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