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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