Metoprolol‐induced psoriatic nail disease

We describe the development of psoriatic nail disease due to metoprolol in a 58‐year‐old woman who was being treated for cardiac arrhythmias. The nail condition was unresponsive to topical and systemic treatments but resolved completely with the withdrawal of metoprolol. The reaction recurred with drug rechallenge and resolved when the drug was ceased.     

Serologic markers of celiac disease in psoriatic patients

Background  Aetiopathogenesis of psoriasis is complex and not yet well known. In recent years, it has been observed that psoriasis can coexist with clinically asymptomatic celiac disease and a gluten-free diet helps to obtain remission, even in patients with very chronic lesions.
Objective  The aim of our work was to investigate how often the positive titres of antibodies characteristic for celiac disease occur in psoriatics' serum in exacerbation in comparison with controls.
Patients/methods  Serum samples from 67 patients with intensified psoriatic lesions were investigated. Serum from healthy people at a comparable age and with no familial predisposition to psoriasis and celiac disease was the control material. Antibodies against human tissue transglutaminase (recombinant antigen), against tissue transglutaminase isolated from guinea pig's liver and against gliadin were determined by enzyme-linked immunosorbent assay technique. Anti-endomysial antibodies were determined by indirect immunofluorescence method.
Results  Patients with psoriasis have significantly higher mean concentrations of antibodies against tissue transglutaminase (human recombinant and guinea pig-derived antigen) and against gliadin for IgA. IgA antibodies against tissue transglutaminase (both antigens) and gliadin positively correlate with psoriasis activity. No anti-endomysial antibodies for IgA were found in any serum.
Conclusions  Our results seem to imply an association between psoriasis and asymptomatic celiac disease/gluten intolerance. High percentage of positive results to guinea pig-derived tTG could be due to cellular activity of tissue transglutaminase in psoriasis.     

Echinococcosis: a possible etiology in psoriatic disease

We aimed to investigate seroprevalence of Echinococcus granulosus in patients with psoriasis to determine a possible etiologic role, since both echinococcosis and psoriasis are defined as T cell-mediated diseases. Forty psoriatic patients and 50 age- and sex-matched control subjects were included in the study. IgG-specific ELISA was used to determine seropositivity. E. granulosus-specific IgG antibodies were found to be positive in 17/40 (42.5%) of the patients with psoriasis and in 11/50 (22%) of the control subjects (p = 0.008). Our results suggest that echinococcosis might be one of the causative pathogens in the etiopathogenesis of psoriasis in highly endemic regions.     

The uninvolved psoriatic epidermis

Normal control and apparently unaffected skin from psoriatics have been compared quantitatively for their acid phosphatase activity. The unaffected skin from psoriatics shows a more rapid reaction, which may be related to a lysosomal defect. No marked differences were detected in the dehydrogenase reactions in these two tissues. However, in frankly involved psoriatic skin it has previously been shown that there is a marked increase in glucose-6-phosphate dehydrogenase activity in the transitional zone. In the present report an increase in glycero-phosphate dehydrogenase activity has been demonstrated in the lower portion of psoriatic epidermis.     

The psoriatic bone manifestation

Besides the known joint involvement as seen in the whole-body scan which uses 99m technetium-phosphate-complexes, skeletal scintigraphic investigations in 17 patients with psoriasis have demonstrated circumscribed or diffuse accumulative pathological concentrations of the radionuclide within the skeleton of the skull, the thyroid cartilage, the bony thorax and osseous long bones. These pathological accumulations of radionuclides of TcP-complexes which are distant from joint regions, point to proliferative phenomena in the bone in case of psoriasis especially in alterations of the collagenous metabolism.     

Solar activity and venereal disease morbidity

Analysis of the solar activity and incidence of sexually-transmitted diseases over the period of 1954 through 1987 has revealed that development of fading of an epidemic process in sexually-transmitted diseases does not depend on enhancement or weakening of solar activity. These values much differ in respect of many parameters in various years, there is no correlation as regards the length of the periods between the minimal and maximal values or over these periods in various years. The morbidity rates are in inverse correlation with the activity of therapeutic and prophylactic institutions in detecting the patients during all types of prophylactic check-ups.     

Prevalence of inflammatory bowel disease in Japanese psoriatic patients

Psoriatic patients reportedly have a higher prevalence of inflammatory bowel disease (IBD); however, there have been few research studies of Japanese psoriatic patients. To elucidate the prevalence of IBD in Japanese psoriatic patients, a cross‐sectional study was performed. Information was collected regarding psoriatic patients with current or prior history of Crohn's disease (CD) or ulcerative colitis (UC) who were treated at Fukuoka University Hospital from 2010 to 2018. Among 681 psoriatic patients (449 men and 232 women), eight (1.2%, six men, two women) had UC and two (0.3%, one man, one woman) had CD. Diagnosis of IBD preceded psoriasis in five patients, while diagnosis of psoriasis preceded IBD in two; the remaining patients’ records did not have sufficient information. Seven of 10 UC‐positive patients had mild psoriasis, two had moderate psoriasis and one had severe psoriasis. When UC‐positive psoriatic patients were compared with IBD‐negative psoriatic patients, there were no differences in age at onset of psoriasis, age at first visit or complications (e.g. psoriatic arthritis, hypertension, hyperlipidemia, hyperuricemia and diabetes). However, UC‐positive patients had significantly higher body mass index (BMI) (26.7 vs 23.7; P = 0.021), compared with patients without IBD. The CD/UC ratio in this cohort was 0.25, while the prevalence of IBD was 1.2%; these values were both lower than those in previous reports involving Caucasian patients. Patients with psoriasis and UC may have higher BMI and milder skin symptoms than those with psoriasis alone. These observations must be further confirmed by controlled domestic studies with larger samples.     

关节病性银屑病合并炎症性肠病一例

患者女,27岁,因全身红斑鳞屑15年,关节痛6个月,纳差3个月,于2017年2月17日到东南大学附属中大医院皮肤科就诊。15年前患者无明显诱因发现手臂伸侧散在黄豆大小红斑,其上覆有银白色鳞屑,易刮除,当地医院诊断银屑病,予外用药治疗（具体不详）。之后鳞屑减少,红斑消退,但皮疹反复发作,无腹痛、腹泻。6个月前患者出现腰背部数个黄豆大小的红斑,双侧膝、肘关节肿胀、疼痛,伴行走困难、左上肢上抬无力,予抗生素治疗,皮疹、关节痛无好转。3个月前皮疹累及小腿屈侧,出现2个黄豆大小红斑,并出现纳差,有轻度吞咽困难和呕吐,呕吐物为胃内容物,量中等,腹泻为水样便,无里急后重、黏液脓血便,体重减轻约5 kg。患者母亲有银屑病病史……     

Patient profiles in psoriatic disease: a case-based approach

Psoriasis and psoriatic arthritis are related conditions that can have numerous untoward consequences. Moreover, appropriate management of these conditions can be challenging, as each affected patient has unique needs that must be addressed. With that in mind, the authors discuss three real-life cases, highlighting principles that may facilitate the effective case-by-case management of psoriatic disease.     

Serum neopterin as an objective marker of psoriatic disease activity

Neopterin is a non-specific marker of the activation of cell-mediated immunity. Several studies have demonstrated the crucial role of CD4+ T cells in the pathogenesis of psoriasis. We have measured serum and urine neopterin levels and urine neopterin/creatinine ratios by radioimmunoassay in 24 patients with plaque-type psoriasis before and after a course of topical treatment with triamcinolone acetonide 0.1% and coal tar 4%. Results were compared with a group of 20 healthy, non-psoriatic volunteers. Serum neopterin levels were significantly elevated in the psoriatic group compared with the control group (p=0.001) and were significantly reduced after treatment (p=0.01). There was a correlation between pretreatment serum neopterin levels and psoriasis area and severity scores (PASI) (r=0.37, p=0.03) and also for pretreatment neopterin/creatinine ratios and PASI scores (r=0.45, p=0.01). These findings indicate that serum neopterin concentrations reflect disease activity in psoriasis.     

Epidemic control work and venereal disease morbidity

Incidence of sexually transmitted diseases was compared to the number of newly diagnosed cases detected at all kinds of prophylactic medical examinations including protective measures in the infection focus. The analysis was made for 1968-1987 and covered the data on the whole of Soviet Union and its separate republics. There was correlation between the two parameters studied.     

The evolution of the psoriatic lesion

Psoriasis comprises a host of abnormalities, and various aspects of the pathogenesis of psoriasis have been suggested to be of primary relevance. The aim of this review is to identity driving factors in the pathogenesis of psoriasis and to explore the dynamics of processes eventually resulting in a psoriatic lesion. In this review observations on the evolution from the symptomless skin to lesional skin in patients with psoriasis will be integrated with observations in various animal models of psoriasis.