Acta Dermato-Venereologica Suppl 219 AbstractPsoriasis2018 | Page 9

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