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Psoriasis: HELP
Articles from Rhode Island
Based on 32 articles published since 2009
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These are the 32 published articles about Psoriasis that originated from Rhode Island during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review Underdiagnosed and undertreated psoriasis: Nuances of treating psoriasis affecting the scalp, face, intertriginous areas, genitals, hands, feet, and nails. 2018

Merola, Joseph F / Qureshi, Abrar / Husni, M Elaine. ·Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. · Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio. ·Dermatol Ther · Pubmed #29512290.

ABSTRACT: Psoriasis of the scalp, face, intertriginous areas, genitals, hands, feet, and nails is often underdiagnosed, and disease management can be challenging. Despite the small surface area commonly affected by psoriasis in these locations, patients have disproportionate levels of physical impairment and emotional distress. Limitations in current disease severity indices do not fully capture the impact of disease on a patient's quality of life, and, combined with limitations in current therapies, many patients do not receive proper or adequate care. In this review, we discuss the clinical manifestations of psoriasis in these less commonly diagnosed areas and its impact on patient quality of life. We also examine clinical studies evaluating the effectiveness of therapies on psoriasis in these regions. This article highlights the need to individualize treatment strategies for psoriasis based on the area of the body that is affected and the emerging role of biologic therapy in this regard.

2 Review Topical Botanical Agents for the Treatment of Psoriasis: A Systematic Review. 2017

Farahnik, Benjamin / Sharma, Divya / Alban, Joseph / Sivamani, Raja K. ·University of Vermont College of Medicine, Burlington, VT, USA. · Department of Medicine, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI, USA. · Alban Acupuncture and Herbs, New York, NY, USA. · Dermveda Inc., Sacramento, CA, USA. · Department of Dermatology, School of Medicine, University of California, Davis, 3301 C Street, Suite #1400, Sacramento, CA, 95816, USA. raja.sivamani.md@gmail.com. ·Am J Clin Dermatol · Pubmed #28289986.

ABSTRACT: BACKGROUND: Patients with psoriasis often enquire about the use of numerous botanical therapeutics. It is important for dermatologists to be aware of the current evidence regarding these agents. METHODS: We conducted a systematic literature search using the PubMed, MEDLINE, and EMBASE databases for controlled and uncontrolled clinical trials that assessed the use of topical botanical therapeutics for psoriasis. The search included the following keywords: 'psoriasis' and 'plant' or 'herbal' or 'botanical'. We also reviewed citations within articles to identify additional relevant sources. We then further refined the results by route of administration and the topical botanical agents are reviewed herein. RESULTS: A total of 27 controlled and uncontrolled clinical trials addressing the use of topical botanical agents for psoriasis were assessed in this review. We found that the most highly studied and most efficacious topical botanical therapeutics were Mahonia aquifolium, indigo naturalis, aloe vera, and, to a lesser degree, capsaicin. The most commonly reported adverse effects were local skin irritation, erythema, pruritus, burning, and pain. However, the overall evidence for these therapeutics remains limited in quantity and quality. CONCLUSION: The literature addresses a large number of studies in regard to botanicals for the treatment of psoriasis. While most agents appear to be safe, further research is necessary before topical botanical agents can be consistently recommended to patients.

3 Review Oral (Systemic) Botanical Agents for the Treatment of Psoriasis: A Review. 2017

Farahnik, Benjamin / Sharma, Divya / Alban, Joseph / Sivamani, Raja. ·1 Department of Dermatology, University of Vermont Larner College of Medicine , Burlington, VT. · 2 Department of Medicine, The Warren Alpert Medical School of Brown University and Rhode Island Hospital , Providence, RI. · 3 Alban Acupuncture and Herbs , New York, NY. · 4 Dermveda, Inc. , Sacramento, CA. · 5 Department of Dermatology, University of California-Davis , Sacramento, CA. ·J Altern Complement Med · Pubmed #28157393.

ABSTRACT: INTRODUCTION: Patients with psoriasis often use botanical therapies as part of their treatment. It is important for clinicians to be aware of the current evidence regarding these agents as they treat patients. METHODS: A systematic literature search was conducted using the PubMed, MEDLINE, and EMBASE database for randomized clinical trials assessing the use of botanical therapeutics for psoriasis. The search included the following keywords: "psoriasis" and "plant" or "herbal" or "botanical." Citations within articles were also reviewed to identify relevant sources. The results were then further refined by route of administration, and the oral (systemic) botanical agents are reviewed herein. RESULTS: A total of 12 controlled and uncontrolled clinical trials addressing the use of oral, systemic botanical agents for psoriasis were assessed in this review. While overall evidence is limited in quantity and quality, HESA-A, curcumin, neem extract, and, to a lesser degree, Traditional Chinese Medicine seem to be the most efficacious agents. CONCLUSION: The literature addresses a large amount of studies in regards to botanicals for the treatment of psoriasis. While most agents appear to be safe, further research is necessary for evidence-based recommendation of oral botanical agents to psoriasis patients.

4 Review Inflammatory and glandular skin disease in pregnancy. 2016

Yang, Catherine S / Teeple, Mary / Muglia, Jennie / Robinson-Bostom, Leslie. ·Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island. ·Clin Dermatol · Pubmed #27265071.

ABSTRACT: A switch from cell-mediated to humoral immunity (helper T 1 [Th1] to helper T 2 [Th2] shift) during gestation plays a key role in placental immune tolerance. As a result, skin diseases that are Th2 mediated often worsen, whereas skin diseases that are Th1 mediated often improve during gestation. Also, due to fluctuations in glandular activity, skin diseases involving sebaceous and eccrine glands may flare, whereas those involving apocrine glands may improve during pregnancy. Despite these trends, inflammatory and glandular skin diseases do not always follow the predicted pattern, and courses are often diverse. We review the gestational course of inflammatory skin diseases, such as atopic dermatitis (atopic eruption of pregnancy), psoriasis, impetigo herpetiformis, urticaria, erythema annulare centrifugum, pityriasis rosea, sarcoidosis, Sweet syndrome, and erythema nodosum, as well as glandular skin diseases, including acne vulgaris, acne rosacea, perioral dermatitis, hidradenitis suppurativa, Fox-Fordyce disease, hyperhidrosis, and miliaria. For each of these diseases, we discuss the pathogenesis, clinical presentation, and management with special consideration for maternal and fetal safety.

5 Review Accumulating evidence for the association and shared pathogenic mechanisms between psoriasis and cardiovascular-related comorbidities. 2014

Shlyankevich, Julia / Mehta, Nehal N / Krueger, James G / Strober, Bruce / Gudjonsson, Johann E / Qureshi, Abrar A / Tebbey, Paul W / Kimball, Alexandra Boer. ·Department of Dermatology, Massachusetts General Hospital, Boston, Mass. · National Heart Lung and Blood Institute, Bethesda, Md. Electronic address: nehal.mehta@nih.gov. · The Rockefeller University, New York, NY. · Department of Dermatology, University of Connecticut Health Center, Farmington, Conn; Probity Medical Research, Waterloo, Ontario, Canada. · Department of Dermatology, University of Michigan, Ann Arbor, Mich. · Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, RI. · International Psoriasis Council, St Louis, Mo. ·Am J Med · Pubmed #25149424.

ABSTRACT: The International Psoriasis Council, a global nonprofit organization dedicated to advancing psoriasis research and treatment, led an initiative to better define the association of various cardiometabolic comorbidities with psoriasis. In November 2013, a workshop was held in Boston, Mass. By assembling a panel of global dermatology, immunology, and cardiovascular experts, the objective was to better define the current status of the science that explains the association of psoriasis with various cardiometabolic-related comorbidities. The International Psoriasis Council has played a historical role in associating psoriasis with various comorbidities by integrating multidisciplinary expertise to advance the scientific and clinical knowledge through publications and clinical trials. This report synthesizes the current understanding of psoriasis with various cardiometabolic risk factors by exploring the potential shared pathogenic mechanisms and genetic connectivity.

6 Clinical Trial Extension of ustekinumab maintenance dosing interval in moderate-to-severe psoriasis: results of a phase IIIb, randomized, double-blinded, active-controlled, multicentre study (PSTELLAR). 2017

Blauvelt, A / Ferris, L K / Yamauchi, P S / Qureshi, A / Leonardi, C L / Farahi, K / Fakharzadeh, S / Hsu, M-C / Li, S / Chevrier, M / Smith, K / Goyal, K / Chen, Y / Muñoz-Elías, E J / Callis Duffin, K. ·Oregon Medical Research Center, Portland, OR, U.S.A. · Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, U.S.A. · Dermatology Institute and Skin Care Center, Santa Monica, CA, U.S.A. · Geffen School of Medicine at UCLA, Los Angeles, CA, U.S.A. · Dermatology, Warren Alport Medical School of Brown University, Rhode Island Hospital, Providence, RI, U.S.A. · Dermatology, Saint Louis University School of Medicine, Saint Louis, MO, U.S.A. · Janssen Pharmaceuticals Inc., Horsham, PA, U.S.A. · Janssen Research & Development LLC, Spring House, PA, U.S.A. · Janssen Research & Development LLC, Titusville, NJ, U.S.A. · Janssen Research & Development LLC, Horsham, PA, U.S.A. · Janssen Research & Development LLC, San Diego, CA, U.S.A. · Dermatology, University of Utah, Salt Lake City, UT, U.S.A. ·Br J Dermatol · Pubmed #28600818.

ABSTRACT: BACKGROUND: Phase III studies showed that some patients maintained response for ≥ 6 months following ustekinumab discontinuation. OBJECTIVES: To assess clinical responses with extended ustekinumab maintenance dosing intervals. METHODS: Adults with moderate-to-severe plaque psoriasis received ustekinumab at weeks 0, 4 and 16 during open-label treatment. Patients achieving a week-28 Physician's Global Assessment (PGA) score of cleared/minimal (PGA = 0/1) were randomized 1 : 4 to group 1 [approved every 12 weeks (q12 wk) maintenance] or group 2 (q12-24 wk; response-based dosing determined by time to loss of PGA = 0/1). Key end points included the number of visits with PGA = 0/1 (primary end point) and ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) between weeks 88 and 112, and PGA/PASI responses between weeks 28 and 112. RESULTS: Overall, 378 patients achieved PGA = 0/1 at week 28 and were randomized to group 1 (n = 76) or group 2 (n = 302). Patients in group 1 had numerically greater mean numbers of visits with PGA = 0/1 than group 2 and also with PASI 75 from week 88 to 112. A higher proportion of patients in group 1 (55%) than group 2 (39%) had PGA = 0/1 at all seven visits from week 88 to 112. Maintenance of response was observed with dose-interval extension beyond q12 wk in a subset of patients. Extending the dosing interval did not affect antibody development or safety. CONCLUSIONS: Efficacy was better maintained among week-28 PGA responders randomized to continue q12 wk ustekinumab vs. extending maintenance dosing based on clinical response, although some patients maintained high levels of efficacy with up to q24 wk dosing.

7 Article Inflammatory dietary pattern and incident psoriasis, psoriatic arthritis, and atopic dermatitis in women: A cohort study. 2019

Bridgman, Alanna C / Qureshi, Abrar A / Li, Tricia / Tabung, Fred K / Cho, Eunyoung / Drucker, Aaron M. ·School of Medicine, Queen's University, Kingston, Canada. · Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island. · Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. · Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada; Women's College Research Institute and Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada. Electronic address: aaron.drucker@wchospital.ca. ·J Am Acad Dermatol · Pubmed #30797850.

ABSTRACT: BACKGROUND: Diet is a modulator of inflammation that might impact inflammatory skin diseases. OBJECTIVE: To assess the relationship between pro-inflammatory dietary patterns and incident psoriasis, psoriatic arthritis (PsA), and atopic dermatitis (AD). METHODS: We conducted cohort studies among women in the Nurses' Health Study II. The Empirical Dietary Inflammatory Pattern (EDIP) score was calculated at baseline and every 4 years. Incident psoriasis, PsA, and AD were assessed by validated self-report. We used multivariable-adjusted Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between EDIP quintiles and risk for psoriasis, PsA, and AD. RESULTS: We had 85,185 participants in the psoriasis analysis and 63,443 in the AD analysis. There were 1432 cases of psoriasis, 262 cases of PsA, and 403 cases of AD. Pro-inflammatory dietary patterns were not associated with the risk for outcomes in multivariable models (all P values for trend >.05). HRs comparing the highest to the lowest EDIP quintile were 0.99 (95% CI 0.83-1.18) for psoriasis, 1.22 (95% CI 0.81-1.83) for PsA, and 0.96 (95% CI 0.69-1.34) for AD. LIMITATIONS: Recall and self-report. CONCLUSION: Our findings do not support dietary inflammatory potential as a risk factor for psoriasis, PsA, or AD.

8 Article All-cause and cause-specific mortality in psoriasis: A systematic review and meta-analysis. 2019

Dhana, Ashar / Yen, Hsi / Yen, Hsuan / Cho, Eunyoung. ·Division of Dermatology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. Electronic address: ashardhana@live.com. · Department of Dermatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. · Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taoyuan, Taiwan. · Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island. ·J Am Acad Dermatol · Pubmed #30590074.

ABSTRACT: BACKGROUND: An overview of mortality risk associated with psoriasis is lacking. OBJECTIVE: To perform a systematic review and meta-analysis of mortality risk in psoriasis. METHODS: We included studies reporting all-cause or cause-specific mortality risk estimates in psoriasis patients compared with general population or subjects free of psoriasis. We calculated pooled relative risks (RRs) and 95% confidence intervals (CIs). RESULTS: We included 12 studies. The pooled RRs for all-cause mortality were 1.21 (95% CI 1.14-1.28) in psoriasis, 1.13 (95% CI 1.09-1.16) in mild psoriasis, and 1.52 (95% CI 1.35-1.71) in severe psoriasis. The pooled RRs for cardiovascular mortality were 1.15 (95% CI 1.09-1.21) in psoriasis, 1.05 (95% CI 0.92-1.20) in mild psoriasis, and 1.38 (95% CI 1.09-1.74) in severe psoriasis. For noncardiovascular causes, mortality risk from liver disease, kidney disease, and infection was significantly increased in psoriasis, regardless of disease severity. The mortality risk in liver and kidney disease was the highest. There was also a significantly increased mortality risk associated with neoplasms in severe psoriasis patients and chronic lower respiratory disease in all and mild psoriasis patients. LIMITATIONS: Although associations were consistent, their magnitude was heterogenous. CONCLUSION: Psoriasis is associated with an increased risk for mortality from all causes (in a dose-response manner with disease severity) and from several specific causes.

9 Article Network meta-analyses of systemic treatments for psoriasis: a critical appraisal: Original Articles: Jabbar-Lopez ZK, Yiu ZZN, Ward V et al. Quantitative evaluation of biologic therapy options for psoriasis: a systematic review and network meta-analysis. J Invest Dermatol 2017; 137:1646-54. Sbidian E, Chaimani A, Garcia-Doval I et al. Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis. Cochrane Database Syst Rev 2017; 12:CD011535. 2019

Ellis, A G / Flohr, C / Drucker, A M. ·School of Public Health, Brown University, Providence, RI, U.S.A. · Institute for Clinical and Economic Review, Boston, MA, U.S.A. · Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, U.K. · Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada. · Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, Canada. ·Br J Dermatol · Pubmed #30347448.

ABSTRACT: AIM: There are numerous systemic medications in use for psoriasis, with additional investigational agents being studied. However, head-to-head, randomized clinical trials are rare and cannot feasibly compare all treatments. A network meta-analysis (NMA) synthesizes the available evidence to provide estimates for all pairwise comparisons. Here, we summarize and appraise two recent NMAs that assessed systemic therapies for moderate-to-severe psoriasis. SETTING AND DESIGN: Two systematic reviews searched databases and the grey literature to identify relevant randomized clinical trials. STUDY PARTICIPANTS: The reviews mostly included trials that involved adults with moderate-to-severe psoriasis. One of the reviews also included two trials involving children. STUDY EXPOSURE: Interventions common to both reviews include adalimumab, etanercept, infliximab, ustekinumab, ixekizumab, secukinumab and methotrexate. One of the reviews included additional interventions, primarily other biological agents along with new small-molecule treatments and systemic conventional treatments. PRIMARY OUTCOMES: One review focused on 'clear/nearly clear' and withdrawals from adverse events as study outcomes, while the second review focused on improvement of ≥ 90% measured on the Psoriasis Area and Severity Index (PASI 90) and serious adverse events. OUTCOMES: Additional outcomes included quality of life, PASI 75, Physician's Global Assessment of 0/1 and any adverse event. RESULTS: Overall, both NMAs are of high quality and provide a comprehensive summary of the evidence base and treatment effects. Results, in terms of both estimates and rankings, suggest that newer biologics targeting the interleukin (IL)-12/23 and IL-17 axes appear to be more effective than older biologics and oral agents. CONCLUSIONS: Patients, clinicians and policy makers can use the relative efficacy assessments of NMAs to inform decision making regarding the clearance of psoriasis skin lesions at relevant time points and improvement in quality of life.

10 Article Semantic and psychometric validation of the Brazilian Portuguese version (PASE-P) of the Psoriatic Arthritis Screening and Evaluation questionnaire. 2018

Costa, Carolina Zorzanelli / Goldenstein-Schainberg, Claudia / Carneiro, Sueli / Rodrigues, José Joaquim / Romiti, Ricardo / Barros, Thiago Bitar Martins / Martins, Gladys / Carneiro, Jamile / Grynszpan, Rachel / Sampaio, Ana Luisa / Mendonça, Tânia Maria Silva / Silva, Carlos Henrique Martins / Qureshi, Abrar A / Pinto, Rogerio de Melo Costa / Ranza, Roberto. ·Universidade Federal Uberlândia, Uberlândia, Brasil. · Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil. · Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil. · Hospital Universitário de Brasília, Brasília, Brasil. · Warren Alpert Medical School, Brown University, Providence, Rhode Island, United States of America. ·PLoS One · Pubmed #30308020.

ABSTRACT: PASE (Psoriatic Arthritis Screening and Evaluation) was developed in the English language to screen for inflammatory arthritis among patients with psoriasis. It is 15 item self administered questionnaire with a score from 15 to 75. A higher score indicates a greater risk for inflammatory joint disease. The purpose of this study was to translate, adapt and validate this questionnaire into Brazilian Portuguese (PASE-P). METHODS: 465 patients diagnosed with psoriasis (158 with psoriatic arthritis confirmed by a rheumatologist according to the CASPAR criteria and 307 without) were evaluated in dermatology clinics. We performed the analysis of semantic equivalence in eight steps. For psychometric equivalence, we evaluated the data quality, reliability, construct validity, well-known groups and discriminant characteristics of the items, as well as a ROC curve to determine optimal PASE-P cutoff points in case identification and their sensitivity / specificity. The final version presented excellent reproducibility (CCI = 0.97) and reliability (Cronbach's alpha> 0.9). A cut-off point of 25 distinguished between patients with and without psoriatic arthritis, with sensitivity of 69.5 and specificity of 86.8. PASE-P proved to be culturally valid and reliable to screen for psoriatic arthritis in Brazilian patients with psoriasis.

11 Article Commentary on Long-Pulsed Nd: YAG Laser Treatment for Nail Psoriasis. 2018

Knackstedt, Thomas / Jellinek, Nathaniel J. ·Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio Dermatology Professionals, Inc., East Greenwich, Rhode Island Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts. ·Dermatol Surg · Pubmed #29053541.

ABSTRACT: -- No abstract --

12 Article Polyphenotypic Psoriasis: A Report from the GRAPPA 2016 Annual Meeting. 2017

Kaskas, Nadine / Merola, Joseph F / Qureshi, Abrar A / Paek, So Yeon. ·From the Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. · N. Kaskas, MD, Department of Dermatology, Warren Alpert Medical School, Brown University; J.F. Merola, MD, MMSc, Brigham and Women's Hospital, Harvard Medical School; A.A. Qureshi, MD, MPH, Department of Dermatology, Warren Alpert Medical School, Brown University; S.Y. Paek, MD, FAAD, Warren Alpert Medical School, Brown University. · From the Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. soyeon_paek@brown.edu. · N. Kaskas, MD, Department of Dermatology, Warren Alpert Medical School, Brown University; J.F. Merola, MD, MMSc, Brigham and Women's Hospital, Harvard Medical School; A.A. Qureshi, MD, MPH, Department of Dermatology, Warren Alpert Medical School, Brown University; S.Y. Paek, MD, FAAD, Warren Alpert Medical School, Brown University. soyeon_paek@brown.edu. ·J Rheumatol · Pubmed #28461530.

ABSTRACT: Recent groundbreaking therapies for psoriasis target specific pathways that drive this systemic inflammatory disease. However, patients with nonplaque psoriasis phenotypes often do not qualify for these therapies and are currently undertreated because of the criteria used during the development of novel agents. We propose use of the phrase "polyphenotypic psoriasis" to describe both plaque and nonplaque subtypes, as well as single and multiple phenotype involvement in individual patients. The goal of using the phrase "polyphenotypic psoriasis" is to remind clinicians about the heterogeneous manifestations of psoriasis in addition to chronic plaque psoriasis.

13 Article Nail Enthesis Ultrasound in Psoriasis and Psoriatic Arthritis: A Report from the 2016 GRAPPA Annual Meeting. 2017

Cunha, Joanne Szczygiel / Qureshi, Abrar A / Reginato, Anthony M. ·From the Division of Rheumatology, and Division of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. Joanne_szczygiel@brown.edu. · J.S. Cunha, MD, Division of Rheumatology, The Warren Alpert Medical School of Brown University; A.A. Qureshi, MD, Division of Dermatology, The Warren Alpert Medical School of Brown University; A.M. Reginato, PhD, MD, Division of Rheumatology, The Warren Alpert Medical School of Brown University. Joanne_szczygiel@brown.edu. · From the Division of Rheumatology, and Division of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. · J.S. Cunha, MD, Division of Rheumatology, The Warren Alpert Medical School of Brown University; A.A. Qureshi, MD, Division of Dermatology, The Warren Alpert Medical School of Brown University; A.M. Reginato, PhD, MD, Division of Rheumatology, The Warren Alpert Medical School of Brown University. ·J Rheumatol · Pubmed #28461527.

ABSTRACT: Musculoskeletal ultrasonography is gaining favor in the evaluation of enthesitis in patients with psoriasis and psoriatic arthritis (PsA). Imaging modalities have shown that the enthesis of the distal interphalangeal joint has a close relationship to the nail itself. Studies have focused on the structure and morphology of nails to determine an association between psoriasis nail changes and the presence or severity of PsA. With the use of higher frequency probes, power Doppler (PD) can determine subclinical inflammation of the area under ultrasound examination. At the 2016 meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), we proposed an ultrasonographic index for the assessment of the nail enthesis to identify the morphologic and PD findings of the nail, with the potential that both rheumatologists and dermatologists can use it to evaluate their patients.

14 Article Effects of tofacitinib on cardiovascular risk factors and cardiovascular outcomes based on phase III and long-term extension data in patients with plaque psoriasis. 2016

Wu, Jashin J / Strober, Bruce E / Hansen, Peter R / Ahlehoff, Ole / Egeberg, Alexander / Qureshi, Abrar A / Robertson, Debbie / Valdez, Hernan / Tan, Huaming / Wolk, Robert. ·Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. Electronic address: jashinwu@gmail.com. · University of Connecticut Health Center, Farmington, Connecticut; Probity Medical Research, Waterloo, Ontario, Canada. · Department of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark. · Department of Cardiology, Copenhagen University Hospital Rigshospitalet, The Heart Centre, Copenhagen, Denmark. · Department of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark; Department of Dermato-Allergology, Herlev and Gentofte Hospital, Hellerup, Denmark. · Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island. · Pfizer location in Collegeville, Collegeville, Pennsylvania. · Pfizer location in New York, New York, New York. · Pfizer location in Groton, Groton, Connecticut. ·J Am Acad Dermatol · Pubmed #27498960.

ABSTRACT: BACKGROUND: Psoriasis is a systemic inflammatory condition that is associated with a higher risk of cardiovascular (CV) disease. Tofacitinib is being investigated as a treatment for psoriasis. OBJECTIVE: We sought to evaluate the effects of tofacitinib on CV risk factors and major adverse CV events (MACEs) in patients with plaque psoriasis. METHODS: Changes in select CV risk factors and the incidence rate (IR) of MACEs were evaluated in patients who were treated with tofacitinib. RESULTS: Tofacitinib treatment was associated with small, dose-dependent increases in total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol, while the total/HDL cholesterol ratio was unchanged. There were no changes in blood pressure and glycated hemoglobin levels; C-reactive protein levels decreased. The IRs of a MACE were low and similar for both tofacitinib doses. Among 3623 subjects treated with tofacitinib, the total patient-years of exposure was 5204, with a median follow-up of 527 days, and the IR of MACEs was 0.37 (95% confidence interval, 0.22-0.57) patients with events per 100 patient-years. LIMITATIONS: There was relatively short follow-up time for patients who had MACEs. CONCLUSIONS: While treatment with tofacitinib is associated with a small increase in cholesterol levels, the total/HDL cholesterol ratio does not change, there are no unfavorable changes in several CV risk factors, and the incidence of MACEs is low.

15 Article Personal history of psoriasis and risk of nonmelanoma skin cancer (NMSC) among women in the United States: A population-based cohort study. 2016

Dai, Hongji / Li, Wen-Qing / Qureshi, Abrar A / Han, Jiali. ·Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China; Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana; Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana. · Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island. · Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China; Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana; Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: jialhan@iu.edu. ·J Am Acad Dermatol · Pubmed #27436157.

ABSTRACT: BACKGROUND: To our knowledge, no prospective studies have examined the association between personal history of psoriasis and risk of nonmelanoma skin cancer. OBJECTIVE: We sought to examine this association based on 2 prospective cohorts, the Nurses' Health Study and Nurses' Health Study II. METHODS: Diagnoses of nonmelanoma skin cancer, including basal cell carcinoma and squamous cell carcinoma (SCC), were obtained by self-reported questionnaires. Information on clinician-diagnosed psoriasis and diagnosis year was collected and validated with a supplementary questionnaire. RESULTS: After 2,487,941 and 2,478,148 person-years of follow-up, we documented 1725 SCC cases and 16,075 basal cell carcinoma cases, respectively. For the combined cohorts, personal history of psoriasis was associated with an elevated risk of SCC, with a multivariate-adjusted relative risk (RR) of 1.51 (95% confidence interval [CI] 1.11-2.05). The associations appeared stronger with increasing psoriasis severity, with RR of 1.42 (95% CI 0.94-2.15) in the mild psoriasis group and RR of 1.99 (95% CI 0.74-5.32) in the moderate to severe psoriasis group (P trend = .03). There was no association between psoriasis and the risk of basal cell carcinoma (RR 0.95; 95% CI 0.75-1.18). LIMITATIONS: Lack of treatment data may bias the result. CONCLUSION: Personal history of psoriasis may be associated with an increased risk of SCC. Further investigations are warranted to understand the underlying mechanisms.

16 Article Comprehensive Assessment of the Psoriasis Patient (CAPP): A Report from the GRAPPA 2015 Annual Meeting. 2016

Paek, So Yeon / Thompson, Jordan M / Qureshi, Abrar A / Merola, Joseph F / Husni, M Elaine. ·From the Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA; Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; and Cleveland Clinic, Cleveland, Ohio, USA.S.Y. Paek, MD, Warren Alpert Medical School of Brown University; J.M. Thompson, BS, Warren Alpert Medical School of Brown University; A.A. Qureshi, MD, MPH, Department of Dermatology, Warren Alpert Medical School, Brown University; J.F. Merola, MD, MMSc, Brigham and Women's Hospital, Harvard Medical School; M.E. Husni, MD, Cleveland Clinic. ·J Rheumatol · Pubmed #27134270.

ABSTRACT: Outcome measures for psoriasis severity are complex because of the heterogeneous presentation of the disease. At the 2015 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members introduced the Comprehensive Assessment of the Psoriasis Patient (CAPP), a novel disease severity measure to more accurately assess the full burden of plaque psoriasis and subtypes, including inverse, scalp, nail, palmoplantar, and genital psoriasis. The CAPP is based on a 5-point physician's global assessment for 7 psoriasis phenotypes and incorporates visual analog scale-based, patient-derived, patient-reported outcomes. By quantifying disease effects of plaque psoriasis, 6 other psoriasis subtypes, as well as quality of life and daily function, the CAPP survey identifies a subset of psoriasis patients with moderate to severe psoriasis that would not be considered moderate to severe when assessed by the Psoriasis Area and Severity Index. The current version of CAPP is focused entirely on psoriasis. Feedback from our industry colleagues and collaborators has suggested that a psoriatic arthritis (PsA) measure may be important to include in the CAPP. At the 2015 GRAPPA meeting, we administered a survey to 106 GRAPPA members to determine whether a PsA measure should be included. A majority (74%) of respondents across all professions agreed that the CAPP should include a measure of PsA. Although responses varied widely on how PsA should be measured, a majority of the respondents reported that presence of PsA in both peripheral and axial joint assessment was important.

17 Article Prevalence of psoriasis phenotypes among men and women in the USA. 2016

Merola, J F / Li, T / Li, W-Q / Cho, E / Qureshi, A A. ·Department of Dermatology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. · Division of Rheumatology, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. · Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. · Department of Dermatology, Alpert School of Medicine, Brown University, Providence, RI, USA. · Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA. ·Clin Exp Dermatol · Pubmed #26890045.

ABSTRACT: BACKGROUND: We present the largest set of US prevalence data for psoriasis to date, obtained from three prospective cohort studies describing validated clinical phenotypes of psoriasis, including novel data about the prevalence of inverse (intertriginous) psoriasis in these groups. Nonplaque psoriasis phenotypes have been largely unmeasured in observational and interventional studies, and this has led to an under-recognition of this aspect of psoriatic disease. AIM: To describe the prevalence of nonplaque psoriasis phenotypes in a large prospective cohort. METHODS: We included 3179 women and 646 men in the analysis. Participants in the Nurses Health Study (NHS) and Health Professionals Follow-up Study (HPFS) with physician-diagnosed psoriasis completed a validated, self-administered questionnaire to assess plaque and nonplaque subsets of psoriasis. RESULTS: Psoriasis phenotypes were as follows: plaque 55%, scalp 52%, palmar-plantar 14%, nail 23% and inverse 21% in the NHS (n = 1604); plaque 60%, scalp 56%, palmar-plantar 16%, nail 27% and inverse 24% in the second NHS study (NHS II) (n = 1575); and plaque 55%, scalp 45%, palmar-plantar 12%, nail 27% and inverse 30% in the HPFS (n = 646). Scalp, nail, palmar-plantar and inverse disease represent highly prevalent phenotypes of psoriasis in the USA. CONCLUSION: Scalp, nail, palmar-plantar and inverse disease represent highly prevalent phenotypes of psoriasis.

18 Article Hormonal Factors and Risk of Psoriasis in Women: A Cohort Study. 2016

Wu, Shaowei / Cho, Eunyoung / Li, Wenqing / Grodstein, Francine / Qureshi, Abrar A. ·Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, USA. ·Acta Derm Venereol · Pubmed #26658522.

ABSTRACT: Previous studies suggest that hormonal factors modulate the natural course of psoriasis in women. However, the association of hormonal factors with psoriasis risk has not been assessed using prospective data. We carried out a thorough prospective analysis on the topic in 163,763 women in the Nurses' Health Study I and II. Participants provided information on age at menarche, parity, menopause status, and exogenous hormone use (oral contraceptive and postmenopausal hormone therapy) over the follow-up. We ascertained 1,253 incident psoriasis cases over 2 million person-years. Psoriasis risk appeared to be higher in women with always irregular menstrual cycles in adulthood (multivariate-adjusted hazard ratio=1.32, 95% CI: 1.01-1.73, compared with regular cycles) and surgical menopause (hazard ratio=1.19, 95% CI: 1.01-1.40, compared with natural menopause). Hormone therapy had suggestive but insignificant associations with psoriasis risk. Our results suggest little evidence for hormonal factors and risk of psoriasis in women that need further investigation.

19 Article Epidemiology of concomitant psoriasis and hidradenitis suppurativa (HS): experience of a tertiary medical center. 2015

Patel, Mital / Cohen, Jeffrey M / Wright, Natalie A / Merola, Joseph F / Qureshi, Abrar A / Vleugels, Ruth Ann. ·Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: mpatel21@partners.org. · Harvard Medical School, Boston, Massachusetts. · Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. · Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Medicine, Division of Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. · Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island. ·J Am Acad Dermatol · Pubmed #26369843.

ABSTRACT: -- No abstract --

20 Article Risk of depression in women with psoriasis: a cohort study. 2015

Dommasch, E D / Li, T / Okereke, O I / Li, Y / Qureshi, A A / Cho, E. ·Department of Dermatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, U.S.A. · Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, U.S.A. · Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A. · Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, U.S.A. · Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A. · Department of Epidemiology, Brown School of Public Health, Providence, RI, U.S.A. · Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, U.S.A. ·Br J Dermatol · Pubmed #26186277.

ABSTRACT: BACKGROUND: Psoriasis is a common, chronic and inflammatory disease of the skin, which has been associated with depression in cross-sectional studies with limited adjustment for confounders. OBJECTIVES: In this prospective cohort study, we investigated the risk of incident depression among individuals with psoriasis and psoriatic arthritis (PsA). METHODS: We included 50 750 US female nurses from the Nurses' Health Study who were free of depression at baseline in 2000. Those participants who had ever self-reported clinician-diagnosed depression or regular use of antidepressants, or had a Mental Health Inventory score of ≤ 52 were excluded. In 2008, we retrospectively asked participants if they had ever received a physician's diagnosis of psoriasis or PsA. We defined depression as self-report of clinician-diagnosed depression or regular use of antidepressant medication. Time-dependent Cox proportional hazard models were used to estimate age and multivariate-adjusted relative risks (RRs) of clinical depression. RESULTS: After adjusting for covariates including body mass index, physical activity, smoking and the presence of major chronic conditions, the multivariate-adjusted RRs of clinical depression were 1·29 [95% confidence interval (CI) 1·10-1·52] for women with psoriasis and 1·52 (95% CI 1·06-2·19) for women with psoriasis and concomitant PsA, compared with women without psoriasis. CONCLUSIONS: We found an increased risk of depression in US women with psoriasis compared with those without psoriasis. This risk was higher in those who reported concomitant PsA. Future studies are needed to confirm these findings in other populations and to identify pathophysiological mechanisms linking psoriasis to depression.

21 Article Should self-destructive behavior affect a patient's access to scarce medical resources? 2015

Yang, Catherine S / Kroumpouzos, George / Bercovitch, Lionel. ·Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Electronic address: catherine_yang@brown.edu. · Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island. ·J Am Acad Dermatol · Pubmed #26089050.

ABSTRACT: -- No abstract --

22 Article Psoriatic arthritis: it's as easy as "PSA". 2015

Cohen, Jeffrey M / Husni, M Elaine / Qureshi, Abrar A / Merola, Joseph F. ·Harvard Medical School, Boston, Massachusetts. · Department of Rheumatologic and Immunologic Disease, Cleveland Clinic and Cleveland Clinic Learner College of Medicine of Case Western Reserve University, Cleveland, Ohio. · Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island. · Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Medicine, Division of Rheumatology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: jfmerola@partners.org. ·J Am Acad Dermatol · Pubmed #25890458.

ABSTRACT: -- No abstract --

23 Article Alcohol intake and risk of incident psoriatic arthritis in women. 2015

Wu, Shaowei / Cho, Eunyoung / Li, Wen-Qing / Han, Jiali / Qureshi, Abrar A. ·From the Department of Dermatology, and the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts; Department of Dermatology, the Warren Alpert Medical School of Brown University, Rhode Island; Department of Epidemiology, Richard M. Fairbanks School of Public Health, the Melvin and Bren Simon Cancer Center, and the Department of Dermatology, School of Medicine, Indiana University, Indianapolis, Indiana, USA.S. Wu, PhD, Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, and Department of Dermatology, The Warren Alpert Medical School of Brown University; E. Cho, ScD, Department of Dermatology, The Warren Alpert Medical School of Brown University, and the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School; W.Q. Li, PhD, Department of Dermatology, The Warren Alpert Medical School of Brown University; J. Han, PhD, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and the Department of Epidemiology, Richard M. Fairbanks School of Public Health, Melvin and Bren Simon Cancer Center, and the Department of Dermatology, School of Medicine, Indiana University; A.A. Qureshi, MD, MPH, Department of Dermatology, The Warren Alpert Medical School of Brown University, and the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School. ·J Rheumatol · Pubmed #25834201.

ABSTRACT: OBJECTIVE: Alcohol intake has been associated with an increased risk of psoriasis. However, the association between alcohol intake and risk of psoriatic arthritis (PsA) has been unclear. We evaluated the association between alcohol intake and risk of incident PsA in a large cohort of US women. METHODS: Our present study included a total of 82,672 US women who provided repeated data on alcohol intake over the followup period (1991-2005). Self-reported PsA was validated using the Psoriatic Arthritis Screening and Evaluation (PASE) questionnaire. Cox proportional hazards models were used to estimate the age-adjusted and multivariate-adjusted HR and 95% CI for the PsA in association with alcohol intake. RESULTS: We documented 141 incident PsA cases during 14 years (1,137,763 person-yrs) of followup. Compared to non-drinkers, the multivariate HR for PsA were 0.70 (95% CI 0.48-1.01) for 0.1-14.9 g/day, 1.43 (95% CI 0.67-3.08) for 15.0-29.9 g/day, and 4.45 (95% CI 2.07-9.59) for ≥ 30.0 g/day of cumulative average alcohol intake. Risk estimates were generally consistent when using updated alcohol intake and baseline alcohol intake in 1991 as the exposures, and when the analysis was restricted to those who developed psoriasis during the followup. CONCLUSION: Excessive alcohol intake was associated with an increased risk of incident PsA in a cohort of US women.

24 Article Prevalence of psoriatic arthritis in a large cohort of Brazilian patients with psoriasis. 2015

Ranza, Roberto / Carneiro, Sueli / Qureshi, Abrar A / Martins, Gladys / Rodrigues, Jose Joaquim / Romiti, Ricardo / Barros, Thiago Bitar M / Carneiro, Jamille / Sampaio, Ana Luisa / Grynszpan, Rachel / Markus, Juliana / Pinto, Rogerio Melo Costa / Goldenstein-Schainberg, Claudia. ·From the Rheumatology Unit, Hospital de Clinicas, and Department of Statistics, Faculdade de Matemática, Universidade Federal Uberlândia, Minas Gerais; Dermatology Department and Rheumatology Department, Hospital Universitario Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro; Rheumatology Unit, Hospital Universitário de Brasilia, Brasilia; Department of Dermatology, Hospital de Clinicas da Universidade de São Paulo; Rheumatology Division, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.R. Ranza, MD, Professor, Rheumatology Unit; J.J. Rodrigues, MD, Dermatology Unit; J. Markus, MD, Rheumatology Unit, Hospital de Clinicas, Universidade Federal Uberlândia; S. Carneiro, MD, PhD, Associate Professor, Dermatology and Rheumatology Department;A.L. Sampaio, MD, Dermatology Department, Hospital Universitario Clementino Fraga Filho, Universidade Federal do Rio de Janeiro; A.A. Qureshi, MD, MPH, Professor and Chair, Department of Dermatology, Warren Alpert Medical School, Brown University; G. Martins, MD, Professor of Dermatology; J. Carneiro, MD, Rheumatology Unit, Hospital Universitário de Brasilia; R. Romiti, MD, Professor, Department of Dermatology, Hospital de Clinicas da Universidade de São Paulo; T.B. Barros, MD, Rheumatology Division, Faculdade de Medicina; C. Goldenstein-Schainberg, MD, PhD, Professor, Disciplina de Reumatologia Faculdade de Medicina, Universidade de São Paulo; R. Grynszpan, MD, Dermatology Department, Hospital Universitario Clementino Fraga Filho, Universidade Federal do Rio de Janeiro; R.M. Pinto, PhD, Professor, Department of Statistics, Faculdade de Matemática, Universidade Federal Uberlândia. ·J Rheumatol · Pubmed #25729032.

ABSTRACT: OBJECTIVE: To determine the prevalence of psoriatic arthritis (PsA) in a large cohort of Brazilian patients with psoriasis (PsO) being seen at dermatology centers. METHODS: A multicenter study was conducted in 4 university dermatology clinics. In each center, consecutive patients with confirmed diagnoses of PsO were evaluated by a rheumatologist. Individuals were classified as having PsA according to the ClASsification criteria for Psoriatic ARthritis (CASPAR). Laboratory tests and radiographs were performed, as needed, based on the clinical judgment of the rheumatologist. RESULTS: A total of 524 patients with PsO were evaluated. The mean age was 48.5 ± 14.5 years, 50% were women, and the mean PsO duration was 15.4 ± 11.7 years. A diagnosis of PsA was documented in 175 patients (33%), of whom 49% were newly identified by the rheumatologist. Most individuals with PsA (72%) had peripheral involvement, 11% had isolated axial involvement, and 17% had both peripheral and axial involvement. Dactylitis occurred in 20% and clinical enthesitis in 30% of the patients. Laboratory and/or radiograph tests were necessary for a definitive diagnosis of PsA in 42 of 175 individuals (24%). CONCLUSION: In our study, one-third of Brazilian patients with PsO, followed in dermatology settings, were diagnosed with PsA by a rheumatologist. Almost half of subjects with PsA had no previous diagnosis. A collaboration between dermatologists and rheumatologists is greatly needed to establish earlier PsA diagnoses and adequate multidisciplinary management.

25 Article Personal history of gallstones and risk of incident psoriasis and psoriatic arthritis in U.S. women. 2015

Tong, L X / Wu, S / Li, T / Qureshi, A A / Giovannucci, E L / Cho, E. ·Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, U.S.A. · Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, U.S.A. · Department of Dermatology, Warren Alpert Medical School, Brown University, 339 Eddy Street, Providence, RI, 02903, U.S.A. · Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, U.S.A. · Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, U.S.A. ·Br J Dermatol · Pubmed #25307342.

ABSTRACT: BACKGROUND: Metabolic syndrome has been associated with both gallstones and psoriasis, suggesting a potential biological linkage between gallstones and psoriasis. However, the association between gallstones and psoriasis has not yet been studied. OBJECTIVES: To investigate the association between gallstones and psoriasis. METHODS: This was a prospective cohort study [Nurses' Health Study II (1991-2005)]. Women aged 25-42 years who were free from psoriasis at baseline and who responded to a 2005 follow-up questionnaire regarding their diagnosis of psoriasis were included (n = 89,230). The relative risk (RR) of developing psoriasis or psoriatic arthritis (PsA), which were self-reported and validated by supplemental questionnaires, was measured. RESULTS: In this population, 2206 participants had gallstones confirmed by a history of cholecystectomy at baseline. A total of 642 individuals had a diagnosis of incident psoriasis, of whom 157 had concomitant PsA. After adjusting for known risk factors of psoriasis besides body mass index (BMI), a baseline history of cholecystectomy-confirmed gallstones was associated with increased risk of psoriasis [multivariate-adjusted RR 2·20, 95% confidence interval (CI) 1·56-3·10] and concomitant PsA (multivariate-adjusted RR 4·41, 95% CI 2·70-7·18). After additionally adjusting for BMI, the fully adjusted RRs associated with a history of cholecystectomy-confirmed gallstones were 1·70 (95% CI 1·20-2·41) for psoriasis and 2·96 (95% CI 1·80-4·89) for PsA. CONCLUSIONS: Personal history of gallstones was associated with an increased risk of psoriasis and PsA, independent of obesity, in a cohort of U.S. women.

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