Tehran University Medical Journal

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Psoriasis is a chronic, inflammatory scaling disorder of the skin. Different patterns of psoriasis exist including plaque type, erythrodemic, pustular, palmoplantar and guttate. The most commonly involved sites are the elbows, knees, lumbosacral area and scalp. PUVA (Psoriasis Plus UVA) therapy [administration of oral psoralen followed by exposure to UVA (320 to 440 nm)] is widely used to treat severe psoriasis. Oral PUVA produces some adverse effects that may limit its applicability in a number of patients. The carcinogenic potential limits its use in patients with psoriasis who probably receive other carcinogenic treatments. Oral PUVA may induce complications such as nausea, vomiting and headache. In light of these problems Bath PUVA therapy is an important alternative to oral PUVA therapy. Bath PUVA is a kind of photochemotherapy in which UVA radiation after administration of topical psoralen in a warm water bath is used. We treated 30 patients with generalized plaque type psoriasis with 8-Mop Bath PUVA in Razi hospital. Bath PUVA cleared psoriasis more rapidly than oral PUVA and required fewer treatments (mean number of sessions: (17.6±2.1) and lower cumulative UVA dose. (49.2±15.4 J/cm²). 83.3 percent of our patients showed complete response to treatment and 13.4 percent showed good response.

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800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Psoriasis is a chronic, inflammatory disease of the skin. Recently, nicotinic cholinergic receptors have been demonstrated on keratinocytes, stimulating calcium influx and accelerating cell differentiation. Therefore, smoking and nicotine seem to influence inflammatory processes in psoriatic skin. The aim of this study was to determine the frequency of cigarette smoking as an independent risk factor in patients with psoriasis who attended the department of dermatology at Razi Hospital in Rasht during the years 2008 and 2009.
Methods : In this descriptive-inferential study, we recruited 96 patients with psoriasis vulgaris and 96 individuals as the controls. The participants were adjusted for sex, age and body mass index. The collected data related to smoking status, duration of smoking habit, smoking intensity, pack-year smoking history, and passively exposure to smoking were documented in a researcher-devised questionnaire. Subsequently, the data were analyzed by descriptive and inferential statistics such as χ², t-test and Mann-Whitney U test by SPSS software.
Results : The smoking rate was 33.3% in the patients and 19.4% in the controls. Pack-year history, regarded as the intensity and duration (years) of smoking, significantly increased the risk of psoriasis vulgaris (P<0.05, OR=2.07, 95% CI=1.17-3.68). Being a passive smoker did not make significant differences between the cases and the controls.
Conclusion: Our study demonstrated that psoriasis vulgaris had a relationship with duration and intensity of cigarette smoking and revealed the importance of smoking cessation, particularly among patients with psoriasis.

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Background: Psoriasis is a common, chronic disease of the skin, in which both genetic and environmental factors play a critical role. The most characteristic lesions consist of red, scaly plaques present particularly over extensor surfaces and scalp. Studies have reported association between psoriasis and many other diseases in both cutaneous and systemic forms of the disease. Several studies with different and sometimes controversial results have been done about the relationship of hyperuricemia and psoriasis. The aim of our study was to assess serum uric acid levels in patients with psoriasis.

Methods: We studied 126 patients with psoriasis in a case-series study in Razi Hospital during one year. After recording the age, sex, duration, type and severity of the disease and presence or absence of psoriatic arthritis in the patients, they were referred to the laboratory for the determination of serum uric acid concentrations.

Results: The mean (±SD) serum uric acid level was 5.4±1.5 mg/dL (ranging from 1.9- 9.5 mg/dL). Although the mean serum uric acid levels were in the normal range but the values were significantly higher in patients with more severe forms of psoriasis (P<0.001), its longer duration (P<0.001) and psoriatic arthritis (P=0.003). Moreover, serum uric acid levels were significantly higher in patients with non-plaque-type than plaque-type psoriasis (P=0.01).

Conclusion: This study revealed that serum uric acid levels exacerbate by increases in the severity and duration of psoriasis, in psoriatic arthritis, and in patients with non-plaque-type psoriasis.

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Background: Psoriasis is a T-cell mediated chronic inflammatory disorder with multiple skin, nails and joints involvement. The reported prevalence of psoriatic arthritis varies from 5 to 42 cases per 100 psoriasis patients. Insulin resistance is believed to be central to the pathogenesis of metabolic syndrome, a constellation of major risk factors for cardiovascular diseases, including atherogenic dyslipidemia, truncal adiposity, hypertension and hyperglycemia. The association of psoriasis and psoriatic arthritis with metabolic syndrome is increasingly being reported. Although the literature relating psoriatic arthritis to metabolic syndrome is accumulating, there is still a paucity of evidence, especially from Asia. Here, we examined the prevalence of metabolic syndrome and its components in patients with psoriatic arthritis.

Methods: The study was performed among outpatients attending the specialty clinic and rheumatology ward of Rasoul-e-Akram general hospital between January 2014 and April 2015. A consecutive sample of 80 patients diagnosed as having psoriatic arthritis was studied. Age, gender, body mass index, blood pressure and waist circumference, and history of smoking of patients were measured and asked at the enrolment visit. Venous samples were taken after 8 h of overnight fasting for the estimation of serum lipid profile, glucose and uric acid levels. Also an ultrasonographic examination was done for detection of non-alcoholic fatty liver disease. Results: 46 patients (57.5%) were male and 34 patients (42.5%) were female. Mean age of the participants was 43 years (SD: 11.3). The prevalence of abnormal components of metabolic syndrome was 53.8% for BMI, 48.8% for TG level, 50% for HDL, 46.3 for LDL, 45% for Cholesterol, 23.8% for FBS, 46% for waist circumflex in men and 47.7% in women and 42.5 for uric acid. 40% of the patients had abnormal SBP and 41.2% had abnormal DBP. Thirty percent of the participants were current smokers and 43.8 had NAFLD on ultrasonographic examination. Conclusion: 51.3% of patients had metabolic syndrome according to the adult treatment panel III criteria for adult Asian patients.

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