IADVL
Indexed with PubMed and Science Citation Index (E) 
 
Users online: 3153 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  Navigate here 
  Search
 
   Next article
   Previous article 
   Table of Contents
  
 Resource links
   Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
  Related articles
   [PDF Not available] *
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
    Introduction
    Materials and Me...
    Results
    Discussion
    References

 Article Access Statistics
    Viewed8401    
    Printed208    
    Emailed14    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal

 
ORIGINAL ARTICLE
Year : 2001  |  Volume : 67  |  Issue : 2  |  Page : 66-68

Disease concomitance in psoriasis: A clinical study of 61 cases


Department of Skin and STD, Kasturba Medical Collge, Mangalore. Karnataka-575 001, India

Correspondence Address:
Mavilethu House, Cherukole P.O, Mavelikara, Kerala-690104, India

   Abstract 

Sixty-one patients with psoriasis were studied for concomitant diseases and compared with 61 age and sex-matched controls. Concomitant cutaneous diseases most often seen with psoriasis were lichen simplex chronicus (16.3%), verruca vulgaris (9.8%) and me Iasina (4.9%). Of the systemic disorders, diabetes showed the highest frequency (13.1%) followed by hypertension (8.1%). Two patients had HIV infection (3.2%). Both the patients had severe and atypical lesions.

How to cite this article:
Alexander E, Pinto J, Pal GS, Kamath N, Kuruvilla M. Disease concomitance in psoriasis: A clinical study of 61 cases. Indian J Dermatol Venereol Leprol 2001;67:66-8


How to cite this URL:
Alexander E, Pinto J, Pal GS, Kamath N, Kuruvilla M. Disease concomitance in psoriasis: A clinical study of 61 cases. Indian J Dermatol Venereol Leprol [serial online] 2001 [cited 2019 Jun 20];67:66-8. Available from: http://www.ijdvl.com/text.asp?2001/67/2/66/8301



   Introduction Top

The prevalence of other diseases associated with psoriasis has been investigated in recent years. These include cutaneous as well as systemic ones. The cutaneous diseases found to be associated include vitiligo, seborrhoeic dermatitis, bullous pemphigoid, photosensitive disorders, viral warts and others.[1] The systemic diseases found to be associated with psoriasis include diabetes, gout, ulcerative colitis, Crohn's disease, cardiac insufficiency and others.[1] In view of the different cutaneous and systemic associations, a study was done on concomitant diseases which included 61 psoriatic and 61 age - and - sex - matched control patients from Dermatology department.

   Materials and Methods Top

Sixty-one patients with psoriasis were stud­ied between January 96 and June 97, and were compared with sixty one age and sex-matched controls. History included details of psoriasis and concomitant cutaneous and systemic diseases. Detailed cutaneous and systemic examination were done. Relevant laboratory investigations were also done.

   Results Top

Among the sixty-one patients with psoria­sis, the male to female ratio was 7.7:1. The maxi­mum incidence of psoriasis was in the age group of 40-50 years.
Psoriasis vulgaris was the most common clinical type of psoriasis (91.8%). Clinical types of psoriasis are shown in [Table - 1].
Among 61 patients with psoriasis, 3 had psoriatic arthritis and these 3 patients had psoriasis vulgaris. Among the three patients of psoriatic arthritis, two had classical type (3.2%) and one had symmetric polyarticular type (1.6%). In all the 3 the skin lesions preceded arthritis.
Various changes observed in the nails in the order of frequency, were pitting (63.9%), ridging (56.3%), discolouration (47.5%), subungual hyperkeratosis (29.5%), onycholysis (16.3%), onychodystrophy (4.9%) and leukonychia (3.2%).
[Table - 2] shows concomitant cutaneous diseases in patients with psoriasis. They included leucoderma, acne vulgaris, seborrhoeic dermatitis, forefoot eczema, sebaceous cyst, freckles, folliculi­tis, alopecia areata, candidiasis and acrochordon.
Concomitant systemic diseases are shown in [Table - 3]. Of the systemic disorders noted with psoriasis, diabetes mellitus showed the highest frequency with an O/E ratio of 2.6 (O/E ratio - observed by expected ratio).

   Discussion Top

We have compared the simultaneous oc­currence of skin and systemic disorders in patients with psoriasis and in control patients without pso­riasis. As a result, a distinct group of cutaneous diseases were more frequently noted in patients with psoriasis than in age matched controls.
In our study of 61 patients 54 (88.5%) were males and 7 (11.4%) were females, which is in agreement with the male preponderance noted by (2.4% and 0.8%) many authors.[2],[3],[4]
Lichen simplex chronicus (-LSC) showed an O/E ratio of 10, which indicates that it is 10 times more common in patients with psoriasis. The high incidence of LSC in our study may be because of a bidirectional relationship i.e., if a psoriatic lesion itches, the lesion may become complicated by a lichen simplex or a lichen simplex can itch per se and the resultant rubbing may worsen the psoriasis.
Several common disorders were less fre­quent in patients with psoriasis such as eczemas, allergic contact dermatitis, urticaria, atopic derma­titis, bacterial, viral and fungal infection. This is an agreement with the study done by Henseler and Christopher.[5] According to Richard Weller,[6] the decreased incidence of skin infections caused by dermatophytes and particularly by bacteria and viruses is due to enhanced production of nitric oxide in psoriatic skin, which has antimicrobial activity against a wide range of organisms including bacteria, fungi and viruses.
Of the systemic disorders, diabetes showed the highest frequency with an O/E ratio of 2.6. This is in agreement with the study done by Sundharam[7] who showed a relationship between abnormal glucose tolerance and psoriasis.
In our study, 2 patients (3.25%) had HIV infection, and both the patients had severe and atypical lesions. This is in agreement with the find­ings of Obuch and Maurae that in HIV patients the different morphological types of psoriasis like papules, crusted and hyperkeratotic lesions co- exist. As the number of patients studied here is small, these findings have to be corroborated by studying a larger group.  

   References Top

1.Tilo Henseler, Enno Christopher. Disease concomitance in psoriasis. J Am Acad Dermatol 1995; 32:982-986.  Back to cited text no. 1    
2.Sharma T, Sepha GL. Psoriasis - Clinical study. Indian J Dermatol Venereol Leprol 1964;30 :191-197.  Back to cited text no. 2    
3.Verma KC, Bharagava NC, Chaudhary, et al. Psoriasis : a clinical and some biochemical investigative study. Indian J Dermatol Venereol Leprol 1979; 45: 32 - 36.  Back to cited text no. 3    
4.Mehta TK, Shah RN, Marquis L. A study of 300 cases of psoriasis. Indian J Dermatol Venereol Leprol 1976; 42: 67-74.  Back to cited text no. 4    
5.Henseler T, Christopher E. Psoriasis of early and late onset. Characterisation of 2 types of psoriasis vulgaris. J Am Acad Dermatol 1985; 13: 450-456.  Back to cited text no. 5    
6.Duncan C, Dougall H, Johnson P, et al. Chemical generation of nitric oxide in the mouth from the enterosalivary circulation of dietary nitrate. Nature Med 1995;1: 546-551.  Back to cited text no. 6    
7.Sudharam JA, Singh Ratan, Agarwal. Psoriasis and diabetes mellitus. Indian 3 Dermatol Venereol Leprol 1980; 46: 158-162.  Back to cited text no. 7    
8.Obuch ML, Maurer TA, Becker BG. Psoriasis and HIV infection. J Am Acad Dermatol S1992, 27: 667-673.  Back to cited text no. 8    

 

Top
Print this article  Email this article
Previous article Next article

    

Online since 15th March '04
Published by Wolters Kluwer - Medknow