1
|
Ayan G, Coras R, Grynszpan R, Herrera S, Jethwa H, Johnsson HJ, Silva DLF, van Mens L, Mulder MLM, Simon D, Vivekanantham A, Proft F. Young-GRAPPA (Y-GRAPPA) at the 2022 GRAPPA Annual Meeting: One Year in Y-GRAPPA. Where Do We Stand, Where Do We Go? J Rheumatol 2023; 50:58-60. [PMID: 37453733 DOI: 10.3899/jrheum.2023-0531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 07/18/2023]
Abstract
Young-GRAPPA (Y-GRAPPA) was introduced at the 2021 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) annual meeting. Here we present the 1-year progress of Y-GRAPPA and future plans of this enthusiastic group of young clinicians and early career researchers interested in psoriasis and psoriatic arthritis.
Collapse
Affiliation(s)
- Gizem Ayan
- G. Ayan, MD, Hacettepe University Medical Faculty, Department of Medicine, Division of Rheumatology, Ankara, Turkey
| | - Roxana Coras
- R. Coras, MD, PhD, Cedars Sinai Medical Center, Division of Rheumatology, Los Angeles, California, USA
| | - Rachel Grynszpan
- R. Grynszpan, MD, MSc, Institute of Dermatology Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro (IDPRDA), and Lagoa Federal Hospital, Institute of Dermatology, Division of Dermatology Rio de Janeiro, Brazil
| | - Sebastián Herrera
- S. Herrera, MD, Clínica Las Américas Auna - ARTMEDICA, Docente Adscrito Universidad CES, Medellín, Colombia
| | - Hannah Jethwa
- H. Jethwa, BSc, MBChB, Imperial College Healthcare NHS Trust Division of Rheumatology, London, UK
| | - Hanna J Johnsson
- H.J. Johnsson, MBChB, PhD, University of Glasgow, Institute of Infection, Immunity and Inflammation, Glasgow, UK
| | - Dimitri L F Silva
- D.L.F. Silva, MD, MSc, Dermatology, University Santo Amaro, Sao Paulo, Brazil
| | - Leonieke van Mens
- L. van Mens, MD, PhD, Amsterdam University Medical Centers/University of Amsterdam, Department of Clinical Immunology and Rheumatology Amsterdam, Infection & Immunity Institute, Amsterdam, the Netherlands
| | - Michelle L M Mulder
- M.L.M. Mulder, MD, PhD, Radboud University Medical Centre, Division of Rheumatology, Nijmegen, the Netherlands
| | - David Simon
- D. Simon, MD, MHBA, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Department of Internal Medicine 3 - Rheumatology and Immunology, and Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - Arani Vivekanantham
- A. Vivekanantham, MPhil, MBChB, University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, UK
| | - Fabian Proft
- F. Proft, MD, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, & Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Berlin, Germany.
| |
Collapse
|
2
|
Grynszpan R, Barreiros G, do Nascimento Paixão M, Frasnelli Fernandes M, Aguinaga F, Camargo C, Ramos-E-Silva M, Carneiro S. Coexistence of onychomycosis and nail psoriasis and its correlation with systemic treatment. Mycoses 2021; 64:1092-1097. [PMID: 34061419 DOI: 10.1111/myc.13331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Epidemiological studies indicate that onychomycosis may affect up to 79% of psoriatic patients. Onychomycosis in psoriatic patients is more commonly caused by yeasts comparing with non-psoriatic. OBJECTIVES Evaluate the prevalence of fungi in nail psoriasis. Evaluate the association between direct mycological examination (DME) and mycological culture, Nail Psoriasis Severity Index (NAPSI) and systemic treatment for psoriasis. METHODS Of 133 nails from 20 patients with nail psoriasis were evaluated as follows: 9 patients were using topical treatment and 11 were on systemic treatment. The assessment of psoriasis severity using NAPSI was performed in all psoriatic nails. The presence of fungi was confirmed in DME and culture. RESULTS DME showed the presence of fungal elements in 45 nails (33.83%) with a predominance of blastoconidia (95.5%) No septate hyphae were seen. Mycological culture was positive in 36 (27.06%) samples. Among them, Candida grew in 31 (86.1%): Candida parapsilosis in 15 (48.38%), Candida spp in 14 (45.16%). No growth of dermatophytes was observed. Patients with systemic treatment showed a higher frequency of positive test (DME and culture) for fungi when compared to topic treatment (p:.006). There was a positive correlation between NAPSI, mycological culture and systemic treatment (p:.0063); the risk was four times higher (OR:4.0). LIMITATION OF THE STUDY Sample size. CONCLUSION These results are consistent with some previous reports, Candida was the fungus with higher frequency on the psoriatic nails, however, the role of these fungi is controversial (contamination x colonisation x infection). The fact that the immunosuppressive treatment increases the chance of fungal infection leads us to a greater attention to this patient profile, to prevent the intensification of nail psoriasis (Köbner phenomenon).
Collapse
Affiliation(s)
- Rachel Grynszpan
- Sector of Dermatology, Medical Clinics Post-Graduation Program, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gloria Barreiros
- Sector of Dermatology, Medical Clinics Post-Graduation Program, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marilene do Nascimento Paixão
- Sector of Dermatology, Medical Clinics Post-Graduation Program, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Frasnelli Fernandes
- Sector of Dermatology, Medical Clinics Post-Graduation Program, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Felipe Aguinaga
- Sector of Dermatology, Medical Clinics Post-Graduation Program, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cláudia Camargo
- Sector of Dermatology, Medical Clinics Post-Graduation Program, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology, Medical Clinics Post-Graduation Program, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sueli Carneiro
- Sector of Dermatology, Medical Clinics Post-Graduation Program, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Medical Specialties Department, Post Graduation Course, Sector of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
3
|
Costa CZ, Goldenstein-Schainberg C, Carneiro S, Rodrigues JJ, Romiti R, Barros TBM, Martins G, Carneiro J, Grynszpan R, Sampaio AL, Mendonça TMS, Silva CHM, Qureshi AA, Pinto RDMC, Ranza R. Semantic and psychometric validation of the Brazilian Portuguese version (PASE-P) of the Psoriatic Arthritis Screening and Evaluation questionnaire. PLoS One 2018; 13:e0205486. [PMID: 30308020 PMCID: PMC6181380 DOI: 10.1371/journal.pone.0205486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 09/26/2018] [Indexed: 11/19/2022] Open
Abstract
PASE (Psoriatic Arthritis Screening and Evaluation) was developed in the English language to screen for inflammatory arthritis among patients with psoriasis. It is 15 item self administered questionnaire with a score from 15 to 75. A higher score indicates a greater risk for inflammatory joint disease. The purpose of this study was to translate, adapt and validate this questionnaire into Brazilian Portuguese (PASE-P). METHODS 465 patients diagnosed with psoriasis (158 with psoriatic arthritis confirmed by a rheumatologist according to the CASPAR criteria and 307 without) were evaluated in dermatology clinics. We performed the analysis of semantic equivalence in eight steps. For psychometric equivalence, we evaluated the data quality, reliability, construct validity, well-known groups and discriminant characteristics of the items, as well as a ROC curve to determine optimal PASE-P cutoff points in case identification and their sensitivity / specificity. The final version presented excellent reproducibility (CCI = 0.97) and reliability (Cronbach's alpha> 0.9). A cut-off point of 25 distinguished between patients with and without psoriatic arthritis, with sensitivity of 69.5 and specificity of 86.8. PASE-P proved to be culturally valid and reliable to screen for psoriatic arthritis in Brazilian patients with psoriasis.
Collapse
Affiliation(s)
| | | | - Sueli Carneiro
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | - Ricardo Romiti
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | | | | | | | - Rachel Grynszpan
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Ana Luisa Sampaio
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | | | | | - Abrar A. Qureshi
- Warren Alpert Medical School, Brown University, Providence, Rhode Island, United States of America
| | | | | |
Collapse
|
4
|
Godinho MM, Aguinaga F, Grynszpan R, Lima VM, Azulay DR, Cuzzi T, Ramos-E-Silva M, Manela-Azulay M. Granulomatous reaction to red tattoo pigment treated with allopurinol. J Cosmet Dermatol 2015. [PMID: 26211454 DOI: 10.1111/jocd.12149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Granulomatous reactions to tattoo ink are most commonly associated with mercury sulfide, a component of red pigments. Treatment options show limited results. Allopurinol, an inhibitor of xanthine oxidase, has been reported as a successful alternative treatment to granulomatous disorders, such as sarcoidosis and granulomatous reactions to fillers and tattoos. We report a case of granulomatous reaction to red tattoo pigment treated with allopurinol for 6 months. Good clinical improvement could be noticed during this time. Two months after we stopped the treatment, the lesion recurred. Allopurinol emerges as an important drug for the management of granulomatous reactions caused by tattoo pigments. Based on the significant clinical improvement noticed during its use, we recommend new studies to elucidate all the potential benefits of the use of allopurinol for the treatment of granulomatous reactions to tattoo ink.
Collapse
Affiliation(s)
- Mariana Marteleto Godinho
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Felipe Aguinaga
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rachel Grynszpan
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Victor Maselli Lima
- Sector of Plastic Surgery, Ivo Pitanguy Institute/Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - David Rubem Azulay
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Sector of Pathology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica Manela-Azulay
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
5
|
Ranza R, Carneiro S, Qureshi AA, Martins G, Rodrigues JJ, Romiti R, Barros TBM, Carneiro J, Sampaio AL, Grynszpan R, Markus J, Pinto RMC, Goldenstein-Schainberg C. Prevalence of Psoriatic Arthritis in a Large Cohort of Brazilian Patients with Psoriasis. J Rheumatol 2015; 42:829-34. [DOI: 10.3899/jrheum.140474] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 02/08/2023]
Abstract
Objective.To determine the prevalence of psoriatic arthritis (PsA) in a large cohort of Brazilian patients with psoriasis (PsO) being seen at dermatology centers.Methods.A multicenter study was conducted in 4 university dermatology clinics. In each center, consecutive patients with confirmed diagnoses of PsO were evaluated by a rheumatologist. Individuals were classified as having PsA according to the ClASsification criteria for Psoriatic ARthritis (CASPAR). Laboratory tests and radiographs were performed, as needed, based on the clinical judgment of the rheumatologist.Results.A total of 524 patients with PsO were evaluated. The mean age was 48.5 ± 14.5 years, 50% were women, and the mean PsO duration was 15.4 ± 11.7 years. A diagnosis of PsA was documented in 175 patients (33%), of whom 49% were newly identified by the rheumatologist. Most individuals with PsA (72%) had peripheral involvement, 11% had isolated axial involvement, and 17% had both peripheral and axial involvement. Dactylitis occurred in 20% and clinical enthesitis in 30% of the patients. Laboratory and/or radiograph tests were necessary for a definitive diagnosis of PsA in 42 of 175 individuals (24%).Conclusion.In our study, one-third of Brazilian patients with PsO, followed in dermatology settings, were diagnosed with PsA by a rheumatologist. Almost half of subjects with PsA had no previous diagnosis. A collaboration between dermatologists and rheumatologists is greatly needed to establish earlier PsA diagnoses and adequate multidisciplinary management.
Collapse
|
6
|
Armstrong AW, Tuong W, Love TJ, Carneiro S, Grynszpan R, Lee SS, Kavanaugh A. Treatments for Nail Psoriasis: A Systematic Review by the GRAPPA Nail Psoriasis Work Group. J Rheumatol 2014; 41:2306-14. [DOI: 10.3899/jrheum.140881] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Nail involvement in psoriatic diseases causes significant physical and functional disabilities. Evaluating, measuring, and treating nail involvement is important in improving the health outcomes and quality of life among patients with psoriasis and psoriatic arthritis (PsA). We performed a systematic analysis of the literature on nail psoriasis to help inform an update of treatment recommendations by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).
Collapse
|
7
|
Abstract
Flagellate dermatitis shows very characteristic lesions: linear erythema or hyperpigmentation in various areas of the skin. It is a side effect of bleomycin, an immunosupressive drug used for several types of cancers. All physicians must be aware of this disease so they can make a rapid diagnosis and interrupt the causative agent. Our patient presented during chemotherapy for a Hodgkin's lymphoma pruritic, erythematous lesions on the lower limbs and the back diagnosed as flagellate dermatitis due to bleomycin.
Collapse
Affiliation(s)
- Rachel Grynszpan
- Sector of Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | |
Collapse
|
8
|
Abstract
Chemotherapy drugs can affect the skin and its appendages. Several clinical presentations can be observed, depending on the affected structure. The most common dermatological side effect is chromonychia. The main causative agents are: (1) cyclophosphamide, which can provoke a diffuse, black pigmentation, longitudinal striae and dark grey pigmentation located proximally on the nails; (2) doxorubicin, which promotes dark brown bands alternating with white striae and dark brown pigmentation in transverse bands, and (3) hydroxyurea, which produces a distal, diffuse, dark brown pigmentation. In the majority of cases, the effects are reversible after the suspension of the causative agent for a few months. We report a patient who developed chromonychia while undergoing treatment with cyclophosphamide, vincristine, doxorubicin, dexamethasone, methotrexate and cytarabine for acute lymphocytic leukemia.
Collapse
Affiliation(s)
- Marien Lopes
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | |
Collapse
|