Poster abstracts
Results: During the study enrolment period 40 patients with
psoriasis and 40 age- and gender-matched controls were included
in this study. Probing depth and periodontal attachment level
showed significant higher values in psoriasis group compared to
healthy subjects.
Conclusions: We found evidence of a psoriasis-associated in-
creased risk of periodontitis. Thus, dermatologists should be
aware of this comorbidity because these patients should be closely
followed-up by a dentist for the adequate and early treatment of
periodontitis. Periodontitis may be associated with psoriasis but
further studies are needed to elucidate their relationship.
References:
1. Egeberg A, Mallbris L, Gislason G et al. Risk of periodontitis in patients
with psoriasis and psoriatic arthritis. JEADV 2017, 31: 288-293.
2. Ungprasert P, Wijampreecha K, Wetter DA. Periodontitis and risk of pso-
riasis: a systematic review and meta-analysis. JEADV 2017, 31: 857-862.
P007
SPLENOMEGALY AND PSORIASIS - A CASE REPORT
Suzana Ozanic Bulic
Department of Dermatovenerology, KBC Sestre milosrdnice, Zagreb,
Croatia
Psoriasis is a chronic, systemic, inflammatory disease associated
with numerous comorbidities that have been well documented in
the literature. Comorbidities often become clinically evident years
after the onset of psoriasis and are related to persistent low-grade
inflammation with secretion of proinflamamtory cytokines, as
seen in metabolic syndrome(1). Nevertheless, the evidence shows
new emerging comorbidities that share link with psoriasis. Hjuler
et al. observed increased splenic inflammation in patients with
moderate-to-severe psoriasis (2). They also showed that splenic
activity was correlating with aortic wall inflammation in psoriasis
patients, explaining the increased risk of heart disease (2).
A 56-year old patient with chronic plaque psoriasis (Fig 1) for
more than thirty years, presented with splenomegaly, diabetes
type two, arterial hypertension, chronic kidney disease stage III,
obesity, with BMI > 40, and depression. Psoriasis severely flared
up in 2012, and on workup up for cataract operation, enlarged
lymph nodes were observed and further confirmed on CT scans in
axillae, inguinum, mediastinum and upper abdomen. Patient was
hospitalized at haematology department and reactive lymphade-
nopathy due to skin inflammation was diagnosed. Acitretin was
started and stopped after a week for worsening of pancytopenia,
and Methotrexate was stopped after two weeks for triple increase
in liver enzymes, although the dose was of only 5 mg weekly. In
August 2017, repeated blood tests were normal and abdominal
US showed no progression in hepato-splenomegaly, with spleen
measuring 23 cm. Psoriasis was severe, with PASI 36, BSA 31%
and DLQI 19. Ustekinumab 90 mg was started in October 2017
with PASI75 achieved after 12 weeks of treatment. Patient has
been closely monitored with no haematological side-effects on
last assessment.
Significant splenomegaly and lymphadenopathy with no underly-
ing haematological disease has not been described as a comorbidity
of psoriasis. The treatment wi th biologics was delayed in our
patient as underlying haematological malignancy was suspected.
The untreated severe psoriasis flared up in the mean time the whole
spectrum of comorbidities, led by depression. Ustekinumab has
significantly improved his psoriasis (Fig 2), with improvement in
depression that was best observed in patient’s motivation to lose
weight and be referred for gastric bypass.
Effective control of psoriasis and associated conditions requires not
only appropriate treatment, but also management of comorbidities,
including screening and treatment by various specialists, as disease
is known for its cumulative impairment over patient’s lifetime (3).
7
P008
PSORIASIS AS PREDICTOR FOR CARDIOVASCULAR
AND METABOLIC COMORBIDITY IN MIDDLE-AGED
WOMEN
Christoffer Blegvad 1 , Anne-Marie Nybo Andersen 2 , Abdulfatah
Adam 2 , Claus Zachariae 1 , Lone Skov 1
Copenhagen Research Group for Inflammatory Skin (CORGIS), Depart-
ment of Dermatology and Allergy, Herlev and Gentofte Hospital, Univer-
sity of Copenhagen, Copenhagen, 2 Section of Epidemiology, Department of
Public Health, University of Copenhagen, Denmark
1
Introduction: Cardiovascular and metabolic comorbidities such as
ischemic heart disease and diabetes are known to be associated
with psoriasis. However, it is less clear whether this is due to com-
mon life-style related risk factors such as overweight and smoking.
Objectives: We wished to investigate the association between
psoriasis and cardiovascular and metabolic comorbidity in a cohort
of middle-aged women, and at the same time taking the effect of
body mass index (BMI) and smoking into account.
Methods: The study population consisted of expectant mothers
in a large nationwide birth cohort established between 1996 and
2002. During pregnancy, the women were asked whether they
have ever had any skin diseases including psoriasis, and whether
the disease was diagnosed by a physician. The relation to self-
reported cardiovascular and metabolic comorbidity 11 years
after giving birth was assessed by multiple logistic regression.
Furthermore, we performed an analysis where the cohort was
followed up for hospital-diagnosed comorbidity including cardiac
death until 31st December 2014. Here the risk was assessed by
Cox proportional hazards regression. All analyses were adjusted
for age, pre-pregnant BMI, and smoking status collected at time
of inclusion during pregnancy.
Results: We identified 2,435 (2.90%) women with a history of
psoriasis and 81,388 women without psoriasis. The women with
and without psoriasis were on average respectively 30.4 (SD
4.5) and 29.9 (SD 4.3) years old at time of inclusion in the study.
Women with psoriasis had slightly higher BMI and smoked mar-
kedly more than women without psoriasis (38.1% vs. 26.4%). A
history of psoriasis was significantly associated with self-reported
hypercholesterolemia (adjusted odds ratio 1.31; 1.01–1.70) and
hospital-diagnosed hypertension (adjusted hazard ratio 1.33;
1.08–1.65). A positive association was also found with respectively
hospital-diagnosed ischaemic heart disease, type 2 diabetes, and
hypercholesterolemia, however, these findings were not statis-
tically significant. No associations were found for self-reported
hypertension, thrombosis, or type 2 diabetes.
Conclusions: Women with psoriasis are at increased risk of
developing cardiovascular and metabolic comorbidity in early
adult life. This may suggest an importance of awareness of these
comorbidities also in younger patients with early screening for
hypertension, hyperglycemia, and hypercholesterolemia.
P009
A CASE OF CONCURRENT PSORIASIS AND VITILIGO
Selma Poparic
Dermatology Department University Clinical Center of Ssrajevo
Introduction: Psoriasis and vitiligo are common dermatoses that
affect 1~3% (psoriasis) and 0.5% (vitiligo) of the general popula-
tion, respectively. Yet the pathogenesis of the association between
these two dermatoses is still unknown.
Case report: We report a case of a 52-year-old patient who was
admitted to our department with a 6-month history of squamous
papules and plaques on his right elbow region and both right and
left lower leg. He was also noticed with hypopigmented patches
on his right and left wrist. Anamnestic questionnaire revealed that
his mother has had similar discolorations on her skin, but never
Acta Derm Venereol 2018