Positive Family History Of Psoriasis Research Articles

Risk Factors of Ixekizumab-Induced Injection Site Reactions in Patients with Psoriatic Diseases: Report from a Single Medical Center.

Ixekizumab (Taltz®) is a humanized anti-IL-17A monoclonal antibody approved for the treatment of various inflammatory diseases including psoriasis and psoriatic arthritis. Despite the favorable efficacy and safety, ixekizumab is also known for its high incidence of injection site reactions (ISRs), ranging from 6% to 55% in different studies according to different definitions and studied population. However, specific risk factors for ixekizumab-induced injection site reactions in patients with psoriatic diseases had not been well studied. In this retrospective study, we found that overweight or obesity might be a protective predictor for the occurrence of ixekizumab-induced ISRs in patients with psoriatic disease. Meanwhile, having a positive family history of psoriasis might be a potential risk factor. Last but not least, patients with diarrhea following ixekizumab injection were associated with a higher risk of developing ISRs. Future high-quality studies with larger samples are warranted to verify the relationship.

A partitioned 88-loci psoriasis genetic risk score reveals HLA and non-HLA contributions to clinical phenotypes in a Newfoundland psoriasis cohort.

Psoriasis is an immune-mediated inflammatory skin disease typically characterized by erythematous and scaly plaques. It affects 3% of the Newfoundland population while only affecting 1.7% of the general Canadian population. Recent genome-wide association studies (GWAS) in psoriasis have identified more than 63 genetic susceptibility loci that individually have modest effects. Prior studies have shown that a genetic risk score (GRS) combining multiple loci can improve psoriasis disease prediction. However, these prior GRS studies have not fully explored the association of GRS with patient clinical characteristics. In this study, we calculated three types of GRS: one using all known GWAS SNPs (GRS-ALL), one using a subset of SNPs from the HLA region (GRS-HLA), and the last using non-HLA SNPs (GRS-noHLA). We examined the relationship between these GRS and a number of psoriasis features within a well characterized Newfoundland psoriasis cohort. We found that both GRS-ALL and GRS-HLA were significantly associated with early age of psoriasis onset, psoriasis severity, first presentation of psoriasis at the elbow or knee, and the total number of body locations affected, while only GRS-ALL was associated with a positive family history of psoriasis. GRS-noHLA was uniquely associated with genital psoriasis. These findings clarify the relationship of the HLA and non-HLA components of GRS with important clinical features of psoriasis.

SEXUAL DISORDERS IN PSORIATIC PATIENTS

Introduction: Psoriasis is a common chronic inflammatory dermatosis. Despite the fact that sex life can be severely affected in patients, it is often poorly assessed by clinicians. Purpose of the work: The aim of this work is to determine the impact of psoriasis on quality of life and sexuality, and the main associated factors. Materials and Methods: A prospective descriptive study with a data collection of psoriatic patients psoriatic patients followed at the Dermatology consultation at the Military Hospital of Instruction in Rabat,over a period of 07 months from October 2017 to May 2018. Results:Thirty-eight patients were included in our study, with an average age of 39.5 ± 12.5 years. Seventeen patients had a positive family history of psoriasis. This represents (44.7%) of the patients recruited. Twelve patients (31.5%) had other significant comorbidities (arterial hypertension, diabetes, dyslipidemia, obesity, benign prostatic hypertrophy). The average age of the psoriasis was 14.3 ± 12.4 years. The majority of patients (60.5%) had plaque psoriasis, 17 patients (44.7%) had scalp involvement, 11 patients had facial lesions (28.9%), palmar-plantar involvement was present in 21 patients (55.2%), trunk involvement in 32 patients (84.2%), while genital area involvement was present in 19 cases (50%) and lower limb involvement in 34 cases (89.4%) The mean PASI was 13.1 ± 11.2 points. 47.3% of the patients had psoriasis considered mild. The mean DLQI score was 10 points, psoriasis had a moderate effect on quality of life in 34.2% of patients. The majority of patients (55.1%) had erectile dysfunction. More than 34.2% of patients often felt that other people considered their skin problem to be a contagious disease, 47.3% of patients at least occasionally avoided social activities. 39.4% of patients reported feeling social rejection sometimes. The majority of the participants (55.2%) pointed out that their disease occasionally influenced their sexual life, 71% of the patients avoided sexual intercourse to a different extent. When being with their sexual partner, 44.7% of the patients felt embarrassed at least occasionally, and 42.1% of them felt stress before sex. Many patients felt at least some discomfort, if the lesions are present on the visible parts of the body (47.3%) and on the genitals (28.9%), genital involvement was one among the causes both personal and related to the spouse. Discussion: Currently, the evaluation of the severity of psoriasis takes into consideration its impact on the quality of life of the patient. The improvement of the quality of life remains the final objective in the management of psoriasis, the average score of DLQI in our study is 10. Thus, 44.7% of our patients had a score higher than 10, indicating a significant alteration in quality of life due to psoriasis. Comparing our results with the average DLQI scores found in other studies of psoriasis patients, we note that the average score of our patients is similar to that found in most studies. Recent studies have shown that this disease can affect psychosocial well-being and may be linked to an increased risk of depression. However, data on the impact of psoriasis on sex life are still limited, in part because erectile dysfunction is an embarrassing and neglected problem. The prevalence of this condition depends on the study population, in our study as many as 55.1% of patients suffer from erectile dysfunction. In addition to low self-esteem, stigma and decreased confidence, Avoidance of sexual contact due to the disease and feeling of rejection also significantly influenced the quality of life of our patients. Conclusion: In the patients included in our study, psoriasis had a moderate impact on quality of life. The assessment of sexual disorders by the IIEF-5, and the predefined questionnaire gave an idea about erectile dysfunction and emotional problems related to sexual life in psoriatic patients. Thus, it is understood that this is a complex disease that requires multidisciplinary management.

Scalp psoriasis and Dermatology Life Quality Index: A retrospective study based on 12-year data from the Malaysian Psoriasis Registry.

Psoriasis affects approximately 2-3% of the population worldwide, although the overall prevalence in Asia is <0.5%. Scalp psoriasis is a common initial presentation of psoriasis, which affects almost 80% of patients with psoriasis. This retrospective descriptive study investigated 1,671 patients with psoriasis with scalp involvement registered with the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018. A total of 21,859 patients with psoriasis were registered with the MPR during the study period; among them, scalp involvement was seen in 7.6% (n= 1,671). Female sex preponderance (61%) was observed in the majority of Malay patients (58.5%), followed by the Chinese (16.9%), Indian (17.1%) and other ethnic patients (7.5%). A positive family history of psoriasis was identified in 22.7% (n=380). Approximately 34.8% (n=581) and 11% (n=172) of the patients had nail changes and psoriatic arthropathy, respectively. The mainstay treatment modality was topical treatment (93.6%), followed by systemic therapy (10%) and phototherapy (0.5%). The comorbidities found among the patients with scalp psoriasis included hypertension (27.9%), obesity (26%), dyslipidaemia (21%), diabetes mellitus (18.4%), ischaemic heart disease (5.4%) and cerebrovascular disease (1.3%). Approximately 23% reported a Dermatology Life Quality Index (DLQI) of >10, which indicated moderate-to-severe impairment. The proportion of patients with psoriasis with scalp involvement in our study (7.6%) is much lower than previous reports. Scalp psoriasis markedly negatively impacts the DLQI.

Psoriasis in Northern Saudi Arabia: Clinical features and implications for quality of life.

Introduction:Psoriasis is a chronic non-contagious inflammatory skin disorder, which might impair patient’s social relationships, limit leisure activities, and lower self-esteem. Psoriasis patients might be stigmatized leading to psychological disorders such as anxiety and depression.Objectives:This study aimed to outline the clinical features of psoriasis and its effects on quality of life, and the feeling of stigmatization among psoriasis patients.Methods:This cross-sectional questionnaire-based study was conducted on 109 adult psoriasis patients in Arar City, Saudi Arabia. The study collected data on socio-demographic and clinical characteristics of psoriasis patients, self-reported psoriasis severity using the self-assessment Simplified Psoriasis Index (sa-SPI-s), patients’ quality of life using the dermatological life quality index (DLQI), and the feeling of stigmatization using the six-items stigmatization scale.Results:The mean age of psoriasis onset in studied patients was 20 (±7.65) years, females represented 58.72%, and 22% were unemployed. Joint and nail affection were reported in 46.79% and 51.38%, respectively. One third of patients had positive family history of psoriasis. Seasonal variation, life stressors, smoking and skin injuries were frequent provocative factors for psoriasis lesions. The average sa-SPI-s was 10.08 (±10.41), which was correlated with patients’ ages, disease duration, obesity, and pruritis. The average DLQI and six-items stigmatization scale for psoriasis patients were 8.95 (±5.77) and 7.61 (±4.5), respectively that were correlated with sa-SPI-s.Conclusion:The clinical manifestations and chronicity of psoriasis impaired patients’ quality of life and accompanied with social stigma due to skin disfigurement. These effects need to be addressed for better care of patients.

Serological estimation of serum level of Vitamin D3 among Psoriasis patients

Background: psoriasis is a prevalent, persistent, non - contagious skin disorder of unknown origin or cure. It has a significant detrimental influence on people’s life. It was hypothesized that there is a relation between reducing vitamin D levels and psoriasis. Psoriasis is a severe global condition that affects at least 100 million people; the incidence of psoriasis ranges from 0.09 to 11.43 %. The incidence of psoriasis is 0.09 % to 11.43 %. Objectives &amp; Methodology: Study the frequency of and incidence of psoriasis and its correlation with serum vitamin D3 level; 150 people aged between 1-45 years old and from both sexes were selected for the current study. All of them were recruited from Hilla Teaching Hospital and TelAfer from November 2018 to February 2019 in Babylon Governorate. Of them, 50 were suffering from Psoriasis symptoms, 50 were presented with a positive family history of psoriasis, and the last 50 people were healthy and considered a control group. They were all subjected to estimating the serum level of vitamin D3 by using the ELISA technique. Results: a significant decrease in the serum level of vitamin D3 was found among patients with psoriasis compared to the control and family history groups. The study also indicates that the onset frequency of psoriasis has a hereditary component. In comparison to the age groups (1-15) and (16-30), the results showed a considerable increase in the age groups (31-45). The incidence was more in males than in females. Conclusions: A significant decrease in vitamin D3 in patients with psoriasis. Keywords. family history, gender types, Vitamin D3, psoriasis

Topical treatment adherence and associated factors in patients with psoriasis: A single center, cross-sectional study.

Topical medications are one of the main treatments for psoriasis. Adherence to treatment is an important factor in achieving successful control of disease. The aim of this study was to evaluate adherence to topical drugs and identify possible associated factors in in patients with psoriasis. Ninety-three patients were evaluated by a two-part questionnaire; the first part examined demographic, socioeconomic and disease-related factors while the second part, the ECOB questionnaire (Elaboration d'un outil d'evaluation de l'observance des traitements medicamenteux), examined adherence to topical drugs. The mean self-reported adherence to topical treatment in this study, was 50.5%. Severe disease, involvement of lower extremity, and positive family history of psoriasis were associated with poor adherence to treatment. Patients with a history of diabetes mellitus had better adherence to treatment. In this study adherence to topical treatment was low and had no significant relationship with most of the studied demographic and socioeconomic factors.

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.

Epidemiological evaluation of paediatric psoriasis patients at the Dermatology Department

Introduction: Psoriasis is a chronic autoinflammatory disease, which mostly affects skin and joints. Patients with psoriasis are at risk of developing comorbidities such as diabetes, cardiovascular diseases or mental disorders. It is reported that even one-third of the total psoriatic cases may have skin symptoms in childhood. Material and methods: The study aimed to perform a retrospective analysis of paediatric patients with psoriasis admitted to the dermatological department between 2018 and 2020. Patients’ data were analysed for age, gender, medical diagnosis (ICD-10) including subtypes of psoriasis, treatment, the clinical course of the disease and results of the diagnostic tests including cholesterol fractions and blood glucose level. Results: In the years 2018–2020 73 children were admitted to the dermatological department. The number of female patients 47 (64.38%) significantly dominated over the number of male patients 26 (35.62%). Almost 95% of them were diagnosed with psoriasis vulgaris. Only 3 cases (4.11%) of generalized pustular psoriasis and 1 case (1.37%) of psoriatic arthritis were reported. Almost 20% of children had a positive family history of psoriasis. Readmission to the ward was required in 35.62% of the cases. 23.4% of patients presented abnormality in lipid profile. 15% had various comorbidities. Conclusions: Better understanding of psoriasis and its management from an early age, may improve the quality of life of psoriasis patients and prevent them from developing serious comorbidities in the future.

Association of body mass index with clinical variants of psoriasis

Introduction/Aim. Psoriasis is a common, chronic, immune-mediated, inflammatory and proliferative skin disease in which both genetic and environmental influences have a role in its pathogenesis. The relationship between psoriasis and obesity is probably bidirectional. The aim of this study was to evaluate the association between psoriasis and obesity, whether a quantitative graduation of overweight using Body Mass Index (BMI) shows direct correlation with various clinical variants of psoriasis, disease duration and having positive family history of psoriasis. Methods. This prospective, observational descriptive cross-sectional study included 120 psoriatic patients who were referred to Clinic of Dermatovenereology at the University Clinical Centre of Vojvodina. Clinical variants of psoriasis were determined. Age, gender, duration of the disease, BMI and family history of psoriasis were measured and compared. Results. In total, 53.3% males and 46.7% females were included in this study. The mean age was 49.5 ? 15.5 years. The most present clinical variants of psoriasis were psoriasis vulgaris (55%) and psoriatic arthritis (30%). Most of the patients (42.5%) were overweight, 23.3% were obese, and 1.7% were morbidly obese. The mean BMI was high (27.7 ? 5.2). Mean duration of the disease was 15.6 ? 14.9 years. Positive family history of psoriasis was found in 33 (27.5%) patients. Conclusion. There was no correlation between the BMI and gender of the patients, psoriasis clinical variants, duration of the disease and positive family history of psoriasis. The slight positive correlation was found between BMI and age of psoriatic patients. That requires further studies that include physical activities questionnaire, considering that lack of physical activities in older patients might be an explanation.

Prevalence of Psoriasis Vulgaris and Its Associated Risk Factors in Pakistan

Aim: To find out the prevalence of psoriasis vulgaris and its associated risk factors.&#x0D; Study Design: Descriptive cross-sectional.&#x0D; Place and Duration of Study: Study was conducted at Rawalpindi Leprosy Hospital during January 2019 to December 2019.&#x0D; Methodology: The diagnosed cases of Psoriasis Vulgaris (PsV) were included in the study. All the patients were investigated on the basis of an in depth Performa. The Performa include all the relevant clinical and family history of the patient along with the personal details. Data was analyzed by using Statistical Package for the Social Sciences (SPSS) version 20. All the numerical variables were presented as mean with standard deviation while categorical data as frequency and percentages. The association of risk factors with the Psoriasis was calculated by using the Chi-square test. p-value less than 0.05 was considered as significant.&#x0D; Results: Mean age with standard deviation of patients was 34.7±14. Most of the diagnosed patients were male and below 40 years of age, only 4.2% cases were having positive family history of Psoriasis and found significant correlation. The frequency of onset of symptoms in adolescent was more as compared to childhood i.e. 95.3% and 4.7% respectively. Majority of psoriasis cases (65.3%) were from non-smoker group and having strong association with smoking. The frequency of arthritis among psoriasis patients was 23.7% and majority of the patients, who developed arthritis were those having age &lt;40 year and were suffering from psoriasis since 5-10 years.&#x0D; Conclusion: Current study concluded that Psoriasis vulgar is having higher prevalence rate among male and below 40 years of age group. The results also suggested a strong association of severity of psoriasis with certain risk factors including family history, age of onset of symptoms, smoking and arthritis.

Prevalence of psoriatic arthritis among patients with plaque psoriasis: a Brazilian retrospective study.

Psoriatic arthritis is the most frequent and impactful comorbidity among psoriatic patients and appears in most cases after skin disease. Dermatologists play a key role in its early diagnosis and treatment. To determine the prevalence of psoriatic arthritis and associated variables among patients with plaque psoriasis seen at a reference center for treating psoriasis. Retrospective cross-sectional study conducted among 300 patients at an outpatient clinic in a university center in Juiz de Fora, MG, Brazil. Standardized records of 300 patients with plaque psoriasis were examined. Demographic data and medical variables relating to psoriasis (Psoriasis Area and Severity Index (PASI), family history, age at onset and disease progression) and psoriasis arthritis (CASPAR criteria) were evaluated. Laboratory and radiographic tests in the medical records were reviewed. Seventy-three (24.3%) of these 300 patients with plaque psoriasis had psoriatic arthritis. Asymmetric oligoarthritis (58.9%) was the most common clinical form, followed by polyarthritis (20.5%), distal interphalangeal arthritis (15.2%) and spondyloarthritis (5.4%). Dactylitis was present in 21.9% and enthesitis in 35.6% of patients. Compared with patients without arthritis, patients with arthritis had higher average age, higher frequency of positive family history of psoriasis, longer duration of evolution and higher PASI rates. Psoriatic arthritis is often underdiagnosed. Since dermatologists perform the initial approach, these professionals need to be trained to diagnose this comorbidity and treat it, together with rheumatologists.

Oral Investigation in Childhood Psoriasis: Correlation With Geographic Tongue and Disease Severity

Background: Childhood psoriasis affects 2% of the world pediatric population. An association between psoriasis and geographic tongue (GT) in adults has been suggested, but there are no studies in children. Objective: This study aimed to compare the prevalence of oral lesions in pediatric patients with psoriasis (PP) and healthy controls and investigate the correlation between GT, severity, and age of psoriasis onset. Methods: The participants were 17 PP aged &lt;18 years and 91 HC. The severity of vulgaris psoriasis was determined according to Psoriasis Area and Severity Index (PASI) and all patients underwent an oral examination. Results: Oral findings were present in 43% of the participants and the most common lesions were candidiasis and GT. There was a mean earlier onset in psoriasis with GT (3 years old) compared to psoriasis without GT (10 years old). The mean PASI scores in psoriasis with GT and psoriasis without GT were 9 and 3, respectively. Conclusion: Geographic tongue and candidiasis were frequently found in PP. Patients with psoriasis with GT are younger and have earlier onset of the disease, a positive family history of psoriasis, and a severe form of the disease. The present study is the first of its type to demonstrate clinical differences in pediatric PP with and without GT.

Childhood and adolescent psoriasis in Taiwan: A retrospective analysis from a single medical center

There are limited studies regarding childhood and adolescent psoriasis in Taiwan. A total of 86 pathologically confirmed cases diagnosed from 1989 to 2017 were retrospectively reviewed. Mean disease onset age was 10.51 years, and plaque psoriasis was the most common type. Compared to studies on Caucasian and other Asian populations, we found a lower estimated prevalence, higher rate of psoriasis limited to the nail at presentation, and higher prevalence of psoriatic arthritis. The most common comorbidities were related to atopy and metabolic syndrome. Positive family history of psoriasis and psoriasis preceded by infection were significantly associated with moderate-to-severe disease.

Transforming growth factor-β1 gene polymorphism in psoriasis vulgaris.

BackgroundIncreased transforming growth factor beta 1 (TGF-β1) in the epidermis and serum has been found in psoriatic patients. The mechanism for this increase remains unclear.ObjectiveTo study the TGF-β1 gene polymorphism at codon 10 and its relation to psoriasis susceptibility in a sample of Egyptian patients.Materials and methodsThis cross-sectional study involved 70 patients with psoriasis vulgaris and 100 age- and sex- comparable healthy volunteers as a control group. Genomic DNA was prepared from peripheral blood lymphocytes from all subjects using QIAamp DNA mini kit (QIAGEN Inc., Germany). The TGF-β1 polymorphism was genotyped by PCR-based restricted fragment length polymorphism (PCR-RFLP) analysis. Amplification of codon 10, located in exon 1 of TGFβ1 gene was done through PCR reaction using gene-specific primers.ResultsStatistically significant difference was found between psoriasis patient and controls as regards TGF-β1 (T869C) polymorphism (P=0.045). The presence of TT genotype was associated with a 3-fold risk of psoriasis compared to CC genotype (P=0.016, OR: 3.13 95% CI: 1.24–7.88). T allele was significantly more frequent in psoriasis patients (P=0.017). TGF-β1 gene mutation was significantly higher among psoriasis patients with positive family history (P=0.007).ConclusionTGF-β1 gene polymorphism at codon 10 (T869C) is significantly associated with susceptibility to psoriasis in Egyptian patients. This polymorphism is more common in patients with a positive family history of psoriasis.

Epidemiology and Clinical Features of Adult Patients with Psoriasis in Malaysia: 10-Year Review from the Malaysian Psoriasis Registry (2007-2016).

Background Psoriasis is a chronic inflammatory skin disease affecting 2-3% of the general population. Aim To evaluate the epidemiology and clinical characteristics of patients with psoriasis who seek treatment in outpatient dermatology clinics throughout hospitals in Malaysia. Materials and Methods Data were obtained from the Malaysian Psoriasis Registry (MPR). All patients (aged 18 and above) who were notified to the registry from July 2017 to December 2017 were included in this study. Results Among 15,794 patients, Malays were the most common (50.4%), followed by Chinese (21.4%), Indian (17.6%), and others (10.6%). The mean age onset of psoriasis for our study population was 35.14 ± 16.16 years. Male to female ratio was 1.3 : 1. 23.1% of patients had positive family history of psoriasis. The most common clinical presentation was chronic plaque psoriasis (85.1%), followed by guttate psoriasis (2.9%), erythrodermic psoriasis (1.7%), and pustular psoriasis (1.0%). Majority of our patients (76.6%) had a mild disease with BSA < 10%. 57.1% of patients had nail involvement, while arthropathy was seen in 13.7% of patients. Common triggers of the disease include stress (48.3%), sunlight (24.9%), and infection (9.1%). Comorbidities observed include obesity (24.3%), hypertension (25.6%), hyperlipidemia (18%), diabetes mellitus (17.2%), ischaemic heart disease (5.4%), and cerebrovascular disease (1.6%). The mean DLQI (Dermatology Life Quality Index) was 8.5 ± 6.6. One-third (33.1%) of the patients had a DLQI score of more than 10, while 14.2% of patients reported no effect at all. Conclusion Our study on the epidemiological data of adult patients with psoriasis in Malaysia showed a similar clinical profile and outcome when compared to international published studies on the epidemiology of psoriasis.

Clinicoepidemiological study of childhood psoriasis in a tertiary care center

Context: Psoriasis is a chronic immune-mediated disease. Although common in children, true incidence and prevalence are not exactly known. There is a paucity of data on childhood psoriasis in India. Aims and Objectives: To study the age and gender distribution, mean age of onset, family history, precipitating factors, seasonal variation, clinical pattern, and nail changes in childhood psoriasis. Study Design: This was a prospective, observational study. Materials and Methods: All children with psoriasis under the age of 18 years were enrolled in the study, and detailed evaluation was done. Statistical Analysis Used: SPSS 20 (IBM SPSS statistics for Windows, version 20.0: IBM Corp., Armonk, NY) and SIGMA STAT 3.5 (Sigma stat 3.5, Systat Software Inc., Richmond, CA.) by applying one-way ANOVA and Chi-square test. Observations and Results: Childhood psoriasis comprised 17.8% of total psoriatic patients. Male to female ratio was 1:1.4. Girls had higher mean age and delayed age of onset (P 0.028). Nearly one-third had positive family history of psoriasis. Trauma was the most common precipitating factor. Anti-streptolysin-O titer was positive in 10.18% of cases, out of which 72.72% belonged to guttate psoriasis. The most common clinical type was plaque psoriasis. Extremities were the most frequently involved site and also the most common site of onset. Pitting was the most common nail change. Conclusion: In our study, a considerable proportion of the psoriatic patients were children (17.8%). Infection was one of the common triggering factors in children; hence, early control of infection may help in reducing the severity and frequency of the disease. Further follow-up of these children is needed to know the outcome and prognosis of the disease.

Histology of psoriatic erythroderma in infants: analytical study of eight cases.

Background:Erythroderma in infants is a rare condition of varied etiology. Psoriasis is now emerging as the most common cause of erythroderma in infants. Early diagnosis of the etiological cause much depends upon the histological confirmation, which is essential for an early and appropriate treatment.Aim:It was aimed to study the histological findings in psoriatic erythroderma in infants.Materials and Methods:A total of 8 infants up to 1 year of age presenting with erythroderma, clinically suspected to be of psoriatic etiology attending private clinic were included. After detailed history taking and astute clinical exam, all of them were biopsied. In case 6, with a positive family history of psoriasis and asthma in parents, biopsy was taken from two sites. The histological findings of all nine biopsies were studied and analyzed.Results:Histology of all eight children showed psoriasi form pattern with acanthosis (AC) and dilated papillary capillaries (PC). Spongiform (SF) pattern was seen in the second biopsy (6b) of child with features of both psoriasis and atopy. SF pustule of Kogoj or Munro's abscess was not seen in any of them.Conclusion:Regular AC and PC dilatation were the consistent histological findings observed in infants with erythrodermic psoriasis. These were the early findings observed in younger infants. Co-existence of psoriasis with atopic dermatitis may indicate a common pathogenic mechanism or an immunogenetic spin-off.

A Psoriatic Arthritis Patient with Multiple Rare Complications – case report and review of literature.

A 28 year old male patient of psoriasis was admitted in a tertiary care hospital of Bangladesh with typical skin lesions for 18 years, nail changes for 16 years, arthritis for 12 years and eye changes for 3 years. In addition he had other rare extra articular complications like severe aortic stenosis, moderate aortic regurgitation and mild mitral regurgitation. He had a positive family history of psoriasis. HLAB27 is positive and X-ray of hands and feet showed classical findings of psoriatic arthritis. We presented the case to show the early age of onset, severity of the disease with rapid progression and multiple extra articular complications. DOI: http://dx.doi.org/10.3329/pulse.v5i2.20266 Pulse Vol.5 July 2011 p.48-53

Recalcitrant psoriasis responding to new bilogic drug: Ustekinumab

Recalcitrant psoriasis responding to new bilogic drug: Ustekinumab