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Elinkichari D, Rabhi F, Jaber K, Dhaoui R. Palmoplantar Psoriasis: Epidemiological and Clinical Features and Impact on Quality of Life. Dermatol Pract Concept 2024; 14:dpc.1403a191. [PMID: 39122505 PMCID: PMC11314393 DOI: 10.5826/dpc.1403a191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION Palmoplantar psoriasis is a rare variant of psoriasis. Its impact on quality of life has been poorly investigated. OBJECTIVES Our aim was to investigate the prevalence of localized palmoplantar psoriasis (PPP), to assess its severity using the modified Palmoplantar Pustular Psoriasis Area and Severity Index (m-PPPASI), and to evaluate the correlation with the Dermatology Life Quality Index (DLQI). METHODS We conducted a descriptive study with prospective data collection from January to June 2021. We enrolled 223 patients with psoriasis. We excluded patients without palmar/plantar involvement and those with a body surface area (BSA) greater than or equal to 10%. RESULTS We included 33 patients with PPP. This corresponded to a 14.8% prevalence among all psoriasis phenotypes. The mean age was 45 years. The male-to-female ratio was 2.3. Pruritus was present in 27 cases. The mean m-PPPASI was 11.77. The mean DLQI was 8.33. A significant correlation was found between DLQI and m-PPPASI: mean DLQI scores for patients with m-PPPASI less than or equal to 10 and m-PPPASI greater than 10 were 5.6 and 11.3, respectively (P = 0.002). Only 11.8% of patients with m-PPPASI less than or equal to 10 had a DLQI greater than 10, whereas 50% of those with m-PPPASI greater than 10 had a DLQI greater than 10 (P = 0.026). CONCLUSIONS Based on the present work, we confirm that, although affecting a reduced BSA, PPP is a severe form of psoriasis. We consider the m-PPPASI to be a reliable tool which can be used to assess the severity of PPP.
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Affiliation(s)
- Dorsaf Elinkichari
- Dermatology Department, Military Hospital of Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis EL MANAR, Tunisia
| | - Faten Rabhi
- Dermatology Department, Military Hospital of Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis EL MANAR, Tunisia
| | - Kahena Jaber
- Dermatology Department, Military Hospital of Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis EL MANAR, Tunisia
| | - Raouf Dhaoui
- Dermatology Department, Military Hospital of Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis EL MANAR, Tunisia
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2
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Zhang Y, Guo Y, Zhang K, Fan L, Ma J, Li Y, Zhou Q, Zhao Q, Hou S, Wang H. Comorbidities among adult patients with psoriasis in Tianjin: a cross-sectional analysis of the Health Database study. BMJ Open 2024; 14:e083683. [PMID: 38772892 PMCID: PMC11110554 DOI: 10.1136/bmjopen-2023-083683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/11/2024] [Indexed: 05/23/2024] Open
Abstract
OBJECTIVES This study aims to examine the prevalence of comorbidities in adult patients with psoriasis and compare them with those in control subjects without psoriasis in Tianjin, China. DESIGN The study is a cross-sectionalanalysis. PARTICIPANTS The participants were established by identifying all patients (age ≥18 years) who visited hospitals and clinics in Tianjin between 1 January 2016 and 31 October 2019. SETTING The study group consisted of 20 678 adult patients with psoriasis, and a comparison group was created after 1:1 propensity score matching. Logistic regression analyses were conducted to examine the risk of 22 comorbidities for these two groups. RESULTS Patients with psoriasis had a significantly higher prevalence of 11 comorbidities and a lower prevalence of 2 comorbidities within 12 months of follow-up. Our results also showed that the proportion of psoriatic arthritis might account for approximately 2% of all patients with psoriasis. This psoriatic arthritis group had a higher average age and CCI (Charlson Comorbidity Index) index score (2.27 >1.62, p <0.001) than the non-arthritis group. CONCLUSIONS This study showed that psoriasis in Tianjin is associated with various comorbidities. It also emphasises the importance of clinical treatment in improving therapeutic effects and reducing the burden of psoriasis in China.
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Affiliation(s)
- Yiming Zhang
- Department of Dermatovenereology, Tianjin Medical University General Hospital/ Tianjin Institute of Sexually Transmitted Disease, Tianjin, China
| | - Yali Guo
- Department of Dermatovenereology, Tianjin Medical University General Hospital/ Tianjin Institute of Sexually Transmitted Disease, Tianjin, China
- Department of Dermatology, Tianjin Haihe Hospital, Tianjin, China
| | - Kaiyue Zhang
- Department of Dermatovenereology, Tianjin Medical University General Hospital/ Tianjin Institute of Sexually Transmitted Disease, Tianjin, China
| | - Liyun Fan
- Department of Dermatovenereology, Tianjin Medical University General Hospital/ Tianjin Institute of Sexually Transmitted Disease, Tianjin, China
| | - Jingyue Ma
- Department of Dermatovenereology, Tianjin Medical University General Hospital/ Tianjin Institute of Sexually Transmitted Disease, Tianjin, China
| | - Yan Li
- Department of Dermatovenereology, Tianjin Medical University General Hospital/ Tianjin Institute of Sexually Transmitted Disease, Tianjin, China
| | - Quan Zhou
- Department of Dermatovenereology, Tianjin Medical University General Hospital/ Tianjin Institute of Sexually Transmitted Disease, Tianjin, China
| | - Qian Zhao
- Department of Dermatovenereology, Tianjin Medical University General Hospital/ Tianjin Institute of Sexually Transmitted Disease, Tianjin, China
| | - Shuping Hou
- Department of Dermatovenereology, Tianjin Medical University General Hospital/ Tianjin Institute of Sexually Transmitted Disease, Tianjin, China
| | - Huiping Wang
- Department of Dermatovenereology, Tianjin Medical University General Hospital/ Tianjin Institute of Sexually Transmitted Disease, Tianjin, China
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Andrade DDBC, Nzundu R, Rodrigues RRD, Romiti R, Santana YRT, Kurizky PS, de Lima APR, Carvalho A, Ashcroft DM, Gomes CM, Griffiths CEM. The epidemiology of atopic dermatitis and psoriasis in the indigenous people of Brazil. J Eur Acad Dermatol Venereol 2024. [PMID: 38577814 DOI: 10.1111/jdv.19984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/28/2024] [Indexed: 04/06/2024]
Affiliation(s)
- Débora D B C Andrade
- Programa de Pós-Graduação Em Ciências Médicas, Universidade de Brasília, Brasília, Brazil
| | | | - Rodolfo R D Rodrigues
- Programa de Pós-Graduação Em Ciências Médicas, Universidade de Brasília, Brasília, Brazil
| | - Ricardo Romiti
- Department of Dermatology, Universidade de São Paulo, São Paulo, Brasil
| | - Yago R T Santana
- Programa de Pós-Graduação Em Ciências Médicas, Universidade de Brasília, Brasília, Brazil
- Ministério da Saúde Do Brasil, Brasília, Brazil
| | - Patrícia S Kurizky
- Programa de Pós-Graduação Em Ciências Médicas, Universidade de Brasília, Brasília, Brazil
| | - Ana P R de Lima
- Programa de Pós-Graduação Em Ciências Médicas, Universidade de Brasília, Brasília, Brazil
| | | | - Darren M Ashcroft
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester, UK
| | - Ciro M Gomes
- Programa de Pós-Graduação Em Ciências Médicas, Universidade de Brasília, Brasília, Brazil
- Programa de Pós-Graduação Em Patologia Molecular, Universidade de Brasília, Brasília, Brazil
| | - Christopher E M Griffiths
- Dermatology Centre, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
- Department of Dermatology, King's College Hospital, King's College London, London, UK
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4
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Avcı A, Avcı D, Ulaş Y, Ertaş R. Can Biologic Agents Improve Treatment Success in Obese Patients With Psoriasis Vulgaris: A Retrospective Review of 320 Patients With Psoriasis Vulgaris. Dermatol Pract Concept 2024; 14:dpc.1401a58. [PMID: 38364434 PMCID: PMC10868959 DOI: 10.5826/dpc.1401a58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Obesity plays a major role in the development of many inflammatory disorders including psoriasis. OBJECTIVES We aimed to demonstrate how treatment responses change according to body mass index (BMI) among patients with psoriasis. METHODS In our study, Psoriasis Area and Severity Index (PASI) 75 and PASI 90 responses were assessed at baseline and at months 1 and 3 among patients who received TNF-α inhibitors, ustekinumab, IL-17 blockers, and IL-23 blockers. The same responses were also assessed with methotrexate and acitretin for a comparison group. Analyses were performed retrospectively. RESULTS The study included 317 patients who received 222 biological and 95 conventional treatments. In the group with BMI ≥30, the proportion of patients who achieved PASI 75 response was 40.0% (N = 26) at month 1 and 55.4% (N = 36) at month 3. The proportion of patients who achieved PASI 90 response was 33.8% (N = 22) at month 1 and 44.6% (N = 29) at month 3 among those receiving biological agents. Improvement was significantly more difficult among obese patients. The proportion of patients who achieved PASI 75 response was 3.6% at month 1 and 25.0% (N = 7) at month 3 among patients receiving conventional systemic treatments. While the presence of joint involvement affected the success of treatment among obese patients with psoriasis, no relationships were found for smoking, the presence of concomitant psychiatric diseases, or the presence of pruritus in psoriasis. CONCLUSIONS Biological agents were more successful in achieving PASI 75 and PASI 90 responses in both non-obese and obese individuals. Based on our study, among biological agents, IL-17 and IL-23 inhibitors may be more successful among obese individuals, but neither of them shows superiority over the other.
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Affiliation(s)
- Atıl Avcı
- Department of Dermatology, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Deniz Avcı
- Department of Internal Medicine, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Yılmaz Ulaş
- Department of Dermatology, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Ragip Ertaş
- Department of Dermatology, Kayseri City Education and Research Hospital, Kayseri, Turkey
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Brandão GVC, Pereira EG, Haddad GR, Miot LDB, Marques SA, Miot HA. Clinical characterization, physical frailty, and depression in elderly patients with psoriasis from a reference center in Brazil: a cross-sectional study. An Bras Dermatol 2024; 99:19-26. [PMID: 37612180 DOI: 10.1016/j.abd.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/25/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND There are few studies dedicated to the characterization of the geriatric population with psoriasis, which has particularities in terms of clinical manifestations and therapeutic limitations. As psoriasis is a chronic disease, presenting a higher prevalence with age, the increase in life expectancy in Brazil demands knowledge about the behavior of the disease among the elderly. OBJECTIVES To characterize elderly people with psoriasis from a tertiary service, from the clinical-epidemiological point of view, presence of comorbidities, physical frailty, and affective impact, and to compare these aspects with adults with psoriasis and elderly people without the disease. METHODS Cross-sectional study of 64 elderly patients with psoriasis, 64 adults with psoriasis, and 64 elderly patients without the disease. Clinical-demographic aspects, the Beck depression scale, and Skindex-16 were evaluated. Indicators of physical frailty were evaluated in elderly patients: handgrip, sit-to-stand test, fatigue, and weight loss >5%. RESULTS In the elderly, the mean age (SD) of psoriasis onset was 44 (10) years, men represented 47% of the sample, the prevalence of arthritis was 22%, and ungual involvement occurred in 72%. Topical corticosteroids were used more often among elderly people with psoriasis (100%) than among adults with the disease (86%), with no difference among other systemic treatments. Diabetes mellitus occurred in 30% of the elderly. Hypertension (59%), dyslipidemia (52%), depression (34%), and fatigue (59%) were more prevalent among the elderly with psoriasis than among the healthy controls. STUDY LIMITATIONS The study was carried out in a public reference service for patients with psoriasis, all of which were undergoing treatment. CONCLUSIONS Elderly people with psoriasis from a tertiary service showed greater affective impairment, metabolic comorbidities, and physical frailty than elderly controls.
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Affiliation(s)
- Giovana Viotto Cagnon Brandão
- Departamento de Infectologia, Dermatologia, Diagnóstico por Imagem e Radioterapia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - Elizandra Gomes Pereira
- Departamento de Infectologia, Dermatologia, Diagnóstico por Imagem e Radioterapia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - Gabriela Roncada Haddad
- Departamento de Infectologia, Dermatologia, Diagnóstico por Imagem e Radioterapia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - Luciane Donida Bartoli Miot
- Departamento de Infectologia, Dermatologia, Diagnóstico por Imagem e Radioterapia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - Silvio Alencar Marques
- Departamento de Infectologia, Dermatologia, Diagnóstico por Imagem e Radioterapia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - Hélio Amante Miot
- Departamento de Infectologia, Dermatologia, Diagnóstico por Imagem e Radioterapia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil.
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Luna PC, Chu CY, Fatani M, Borlenghi C, Adora A, Llamado LQ, Wee J. Psychosocial Burden of Psoriasis: A Systematic Literature Review of Depression Among Patients with Psoriasis. Dermatol Ther (Heidelb) 2023; 13:3043-3055. [PMID: 37995052 PMCID: PMC10689612 DOI: 10.1007/s13555-023-01060-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/18/2023] [Indexed: 11/24/2023] Open
Abstract
Psoriasis is associated with various comorbidities with a notable psychosocial burden. This systematic literature review explores the burden of depression in patients with psoriasis, comparing it with that experienced by patients with other chronic medical conditions. Embase via Ovid, PubMed, and Cochrane Database of Systematic Reviews via Ovid were searched for peer-reviewed studies published in English between January 1, 2016 and December 6, 2021 that reported real-world evidence or observational studies involving at least 100 adults (age ≥ 18 years) with general (unspecified) or plaque psoriasis experiencing symptoms of depression (but not restricted to patients with a clinical diagnosis). Any report of depression or suicidality was eligible for inclusion. Systematic literature reviews reporting depression/suicidality in other chronic medical conditions were also included. Statistical analysis was not performed; the study was descriptive only. A total of 1744 records were identified, and after several defined screenings by two independent reviewers for publication year, relevance, and sample size, 82 publications were included. Psoriasis was significantly associated with depression. The prevalence of depression in patients with psoriasis ranged from 0.2% to 74.6%, with incidence from 4.83 to 91.9 per 1000 person-years. The prevalence of depression was generally higher among patients with more severe psoriasis than those with less severe disease (as determined by Psoriasis Area Severity Index [PASI] scoring system) and was more prevalent among women than men with psoriasis. Depression in psoriasis significantly reduced quality of life, including factors such as sexual dysfunction, sleep difficulties, subjective well-being, and addictions. Comorbid hypertension, hyperlipidemia, psoriatic arthritis, obesity, inflammatory bowel disease, diabetes, and statin use were all associated with increased depression risk in patients with psoriasis. This systematic literature review found that the burden of depression in psoriasis is no lower than in other chronic medical conditions. Greater awareness of the psychological impact of psoriasis would improve care and management, which should incorporate psychological interventions.
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Affiliation(s)
- Paula C Luna
- Hospital Aleman, Arenales 2557 1a ZC 1425, Buenos Aires, Argentina.
| | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
- National Taiwan University College of Medicine, Taipei, Taiwan
| | - Mohammad Fatani
- Dermatology Department, Hera General Hospital, Makkah, Saudi Arabia
| | | | - Anna Adora
- Department of Internal Medicine, National Kidney and Transplant Institute, Quezon City, Metro Manila, Philippines
- Department of Adult Cardiology, Philippine Heart Center, Quezon City, Metro Manila, Philippines
| | | | - James Wee
- Pfizer Inc., Makati City, Philippines
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Song Q, Chen Y, Ma J, Zhou W, Song J, Wu C, Liu J. Metabolomics Reveals Molecular Signatures for Psoriasis Biomarkers and Drug Targets Discovery. Clin Cosmet Investig Dermatol 2023; 16:3181-3191. [PMID: 37941849 PMCID: PMC10631377 DOI: 10.2147/ccid.s433280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/19/2023] [Indexed: 11/10/2023]
Abstract
Purpose Psoriasis is a chronic, multi-system skin disease that can be influenced by immunological, environmental, and genetic factors. Plasma metabolomic analysis can provide a great deal of information on potential diagnostic biomarkers, pathogenesis and personalized treatment. However, the role of metabolites in psoriasis is unknown. Patients and Methods We performed an untargeted metabolomic analysis of plasma based on high-resolution liquid chromatography mass spectrometry from 10 plaque psoriasis patients and 10 healthy controls. Results A total of 301 differential metabolites were detected, of which 10 metabolites were possible potential biomarkers, including vitamins, amino acids, and lipids. At the same time, KEGG pathway enrichment analysis was performed for all detected differential metabolites, and it was found that protein digestion and absorption, amino acid metabolism and lipid metabolism may be jointly involved in regulating the pathogenesis of psoriasis. In addition, the proteins ESR1, OPRM1 and HSD11B1 were identified as possible potential topical therapeutic targets for psoriasis through analysis of the metabolite-protein interaction network. Conclusion In this study, we identified 10 differential metabolites as possible potential combinatorial biomarkers for the diagnosis of psoriasis. 12 metabolic pathways were significantly enriched that may be closely related to the occurrence and development of psoriasis. Three proteins, ESR1, OPRM1, and HSD11B1, were identified as possible potential therapeutic targets for psoriasis.
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Affiliation(s)
- Qian Song
- Department of Medical Laboratory, North China Medical & Health Group Xingtai General Hospital, Orthopedic Hospital of Xingtai, Xingtai, People’s Republic of China
| | - Ying Chen
- BGI Genomics, BGI-Shenzhen, Shenzhen, People’s Republic of China
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, People’s Republic of China
| | - JianQing Ma
- Department of Medical Laboratory, North China Medical & Health Group Xingtai General Hospital, Orthopedic Hospital of Xingtai, Xingtai, People’s Republic of China
| | - Wei Zhou
- China National Genebank, BGI-Shenzhen, Shenzhen, People’s Republic of China
| | - JunYan Song
- Department of Medical Laboratory, North China Medical & Health Group Xingtai General Hospital, Orthopedic Hospital of Xingtai, Xingtai, People’s Republic of China
| | - ChunFu Wu
- Yantai Harbor Hospital, Yantai, People’s Republic of China
| | - Jie Liu
- BGI Genomics, BGI-Shenzhen, Shenzhen, People’s Republic of China
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Abstract
Psoriasis is a chronic disease that is caused by multiple factors and is identified by itchiness, unpleasant, red, or white scaly patches on the skin, particularly on regularly chafed body regions such as the lateral areas of the limbs. Reports suggest that globally around 2%-3% of the population suffers from psoriasis. In this review, we have discussed the clinical classification of psoriasis and also the ideal characteristics of the biomarkers. An overview regarding the discovery of the biomarker and method for validating the study has been discussed. A growing body of research suggests a link to certain other systemic symptoms such as cardiovascular disorder, metabolic syndrome, and few other comorbidities such as hypertension and nonalcoholic fatty liver disease. Natural killer (NK) cells are lymphocyte cells that concentrate on the destruction of virally infected and malignant cells; these tend to produce a wide range of inflammatory cytokines, some of which are associated with the etiology of psoriasis. Detailed information on the molecular pathogenesis of psoriasis in which interleukin (IL)-17, IL-23, tumor necrosis factor-α (TNF-α), and CCL20 play a very significant role in the development of psoriasis. In this review, we have discussed an overview of the recent state of the biomarkers available for the diagnosis and treatment of psoriasis by emphasizing on the available biomarkers such as epigenomic, transcriptomic, glycomic, and metabolomic. The most recent advancements in molecular-targeted therapy utilizing biologics and oral systemic therapy (methotrexate, apremilast) enable to adequately treat the most serious psoriatic symptoms and also the studies have validated the efficacy of biologic therapy such as TNF-α antagonist (infliximab, adalimumab), IL-23 antagonist (guselkumab, risankizumab), and IL-17 antagonist (secukinumab, ixekizumab). Finally, an overview about the technological opportunities as well as various challenges has been discussed.
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Affiliation(s)
- Deblina Dan
- Department of Pharmaceutics, Amity Institute of Pharmacy, Lucknow, Amity University Uttar Pradesh, Noida, India
| | - Nimisha Srivastava
- Department of Pharmaceutics, Amity Institute of Pharmacy, Lucknow, Amity University Uttar Pradesh, Noida, India
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Kim SM, Ahn J, Cho YA, Sung JY, Kim CY, Yu DA, Lee YW, Won S, Choe YB. Increased risk of suicidality in patients with psoriasis: A Nationwide cohort study in Korea. J Eur Acad Dermatol Venereol 2023; 37:75-84. [PMID: 36028994 DOI: 10.1111/jdv.18565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/27/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Psoriasis has a devastating psychological impact on patients' quality of life. However, the relationship between suicidality and psoriasis remains unclear. OBJECTIVE This study analysed and compared the risk of suicidality (suicidal ideation, suicide attempt and completed suicide) between patients with psoriasis and the general population. METHODS This nationwide, population-based, retrospective, cohort study analysed the Korean National Health Insurance Service claim data from 2005 to 2018. RESULTS The study included 348,439 patients with psoriasis aged over 18 years and with age- and sex-matched controls. The risk of suicidality was higher in the psoriasis group than in the control group [adjusted hazard ratio (aHR) 1.21; 95% confidence interval (CI), 1.18-1.24]. The aHR of suicidality was higher in the psoriatic arthritis group (aHR, 1.46; 95% CI, 1.39-1.54) than in the psoriasis-alone group (aHR, 1.17; 95% CI, 1.13-1.20). However, the severity of psoriasis and suicidality showed no correlation (mild psoriasis group: aHR, 1.22; 95% CI, 1.18-1.25; moderate-to-severe psoriasis group: aHR, 1.16; 95% CI, 1.10-1.23). CONCLUSION Patients with psoriasis have an increased risk of suicidality. In particular, the presence of arthritis in patients had a more significant effect on the risk of suicidality.
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Affiliation(s)
- Sung Min Kim
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Juhee Ahn
- Department of Public Health Sciences, Seoul National University, Seoul, Republic of Korea
| | - Young Ah Cho
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Jae Young Sung
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Chang Yong Kim
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Da-Ae Yu
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Republic of Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Yang Won Lee
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Republic of Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Sungho Won
- Department of Public Health Sciences, Seoul National University, Seoul, Republic of Korea.,Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, Republic of Korea.,RexSoft Inc, Seoul, Republic of Korea
| | - Yong Beom Choe
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Republic of Korea.,Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
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10
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Donegan JJ, Nemeroff CB. Suicide and Inflammation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1411:379-404. [PMID: 36949319 DOI: 10.1007/978-981-19-7376-5_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Suicide is a leading cause of death worldwide. Although the neurobiological dysfunction underlying suicidal behavior remains unclear, recent work suggests that the immune system may play a role in the pathophysiology of suicide. In this chapter, we discuss a nascent body of literature suggesting that peripheral and central nervous systems (CNS) inflammation are associated with suicidal behavior. Because early-life stress is a major risk factor for suicidal behavior and is also associated with immune dysregulation, we hypothesize that such immune dysregulation may be the mechanism by which childhood maltreatment leads to an increased risk of suicidal behavior and suicide. Targeting inflammatory processes may be a novel treatment strategy, especially in populations that have experienced childhood trauma and exhibit elevated inflammation. Future work should directly test the hypothesis that reducing inflammation would result in a reduction in suicidal behavior.
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Affiliation(s)
- Jennifer J Donegan
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Dell Medical School, Austin, TX, USA
- Department of Neuroscience, University of Texas at Austin, Dell Medical School, Austin, TX, USA
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Dell Medical School, Austin, TX, USA.
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11
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Bardazzi F, Bonci C, Sacchelli L, DI Altobrando A, Iommi M, Rucci P, Sacchelli P, Berardi D, Patrizi A, Tengattini V. Suicide risk and depression in patients with psoriasis. Ital J Dermatol Venerol 2022; 157:497-501. [PMID: 36651203 DOI: 10.23736/s2784-8671.22.07184-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Psoriasis is associated with comorbid psychiatric conditions. However, its relationship with suicidality is not completely understood. The aim of this study was to analyze the prevalence and the correlates of depressive symptoms and suicide risk in patients with psoriasis. METHODS Adult psoriatic patients referring to the Outpatient Service of the Sant'Orsola-Malpighi Polyclinic were enrolled. Depressive symptoms and suicidality were assessed using the Patient Health Questionnaire (PHQ-9) and section C of Mini-International Neuropsychiatric Interview (M.I.N.I. 5.0.0). Psoriasis was evaluated using the Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA) and the Dermatology Life Quality Index (DLQI). RESULTS The prevalence of depressive symptoms was 14.9% and that of suicidality 6.3%. PHQ-9 scores were higher in patients with moderate-to-severe psoriasis (PASI≥10, Mann-Whitney U Test=4014.5; P<0.001; BSA≥10, Mann-Whitney Test=3930.5; P<0.001) and poorer quality of life (Mann-Whitney Test=805.5; P=0.024). Moreover, PHQ-9 scores were higher in females (Mann-Whitney Test U=3612.5; P=0.008) and were unrelated to age (r<inf>s</inf>=-0.056, P=0.423). Conversely, suicide risk was significantly higher in younger patients (Mann-Whitney=744, P=0.013) and females (χ2=5.69, P=0.028), and was unrelated to psoriasis severity. CONCLUSIONS Patients with moderate-to-severe psoriasis, especially females, should be screened for depression and suicidal ideation to support them with effective strategies to treat depressive symptoms.
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Affiliation(s)
- Federico Bardazzi
- Unit of Dermatology, Department of Specialized, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Camilla Bonci
- Unit of Dermatology, Department of Specialized, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Lidia Sacchelli
- Unit of Dermatology, Department of Specialized, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy -
| | - Ambra DI Altobrando
- Unit of Dermatology, Department of Specialized, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Marica Iommi
- Department of Biomedical and Neuromotor Sciences, Division of Hygiene and Biostatistics, University of Bologna, Bologna, Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, Division of Hygiene and Biostatistics, University of Bologna, Bologna, Italy
| | - Paola Sacchelli
- School of Specialization in Psychotherapy with "Relationship Psychoanalysis, " Area 25 Clinical Center, Società Italiana di Psicoanalisi della Relazione (SIPRe), Milan, Italy
| | - Domenico Berardi
- Department of Biomedical and Neuromotor Sciences, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Unit of Dermatology, Department of Specialized, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy.,Departiment of Dermatology, IRCCS Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Vera Tengattini
- Unit of Dermatology, Department of Specialized, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
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Psychopathology and Alexithymia in Patients with Moderate-to-Severe Psoriasis: Development of a Novel Index with Prognostic Value. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074029. [PMID: 35409713 PMCID: PMC8998217 DOI: 10.3390/ijerph19074029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/20/2022] [Accepted: 03/24/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Psoriasis is a chronic, relapsing, inflammatory disease with a high risk of developing mental health difficulties. OBJECTIVE The purposes of the study were to evaluate in moderate-to-severe psoriasis (a) the prevalence of depression and psychopathology, (b) the relationship between depression, psychopathology symptoms, and alexithymia, including its three dimensions, difficulty in identifying feelings (DIF), difficulty in describing feelings (DDF), and externally oriented thinking (EOT), and (c) to establish a novel index for the development of depression according to patients' psychopathological profile. METHODS In 104 patients, alexithymia was evaluated with the Toronto Alexithymia Scale (TAS-20), depression with the Beck Depression Inventory (BDI), and psychopathology with the Brief Symptom Inventory SCL-90 (SCL90). A psychopathology index that combines information from the BDI and SCL90 scales was constructed and the performance of the index with alexithymia was examined. RESULTS Female patients and active smokers score higher on BDI and SCL90 scales. Overweight patients tend to score arithmetically higher. The psychopathology index developed correlates significantly with age, DIF, DDF, and TAS-20. DIF, DDF, and TAS-20 are significant predictors of the psychopathology index. Patients with alexithymia/possible alexithymia are six times as likely to score higher in one of the psychopathology scales. CONCLUSIONS Alexithymia is a significant factor in the development of psychopathology in psoriasis patients. The use of the proposed novel psychopathology index could be essential in order to identify patients with moderate-to-severe psoriasis who are more likely to experience depression and psychopathology. This could have an impact on the decision-making of psoriasis treatment and monitoring of the patient.
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Monks G, Rivera-Oyola R, Lebwohl M. The Psoriasis Decision Tree. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:14-22. [PMID: 34055182 PMCID: PMC8142826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Psoriasis, an inflammatory disorder of the skin, is associated with an increased risk of systemic diseases, such as psoriatic arthritis, psychiatric disorders, malignancy, and cardiometabolic and inflammatory bowel diseases. Careful consideration of the presence of these comorbidities should guide selection of appropriate therapy. The evolution of therapeutic targets for the treatment of psoriasis has significantly advanced available treatment options, potentially leading to uncertainty when selecting the optimal treatment for each patient. In this article, we review evidence-based guidelines for the use of psoriasis treatments in patients with distinct comorbidities, and group appropriate therapeutic options into a visual aid. An easy-to-use visual tool incorporating treatment options best suited for specific comorbidities can increase physicians' confidence when selecting the most appropriate treatment on an individualized basis.
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Affiliation(s)
- George Monks
- Dr. Monks is with the Department of Dermatology, University of Oklahoma College of Medicine in Oklahoma City, Oklahoma
- Mr. Rovera-Oyola and Dr. Lebwohl are with the Department of Dermatology, Icahn School of Medicine at Mt. Sinai Hospital in New York, New York
| | - Ryan Rivera-Oyola
- Dr. Monks is with the Department of Dermatology, University of Oklahoma College of Medicine in Oklahoma City, Oklahoma
- Mr. Rovera-Oyola and Dr. Lebwohl are with the Department of Dermatology, Icahn School of Medicine at Mt. Sinai Hospital in New York, New York
| | - Mark Lebwohl
- Dr. Monks is with the Department of Dermatology, University of Oklahoma College of Medicine in Oklahoma City, Oklahoma
- Mr. Rovera-Oyola and Dr. Lebwohl are with the Department of Dermatology, Icahn School of Medicine at Mt. Sinai Hospital in New York, New York
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Rivera-Oyola R, Stanger R, Litchman GH, Thibodeaux Q, Koo J, Fried R, Goldenberg G, Han G, Hsu S, Kircik L, Knuckles M, Murina A, Weinberg J, Wu JJ, Lebwohl M. The Use of Brodalumab in Three Patients with Psoriasis and Psychiatric Comorbidities. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2020; 13:44-48. [PMID: 33488920 PMCID: PMC7819587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Brodalumab, a first-in-class interleukin-17 (IL-17) receptor blocker, carries a black box warning for suicidal ideation and behavior, yet it is also one of the most powerful biologic agents in our armamentarium. We wish to highlight three patients with moderate-to-severe psoriasis and comorbid depression who were successfully treated with brodalumab. The patients were chosen by an expert panel comprising dermatologists, psychiatrists, and psychologists. Psoriasis disease severity was measured using the Psoriasis Area and Severity Index (PASI) score. All three patients experienced PASI 100 after treatment with brodalumab (N=3). Importantly, depressive symptoms improved or resolved in two out of three patients. One patient, who had a history of psychiatric hospitalizations, required in-patient psychiatric treatment during treatment. The use of brodalumab in patients with psoriasis can provide rapid-onset improvement in both skin and depressive symptoms.
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Affiliation(s)
- Ryan Rivera-Oyola
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Roselyn Stanger
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Graham H Litchman
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Quinn Thibodeaux
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - John Koo
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Richard Fried
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Gary Goldenberg
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - George Han
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Sylvia Hsu
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Leon Kircik
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Melissa Knuckles
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Andrea Murina
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Jeffrey Weinberg
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Jashin J Wu
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
| | - Mark Lebwohl
- Mr. Rivera-Oyola and Drs. Stanger, Goldenberg, Han, Kircik, Weinberg, and Lebwohl are with the Icahn School of Medicine at Mt. Sinai Hospital in the Department of Dermatology in New York, New York
- Dr. Litchman is with the National Society for Cutaneous Medicine in New York, New York
- Drs. Thibodeaux and Koo are with the University of California San Francisco in their Department of Dermatology in San Francisco, California
- Dr. Fried is with Yardley Dermatology Associates and Yardley Clinical Research Associates in Yardley, Pennsylvania
- Dr. Hsu is with Temple University's Lewis Katz School of Medicine in their Department of Dermatology in Philadelphia, Pennsylvania
- Dr. Knuckles is with M. L. F. Knuckles Dermatology in Corbin and Richmond, Kentucky and AdventHealth Hospital in Manchester, Kentucky
- Dr. Murina is with Tulane University's School of Medicine in their Department of Dermatology in New Orleans, Louisiana
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
- Dr. Goldenberg is also with Goldenberg Dermatology in New York, New York
- Dr. Kircik is also with Indiana University Medical Center in Indianapolis, Indiana
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Founta O, Adamzik K, Tobin AM, Kirby B, Hevey D. Psychological Distress, Alexithymia and Alcohol Misuse in Patients with Psoriasis: A Cross-Sectional Study. J Clin Psychol Med Settings 2020; 26:200-219. [PMID: 30206746 DOI: 10.1007/s10880-018-9580-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study investigates (a) the prevalence of psychological distress, alexithymia and alcohol misuse in psoriasis patients; and (b) the relationship between psoriasis severity, alexithymia, alcohol and psychological distress in patients with psoriasis. A cross-sectional study was conducted. Outpatients (n = 184) with moderate to severe psoriasis completed a psychological screening battery. Measures included the Hospital Anxiety and Depression Scale, the Penn State Worry Questionnaire, the twenty-item Toronto Alexithymia Scale, the Dermatology Life Quality Index, the Psoriasis Area and Severity Index, the Self-Administered Psoriasis Area and Severity Index, and the Alcohol Use Disorders Identification Test. Demographic, clinical details and information on knowledge of psychosocial issues, alcohol and confidence on coping with distress and talking to others about psoriasis was also gathered. Alexithymia was associated with anxiety, depression and worry; subjective psoriasis severity was associated with worry. Alcohol misuse was related to anxiety and worry, but not to depression. Appropriate identification and treatment of alcohol difficulties and psychological distress of patients with psoriasis is needed.
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Affiliation(s)
- Ourania Founta
- Research Centre for Psychological Health, School of Psychology, Trinity College Dublin, Dublin 2, Ireland.
| | - Karoline Adamzik
- Dermatology Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Anne-Marie Tobin
- Dermatology Department, The Adelaide & Meath Hospital, Tallaght, Dublin 24, Ireland
| | - Brian Kirby
- Dermatology Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.,Charles Department of Dermatology, St Vincent's University Hospital and School of Health Sciences, UCD, Dublin 4, Ireland
| | - David Hevey
- Research Centre for Psychological Health, School of Psychology, Trinity College Dublin, Dublin 2, Ireland
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Guidelines for the Diagnosis and Treatment of Psoriasis in China: 2019 Concise Edition#. INTERNATIONAL JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2020. [DOI: 10.1097/jd9.0000000000000074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lin CC, Lin HC, Chiu HW. Association Between Psoriasis and Dementia: A Population-Based Case-Control Study. Am J Clin Dermatol 2019; 20:457-463. [PMID: 30649680 DOI: 10.1007/s40257-018-00420-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Dementia is a syndrome that involves the deterioration of several higher mental functions in advanced age, and psoriasis is an autoimmune disease characterized by skin plaque. Epidemiological studies have indicated an association between dementia and psoriasis; however, to date, no studies in Asia have reported this association. OBJECTIVE This study used a population-based medical dataset to explore the association between previously diagnosed psoriasis and dementia in Taiwan. METHODS Using the Taiwan Longitudinal Health Insurance Database 2000, we identified 7118 individuals with a diagnosis of dementia; a further 21,354 sex- and aged-matched individuals were randomly extracted as controls. Patients with bullous pemphigoid, which is characterized by inflammatory phenomena similar to that evident in psoriasis, were chosen as a control group. Conditional logistic regression was performed to evaluate the association between dementia and prior psoriasis or bullous pemphigoid among the sampled patients. RESULTS Of the 28,472 individuals, 2.2, 3.0, and 1.5% of the total, case, and control groups, respectively, had been diagnosed with psoriasis. After adjustments were made for patients' monthly income, region, urbanization level, diabetes, hyperlipidemia, hypertension, and coronary heart disease, the odds ratio (OR) of diagnosed psoriasis for the case group was 1.46 (95% confidence interval [CI] 1.23-1.73; p < 0.001) compared with the control group. The ORs of a previous psoriasis diagnosis with arthritis and without arthritis in the case group were, respectively, 1.95 and 1.44 times (95% CI 1.03-3.89 and 1.21-1.72, respectively) those of the control group after adjustments for socioeconomic variables, diabetes, hyperlipidemia, hypertension, and coronary heart disease. However, no significant differences in prior bullous pemphigoid were observed between the dementia and control groups (0.5% and 0.4%, respectively). CONCLUSIONS More patients with dementia had prior psoriasis than did patients in the control group. Additional research is required to confirm our results and clarify the relationship.
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Wu KK, Armstrong AW. Suicidality among psoriasis patients: a critical evidence synthesis. GIORN ITAL DERMAT V 2019; 154:56-63. [DOI: 10.23736/s0392-0488.18.06112-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Childhood exposure to traumatic events, termed early life stress (ELS), is now widely recognized for causing long-term negative health effects that may not manifest until adulthood. Allostatic load (AL) describes the cumulative "wear-and-tear" effects of chronic stress on the body that may adversely affect human health by accelerating other disease processes. Recent epidemiological studies have reported higher stress levels in industrialized countries and trends of increasing prevalence in autoimmune diseases during recent decades. To elucidate mechanisms of stress-related immune dysregulation, most animal studies up to now have focused on AL and stress-triggered events occurring in adults but have not explored ELS in the context of autoimmune disorders. We have identified a current gap in understanding the impact of ELS on immune system ontogeny and its potential for priming genetically susceptible individuals who are at increased risk for autoimmune diseases later in life, through mechanisms involving neuroendocrine-immune cross talk. In this review, we highlight the intersection between stress and immune function, with a focus on ELS as consequential for increased autoimmune disorder risks later in life.
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Affiliation(s)
- Jamie Y. Choe
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Texas 76107
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas 76107
| | - Maya Nair
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Texas 76107
| | - Riyaz Basha
- Department of Pediatrics and Women’s Health, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas 76107
| | - Byung-Jin Kim
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Harlan P. Jones
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Texas 76107
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20
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High prevalence of erectile dysfunction in men with psoriasis: evidence from a systematic review and meta-analysis. Int J Impot Res 2018; 31:74-84. [DOI: 10.1038/s41443-018-0093-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/25/2018] [Accepted: 10/15/2018] [Indexed: 02/06/2023]
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21
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Liang SE, Cohen JM, Ho RS. Psoriasis and suicidality: A review of the literature. Dermatol Ther 2018; 32:e12771. [PMID: 30315629 DOI: 10.1111/dth.12771] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/01/2018] [Accepted: 10/07/2018] [Indexed: 01/23/2023]
Abstract
Psoriasis is a chronic systemic inflammatory skin disease, which has been associated with an increased risk of numerous medical and psychiatric comorbidities, including suicidality. Suicidality, which can be divided into the categories of suicidal ideation, suicide attempt, and completed suicide, is highly prevalent in the psoriasis population, and multiple studies have been published on the subject of psoriasis and suicidal ideation and behavior (SIB), including two recent meta-analyses. However, the available literature is limited and inconsistent, and the association between the two remains incompletely understood. The present review aims to cohesively synthesize and summarize the available evidence, while making a clinically relevant distinction between the sub-categories of suicidality, by examining not only the epidemiology of the association but also the plausible molecular mechanisms and the potential influence of biologic therapies. Additionally, this review aims to critically examine and understand the potential contribution of depression in the psoriasis and suicidality relationship. This will allow us to better understand the complex and multi-faceted relationship between psoriasis and suicidality, to identify those who may be most at risk for SIB, to make evidence-based clinical decisions regarding treatment and management, and to more completely address the needs of psoriasis patients.
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Affiliation(s)
| | - Jeffrey M Cohen
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
| | - Roger S Ho
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY
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22
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Parisi R, Webb RT, Kleyn CE, Carr MJ, Kapur N, Griffiths CEM, Ashcroft DM. Psychiatric morbidity and suicidal behaviour in psoriasis: a primary care cohort study. Br J Dermatol 2018; 180:108-115. [PMID: 30007069 DOI: 10.1111/bjd.17004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Psychological distress among people with psoriasis may lead to elevated risks of suicide and nonfatal self-harm. OBJECTIVES To investigate psychiatric comorbidity, psychotropic medication prescribing and risk of suicidality in people with psoriasis. METHODS A cohort of patients with psoriasis (1998-2014) was delineated using the Clinical Practice Research Datalink, with linkage to Hospital Episode Statistics and Office for National Statistics mortality records. Each patient with psoriasis was matched with up to 20 patients without psoriasis on age, sex and general practice. A stratified Cox regression model was used to estimate the hazard ratios (HRs) for suicide or nonfatal self-harm risks adjusted for socioeconomic status. RESULTS At baseline, among 56 961 and 876 919 patients with and without psoriasis, higher prevalence for histories of alcohol misuse, bipolar disorder, depression, anxiety disorders, self-harm and psychotropic drug prescription were observed. The deprivation-adjusted HR indicated lower suicide risk in people with psoriasis [HR 0·59, 95% confidence interval (CI) 0·41-0·85]. The risk of suicide varied according to age: it was lower in people with psoriasis diagnosed at ≥ 40 years (HR 0·38, 95% CI 0·21-0·66), whereas there was no difference in risk of suicide in people with psoriasis diagnosed before age 40 years (HR 0·92, 95% CI 0·58-1·46). Conversely, there was a small increased risk for self-harm (HR 1·15, 95% CI 1·04-1·27) associated with psoriasis. CONCLUSIONS The prevalence of mental illness was raised in people with psoriasis, and this may lead to a greater risk of self-harm. Nevertheless, having psoriasis does not appear to be associated with an increased risk of suicide. Healthcare professionals caring for patients with psoriasis should continue to monitor and tackle effectively the psychological needs of these individuals.
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Affiliation(s)
- R Parisi
- Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
| | - R T Webb
- Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
| | - C E Kleyn
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,NIHR Manchester Biomedical Research Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, U.K
| | - M J Carr
- Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
| | - N Kapur
- Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K
| | - C E M Griffiths
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,NIHR Manchester Biomedical Research Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, U.K
| | - D M Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,NIHR Manchester Biomedical Research Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, U.K
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23
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Pro-inflammatory Cytokines, Biomarkers, Genetics and the Immune System: A Mechanistic Approach of Depression and Psoriasis. ACTA ACUST UNITED AC 2018; 47:177-186. [DOI: 10.1016/j.rcp.2017.03.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 10/14/2016] [Accepted: 03/27/2017] [Indexed: 11/18/2022]
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24
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Imafuku S, Zheng M, Tada Y, Zhang X, Theng C, Thevarajah S, Zhao Y, Song HJ. Asian consensus on assessment and management of mild to moderate plaque psoriasis with topical therapy. J Dermatol 2018; 45:805-811. [PMID: 29740870 PMCID: PMC6055873 DOI: 10.1111/1346-8138.14338] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/27/2018] [Indexed: 11/30/2022]
Abstract
A working group of dermatologists in Asian countries assessed the current status of psoriatic management in the region to prepare a consensus report on topical treatment in mild to moderate plaque psoriasis. Even though the association of psoriasis with systemic comorbidities is increasingly acknowledged, psoriasis is still lower in health‐care priority lists in the region. The psychosocial impact of psoriasis may be greater in Asian countries due to cultural norms and social discrimination. Non‐adherence to treatment is also common among Asians. The current care given to patients with mild to moderate psoriasis needs to be streamlined, enhanced and organized with a patient‐centered care approach to achieve better outcomes. A comprehensive assessment of the disease severity and its impact on a patient's life is required before initiating treatment. Education and active involvement of the patient in the treatment plan is an important part of psoriatic management. It is recommended to personalize topical treatment to meet the needs of the patient, depending on disease severity, psychosocial impact, the patient's expectations and, more importantly, the patient's willingness and ability to actively follow the treatment procedure. Fixed‐dose combination of corticosteroid and vitamin D analogs is the preferred topical medication for both initial and maintenance phases of treatment. The fast containment of the disease is the goal of the initial phase of 4–8 weeks and it demands a potent fast‐acting topical therapy. Satisfactory control of the disease and prevention of relapses should be achieved during the maintenance phase with twice a week or weekend applications.
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Affiliation(s)
- Shinichi Imafuku
- Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Min Zheng
- Department of Dermatology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yayoi Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Xibao Zhang
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, China
| | - Colin Theng
- The Skin Specialists & Laser Clinic, Singapore
| | | | - Yi Zhao
- Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hae Jun Song
- Department of Dermatology, Guro Hospital, College of Medicine, Korea University, Seoul, Korea
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25
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Rousset L, Halioua B. Stress and psoriasis. Int J Dermatol 2018; 57:1165-1172. [DOI: 10.1111/ijd.14032] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 01/16/2018] [Accepted: 04/08/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Laurie Rousset
- Dermatology Unit; Assistance Publique - Hôpitaux de Paris (AP-HP); Ile de France France
| | - Bruno Halioua
- Dermatology Unit; Institut Alfred Fournier; Paris France
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26
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Kwan Z, Bong YB, Tan LL, Lim SX, Yong ASW, Ch'ng CC, Tan MP, Ismail R. Determinants of quality of life and psychological status in adults with psoriasis. Arch Dermatol Res 2018; 310:443-451. [PMID: 29687328 DOI: 10.1007/s00403-018-1832-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 03/24/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
Abstract
We investigated whether disease severity and clinical manifestations were associated with depression, anxiety, stress and quality of life in adults with psoriasis. Participants were recruited from a dermatology outpatient clinic at a teaching hospital. Information on sociodemographic characteristics, disease severity, presence of arthropathy and head involvement was specifically recorded. Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). Quality of life and psychological symptoms were measured using the Dermatology Life Quality Index (DLQI) and the Depression Anxiety Stress Scale (DASS), respectively. One hundred individuals were recruited. Unadjusted analysis revealed that head involvement was associated with depression [odds ratio (OR) 8.509; 95% confidence interval (CI) 1.077-67.231] and anxiety (OR 6.46; 95% CI 1.401-29.858). Severe disease was associated with a poorer quality of life compared to mild disease (OR 3.750; 95% CI 1.330-10.577). Younger age was associated with an increased risk of depression [mean difference (MD) - 8.640; 95% CI - 16.390 to - 0.890], anxiety (MD - 11.553; 95% CI - 18.478 to- 4.628), stress (MD - 11.440; 95% CI - 19.252 to - 3.628) and severely impaired quality of life (MD - 12.338; 95% CI - 19.548 to - 5.127). Following adjustments for age and disease severity, anxiety, stress and depression remained associated with severely impaired quality of life.
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Affiliation(s)
- Zhenli Kwan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. .,Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.
| | - Yii Bonn Bong
- Institute of Research Management and Services, University of Malaya, Kuala Lumpur, Malaysia
| | - Leng Leng Tan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Shu Xian Lim
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Adrian Sze Wai Yong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Chin Chwen Ch'ng
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rokiah Ismail
- School of Healthy Aging, Medical Aesthetics and Regenerative Medicine, UCSI University, Kuala Lumpur, Malaysia
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27
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Crosta ML, De Simone C, Di Pietro S, Acanfora M, Caldarola G, Moccia L, Callea A, Panaccione I, Peris K, Rinaldi L, Janiri L, Di Nicola M. Childhood trauma and resilience in psoriatic patients: A preliminary report. J Psychosom Res 2018; 106:25-28. [PMID: 29455895 DOI: 10.1016/j.jpsychores.2018.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 01/06/2018] [Accepted: 01/07/2018] [Indexed: 12/13/2022]
Abstract
AIMS Psoriasis is a chronic inflammatory skin disease with a complex etiology, involving the immune system, genetic factors, and external/internal triggers, with psychosomatic aspects. The aim of the study was to investigate childhood trauma and resilience in a psoriatic sample compared with healthy controls. Correlations between childhood trauma, resilience, quality of life, clinical data and psoriatic features were also evaluated. METHODS Seventy-seven psoriatic patients and seventy-six homogeneous healthy controls were enrolled. We used the Psoriasis Area and Severity Index (PASI) to assess the severity of psoriasis and the Skindex-29 to measure health-related quality of life. The psychometric battery included the Childhood Trauma Questionnaire (CTQ) and the Connor-Davidson Resilience Scale (CD-Risc) to assess trauma exposure and resilience, respectively. RESULTS Psoriatic patients showed a significant prevalence of childhood trauma and a lower resilience level compared to healthy controls. Associations between traumatic experiences, low resilience and reduced quality of life in psoriatic subjects were also observed. CONCLUSIONS A multidisciplinary approach is helpful to investigate clinical aspects, trigger factors and psychophysiological stress response in psoriatic subjects. Improving resilience with an early psychological intervention focused on self-motivation and strengthening of self-efficacy could facilitate the management of psoriasis.
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Affiliation(s)
- Maria Luigia Crosta
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Clara De Simone
- Institute of Dermatology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Salvatore Di Pietro
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mariateresa Acanfora
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giacomo Caldarola
- Institute of Dermatology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenzo Moccia
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Isabella Panaccione
- NESMOS Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Ketty Peris
- Institute of Dermatology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lucio Rinaldi
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Di Nicola
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
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28
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Innamorati M, Quinto RM, Lester D, Iani L, Graceffa D, Bonifati C. Cognitive impairment in patients with psoriasis: A matched case-control study. J Psychosom Res 2018; 105:99-105. [PMID: 29332640 DOI: 10.1016/j.jpsychores.2017.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/06/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND In the past decade, a few studies have suggested that psoriasis could be associated with the presence of mild cognitive deficits. OBJECTIVES The aim of the present matched case-control study was to investigate several cognitive domains (executive functions, verbal memory, attention, and language) in a sample of outpatients with psoriasis. We also investigated whether cognitive impairment was associated with poor health-related quality of life (HRQoL) in patients with psoriasis. METHODS Fifty adult outpatients and 50 age- and sex-matched healthy controls were administered a battery of neuropsychological tests investigating major cognitive domains, psychopathology (anxiety and depression), alexithymia, and HRQoL. RESULTS At the bivariate level, psoriasis patients (compared to healthy controls) performed worse on most of the neuropsychological tests, and they also reported more anxiety and depressive symptoms, higher scores for alexithymia, and worse physical and mental health. At the multivariate level, cognitive performance was independently associated with psoriasis even when controlling for psychopathology and alexithymia. CONCLUSIONS Patients with psoriasis show impaired cognitive performance, high levels of anxiety and depression, and impaired quality of life. Based on the current results, clinicians should assess the presence of psychological symptoms in their patients and evaluate whether the presence of cognitive deficits is limiting the patients' ability to cope with the disease.
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Affiliation(s)
- Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy.
| | - Rossella M Quinto
- Department of Human Sciences, European University of Rome, Rome, Italy
| | | | - Luca Iani
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Dario Graceffa
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - Claudio Bonifati
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
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29
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The Pathophysiological Mechanisms and the Quest for Biomarkers in Psoriasis, a Stress-Related Skin Disease. DISEASE MARKERS 2018; 2018:5823684. [PMID: 29619128 PMCID: PMC5829341 DOI: 10.1155/2018/5823684] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/20/2017] [Accepted: 12/28/2017] [Indexed: 12/24/2022]
Abstract
Psoriasis is a physically, emotionally, and socially invalidating multifactorial disorder, with a significant impact on the patients' quality of life. Stress is one of the leading triggers for psoriasis and has been associated with disease onset and subsequent flare-ups, while the flare-ups by themselves often lead to psychological discomfort. The treatment of psoriasis is individualized, depending on the patients' measurable severity of illness, as well as the impact the skin condition has on patients' quality of life, as assessed by standardized questionnaires. The clinical scales used nowadays for measuring the severity of psoriasis are characterized by low reproducibility and high variability between examiners. Hence, there is a real need to identify objectively measurable biomarkers to standardize the assessment of the severity of psoriasis. We aim to review the pathophysiological mechanisms involved in psoriasis, focusing on the most critical advances in psoriasis biomarker discovery, pointing out those biomarkers which have also been studied in other stress-related conditions, thus emphasizing the relationship between psoriasis and stress.
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30
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Lebwohl MG, Papp KA, Marangell LB, Koo J, Blauvelt A, Gooderham M, Wu JJ, Rastogi S, Harris S, Pillai R, Israel RJ. Psychiatric adverse events during treatment with brodalumab: Analysis of psoriasis clinical trials. J Am Acad Dermatol 2018; 78:81-89.e5. [DOI: 10.1016/j.jaad.2017.08.024] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 08/07/2017] [Accepted: 08/10/2017] [Indexed: 11/27/2022]
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31
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Wu JJ, Feldman SR, Koo J, Marangell LB. Epidemiology of mental health comorbidity in psoriasis. J DERMATOL TREAT 2017; 29:487-495. [PMID: 29057684 DOI: 10.1080/09546634.2017.1395800] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIM The occurrence of mental health comorbidities such as depression, anxiety, and suicidal ideation or behavior is not uncommon in the context of psoriasis. The negative influence of psoriatic disease on a patient's physical and mental well-being, in combination with overlapping pathophysiology, increase the risk for clinically significant psychiatric conditions. These psychiatric conditions, in turn, influence the patient's outlook and potentially, prognosis. Although the healthcare community increasingly recognizes the association of mental health comorbidities with psoriasis, the extent of the correlation is not fully appreciated. To better understand the relationship between mental health comorbidities and psoriasis, including prevalence, risk factors, and response of psychiatric comorbidities to psoriasis treatment, a narrative review of the published literature was conducted. METHODS Data from epidemiologic, observational, and clinical studies demonstrate a substantially greater mental health comorbidity burden in patients with psoriasis compared with those without psoriasis or patients with other dermatologic conditions. RESULT The influence of contemporary drug therapies on measures of depression and anxiety are predominantly positive, although further data are needed to better understand the effects of long-term therapy. CONCLUSION Clinicians should consider the heightened potential for mental health comorbidities when determining an optimal management strategy for their patients with psoriasis.
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Affiliation(s)
- J J Wu
- a Kaiser Permanente Los Angeles Medical Center , Los Angeles , CA , USA
| | - S R Feldman
- b Wake Forest University School of Medicine , Winston-Salem , NC , USA
| | - J Koo
- c University of California San Francisco , San Francisco , CA , USA
| | - L B Marangell
- d The University of Texas McGovern School of Medicine , Houston , TX , USA.,e Brain Health Consultants , Houston , TX , USA
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32
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Li L, Chuan-Jian L, Ling H, Jing-Wen D, Ze-Hui H, Yu-Hong Y, Zhong-Zhao Z. Untargeted serum metabonomics study of psoriasis vulgaris based on ultra-performance liquid chromatography coupled to mass spectrometry. Oncotarget 2017; 8:95931-95944. [PMID: 29221177 PMCID: PMC5707071 DOI: 10.18632/oncotarget.21562] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 08/29/2017] [Indexed: 12/11/2022] Open
Abstract
Psoriasis is a common, chronic, systemic inflammatory skin disease, the etiology and pathogenesis is unclear. An untargeted high-throughput metabonomics method based on liquid chromatography coupled to mass spectrometry was applied to study the serum metabolic changes in psoriasis vulgaris patients, and to discover serum potential biomarkers for identification, diagnosis and exploring pathogenesis of psoriasis. The serum metabolic profiles from 150 subjects (75 psoriasis patients and 75 healthy controls) were acquired, the raw spectrometric data were processed by multivariate statistical analysis, and 44 potential biomarkers were screened out and identified. The potential biomarkers were mainly involved in glycerophospholipid metabolism, sphingolipid metabolism, arachidonic acid metabolism, bile acid biosynthesis, indicated the pathogenesis of psoriasis may be related to the disturbed metabolic pathways.
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Affiliation(s)
- Li Li
- Molecular Biology and Systems Biology Team of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, China
| | - Lu Chuan-Jian
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, China
| | - Han Ling
- Molecular Biology and Systems Biology Team of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, China
| | - Deng Jing-Wen
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, China
| | - He Ze-Hui
- Large Data Research Team of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, China
| | - Yan Yu-Hong
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, China
| | - Zhang Zhong-Zhao
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, China
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33
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Pompili M, Innamorati M, Forte A, Erbuto D, Lamis DA, Narcisi A, Rea C, Orsini D, D'Arino A, Arcese A, Bellini S, Trovarelli S, Serafini G, Amore M, Costanzo A, Girardi P. Psychiatric comorbidity and suicidal ideation in psoriasis, melanoma and allergic disorders. Int J Psychiatry Clin Pract 2017; 21:209-214. [PMID: 28326880 DOI: 10.1080/13651501.2017.1301482] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Psychiatric disorders and suicide risk (especially in psoriasis) are frequent and disabling conditions in patients with skin diseases. The aim of this study was to examine the risk of suicide and stressful life events in a sample of patients with skin disease. METHODS A sample of 242 dermatological patients (142 women and 100 men), 112 of which had psoriasis, 77 had melanoma, and 53 were suffering with chronic allergic diseases. Patients were administered the MINI International Neuropsychiatric Interview (MINI), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Patients were also asked about their experiences with stressful life events. RESULTS Patients with psoriasis were more likely to have a history of psychiatric disorders (36.6% vs. 13.2% χ2(1) = 9.55; p = 0.002) compared to patients with allergies. Specifically, patients with psoriasis more likely had a diagnosis of a mood disorder (16.1% vs. 3.9% χ2(1) = 6.85; p = 0.009; 16.1% vs. 0% χ2(1) = 9.56; p = 0.002) and reported past suicidal ideation (33.9% vs. 15.6% χ2(1) = 7.89; p = 0.005; 33.9% vs. 18.9% χ2(1) = 3.96; p = 0.047) as compared to those with melanoma and allergy. CONCLUSIONS The results from this study suggest that patients affected by psoriasis have an increased risk of psychiatric comorbidities and suicidal ideation compared to those who have other dermatological disorders.
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Affiliation(s)
- Maurizio Pompili
- a Department of Neurosciences, Mental Health and Sensory Organs , Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | - Marco Innamorati
- b Department of Human Sciences , European University of Rome , Rome , Italy
| | - Alberto Forte
- a Department of Neurosciences, Mental Health and Sensory Organs , Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | - Denise Erbuto
- a Department of Neurosciences, Mental Health and Sensory Organs , Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | - Dorian A Lamis
- c Department of Psychiatry and Behavioral Sciences , Emory University School of Medicine , Atlanta , GA , USA
| | - Alessandra Narcisi
- d Dermatology Unit, Department of Neurosciences, Mental Health and Sensory Organs , Sapienza University of Rome , Rome , Italy
| | - Claudia Rea
- a Department of Neurosciences, Mental Health and Sensory Organs , Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | - Diego Orsini
- d Dermatology Unit, Department of Neurosciences, Mental Health and Sensory Organs , Sapienza University of Rome , Rome , Italy
| | - Andrea D'Arino
- d Dermatology Unit, Department of Neurosciences, Mental Health and Sensory Organs , Sapienza University of Rome , Rome , Italy
| | - Annalisa Arcese
- d Dermatology Unit, Department of Neurosciences, Mental Health and Sensory Organs , Sapienza University of Rome , Rome , Italy
| | - Samantha Bellini
- a Department of Neurosciences, Mental Health and Sensory Organs , Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | - Sara Trovarelli
- a Department of Neurosciences, Mental Health and Sensory Organs , Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
| | - Gianluca Serafini
- e Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry , University of Genova , Genova, Italy
| | - Mario Amore
- e Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry , University of Genova , Genova, Italy
| | - Antonio Costanzo
- f Dermatology Unit, Department of Biomedical Sciences , Humanitas University , Rozzano-Milan , Italy
| | - Paolo Girardi
- a Department of Neurosciences, Mental Health and Sensory Organs , Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome , Rome , Italy
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Psoriasis and suicidality: A systematic review and meta-analysis. J Am Acad Dermatol 2017; 77:425-440.e2. [DOI: 10.1016/j.jaad.2017.05.019] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/15/2017] [Accepted: 05/19/2017] [Indexed: 12/18/2022]
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Koo J, Marangell L, Nakamura M, Armstrong A, Jeon C, Bhutani T, Wu J. Depression and suicidality in psoriasis: review of the literature including the cytokine theory of depression. J Eur Acad Dermatol Venereol 2017; 31:1999-2009. [DOI: 10.1111/jdv.14460] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/08/2017] [Indexed: 12/13/2022]
Affiliation(s)
- J. Koo
- San Francisco Medical Center; University of California; San Francisco CA USA
| | | | - M. Nakamura
- San Francisco Medical Center; University of California; San Francisco CA USA
| | - A. Armstrong
- University of Southern California; Los Angeles CA USA
| | - C. Jeon
- San Francisco Medical Center; University of California; San Francisco CA USA
| | - T. Bhutani
- San Francisco Medical Center; University of California; San Francisco CA USA
| | - J.J. Wu
- Kaiser Permanente Los Angeles Medical Center; Los Angeles CA USA
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Bujor CE, Vang T, Nielsen J, Schjerning O. Antipsychotic-associated psoriatic rash - a case report. BMC Psychiatry 2017; 17:242. [PMID: 28676105 PMCID: PMC5496600 DOI: 10.1186/s12888-017-1411-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 06/29/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Antipsychotics are a heterogeneous group of drugs. Although, antipsychotics have been used for years, unexpected side effects may still occur. With this case report we focus on a possible association between psoriasis and antipsychotics. Data on the patient's course of psychiatric disease, onset of psoriasis and its evolution were extracted from the patient's medical files. CASE PRESENTATION We present a case of a 21-year-old female diagnosed with schizophrenia. She was initially treated with quetiapine, and later switched to aripiprazole due to weight gain. After initiation of antipsychotic treatment, the patient suffered from severe psoriasis lesions. CONCLUSIONS Antipsychotics may possess immunological properties that may be involved in immune-mediated conditions, such as psoriatic rash. Further studies are warranted to determine causality and mechanism.
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Affiliation(s)
- Camelia-Eugenia Bujor
- 0000 0004 0646 7349grid.27530.33Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark
| | - Torkel Vang
- 0000 0001 0742 471Xgrid.5117.2Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jimmi Nielsen
- 0000 0004 0646 7349grid.27530.33Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark ,0000 0001 0742 471Xgrid.5117.2Department of Clinical Medicine, Aalborg University, Aalborg, Denmark ,0000 0001 0674 042Xgrid.5254.6Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Ole Schjerning
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark. .,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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Abstract
Affibody molecules can be used as tools for molecular recognition in diagnostic and therapeutic applications. There are several preclinical studies reported on diagnostic and therapeutic use of this molecular class of alternative scaffolds, and early clinical evidence is now beginning to accumulate that suggests the Affibody molecules to be efficacious and safe in man. The small size and ease of engineering make Affibody molecules suitable for use in multispecific constructs where AffiMabs is one such that offers the option to potentiate antibodies for use in complex disease.
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Reich K, Augustin M. Arzneimittelsicherheit bei Psoriasis: Welche Rolle spielt Suizidalität? J Dtsch Dermatol Ges 2017; 15:353-355. [PMID: 28252863 DOI: 10.1111/ddg.13178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Innamorati M, Quinto RM, Imperatori C, Lora V, Graceffa D, Fabbricatore M, Lester D, Contardi A, Bonifati C. Health-related quality of life and its association with alexithymia and difficulties in emotion regulation in patients with psoriasis. Compr Psychiatry 2016; 70:200-8. [PMID: 27565774 DOI: 10.1016/j.comppsych.2016.08.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 07/27/2016] [Accepted: 08/01/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) in psoriasis patients could be negatively affected by medical (e.g., obesity) and psychological (e.g., depression, anxiety, and alexithymia) conditions the presence of which suggests difficulties in understanding and regulating inner states and emotions. Thus, the aim of this study was to investigate HRQoL and its association with obesity and difficulties in understanding and regulating inner states and emotions in patients with psoriasis. A second objective was to examine whether the presence of difficulties in understanding and regulating inner states and emotions may mediate the association between psoriasis and poor HRQoL. METHOD One hundred adult outpatients and 97 healthy controls were administered a checklist assessing major socio-demographic variables, and measures of HRQoL, difficulties in emotion regulation, alexithymia, anxiety, depression, and food craving. RESULTS Psoriasis patients (compared to controls) reported more frequently obesity, alexithymia, anxiety, depression and food craving, and reported lower scores on the mental and physical components of HRQoL. A mediation model, with mental health as the dependent variable, indicated significant direct and indirect (through BMI, difficulties in emotion regulation, anxiety, depression, and food craving) effects of psoriasis on the quality of life, so that psoriasis was associated with worse mental health. A second mediation model with physical health as dependent variable indicated only a significant indirect effect (through BMI and depression) of psoriasis on the quality of life. CONCLUSIONS Psoriasis is characterized by poor HRQoL and the presence of difficulties in understanding and regulating inner states and emotions. In patients with psoriasis the possible influence of food craving on abnormal eating habits should be carefully assessed.
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Affiliation(s)
- Marco Innamorati
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy.
| | - Rossella M Quinto
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy
| | - Claudio Imperatori
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy
| | - Viviana Lora
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Dario Graceffa
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy
| | | | | | - Anna Contardi
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy
| | - Claudio Bonifati
- Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy
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