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5 th World Psoriasis & Psoriatic Arthritis Conference 2018
underwent any diagnostic procedure , nor treatment . Clinical and hystopathological diagnosis of erythematosquamous areas on the patients right elbow and right and left lower leg was a plaque psoriasis , while hypopigmented patches on his wrists were diagnosed as vitiligo . Blood work up and T3 , fT4 , TSH , ANA laboratory tests were within normal ranges . Conclusion : Psoriasis and vitiligo , although seemingly unrelated skin disorders , have a lot in common . Causes , incidence , and even distribution seem to strongly correlate between these two .
P010 SUCCESSFUL LONG-TERM DOUBLE DISEASE CONTROL BY ADALIMUMAB IN A PATIENT WITH PSORIASIS VULGARIS AND HIDRADENITIS
SUPPURATIVA Melita Vuksic Polic 1 , Zlatica Jukic 1 , Andrea Krnic 1 , Renata Vukadin 1 , Ivana Patrk 2
1
Osijek University Hospital : Faculty of Medicine Osijek , 2 Privat dermatovenerological clinic dr Ivana Patrk , Zadar
Introduction : Psoriasis vulgaris / PV / is a chronic inflammatory skin disease 1 . Studies have shown the role of genes important for the transcription of inflammatory citokines , such as TNF alpha and IL-23 , which play main role in the patoghenesis of psoriasis 2 . Hidradenitis suppurativa / HS / is chronic inflammatory skin disease 3 , in which pathogenesis are IL-23 and TNF alpha , supporting the theory of the immunologic disease 4 . Adalimumab is human monoclonal antibody that has a great affinity for the membrane of TNF alpha 5 . We report the case of a 44-year-old Caucasian woman with a history of PV and HS , both diseases are in remission during the therapy with adalimumab . Case report : We report the case of a 44-year-old Caucasian woman with a history of PV and HS that started adalimumab therapy 3 years ago . PV started 14 years ago and was verified by skin biopsy . Initially , the clinical course of psoriasis was mild and later she took course to moderate psoriasis with PASI 10 . Psoriasis was treated only with local therapy . HS started when she was 38-years-old in her left groin , as swelling and pain on palpation and in movement . Skin changes started to develop also on the right groin and perianal region as painful nodules , with pus draining , and fistula tracts . Skin biopsy confirmed HS . Chest X-ray and gastroenterology examination were performed to exclude any additional illnesses and she also did a psychologcal testing . She was treated with different antibiotics also prednisone and isotretinoin at a dose 1mg / kg / day . Topical therapy was consisting of antibiotics , antiseptics and hydrocolloid dressings . She had 3 surgical interventions . In 2015 , she started adalimumab according to the scheme . On the day of the initial aplication of adalimumab , patient had 4 abscesses , 13 nodules and 16 fistula tracts . She had successful clinical response to the drug and is without psoriatic symptoms or HS active lesions . Both diseases are successfuly controled and quality of life has improved . References : 1 . Nevitt GJ , Hutchinson PE . Psoriasis in the community : prevalence , severity and patient ´ s beliefs and attidudes towards he disease . Br J Dermatol 1996 ; 135:533-7 . 2 . Reich K , Hüffmeier U , König IR , Lasorz J , Lohman J , Wendler J , Traupe H , Mössner R , Reis A , Burhardt H . TNF polymorphisms in psoriasis association of psoriatic arthritis with the promoter polymorphism TNF-857 independent of th PSORS1 risk allele . Arthritis Rheum 2007,56:2056-64 . 3 . Fimmel S , Zouboulis CC . Comorbidities of hidradenitis suppurativa ( acne inversa ). Dermatoendocrinol 2010 ; 2:9-16 . 4 . Matusiak I , Bieniek A , Szepietowski JC . Increaed serum tumour necrosis factor-alpha in hidradenitis suppurativa patients : is there a basis for treatment with anti-tumour necrosis factor-alpha agents ? Acta Derm Venereol 2009 ; 89:601-3 . 5 . Haslund P , Lee Ra , Jemec GB . Treatment of hidradenitis suppurativa with tumour necrosis factor-alpha inhibitors . Acta Derm Venereol 2009 ; 89:595-600 .
P011 CLINICAL AND EPIDEMIOLOGICAL CARACTERIZATION OF PSORIASIS AND PSORIATIC ARTHRITIS ON A MULTIDISCIPLINARY ASSESMENT
MODEL Karla Del Rocio Macias-Garcia , Dalila Alejandra Lopez Rodriguez Dermatologico Country
Introduction : Presentation and clinical course in Psoriasis are heterogeneos . A multidisciplinary assessment model was designed by five specialties : dermatology , rheumatology , internal medicine , nutrition and psychiatry , to evaluate at the same time and place , patients with psoriasis . Objetive : To ascertain frequency of comorbilities in psoriatic patients and conduct a clinical and epidemiological characterization . Methods : Prospective study , from August 2016 to february 2018 , patients attending to Multidisciplinary Clinic for psoriasis in Dermatologico Country were included . Results : 53 patients were included . Median age was 42 years old and 62.3 % were female . Family history of psoriasis was found in 26.4 % patients and 19.4 % had spodyloarthropathy family history . Most common comorbidities found obesity , metabolic syndrome , diabetes mellitus , dyslipidemia , hypertension and fatty liver . Affective assessment was found for 49.1 % met criteria for anxiety . Psoriasis found 96.2 % with psoriasis in skin and 56.6 % in nails . Most common presentation of psoriasis , was plaque psoriasis in 66 %. PASI score showed 50.9 % with mild disease , 15.1 % moderate , and 34 % had severe . NAPSI score was from 0 to 61 , with a median of 3 ( 0.13 ). DLQI indicated that only 13.2 % had no condition in life quality , meanwhile 86.8 % patients had impaired quality of life . Psoriatic arthritis , and identify 58.5 % patients that met CASPAR criteria , axial disease was present in 51.6 %, peripheral joint disease in 71 % and in 13.2 % both were present . 54.8 %( 17 ) patients had enthesitis and 16.1 % had dactilitis . DAS28 was performed , and showed 45.2 % with severe activity . Total number of subjects with peripheral disease 100 %, did not met criteria for MDA . HAQ score to assess PsA patients quality of life , revealed a median of 1.38 ( 1.10 , 2.25 ). Conclusions : we found that more than half of the patients presented a severe form of psoriasis with significant quality of life impairment . The number of psoriatic arthritis was higher than expected with both axial and peripheral manifestations . We have found a high proportion of patients with comorbidities such as metabolic syndrome , diabetes mellitus , hypertension , dyslipidemia and obesity . We also found a high frequency of psychiatric illness . The limitations of our study are the small sample to highlight if comorbidities had an impact on the severity of skin and joint disease . This multidisciplinary model has identified psoriasis as a disease with an unpredictable course , which requires several evaluations by a multidisciplinary model , with a group of experts beyond Dermatologist and Rheumatologist .
P012 ALCOHOL AND PSORIASIS- A PROSPECTIVE SWEDISH
STUDY Caroline Svanström 1 , Sol-Britt Lonne-Rahm 1 , Ebru Bircan 2 , Knut Stokkeland 3 , Johan Franck 4 , Klas Nordlind 5
1
Department of Dermatology , Mälarsjukhuset , Eskilstuna , 2 Department of Medicine , Solna , Dermatology and Venereology Unit , Karolinska Institutet , 3 Department of Medicine , Gastroenterology and Hepatology Unit , Karolinska Institutet , 4 Department of Clinical Neuroscience , Division of Psychiatry , Karolinska Institutet , Stockholm , and Department of Medicine , Visby Hospital , Visby , 5 Department of Medicine , Solna , Dermatology and Venereology Unit , Karolinska Institutet , Stockholm , Sweden
Background : We have earlier in a limited cross-sectional study shown a correlation in females for alcohol consumption and extent www . medicaljournals . se / acta