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Shen F, Duan Z, Li S, Gao Z, Zhang R, Gao X, Li B, Wang R. Factors associated with a better treatment efficacy among psoriasis patients: a study based on decision tree model and logistic regression in Shanghai, China. BMC Public Health 2024; 24:1934. [PMID: 39026285 PMCID: PMC11264755 DOI: 10.1186/s12889-024-19468-9] [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: 11/07/2023] [Accepted: 07/12/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Many effective therapies for psoriasis are being applied in clinical practice in recent years, however, some patients still can't achieve satisfied effect even with biologics. Therefore, it is crucial to identify factors associated with the treatment efficacy among psoriasis patients. This study aims to explore factors influencing the treatment efficacy of psoriasis patients based on decision tree model and logistic regression. METHODS We implemented an observational study and recruited 512 psoriasis patients in Shanghai Skin Diseases Hospital from 2021 to 2022. We used face-to-face questionnaire interview and physical examination to collect data. Influencing factors of treatment efficacy were analyzed by using logistic regression, and decision tree model based on the CART algorithm. The receiver operator curve (ROC) was plotted for model evaluation and the statistical significance was set at P < 0.05. RESULTS The 512 patients were predominately males (72.1%), with a median age of 47.5 years. In this study, 245 patients achieved ≥ 75% improvement in psoriasis area and severity index (PASI) score in week 8 and was identified as treatment success (47.9%). Logistic regression analysis showed that patients with senior high school and above, without psoriasis family history, without tobacco smoking and alcohol drinking had higher percentage of treatment success in patients with psoriasis. The final decision tree model contained four layers with a total of seventeen nodes. Nine classification rules were extracted and five factors associated with treatment efficacy were screened, which indicated tobacco smoking was the most critical variable for treatment efficacy prediction. Model evaluation by ROC showed that the area under curve (AUC) was 0.79 (95%CI: 0.75 ~ 0.83) both for logistic regression model (0.80 sensitivity and 0.69 specificity) and decision tree model (0.77 sensitivity and 0.73 specificity). CONCLUSION Psoriasis patients with higher education, without tobacco smoking, alcohol drinking and psoriasis family history had better treatment efficacy. Decision tree model had similar predicting effect with the logistic regression model, but with higher feasibility due to the nature of simple, intuitive, and easy to understand.
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Affiliation(s)
- Fanlingzi Shen
- Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University, 1278 Baode Road, Jing'an District, Shanghai, 200443, China
- School of Public Health, Shanghai University of Traditional Chinese Medicine, 1200 Cai Lun Road, Shanghai, China
| | - Zhen Duan
- School of Public Health, Shanghai University of Traditional Chinese Medicine, 1200 Cai Lun Road, Shanghai, China
| | - Siyuan Li
- School of Public Health, Shanghai University of Traditional Chinese Medicine, 1200 Cai Lun Road, Shanghai, China
| | - Zhongzhi Gao
- Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University, 1278 Baode Road, Jing'an District, Shanghai, 200443, China
| | - Rui Zhang
- Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University, 1278 Baode Road, Jing'an District, Shanghai, 200443, China
| | - Xiangjin Gao
- Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University, 1278 Baode Road, Jing'an District, Shanghai, 200443, China
| | - Bin Li
- Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University, 1278 Baode Road, Jing'an District, Shanghai, 200443, China
| | - Ruiping Wang
- Clinical Research Center, Shanghai Skin Diseases Hospital, School of Medicine, Tongji University, 1278 Baode Road, Jing'an District, Shanghai, 200443, China.
- School of Public Health, Shanghai University of Traditional Chinese Medicine, 1200 Cai Lun Road, Shanghai, China.
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Törőcsik D, Várvölgyi T. Hairy drinking may cause severe hangover symptoms in patients taking low-dose minoxidil. Int J Dermatol 2024; 63:837-838. [PMID: 38853368 DOI: 10.1111/ijd.17317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/11/2024]
Affiliation(s)
- Daniel Törőcsik
- Department of Dermatology, MTA Centre of Excellence, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- HUN-REN-DE Allergology Research Group, Debrecen, Hungary
| | - Tünde Várvölgyi
- Department of Dermatology, MTA Centre of Excellence, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Bellinato F, Maurelli M, Geat D, Girolomoni G, Gisondi P. Managing the Patient with Psoriasis and Metabolic Comorbidities. Am J Clin Dermatol 2024; 25:527-540. [PMID: 38748391 PMCID: PMC11193697 DOI: 10.1007/s40257-024-00857-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 06/23/2024]
Abstract
Epidemiological data demonstrate strong associations between psoriasis and metabolic comorbidities, including obesity, hypertension, diabetes mellitus, dyslipidemia, and non-alcoholic fatty liver disease. The presence of metabolic comorbidities significantly influences the selection and effectiveness of pharmacological treatments. Some drugs should be prescribed with caution in patients with metabolic comorbidities because of an increased risk of adverse events, while others could have a reduced effectiveness. The aim of this narrative review is to highlight the challenges that healthcare professionals may face regarding the management of psoriasis in patients with metabolic comorbidities. In the first part of the article, the epidemiological association between psoriasis and metabolic comorbidities and their pathogenetic mechanisms is summarized. The second part describes the efficacy and safety profile of conventional and biologic drugs in patients with selected metabolic comorbidities including obesity, non-alcoholic fatty liver disease/hepatic steatosis, and diabetes. Finally, the role of pharmacological and non-pharmacological interventions, such as diet, alcohol abstinence, physical activity, and smoking avoidance is discussed. In conclusion, the choice of the best approach to manage patients with psoriasis with metabolic comorbidities should encompass both tailored pharmacological and individualized non-pharmacological interventions.
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Affiliation(s)
- Francesco Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Martina Maurelli
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Davide Geat
- Department of Dermatology, Spedali Civili, Brescia, Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy.
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Jordan A, Näslund-Koch C, Vedel-Krogh S, Egil Bojesen S, Skov L. Alcohol consumption and risk of psoriasis: Results from observational and genetic analyses in more than 100,000 individuals from the Danish general population. JAAD Int 2024; 15:197-205. [PMID: 38707928 PMCID: PMC11066682 DOI: 10.1016/j.jdin.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2024] [Indexed: 05/07/2024] Open
Abstract
Background Psoriasis is associated with high alcohol consumption, but the causality of this relationship is unclear. Objective We aimed to use a Mendelian randomization approach to investigate the causal effects of alcohol on incident psoriasis. Methods We included 102,655 adults from the prospective Copenhagen studies. All participants filled out a questionnaire on alcohol consumption, were physically examined, and had blood drawn for biochemical and genetic analyses. We created a genetic instrument based on the number of fast-metabolizing alleles in alcohol dehydrogenase 1B and alcohol dehydrogenase 1C, known to be associated with alcohol consumption, to test whether alcohol consumption was causally associated with psoriasis. Results Observationally, we found an increased risk of incident psoriasis among individuals with high alcohol consumption compared to those with low alcohol consumption with a hazard ratio of 1.30 (95% confidence interval 1.05-1.60) in the fully adjusted model. Using genetic data to predict alcohol consumption to avoid confounding and reverse causation, we found no association between number of fast-metabolizing alleles and risk of psoriasis. Limitations Alcohol consumption was self-reported and psoriasis was defined using the International Classification of Diseases 10th revision and 8th revision codes. Conclusion Alcohol consumption is observationally but not causally associated with incident psoriasis.
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Affiliation(s)
- Alexander Jordan
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Charlotte Näslund-Koch
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Signe Vedel-Krogh
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Stig Egil Bojesen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Copenhagen City Heart Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Potestio L, Lauletta G, Tommasino N, Portarapillo A, Salsano A, Battista T, Martora F, Megna M. Risk Factors for Psoriasis Flares: A Narrative Review. PSORIASIS (AUCKLAND, N.Z.) 2024; 14:39-50. [PMID: 38831846 PMCID: PMC11146339 DOI: 10.2147/ptt.s323281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/25/2024] [Indexed: 06/05/2024]
Abstract
Psoriasis is a chronic inflammatory cutaneous disease with multifactorial pathogenesis involving both genetic and environmental factors as well as the innate and acquired immune response. Several triggering factors may exacerbate or worsen the disease. In this context, we performed a review manuscript with the aim of investigating current literature on psoriasis risk factors, also showing possible mechanisms by which they act on psoriasis. Globally, risk factors can be divided in classic risk factors (eg, mechanical stress, infections and dysbiosis of the skin, common drugs, environment and pollution, lifestyle, psychological stress, hormonal and metabolic alterations) which have long been known to be responsible for worsening and/or reoccurrence of psoriatic manifestations, and emerging risk factors (eg, biological drugs, immunotherapy for oncologic disease, Covid-19, and vaccines) defined as those newly identified risk factors. Accurate patient information and monitoring of risk factors as well as planned follow-ups may help to prevent and treat the worsening of psoriasis and consequently improve the quality of life of psoriatic patients.
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Affiliation(s)
- Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Giuseppe Lauletta
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Nello Tommasino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Antonio Portarapillo
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Antonia Salsano
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Teresa Battista
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Fabrizio Martora
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Hernandez-Nicols BF, Robledo-Pulido JJ, Alvarado-Navarro A. Etiopathogenesis of Psoriasis: Integration of Proposed Theories. Immunol Invest 2024; 53:348-415. [PMID: 38240030 DOI: 10.1080/08820139.2024.2302823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Psoriasis is a chronic inflammatory disease characterized by squamous and erythematous plaques on the skin and the involvement of the immune system. Global prevalence for psoriasis has been reported around 1-3% with a higher incidence in adults and similar proportions between men and women. The risk factors associated with psoriasis are both extrinsic and intrinsic, out of which a polygenic predisposition is a highlight out of the latter. Psoriasis etiology is not yet fully described, but several hypothesis have been proposed: 1) the autoimmunity hypothesis is based on the over-expression of antimicrobial peptides such as LL-37, the proteins ADAMTSL5, K17, and hsp27, or lipids synthesized by the PLA2G4D enzyme, all of which may serve as autoantigens to promote the differentiation of autoreactive lymphocytes T and unleash a chronic inflammatory response; 2) dysbiosis of skin microbiota hypothesis in psoriasis has gained relevance due to the observations of a loss of diversity and the participation of pathogenic bacteria such as Streptococcus spp. or Staphylococcus spp. the fungi Malassezia spp. or Candida spp. and the virus HPV, HCV, or HIV in psoriatic plaques; 3) the oxidative stress hypothesis, the most recent one, describes that the cell injury and the release of proinflammatory mediators and antimicrobial peptides that leads to activate of the Th1/Th17 axis observed in psoriasis is caused by a higher release of reactive oxygen species and the imbalance between oxidant and antioxidant mechanisms. This review aims to describe the mechanisms involved in the three hypotheses on the etiopathogeneses of psoriasis.
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Affiliation(s)
- Brenda Fernanda Hernandez-Nicols
- Centro de Investigación en Inmunología y Dermatología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Juan José Robledo-Pulido
- Centro de Investigación en Inmunología y Dermatología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Anabell Alvarado-Navarro
- Centro de Investigación en Inmunología y Dermatología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
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Torres T, Filipe P, Menezes Brandão F, Figueiredo A, Pinto Soares A, Sousa Basto A, Rebelo C, Correia O, Ferreira P, Brasileiro A, Mendes-Bastos P, Paiva-Lopes MJ, Marques Pinto G, Severo M, Mendonça D, Oliveira P, Selores M, Massa A, Pereira M, Tavares Bello R. Epidemiology of Psoriasis in Portugal: A Population-Based Study. ACTA MEDICA PORT 2023; 36:541-549. [PMID: 36608696 DOI: 10.20344/amp.19048] [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: 09/07/2022] [Accepted: 11/22/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Psoriasis is a common, chronic, and inflammatory skin disorder with a high personal, social and economic burden and important implications for healthcare systems. The aim of this study was to provide an epidemiological characterization of individuals with psoriasis in Portugal. MATERIAL AND METHODS A large observational, cross-sectional, nationwide, population-based survey study developed by the Portuguese Psoriasis Group of the Portuguese Society of Dermatology and Venereology (GPP-SPDV). A structured questionnaire was designed and applied by experienced interviewers to a random, representative sample of Portuguese individuals with psoriasis and/or psoriatic arthritis. Patients were considered to have psoriasis if they replied positively to one of the following questions: "Does any physician have ever diagnosed you with psoriasis?" or "Do you have a skin disorder characterized by scaling, reddish skin lesions located in the elbows/knees/scalp?". RESULTS A total of 6381 individuals were interviewed, of which 283 met the criteria for psoriasis, corresponding to a prevalence rate of 4.4% (95% CI 3.95 - 4.98). Out of the participants that met psoriasis criteria, 24% had suggestive signs/symptoms but did not have a clinical diagnosis established and were not being monitored by a physician. Although more than 70% of participants had active disease (scaling, erythema, or pruritus) and one third had joint symptoms, only 12% were on systemic treatment. Fifty percent of participants with psoriasis (n = 139) had relevant comorbidities (most frequently depression/anxiety and cardiometabolic diseases). Sixteen percent of participants with psoriasis (n = 46) reported that psoriasis interfered with their daily activities (median impact of 5 in a 0 - 10 scale) and 12% mentioned the disease had an impact in their sexual life (median impact of 5 in a 0 - 10 scale). CONCLUSION The results of this study suggest that the prevalence rate of psoriasis is likely to be high in Portugal, and several gaps exist at different levels of healthcare delivery to these patients, from diagnosis to treatment. This study provides important data for the future planning of interventions targeting the improvement of psoriasis care in Portugal.
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Affiliation(s)
- Tiago Torres
- Department of Dermatology. Centro Hospitalar Universitário do Porto. Porto; Instituto de Ciências Biomédicas Abel Salazar. University of Porto. Porto. Portugal
| | - Paulo Filipe
- Department of Dermatology. Hospital de Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisbon; Faculty of Medicine. University of Lisbon. Lisbon; Dermatology Research Unit. iMM João Lobo Antunes. University of Lisbon. Lisbon. Portugal
| | | | | | | | | | - Clarisse Rebelo
- Department of Dermatology. Centro Hospitalar Universitário do Algarve. Faro. Portugal
| | - Osvaldo Correia
- Centro de Dermatologia Epidermis. Instituto CUF. Porto; Centre for Health Technology and Services Research. University of Porto; Basic and Clinical Immunology Unit. Department of Pathology. Faculty of Medicine. University of Porto. Portugal
| | - Paulo Ferreira
- Dermatology Center. Hospital CUF Descobertas. Lisbon. Portugal
| | - Ana Brasileiro
- Department of Dermatology. Centro Hospitalar Universitário de Lisboa Central. Lisbon; NOVA Medical School. Faculdade de Ciências Médicas. Universidade NOVA de Lisboa. Lisbon. Portugal
| | | | - Maria João Paiva-Lopes
- Department of Dermatology. Centro Hospitalar Universitário de Lisboa Central. Lisbon; Chronic Diseases Research Center. NOVA Medical School. Faculdade de Ciências. Médicas. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Gabriela Marques Pinto
- Department of Dermatology. Centro Hospitalar Universitário de Lisboa Central. Lisbon. Portugal
| | - Milton Severo
- Departamento de Ensino Pré-Graduado. Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional. Porto; Unidade de Investigação em Epidemiologia. Instituto de Saúde Pública. Universidade do Porto. Porto. Portugal
| | - Denisa Mendonça
- Departamento de Ensino Pré-Graduado. Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional. Porto; Unidade de Investigação em Epidemiologia. Instituto de Saúde Pública. Universidade do Porto. Porto. Portugal
| | - Pedro Oliveira
- Departamento de Ensino Pré-Graduado. Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto. Porto; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional. Porto; Unidade de Investigação em Epidemiologia. Instituto de Saúde Pública. Universidade do Porto. Porto. Portugal
| | - Manuela Selores
- Department of Dermatology. Centro Hospitalar Universitário do Porto. Porto. Portugal
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Shih MC, Li CL, Liao EC, Yen CY, Yen LJ, Wang KC, Lu LY, Chou TY, Chen YC, Yu SJ. Inhibition of NLRP3 Inflammasome Activation by 3H-1,2-Dithiole-3-Thione: A Potential Therapeutic Approach for Psoriasis Treatment. Int J Mol Sci 2023; 24:13528. [PMID: 37686332 PMCID: PMC10487783 DOI: 10.3390/ijms241713528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
Psoriasis is a chronic autoimmune skin disease with a significant impact on quality of life and potential for severe comorbidities. Inflammation in the skin is induced by immune cells that overexpress pro-inflammatory cytokines, with the Th17 cell playing a crucial role. NLRP3 inflammasome activation is associated with inflammatory diseases and abnormal T cell differentiation. 3H-1,2-dithiole-3-thione (D3T), isolated from cruciferous vegetables, has anti-inflammatory effects and inhibits Th17 differentiation. This study aimed to investigate how D3T reduces skin inflammation and modulates Th17 cell differentiation by inhibiting NLRP3 inflammasome activation. In an imiquimod-induced psoriasis mouse model, D3T treatment demonstrated significant reductions in ear thickness, skin redness, and scaling compared to a control group. Our study also observed decreased expression of ki-67, NLRP3 inflammasome, and cleaved caspase-1 in skin samples, reduced levels of IL-6 and IL-17A in serum samples, and inhibition of Th17 differentiation after D3T application. D3T could also inhibit the expression of NLRP3, caspase-1, and IL-1β in TNF-α stimulated HaCaT cells. The mechanical study also revealed that D3T could inhibit NLRP3 inflammasome activation by inhibiting the JNK pathway in HaCaT cells. These results indicate that targeting NLRP3 inflammasome activation is a promising strategy in the treatment of psoriasis.
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Affiliation(s)
- Meng-Chieh Shih
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (M.-C.S.); (L.-J.Y.); (K.-C.W.); (L.-Y.L.); (Y.-C.C.)
| | - Chia-Ling Li
- Children’s Medical Center, Taichung Veterans General Hospital, Taichung 407, Taiwan;
| | - En-Chih Liao
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei City 252, Taiwan;
- Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan
| | - Chung-Yang Yen
- Department of Dermatology, Taichung Veterans General Hospital, Taichung 407, Taiwan;
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Integrated Care Center of Psoriatic Disease, Taichung Veterans General Hospital, Taichung 407, Taiwan
| | - Ling-Jung Yen
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (M.-C.S.); (L.-J.Y.); (K.-C.W.); (L.-Y.L.); (Y.-C.C.)
| | - Kai-Chun Wang
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (M.-C.S.); (L.-J.Y.); (K.-C.W.); (L.-Y.L.); (Y.-C.C.)
- The Doctoral Program of Clinical and Experimental Medicine, National Sun Yat-Sen University, Kaohsiung 804, Taiwan
| | - Ling-Ying Lu
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (M.-C.S.); (L.-J.Y.); (K.-C.W.); (L.-Y.L.); (Y.-C.C.)
| | - Ting-Yu Chou
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 407, Taiwan;
| | - Ying-Chin Chen
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; (M.-C.S.); (L.-J.Y.); (K.-C.W.); (L.-Y.L.); (Y.-C.C.)
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 804, Taiwan
| | - Sheng-Jie Yu
- Integrated Care Center of Psoriatic Disease, Taichung Veterans General Hospital, Taichung 407, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 407, Taiwan;
- Institute of Biomedical Sciences, College of Life Sciences, National Chung Hsing University, Taichung 407, Taiwan
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Michalski P, Palazzo-Michalska V, Michalska-Bańkowska A, Bańkowski M, Grabarek BO. Impact of Alcohol Consumption, Smoking, and Diet on the Severity of Plaque Psoriasis: A Comprehensive Assessment using Clinical Scales and Quality of Life Measures. Med Sci Monit 2023; 29:e941255. [PMID: 37528577 PMCID: PMC10405633 DOI: 10.12659/msm.941255] [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: 05/27/2023] [Accepted: 06/26/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the effects of alcohol intake, assessed using the Alcohol Use Disorder Identification Test (AUDIT) questionnaire, on the severity of plaque psoriasis using the Body Surface Area (BSA) and Psoriasis Area and Severity Index (PASI) scales, and quality of life using the Dermatology Life Quality Index (DLQI) questionnaire. MATERIAL AND METHODS The diagnosis of psoriasis was made based on the clinical picture. We enrolled 24 patients with psoriasis vulgaris, and the AUDIT test conducted at the time of follow-up indicated a possible risky/harmful pattern of alcohol consumption or alcohol dependence syndrome among the patients (>8 points). The comparison group consisted of 20 psoriatic patients and AUDIT <8 points. The BSA and PASI scales were used to determine the severity of psoriasis, and the DLQI questionnaire assessed patients' quality of life and how they felt during the week preceding the survey. RESULTS As the amount and frequency of alcohol consumed increased, the exacerbation of lesions measured according to the PASI and BSA scales was significantly higher (P<0.05), and the quality of life decreased (P<0.05). We noted that inadequate and excessive dietary intake of total protein, total fat, and assimilable carbohydrates were associated with statistically significantly higher values of BSA and PASI scores and, thus, more severe psoriatic lesions (P<0.05). CONCLUSIONS An unbalanced diet, alcohol abuse, and smoking negatively affect the course of psoriasis vulgaris, hence the importance of patient education.
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Affiliation(s)
- Piotr Michalski
- Department of Biochemistry, Faculty of Medicine in Zabrze, Academy of Silesia, Katowice, Poland
| | | | | | - Mirosław Bańkowski
- Individual Specialist Medical Practice Mirosław Bańkowski, Czeladź, Poland
| | - Beniamin Oskar Grabarek
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine in Zabrze, Academy of Silesia, Katowice, Poland
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Aghaei M, Aghaei S, Nilforoushzadeh MA, Abdellahi L, Naeini FF, Iraji F, Hosseini SM, Hejazi SH. Chlamydia pneumoniae Seropositivity in the Iranian Patients with the Skin Inflammatory Disorder of Rosacea. Adv Biomed Res 2023; 12:72. [PMID: 37200759 PMCID: PMC10186054 DOI: 10.4103/abr.abr_233_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 03/16/2022] [Accepted: 05/10/2022] [Indexed: 05/20/2023] Open
Abstract
Background Rosacea is a skin chronic inflammation with an unknown cause and cure. Environmental and genetic factors could not entirely explain the disease pathogenesis. Recently, infections like Chlamydia pneumoniae are of more attention in the rosacea progression. This study investigated the relationship between the C. pneumoniae seropositivity and the rosacea disorder. Materials and Methods We aimed at a cohort of 100 patients with the rosacea disorder (60 active and 40 inactive) and from 100 sex- and age-matched healthy controls in Isfahan and determined the immunoglobulin M (IgM)/IgG antibodies titers to C. pneumoniae in the serum using the enzyme-linked immunosorbent assay method. The groups were compared using the analysis of variance procedure at the significant level of P < 0.05, statistically. Results The mean of IgG in the controls was significantly higher than the levels in both the active and the inactive rosacea patients (p < 0.022). Also, the titer of serum IgM to C. pneumoniae in the controls was different, compared with the active (p < 0.019) and the inactive (p < 0.02) rosacea patients. In addition, the median titer of serum IgG (not IgM) to C. pneumoniae in the females with the inactive rosacea disorder was lower than the active rosacea disorder (p < 0.019) and controls women (p < 0.008). Furthermore, the serum level of IgG or IgM to C. pneumoniae in the controls males was higher than the males with the rosacea disorder (p < 0.05) and (p < 0.02), alternatively. Conclusion C. pneumoniae seropositivity in the rosacea patients and controls was insignificant.
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Affiliation(s)
- Maryam Aghaei
- Skin Diseases and Leishmaniasis Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahrzad Aghaei
- Department of Molecular Medicine, School of Advanced Technologies, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | - Latifeh Abdellahi
- Skin Diseases and Leishmaniasis Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farahnaz Fatemi Naeini
- Skin Diseases and Leishmaniasis Research Centre, Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Iran
| | - Fariba Iraji
- Skin Diseases and Leishmaniasis Research Centre, Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Iran
| | - Sayed Mohsen Hosseini
- Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Hossein Hejazi
- Skin Diseases and Leishmaniasis Research Center, Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Address for correspondence: Prof. Seyed Hossein Hejazi, Skin Diseases and Leishmaniasis Research Center, Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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11
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Kearney N, Kirby B. Alcohol and Psoriasis for the Dermatologist: Know, Screen, Intervene. Am J Clin Dermatol 2022; 23:881-890. [PMID: 35997945 PMCID: PMC9576661 DOI: 10.1007/s40257-022-00713-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2022] [Indexed: 01/19/2023]
Abstract
Psoriasis patients are at increased risk of harmful alcohol use and alcohol dependency with many deleterious effects. Increasing alcohol use is associated with worsening psoriasis severity, is a risk factor for poor response to systemic treatments and may impact on comorbidities such as psoriatic arthritis, cardiovascular disease, cancer and liver disease. Harmful alcohol use and alcohol dependency can be defined by the updated ICD-11 coding system and screening can be completed using many tools including the Cut down, Annoyed, Guilty, Eye-Opener (CAGE), Alcohol Use Disorders Identification Test (AUDIT) and Michigan Alcohol Screening Test (MAST) questionnaires. Dermatologists may be able to complete brief interventions encouraging alcohol reduction in psoriasis patients. Psoriasis patients may respond to messages of gain with reduced psoriasis severity and loss with reduced cardiovascular risk. It is important for dermatologists to discuss alcohol with all psoriasis patients, to be aware of the impact of alcohol in psoriasis and to familiarise themselves with screening tools, brief intervention and local services available to patients who require specialist input for harmful alcohol use or alcohol dependency.
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Affiliation(s)
- Niamh Kearney
- Department of Dermatology, St. Vincent's University Hospital Dublin, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Brian Kirby
- Department of Dermatology, St. Vincent's University Hospital Dublin, Dublin, Ireland. .,School of Medicine, University College Dublin, Dublin, Ireland. .,Charles Institute of Dermatology, University College Dublin, Dublin, Ireland.
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12
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Neurological Complications of Biological Treatment of Psoriasis. Life (Basel) 2022; 12:life12010118. [PMID: 35054511 PMCID: PMC8777957 DOI: 10.3390/life12010118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 12/16/2022] Open
Abstract
In the available literature, little attention has been paid to the assessment of psoriasis and the biological therapy used for it and the nervous system. The purpose of this article is to discuss the relationship between psoriasis and the nervous system as well as to analyze the mechanisms that lead to neurological complications during anticytokine therapies in psoriasis. However, this connection requires further analysis. The use of biological drugs in psoriasis, although it yields positive therapeutic results, is not without numerous side effects. Serious neurological side effects of the therapy are most often visible with the use of anti-TNF-alpha, which is why patients should be monitored for their potential occurrence. Early detection of complications and rapid discontinuation of treatment with the drug may potentially increase the patient’s chances of a full recovery or improvement of his/her neurological condition. It also seems reasonable that, in the case of complications occurring during anti-TNF-alpha therapy, some of the drugs from other groups should be included in the therapy.
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13
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Szentkereszty-Kovács Z, Fiatal S, Janka EA, Kovács D, Szegedi A, Remenyik É, Törőcsik D. Leptin Receptor (rs1137101) and Brain-Derived Neurotrophic Factor (rs925946) Gene Variants Are Associated with Obesity in the Early- but Not in the Late-Onset Population of Hungarian Psoriatic Patients. Life (Basel) 2021; 11:life11101086. [PMID: 34685457 PMCID: PMC8538564 DOI: 10.3390/life11101086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Psoriatic patients have considerably higher odds of being obese compared with the general population; however, the exact pathophysiological link between psoriasis and obesity needs to be elucidated. Methods: To investigate the association of psoriasis with established obesity-related gene variants, we conducted a population-based case-control study including 3541 subjects (574 psoriasis cases and 2967 controls from the general Hungarian population). Genotyping of 20 SNPs at ADIPOQ, BDNF, FTO, GNPDA2, LEPR, MC4R, NEGR1, NPY, PPARG, TMEM18, and UCP2 were determined, and differences in genotype and allele distributions were investigated. Multiple logistic regression analyses were implemented. Results: Analysis revealed an association between the G allele of the rs1137101 polymorphism (LEPR gene) and obesity risk (OR: 3.30 (1.45; 7.50), p = 0.004) in the early-onset group of psoriatic patients. Furthermore, the T allele of rs925946 polymorphism (BDNF gene) was also associated with increased risk of obesity in early-onset psoriasis (OR: 2.26 (1.24; 4.14), p = 0.008). Conclusions: Our results suggest that in psoriatic patients, there are prominent differences in the causes of obesity that should be accounted for, including not only environmental factors but also patient characteristics, such as the time of disease onset as well as genetic factors.
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Affiliation(s)
- Zita Szentkereszty-Kovács
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
| | - Szilvia Fiatal
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai út 26, 4012 Debrecen, Hungary;
| | - Eszter Anna Janka
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
| | - Dóra Kovács
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
| | - Andrea Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
| | - Éva Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
| | - Dániel Törőcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei Krt. 98, 4032 Debrecen, Hungary; (Z.S.-K.); (E.A.J.); (D.K.); (A.S.); (É.R.)
- Correspondence: ; Tel.: +36-52-255-602
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