Poster abstracts
5
POSTERS
P001
A METAGENOMICS STUDY OF THE ELBOW OF PSORIA
SIS SUBJECTS AND THEIR HEALTHY RELATIVES
Hailun Wang 1 , Michael Ni 1 , Japio Fung 1 , Kang Yan 1 , Xiaoxin Yao 1 ,
Yinpeng Wang 1 , Martin Kriegel 2 , Henry Chan 1 , Herbert Pang 1
The University of Hong Kong, and 2 Yale University
1
Introduction: Psoriasis is a multifaceted immune-mediated skin
disease and has been associated with other comorbidities. Previous
studies in psoriasis reported the abundance of microbial taxa above
the species rank (family Firmicutes and genus Staphylococcus),
or the combined abundance of multiple taxa (Corynebacterium,
Propionibacterium, Staphylococcus, and Streptococcus) were
associated with psoriasis [1–3]. Characterizing the skin micro-
biome of psoriasis subjects and family controls can further our
understanding of microbiota’s role in this disease.
Objectives: This study aims to reveal the difference of skin mi-
crobiome between skin lesion area and normal area of the elbow
as well as family controls.
Methods: DNA samples was extracted from 21 elbow-skin. 14 of
21 were from 7 psoriasis subjects’ lesion side and normal side.
The rest were from a healthy family member whom the subject
lives with. Shotgun metagenomic sequencing was adapted to
resolute the skin microbiota. Partially overlapping t-test was used
to investigate differentially abundant taxa. PERMANOVA was
used to test the difference of microbial community composition
influenced by psoriasis and sampling families.
Results: Bacteria phyla Proteobacteria, Actinobacteria, and Bac-
teroidetes were three most abundant microbial taxa in both lesion
and normal skin. Bacteria phyla Cyanobacteria and Candidatus
Parcubacteria, family Hymenobacteraceae were less abundant
on lesion skin than normal skin (p < 0.05). Sampling families
had significantly different elbow-skin microbial composition for
bacterial genus level profile (p = 0.001).
Conclusions: Several bacterial taxa different from those previously
discovered are more abundant on normal skin than lesion skin in
the elbow.
References:
[1] Unexplored diversity and strain-level structure of the skin microbiome
associated with psoriasis. NPJ Biofilms Microbiomes. 3,14 (2017).
[2] Statnikov, A. et al. Microbiomic signatures of psoriasis: feasibility and
methodology comparison. Sci. Rep. 3, 2620 (2013).
[3] Alekseyenko, A. V. et al. Community differentiation of the cutaneous
microbiota in psoriasis. Microbiome. 1, 31 (2013).
P002
NAIL DISORDERS IN PATIENTS WITH PSORIASIS
VULGARIS
Jasmina Muhovic
University Clinical Centre Sarajevo
Introduction: Psoriasis vulgaris is a chronic inflammatory skin
disease characterized by T-cell-mediated hyperpfoliferation of
keratinocytes in the skin. Approximately, 10–78% of patients
with psoriasis have concurrent nail psoriasis while isolated nail
involvement is seen in 5–10% of patients. Affected nail plates often
thicken and crumble and because they are very visible patients
tend to avoid normal day-to-day activities and social interactions.
Importantly, 70–80% of patients with psoriatic arthritis have nail
psoriasis. In this overview, we review the clinical manifestations
of psoriasis affecting the nails.
Objectives: To correlate frequency of certain nail dissorders
in patients with psoriasis vulgaris. The observed dissorders
were:onicholysis, subungual hyperkeratosis, oil spots, and pitting
in both male and female patients aged 15–75 and combined with
psoriatic arthritis.
Methods: A total of 60 patients who were treated in our Inpatients
Service with diagnosis of Psoriasis vulgaris from January 2017
to July 2017 at Dermatology Department, University Clinical of
Sarajevo.We searched for specific nail dissorders.
Results: A total number of 60 patients with Psoriasis vulgaris,
both male and female aged 15–75 werw examined. Out of that
number, 43 patients reported to have specific nail dissorders and/
or psoriatic arthritis, and 17 of them were without any nail diss-
orders or psoriatic arthritis. Among the number of 43 examined
psoriatis patients with nail dissorders, there were 23 female and
20 male patients, all of them aged between 45–60. Seven female
and eight male patients had previously diagnosed psoriatic arthritis
combined with psoriasis and nail disorders, while the rest of them,
28 patients, only had psoriasis followed by progressive changes
on their nails, but without any signs of psoriatic arthritis. The
presented nail dissorders in all patients included in these two
groups were: subungual hyperkeratosis, onicolysis and pitting
all combined in 14 patients, only subungual hyperkeratosis in 10
patients, pitting in 7 patients, 7 of them showed only onycholysis
on both hands and 6 patients had oil spotting and pitting together.
In patients without psoriatic arthritis the prevalence of dissorders
in all affected groups was in male patients.
Conclusion: Nail psoriasis engenders both physical and psycho-
logical handicap, leading to significant negative repercussions in
the quolity of life. The presence of nail disease in a patient with
psoriasis may indicate a severe form of the disease and must be
taken into account when selecting a treatment otion, with an aim to
reduce pain, functional impairment as well as emotional distress.
P003
PSORIASIS HIDDEN IN GOTTRON’S PAPULES
Florentina Berianu, Juan J. Maya
Mayo Clinic Florida
Introduction: Patients with Dermatomyositis (DM) present with
rashes in a photosensitive distribution and occasionally a scaly
rash over elbows, knees and scalp can resemble psoriasis. The
biopsy of such lesions shows interface dermatitis which is highly
distinguishing for DM. In rare occasions, patients can suffer
from both DM and psoriasis (Ps). Objectives: To report a case of
Dermatomyositis and Psoriatic arthritis
Method: 45 years old female presented with a red, itchy rash with
diffuse swelling over the entire body associated with sw allowing
difficulties and weakness affecting mainly the proximal muscles
of upper and lower extremities. She has pain and stiffness in her
hands and feet. DM was confirmed based on specific findings on
skin biopsy, EMG with myopathic features and a muscle biopsy
that confirmed the myopathy. Patient had insulin dependent dia-
betes and IVIG was the initial choice of therapy to avoid steroid
use. Patient responded excellent in regards to generalized rash
and had reported improvement in regards to proximal muscle
weakness and swallowing difficulties but she had persistence of
the scaly rash over elbows, knees and developed what resembled
dactylitis along with worsened asymmetric inflammatory arthritis
of ankle, hand and feet joints. Based on her presentation, Ps and
psoriatic arthritis (PsA) were diagnosed. Methotrexate was added
and patient had improved in skin psoriasis along with inflammatory
arthritis. Results: Ps and PsA were associated with DM in this
patient. These are distinct diseases that have parallel courses and
require different therapeutic approaches.
Conclusion: Ps has been reported in association with Connective
Tissue Diseases. Gotron’s papules can resemble Ps in patients
with DM but rare case reports have described concomitant DM
and Ps. The association of DM, Ps and PsA was even more rarely
described.
References:
1. Tselios K, Yap KS, Pakchotanon R et al. Psoriasis in systemic lu-
Acta Derm Venereol 2018