Poster abstracts 9 of psoriasis . There are few prospective studies on the relation of alcohol with the extent of psoriasis . Objectives : The purpose of this prospective study was to further investigate how alcohol affects psoriasis in female patients . Methods : Twenty-two female psoriasis patients with light to moderate psoriasis , with only local treatment and with a regular alcohol intake , were recruited . The study was run for three years , starting in 2014 . We used Christmas and New Year , as intervention period , when the amount of alcohol is expected to exceed normal consumption . The total study period was 8 weeks . During the study period , the alcohol intake was measured by the patients filling a calendar , specifying the alcohol intake per day , moreover , the degree of severity of psoriasis , degree of pruritus , and of perceived stress , using a visual analog scale . In addition , the patients once a week determined Self-Administered Psoriasis Area and Severity Index ( SAPASI ). Results : The alcohol intake , which was generally low to moderate , increased during Christmas and New Year , reaching its maximum during week 52 ( Christmas week ). There was a marginal increase in the extent of psoriasis , determined by SAPASI , during week 52 . There was no correlation with alcohol intake nor pruritus . The level of perceived stress decreased shortly after week 52 , and reached its lowest value during week 1 , after that increasing . Conclusion : Even if there is an increased alcohol consumption during Christmas and New Year , there is no evident worsening of psoriasis .
P013 PSORIASIS AND CANCER . RETROSPECTIVE STUDY IN THE PSORIASIS SECTOR OF THE DERMATOLOGY
SERVICE AT RAMOS MEJIA HOSPITAL Jennifer Kreimer , Alejandra Crespo , Elena Chaparro , Daniela Gonzalez , Veira Rosana , Kogan Nora Introduction : Psoriasis is a chronic , systemic , immune-mediated inflammatory disease that compromises the skin , attachments , semi-mucosal , mucous membranes and joints . There are different clinical forms that can vary in the same patient at different times of life . It is accompanied by comorbidities that affect the quality and survival of patients . Within the comorbidities associated with psoriasis , malignancies constitute a prominent and controversial group . In the review of the current literature , there would be evidence of a relationship between psoriasis and cancer , given the existence of structural and molecular similarities between the two pathologies . Objectives : To assess the prevalence of cancer development in patients with psoriasis in our population . Methods : A retrospective epidemiological analysis of the total population of 1969 patients with psoriasis is carried out , attended in the psoriasis sector of the dermatology service of Ramos Mejía Hospital in the period between January 2008 and January 2018 . Results : We identified 56 patients who presented coexistence of oncological pathology and psoriasis of different severity : 38 severe , 14 moderate and 4 mild . The population was divided equally between both sexes . Of these 56 patients , 61 tumors were detected ( non-melanoma skin cancer , solid tumors and lymphomas ). The oncological manifestations are the following : table 1 . Table 1 . Oncological manifestations Oncological manifestations Tumor quantification Total % Cutaneous Squamous Cell Carcinoma 4 7 % Basal Cell Carcinoma 12 20 % Breast Cancer 9 15 % Prostate Cancer 12 20 % Thyroid Cancer 6 10 % Endometrial Cancer 3 5 % Lung Cancer 1 2 % Colon Cancer 4 7 % Lymphoma No Hodgkin 1 2 % Cervical Cancer 2 3 % Kidney Cancer 1 2 % Multiple Myeloma 1 2 % Testicular Cancer 2 3 % Tumoral Micosis Fungoide 1 2 % Acute Myeloid Leukemia 1 2 % Bladder Cancer 1 2 % TOTAL 61 100 % The epidemiological analysis of this group of patients showed an incidence for all types of malignancies of 3.098 % in this population . The diagnosis of psoriasis preceded the oncological diagnosis in 50 of the patients studied .
Conclusions : The incidence of cancer in the general population in Argentina , according to the Ministry of Health is 172.3 – 242.9 per 100,000 inhabitants . In our study population , we found an incidence of 3.098 %, which would support the hypothesis of an increased risk of developing cancer in patients with psoriasis . The risk was identical in both sexes and directly proportional to the degree of severity of the psoriasis . Reference : Pouplard C , Brenaut E , et al . Risk of cancer in psoriasis : a systematic review and meta-analysis of epidemiological studies . JEADV 27 ( Suppl . 3 ), 36 – 46 , 2013Ramos Mejia , Service of Dermatology
P014 HEMATOLOGICAL DISORDERS IN THE PATIENT WITH PSORIATIC ARTHRITIS TREATED WITH METHOTREXATE AND TUMOR NECROSIS ALPHA
( TNFALPHA ) INHIBITOR Renata Sokolik 1 , Aleksandra Butrym 2 , Grzegorz Mazur 2 , Piotr Wiland 1 1
Department and Clinic of Rheumatology and Internal Medicine , 2 Department and Clinic of Internal and Occupational Diseases and Hypertension , Wroclaw Medical University , Wroclaw Poland
Introduction : Non-Hodgkin lymphomas are a heterogenous group of neoplastic disorders characterized by clonal limphoid cell proliferation . They rank sixth among the cancers in terms of the frequency of occurrence in adults . Waldenstrom macroglobulinemia is lymphoplasmic hyperplasia with excessive production of monoclonal M-protein . According to literature data , patients with psoriasis have more frequent lymphomas than healthy population . The real risk of lymphoproliferative disease in psoriatic arthritis patients has not yet been defined . Objectives : The aim of the study was to describe a case of a patient with psoriatic arthritis and concurent monoclonal gammopathy , who did not respond to treatment with TNFalpha inhibitor in combination with methotrexate . Methods : A 57 year old woman with psoriasis and psoriatic arthritis diagnosed in 2012 ( presence of HLA B27 antigen , arthritis of the sacroiliac joints , peripheral arthritis ) with monoclonal gammopathy of undeterminated significance , was treated with non-steroid anti-inflammatory drugs , methotrexate ( 20 mg once a week ), folic acid 15 mg and inhibitor of TNFalpha . At the beginning of biological therapy she presented with laboratory results : ESR 126 , total protein 8 g / dl , abnormal IgM 11.6 g / l ( normal range 0.4 – 2.3 g / l ), IgG 2.25 g / l ( normal range 7 – 16g / l ), IgA 0.32 g / l ( normal range 0.7 – 4 g / l ). Immunofixation test revealed possitivity for IgM kappa monoclonal protein . There were no abnormalities in the bone marrow aspiration biopsy , no lymphadenopathy was observed . She complained of general weakness and polineuropathy . Analysis of spino-cerebral fluid showed type V of oligoclonal band . Results : In 2017 , after 2 years of TNFalpha inhibitor combined with methotrexate therapy , the diagnosis of Waldenstrom macroglobulinemia has been done . The patient presented with high ESR 103 and monoclonal IgM 33 g / l . Repeated aspiration bone marrow biopsy showed 3 % of plasmocytes and 21 % of lymphocytes . Conclusions : The patient started standard RCD chemotherapy regimen ( rituximab , cyclophosphamide , dexamethason ) with good clinical response to therapy .
P015 THE RELATIONSHIP BETWEEN PSORIASIS , COMORBIDITIES , AND DEPRESSION ONSET : A
NATIONWIDE OBSERVATIONAL CONTROL STUDY Kirk Geale 1 , Martin Henriksson 2 , Jussi Jokinen 3 , Marcus Schmitt-
Egenolf 1 1
Dermatology , Department of Public Health and Clinical Medicine , Umeå
Acta Derm Venereol 2018