio=2.5:1) among geriatrics attending dermatology OPD. Most common(49.9%) as well as initial site affected(39.3%) were Palms±Soles. Nummular plaque (90.2%) was most common type. Superficial fungal infection(26.9%) and pruritus(90.8%) were commonly associated cutaneous disease and symptom(p&lt;0.05) respectively. Hypertension(49.7%), Diabetes Mellitus(22.8%), dyslipidemia(25.8%) and Metabolic syndrome(MS)(17.8%) were associated systemic comorbidities. Dyslipidemia and MS(p&lt;0.0001) were more common among GP(163) than controls(963). Drug aggravated psoriasis could not be linked to polypharmacy. Although, topicals were mainstay, oral Methotrexate was most efficacious systemically. Conclusion: Our findings suggest a trimodal age of psoriasis onset at 68 years. As age advances, psoriasis severity decreases, unstable guttate lesions decrease; palms±soles commonly involved; infrequent familial occurrence with Polypharmacy not aggravating psoriasis. Active screening for cardiovascular comorbidities in all geriatric psoriasis patients is highly recommended.

Antigen-Presenting Cells in Psoriasis.

Psoriasis is classically considered a chronic inflammatory skin disorder, however the identification of autoantigens in its pathogenesis established it as a T cell mediated autoimmune disease. As such professional antigen-presenting cells (APCs) are key players in the development of lesions. APCs in the skin include dendritic cells, Langerhans cells and monocytes/macrophages. In addition, epidermal keratinocytes and dermal mast cells are also endowed with antigen-presenting capacity. Skin APCs have central role in the maintenance of cutaneous immune homeostasis, as well as in initiating and sustaining inflammation under pathologic conditions. In this review we discuss the functional specialization of human skin APCs that promote T cell activation and adaptive immune response during psoriasis initiation and onset.

Psoriasis rate is increased by the exposure to TNF inhibition in children with JIA

ObjectiveWe aimed to investigate the relationship between tumour necrosis factor inhibitors (TNFi) therapy and the onset of new psoriasis in children with juvenile idiopathic arthritis (JIA) using Childhood Arthritis and...

Human Papillomavirus Within Psoriasis Plaques in a Patient With Psoriasis: A Case Report

Introduction: Psoriasis may be triggered by several factors, and its pathophysiology is related to inflammatory cellular processes. We herein describe a patient with psoriasis who developed warts on multiple psoriasis plaques and was successfully treated with systemic subcutaneous methotrexate. Case presentation: A 67-year-old man who had been diagnosed with psoriasis 14 years previously developed an outbreak of small erythematous desquamative plaques distributed symmetrically on his arms and trunk. Multiple spiny whitish papules had developed over his previously established psoriasis lesions. The appearance of the papules was consistent with viral warts. The patient was treated with systemic methotrexate injected subcutaneously and oral folic acid, both dosed weekly. This treatment produced good results. Discussion: A remarkable feature of this case is that psoriasis was the first diagnosis and that human papillomavirus (HPV) appeared over widespread erythematous squamous plaques. The pathophysiology of psoriasis is related to inflammatory cellular processes. Some authors have reported that HPV proteins may stimulate keratinocyte proliferation. Others have reported that HPV infection mostly stimulates systemic interleukin 17 production; consequently, HPV infection could provide a better environment for interleukin 17 secretion and facilitate new onset of psoriasis. One report indicated that methotrexate was discontinued in a patient who presented with both pathologies, although we had very good results. Conclusion: Psoriasis and HPV may be pathophysiologically related. HPV may stimulate keratinocyte proliferation and systemic interleukin 17 production, resulting in a better environment for psoriasis. Systemic methotrexate injected subcutaneously resulted in a good outcome in our patient.

Relationship between onset of psoriasis and spondyloarthritis symptoms with clinical phenotype and diagnosis: data from REGISPONSER registry.

Background:The relationship of psoriasis and spondyloarthritis (SpA) is well-known, and the age of appearance of different manifestations has been described as a determinant of SpA phenotype. However, differences between Spa with psoriasis and psoriatic arthritis (PsA) are still controversial.Objectives:To evaluate whether the time of onset of psoriasis relative to the appearance of rheumatic symptoms in patients with SpA is associated with a clinical phenotype, a rheumatologist’s diagnosis and the evolution of the disease.Design:This was a cross-sectional study with data extracted from the REGISPONSER (Spondyloarthritis Registry of the Spanish Rheumatology Society) registry.Methods:All patients had data available for both psoriasis and SpA dates of onset. Patients were classified into two groups depending on the time of appearance of psoriasis: psoriasis before or after rheumatic symptoms. The clinical characteristics, disease activity, radiographic damage, functional ability and received treatments were compared between the two groups. Moreover, the rheumatologists’ diagnoses were compared between the two groups. Univariate and multivariate logistic regressions were conducted to evaluate the factors associated with each group.Results:A total of 433/2367 (18.3%) patients included in the REGISPONSER database had psoriasis: 330 (76.2%) patients had psoriasis before rheumatic symptoms, and 103 (23.8%) had psoriasis after rheumatic symptoms. Patients with psoriasis before rheumatic symptoms had a shorter disease duration and a lower body mass index, a lower prevalence of both HLA-B27 antigens and anterior uveitis, a higher prevalence of dactylitis and an increase in levels of the erythrocyte sedimentation rate (ESR). Furthermore, a higher prevalence of PsA diagnoses (78.1% versus 56.4%) and a more frequent fulfilment of the CASPAR criteria (57.5% versus 42.2%) were found in these patients. The use of DMARDs was not significantly different between the two groups.Conclusion:The time of appearance of psoriasis is associated with the clinical phenotype of SpA and could determine a diagnosis of PsA by rheumatologists.

Early predictors of psoriatic arthritis: a Delphi-based consensus from Italian dermatology centers

Psoriatic arthritis (PsA) is an inflammatory condition which can affect up to 41% of psoriatic patients [1]. In 40-60% of patients, PsA can determine cartilage destruction and joint deformities, hereby heavily impacting physical function and quality of life, even increasing the risk of death compared to the general population [1]. PsA manifestations usually develop after psoriasis onset; therefore, dermatologists play a crucial role in the detection of early signs of arthritis. In our study, we aimed to identify simply detectable clinical and ecographic signs of early PsA and to assess their reliability. We assessed the opinion of a group of expert dermatologists, who were asked to express their opinion on the level of association between the selected anamnestic, clinical or instrumental signs and the onset of psoriatic arthritis by giving a score to each item. Psoriatic onycopathy, signs of dactylitis and ultrasonographic alterations of selected joints were, respectively, the dermatologic, rheumatologic and imaging signs which had the strongest significance in the opinion of the experts. These signs should be carefully looked for during dermatological examinations in order to detect early PsA.

The differences of blood type in relation to psoriasis and its onset: Cross sectional study

Background: Psoriasis is a chronic skin disease caused by inflammatory response and attacks 2% of population, with the prevalence influenced by age, geographical location, and genetic background. Until this day, there are several studies that discuss about the relationship between blood type with disease. However, discussion about the difference between blood type and the relationship with skin disease remains limited. The objective of this study is to know the relationship between blood type, psoriasis, and onset of psoriasis. Methods: This study adopted cross-sectional design of analytic observational study. The subjects of this study were patients in Department of Dermatology and Venereology at Dr. Moewardi General Hospital and UNS Hopital in Surakarta. The blood types were determined by two methods; by using ABD-Pad measurement tools that able to see the reaction of antigen and antibody in short time and by using the hospital&rsquo;s laboratory facility where sample was taken. Anamnesis were done to collect data about the onset of psoriasis. Chi-square (X 2 ) statistical test was used to analyze the data. Results: Total sample of this study were 62 people with 31 subjects (50%) were psoriasis patients and 31 others (50%) are non-psoriasis patients. Chi-square test (X 2 ) between blood type with psoriasis and blood type with the onset of psoriasis are p = 0.269 and p = 0.188 respectively. Conclusion: The significance level used was p &lt; 0.05, therefore there&rsquo;s no significant correlation between blood type with psoriasis and the onset of psoriasis. &nbsp; Keywords : blood type, onset of psoriasis, psoriasis