COMORBIDITIES IN PSORIASIS

P 114
Relationships between the incidence of onychomycosis and nails
psoriasis
S. Valiukeviciene,* S. Kavaliauskiene,

R. Povilionyte,

J. Jakubovskiene,

D. Jasaitiene,

R. Petrauskiene,

R.P. Zarankiene,

E. Skrodeniene,

A. Vitkauskiene

*The Hospital of Kaunas University of Medicine, Kaunas, Lithuania;

Clinic
of Skin and Venereal Diseases, The Hospital of Kaunas University of
Medicine, Kaunas, Lithuania;

Department of Laboratory Medicine, the
Hospital of Kaunas University of Medicine, Kaunas, Lithuania
Background: Psoriasis is a widespread skin disorder in which nail
involvement is a common symptom. Many psoriatic patients have nail
changes morphologically resembling onychomycosis. There is some con-
troversy about the incidence of onychomycosis in patients with psoriasis
compared to non-psoriatics. We therefore measured the incidence of ony-
chomycosis among psoriatics when the nails were clinically abnormal and
non-psoriatics patients.
Objectives: The aim of the study was to determine the incidence of ony-
chomycosis in affected nails among psoriatic and non-psoriatic patients.
Methods: The study included 559 patients (168 males and 391 females)
examined for fungal infection of nails using direct microscopy and culture
tests.
Results: Thirty out of 559 patients (5.3%) (9 males and 21 females) had
psoriasis. The incidence of onychomycosis (determined according to posi-
tive results of culture tests) among psoriatic patients was 7/30 (23.3%),
compared to 125/529 (23.6%) among non-psoriatic patients (p > 0.05).
Among psoriatic patients, in 5/7 cases (71.4%) dermatophytes were
detected, and in the remaining two cases, yeast and yeast-like fungi were
found. Among non-psoriatic patients, of 125 positive cultures, dermato-
phytes, yeast and mould were detected in 66, 43 and 16 cases, respectively.
The sensitivity of the microscopic examination versus culture to the iden-
tied dermatophytes was 87.3%, and to yeast 18.6%, accordingly.
Conclusion: There was no difference in the incidence of onychomycosis
and the spectrum of fungal infection among psoriatic and non-psoriatic
patients. Onychomycosis was detected in less than one-third of patients
with clinically affected nails. The culture test is an important technique in
diagnosing onychomycosis and selecting systemic treatment.
Disclosure of Interest: None declared.
P 115
Metabolic syndrome in Japanese psoriasis patients. - correlations
with disease severities and the inuence of treatments -
T. Ito,* O. Fukuchi,* H. Katayama,* N. Takagi,* S. Kikuchi,*
H. Nakagawa,* R. Yoshihara

*Dermatology, The Jikei University, School of Medicine, Tokyo, Japan;

Internal Medicine, Division of Diabetes, Metabolism and Endocrinology,

The Jikei University, School of Medicine, Tokyo, Japan
Background: For many years, it has been reported that psoriasis patients
often develop life style-related diseases such as diabetes, lipid metabolism
disorders, hypertension, and hyperuricemia. Since the WHO published
the criteria for metabolic syndrome in 1998, the incidence of these dis-
eases and concomitant metabolic syndrome has been demonstrated to be
high in psoriasis patients. In addition, it has been increasingly reported
overseas that these concomitant diseases inuence the severity of the
symptoms of psoriasis. However, few such reports have been published in
Japan.
Objectives: In this study, we investigated the relationship between the
severity of the symptoms of Japanese patients with psoriasis and meta-
bolic syndrome.
Methods: Psoriasis patients regularly visiting our hospital were evaluated
for the presence or absence of metabolic syndrome and serum total
adiponectin and TNF-a level. The association between treatment-induced
changes of symptoms and the variation in these levels, as well as lifestyles
inuencing the treatment outcome, was also analyzed.
Results: As a result, in male psoriasis patients, a higher PASI was associ-
ated with a signicantly lower level of total serum total adiponectin. In
the male psoriasis patients, treatment-induced changes in the PASI were
not correlated with serum total adiponectin or TNF-a level. However, in
female psoriasis patients without concomitant metabolic syndrome, PASI
improvement resulted in a signicant rise in serum total adiponectin, and
the TNF-a level tended to decrease. In addition, the incidence of smoking
and drinking was signicantly higher in male psoriasis patients with con-
comitant metabolic disease, whereas the incidence of smoking was signi-
cantly higher in those without concomitant metabolic syndrome.
Conclusion: These results suggest an association between the severity of
the symptoms of psoriasis and serum total adiponectin levels, and that
smoking and drinking inuence the treatment outcome.
Disclosure of Interest: None declared.
P 116
Psoriasis and metabolic syndrome; preliminary study: experience in
the department of dermatology of telmcen (west Algeria)
O.B. Boudghene Stambouli, B.D. Dahmani*
*Dermatology, University Hospital, Tlemcen, Algeria
Background: Psoriasis is a chronic dermatosis involving erthemat-
o.squameuse keratinocyte abnormalities and chronic inammation of the
dermis and epidermis.
Objectives: The aim of our study is to identify the occurrence of meta-
bolic syndrome in patients with psoriasis.
Methods: It is a retrospective study conducted over a period of 2 years in
January 2008January 2010.dans the dermatology department at CHU
Tlemcen.
Results: We collected 207 cases: 132 men and 63.77%, 75 women
(36.23%) with a sex ratio M/F of 1.76. The metabolic abnormalities were
found in 57 cases / 207 or 27.53% of cases when the complete metabolic
synderme has been objectied in 21 cases as either a percentage of
10.14%. In the L females older than 40 years in 17/22 patients or 86% of
cases. metabolic abnormalities found in 22 cases while the complete meta-
bolic syndrome was observed in 10 cases or 13.33% of female cases com-
prised mostly from obesity (around umbilical sup 100 cm) in 100% of
patients either at 10 but if other criteria were found in different propor-
tions namely hypertension in 08 patients, dyslipidemia in 07 patients. For
all males combined anomalies were found in 35 cases of 132 or 26.5% of
cases when the complete metabolic syndrome was found in 11 cases either
a percentage of 8.33% of cases as opposed to the female population,
hypertension and dyslipidemia type 2 diabetes are most found in 15 cases
or 42% of cases. For the 02 gender psoriasis vulgaris plaque is heard in
over 70% of cases, while other clinical forms namely, and drop in, pustu-
lar, arthropatiqueerythrodermique only 30% of cases. It has been demon-
strated that this syndrome was developed mainly in patients with age-sup
to 40 years and a period of very long (over 15 years) psoriasis is the most
ancient higher the risk is high (1) it has been demonstrated that even
among the components of this syndrome, hypertension was more com-
mon among males in relation to the presence of certain risk factors such
as tobacco and alcohol while obesity and lipid disorders among females
in whom a sedentary lifestyle and diet plays an important role. (2) Is
2010 The Authors
Journal Compilation 2010 European Academy of Dermatology and Venereology JEADV (2010) 24 (Suppl. 4), 183
Poster Abstracts 51
currently known as the metabolic syndrome is an important precursor of
cardiovascular disease and the presence of psoriasis may increase the risk.
Conclusion: There is a link between psoriasis and the occurrence of met-
abolic syndrome which is common inammation.
References:
1. Sahel H, Pr Bouadjar et collaborateurs : syndrome metabolique et
psoriasis .annales de dermatoloie fevrier 2009 F32.
2. E Suarez et coll co-morbites et psoriasis annales de dermatoloie fevrier
2009 F33.
3. Mallbris L, et al. Increased risk for cardiovascular mortality in psoriasis
inpatients but not in outpatients. Eur J Epidemiol 2004; 19:225230.
Disclosure of Interest: None declared.
P 117
Weight gain associated with anti-tnfa in psoriasis: a neglected side
effect?
N. Bonnet,* A. Nuccio-Leve`que,* M.-C. Koeppel,* P. Berbis*
*Dermatology, Hopital Nord, Marseille, France
Background: Metabolic syndrome is known as a comorbidity in psoriasis.
The impact of anti-TNFa on the components of metabolic syndrome
remains unclear.
Objectives: We report four cases of signicant weight gain, independently
of dietary factors, in psoriatic patients treated with anti-TNFa.
Methods: Case n1: Male, 60-years old, treated by adalumimab. Body
Mass Index (BMI) of 30 kg/m
2
before treatment. Weight gain of 7 kg (+
6.6% in BMI) after 7 months of treatment. Case n2: Female, 78-years
old, treated by adalumimab. BMI of 30 kg/m
2
before treatment. Weight
gain of 3 kg (+ 4.5% in BMI) after 12 months of treatment. Case n3:
Female, 50-years old, treated by iniximab. BMI of 31 kg/m
2
before treat-
ment. Weight gain of 5 kg (+ 6.5% in BMI) after 12 months of treatment.
Case n4: Male, 51-years old, treated by iniximab. Body Mass Index
(BMI) of 29 kg/m
2
before treatment. Weight gain of 5 kg (+6.8% in
BMI) after 10 months of treatment.
Results: Weight gain associated with the blockage of TNFa, which is a
cachexin, is a plausible consideration. However, increase in body weight
in patients treated with anti-TNFa seems inconstant. The frequency and
potential favouring factors associated with this event remain difcult to
identify because of the small number of studies on this issue. Briot et
al.(1) observed a signicant increase in body weight (2.2 kg at 1 year) in
patients with spondyloarthropathy receiving anti-TNFa treatment. Studies
on rheumatoid arthritis had not shown this trend (2). In psoriasic
patients, Gisondi et al. (3) and Saraceno et al. (4) described a weight gain
of 2.5 kg (iniximab), 1.5 kg (etanercept) and 2.2 kg (adalumimab) after
24 weeks of treatment. An increase in BMI of 0.8 and 0.5 kg/m
2
was
observed with iniximab and etanercept, respectively. This difference in
outcome on weight and BMI after TNFa blockade may reect common
genetic predispositions in patients with psoriasis and spondylarthropathy.
Studies in psoriasis remain limited by the lack of evaluation of fat and
lean mass components. In our 4 patients, weight gain was not explained
by dietary changes.
Conclusion: Additional long-term prospective studies in a large number
of patients are needed to assess the frequency and potential predisposing
factors of this side effect, and its impact on metabolic syndrome and car-
diovascular morbidity. Finally, increase in body weight may have a thera-
peutic impact: obesity has been suggested as a factor of poor response to
xed-dosed biologics (etanercept, adalumimab) (5).
References:
1. Briot K, Gossec L, Kolta S, et al. J Rheumatol 2008;35:855861
2. Channual J, Wu JJ, Dann FJ. Dermatol Ther 2009; 22:6173
3. Gisondi P, Cotena C, Tessari G, et al. J Eur Acad Dermatol Venereol
2008;22: 341344
4. Saraceno R, Schipani C, Mazzotta A, et al. Pharmacol Res 2008;57:290
295
5. Clark L, Lebwohl M. J Am Acad Dermatol 2008; 58: 443446
Disclosure of Interest: None declared.
P 119
Assessment of the atherogenic prole of lipids and lipoprotein and
their relationship with severity of psoriasis
M. El Asmi,* A. Mebazaa,

W. Zidi,* Y. Zayani,* R. Cheikhrouhou,

S. Ouni,* T. Hdider,* M. Fkih,* M. Mokni,

A. Ben Osman,

N. Kaabachi*
*Biochemistry, La Rabta Hospital, Tunis, Tunisia;

Dermatology, La Rabta
Hospital, Tunis, Tunisia
Background: Psoriasis is a common chronic and recurrent inammatory
dermatosis that has been associated with an increased cardio-vascular risk.
Metabolic syndrome and its components especially serum lipid metabo-
lites are signicant predictors of cardiovascular events.
Objectives: To assess plasma lipid prole in psoriatic patients in compar-
ison with healthy controls, and determine their relationship with severity
of psoriasis.
Methods: Across-sectional controlled study was conducted at the Derma-
tology Department of La Rabta Hospital of Tunis from August 2008 to
December 2009. The study group has included 51 psoriatic patients (27
males and 24 females), and 71 sex- and age-matched healthy volunteers
(36 males and 35 females). Assessment of psoriasis severity was made
according to Psoriasis Area and Severity Index (PASI). Psoriasis was con-
sidered as mild (PASI < 5), moderate (5 PASI < 10) and severe (PASI
3
10). Blood samples were realized after a 12-hour fasting to measure levels
of cholesterol (CT), HDL-C and triglycerides (TG). LDL-cholesterol
(LDL-c) was calculated using the Friedewald formula.
Results: Male psoriatic patients had a higher PASI score than females
(3.4 vs. 2.4, p < 0.05). Biologically, psoriatic patients had signicantly
decreased CT (p < 0.01), and HDL-c (p < 0.001). The atherogenic ratios
CT/HDL-c and LDL-c/HDL-c were signicantly higher in psoriatic
patients (p < 0.05). In addition, statistical tests have objected a signicant
negative correlation between PASI and HDL-c (r = -0.46; p < 0.01) and a
signicant positive correlation between PASI and CT/HDL-c (r = 0.33;
p < 0.05) and PASI and LDL-c/HDL-c (r = 0.30; p < 0.05). These athero-
genic ratios tend to increase signicantly with the severity of psoriasis.
Conclusion: Patients with psoriasis had signicantly decreased HDL-c
levels and higher atherogenic ratios (CT/HDL-c and LDL-c/HDL-c).
We recommend for psoriatic patients a systematic screening for serum
lipid metabolites especially HDL-c levels and CT/HDL-c and LDL-c/HDL-
c which are signicant predictors of cardiovascular events.
Disclosure of Interest: None declared.
P 120
Photosensitivity in patients of psoriasis the unfortunate few
S. Gurnurkar, A. S. Kumar*
*Dermatology, Owaisi Hospital & Research Centre, Hyderabad, India
Background: UV Light exposure both in PUVA or PUVA SOL and in
Goeckermans regimen is an important component of therapeutic strategy
for psoriasis in India. Most patients get remission in summer and rarely
aggravated by sun. Those unfortunate to get summer are or photosensi-
tivity are prospectively studied in Psoriasis clinics. This is rarely reported
in India
Objectives: To study the development of photo sensitivity in psoriasis
patients, compare them with other data and to nd out the best therapeu-
tic option.
2010 The Authors
JEADV (2010) 24 (Suppl. 4), 183 Journal Compilation 2010 European Academy of Dermatology and Venereology
52 Poster Abstracts
Methods: Prospective study and to delineate the causes if any, clinical
examination, therapy details, follow up, ANA estimation and devise ther-
apy strategies for them
Results: Out of 108 patients in 1 year (20072008), ve patients had
photosensitive psoriasis; four had frank photosensitivity and psoriasis in
exposed areas. One had developed PLE with Psoriasis (in exposed areas).
ANA was negative in all but one (with PLE). PUVA was tried in 1
patient, withdrawn due to severe are up. REPUVASOL was tried in one;
Methotrexate in four patients. Patients reported relief.
Conclusion: Photosensitivity is rare in Indian Psoriatics and differs from
western patients in therapy
Reference:
Ros A, Eklund G, Photosensitive psoriasis. An epidemiologic study. J. Am
Acad dermatol 1987 (Nov); vol. 17, issue. 5, P 752758
Disclosure of Interest: None declared.
P 121
Psoriasis and atopic dermatitis-are they mutually exclusive?
N. Kondapally, A.S. Kumar,* T. Aziz*
*Dermatology, Owiaisi Hospital & Research Centre, Hyderabad, India
Background: Psoriasis & Atopic dermatitis, common immune mediated
diseases, one Th1 and other Th2 mediated diseases. Their occurance toge-
ather is considered rare & mutually exclusive. Reports of iniximab
inducing atopic dermatitis while resulting in remission of psoriasis, pro-
mpted us to look for both diseases in our patients
Objectives: Prospective study of psoriasis and allergy clinic patients for
study of occurence of either with family history or both, and their clinical
outcome
Methods: Clinical, historical study and followup of Psoriasis clinic and
Allergy clinic, examination of all members of family were done and results
recorded
Results: Two year data of clinics & followup (458 patients) showed occu-
rence of both conditions in 4 patients, while two patients had them at dif-
ferent times, two patients had at the same time. Family history of both
condition were present in three families, while one parent had only atopic
history.
Conclusion: Phentypical variation account for the different conditions
(Psoriasis and atopic dermatitis) in different countries. Both may occur
togeather and may be missed clinically
Disclosure of Interest: None declared.
P 122
Features of clinical course of psoriasis on the background of the
metabolic syndrome as a result of retrospective analysis
M. Kozlova*
*Dermatology, Ternopil State Medical University, Ternopil, Ukraine
Background: The study of the relationship between metabolic syndrome
and features of the clinical course of psoriatic disease.
Objectives: Five hundred and thirty-two case histories of patients with
psoriasis who were hospitalized in 20062009.
Methods: At researching the medical records of patients with psoriasis,
we used a modied and improved criteria of the International Federation
of diabetes (IDF, 2005)
Results: From 532 medical records of patients with psoriasis at 227
(42.7%) patients was found the metabolic syndrome. Among patients
with metabolic syndrome were 53 (23.4%) females and 174 (76.6%)
males. Meanwhile the age of patients was different, but most of them
were in age range from 41 to 60 years - 143 people (63%). Case reports
of patients with disseminated psoriasis and metabolic syndrome, we
observed the usual chronic plaque psoriasis, guttate psoriasis, end psoriat-
ic plaque lesions of the scalp, arthropathic, pustular, erythrodermic. With
arthropathic form of course there were 94 (41.41%) patients, with pustu-
lar form - 3 (1.32%) patients, and erythrodermic - 11 (4.84%) patients,
and with chronical plaque psoriasis form - 85 (37.44%) patients, psoriasis
guttate - 10 (4.4%) patients, end plaque lesions of the scalp 24 (10.57%)
patients. At 79 (14.85%) patients was noted psoriatic onychodystrophy
(nail psoriasis) at 45 (56.7%) patients with psoriasis and the metabolic
syndrome.
Conclusion: 1. Thus, in our investigation the number of psoriasis
patients with metabolic syndrome that are 227 (42.7%) patients, signi-
cantly higher than the prevalence of metabolic syndrome in the general
population (1525%).
2. At psoriasis patients with metabolic syndrome prevails arthropathic
form of the disease 94 (41.41%) patients, we also noted the increase of
the frequency of psoriatic onychodystrophy (nail psoriasis) at 45 (56.7%)
patients.
References:
1. Gisondi P, Tessari G, Conti A, et al. Prevalence of metabolic syndrome
in patients with psoriasis: a hospital-based case-control study. Br J Der-
matol 2007; 157:6873.
2. Sterry W, Strober BE, Menter A. Obesity in psoriasis: the metabolic,
clinical and therapeutic implications. Report of an interdisciplinary
conference and review. Br J Dermatol. 2007; 157: 649655.
3. Sommer DM, Jenisch S, Suchan M, et al. Increased prevalence of the
metabolic syndrome in patients with moderate to severe psoriasis. Arch
Dermato! Res. 2006; 298: 321328.
4. Johnson LW, Weinstock RS. The metabolic syndrome: concepts and
controversy. Mayo Clin Proc. 2006; 81: 16151620.
5. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management
of the metabolic syndrome: an American Heart Association/National
Heart, Lung, and Blood Institute Scientic Statement. Circulation.
2005; 112: 27352752.
Disclosure of Interest: None declared.
P 123
Cardiovascular pathology in patients with psoriasis: risk and
realities.
M. Kozlova
Dermatology, Ternopil State Medical University, Ternopil, Ukraine
Background: Nowadays cardiovascular pathologies still represent one of
the main factors of population morbidity and mortality in the whole
world. This problem leads to the search of the new risk factors, the identi-
cation of which will give the possibility to inuence the mortality rate of
the pathology. Therefore, the results of the numerous published modern
researches dedicated to the connection of psoriasis with the increased
cardiovascular pathology risk are of great scientic interest. The microcir-
culation violations are known to play a signicant role in the pathogenesis
of the skin syndrome at psoriasis. Since the capillaries are notably suscep-
tible to the changes of the blood viscosity, the increase of the erythrocyte
irrigation - one of the blood viscosity indices - is the characteristic feature
of the cardiovascular diseases, ischemic heart diseases, and vessel athero-
sclerosis of the lower extremities. The factors that lead to the microcircu-
lation, lipid exchange and cyclic nucleotide contents violations as well as
signicant changes in the capillaries of the venous circulation have been
observed at psoriasis. So, the study of the blood viscosity changes in
patients with psoriasis is proved to be correlatively connected with the
cardiovascular pathology development pathogenesis.
2010 The Authors
Journal Compilation 2010 European Academy of Dermatology and Venereology JEADV (2010) 24 (Suppl. 4), 183
Poster Abstracts 53
Objectives: Twenty ve patients with the average and complicated psoria-
sis.
Methods: The indices of brinogen, brinogen B and of C-reactive pro-
tein in blood tests.
Results: We have examined 25 patients with the average and complicated
psoriasis. The indices of brinogen and C-reactive protein have been
tested. The results of the research have shown that positive brinogen B
has been found in all the tests, 18 patients have revealed the increased
level of brinogen; 8 patients - C-reactive protein. It gives the possibility
to add the patients with the average and complicated psoriasis to the risk
group of the cardiovascular pathology.
Conclusion: Therefore, the results of the research can be used in the
studies of the risk factors in patients with psoriasis of the cardiovascular
pathology and their prevention.
References:
1. Gelfand JM, Neimann AL, Shin DB, et al. Risk of myocardial infarction
in patients with psoriasis. JAMA (2006 Oct 11); 296(14):17351741
2. Mallbris L, Akre O, Granath F, et al. Increased risk for cardiovascular
mortality in psoriasis inpatients but not in outpatients. Eur J Epidemiol
2004; 19(3):225230.
3. Stary HC, Chandler AB, Dinsmore RE, et al. A denition of advanced
types of atherosclerotic lesions and a histological classication of ath-
erosclerosis. A report from the Committee on Vascular Lesions of the
Council on Arteriosclerosis, American Heart Association. Circulation
(1995 Sep 1); 92(5):13551374.
4. Hansson GK. Inammation, atherosclerosis, and coronary artery
disease. N Engl J Med (2005 Apr 21); 352(16):16851695
Disclosure of Interest: None declared.
P 124
Meta-analysis: psoriasis and BMI
V.E. Espinoza-Chavez
Facultad de Medicina, UNAM, Mexico City, Mexico
Background: There has been an increase in publications that suggest the
existence of a relationship between psoriasis and a higher body mass
index (BMI), an association that would be given by the chronic inam-
matory component of obesity, thus possibly increasing the probability of
suffering psoriasis.
Objectives: To quantify the probability of suffering psoriasis of psoriasis
among different levels of BMI.
Methods: A meta-analysis was performed. Were searched in the databas-
es: MEDLINE (PUBMED: 1966 to July 2009), EMBASE (OVID: 1988 to
July 2009). Used MESH words: Body mass index and psoriasis. The
publications obtained and conducted an additional search of relevant
studies through the references of selected studies. Data were extracted by
two investigators, in order to make three comparisons between psoriasis
patients and controls: (1) BMI < 25 kg/m
2
vs. 25 kg/m
2
, (2) BMI < 25
kg/m
2
vs. 2529.9 kg/m
2
(3) BMI < 30 kg/m
2
vs. 30 kg/m
2
.
Inclusion Criteria (publications): 1. Written in English. 2. Design: Case-
control or cohort including letters to the editor or comments (with case-
control description of demographic data). 3. Patient case: any age/sex
with psoriasis, diagnosis made by: dermatologist, a physicians with an
interest in skin diseases or reported by the patient. 4. Control subjects:
any age and sex without diagnosis of psoriasis (healthy or with another
dermatologic condition) 5. BMI dened in the following subgroups: nor-
mal BMI (<25 kg/m
2
), overweight ( 2529.9 kg/m
2
) and obesity (>
30 kg/m
2
). The effect was estimated with odds ratio (OR) for dichoto-
mous variables, calculating the condence intervals 95% (CI) using the
random model (given the signicant heterogeneity between studies - I
2
)
and the Mantel Haenszel in RevMan 5.0.20
Results: Eight ve hundred and one articles were found, of which 12
were included in the analysis: nine for the initial search and three identi-
ed in the references.
The comparison between BMI < 25 kg/m
2
and BMI 25 kg/m
2
(obesity
and overweight) resulted in a OR = 1.28, 95% CI 1.131.44)
(1,3,4,6,8,9,11). The comparison between BMI<25 kg/m
2
and BMI 25
29.9 kg/m
2
resulted in a OR = 1.12 95% CI 1.091.17) -using xed
model. (1,3,4,6,11).
The comparison between BMI <25 kg/m
2
and BMI 30 kg/m
2
resulted
in an OR = 1.44, 95% CI 1.291.60). (1, 2, 3,4,5,6,7,10,11,12).
Conclusion: A high BMI increases the risk for psoriasis.
References:
1. Brauchli .J Clin Psychopharmacol. 2009; 29(2):134140.
2. Kaye. British Journal of Dermatology 2008; 159:895902.
3. Huerta. Arch Dermatol 2007; 143:15591565.
4. McGowan. Arch Dermatol 2005; 141:16011602.
5. Neimann. J Am Acad Dermatol 2006; 55:829835.
6. Setty. Arch Intern Med 2007; 167:16701675.
7. Driessen. J.Dermatolog Treat 2009; 20:4247.
8. Gunes. Arch Dermatol Res 2008; 300:435440.
9. Jin. J Dermatol Sci 2008; 52:123129.
10. Herron. Arch Dermatol 2005; 141:15271534.
11. Mallbris. J Am Acad Dermatol 2006; 54:614621
12. Naldi. Dermatology 2008; 216:125130.
Disclosure of Interest: None declared.
P 125
Questionnaire-based survey of the treatment of psoriasis patients
with hepatitis c in japan
S. Imafuku,* J. Nakayama*
*Dermatology, Fukuoka University, Fukuoka, Japan
Background: Interferon (IFN) alpha therapy with ribavirin currently pro-
vides 80% eradication of hepatitis C virus in chronic hepatitis C. How-
ever, IFN alpha can induce or exacerbate psoriasis and psoriatic arthritis.
Cyclosporine A (CyA), the most potent oral medication for psoriasis, is
considered unsuitable for use in patients with chronic infections. Cur-
rently, there is no consensus for treating patients with both hepatitis C
and psoriasis.
Objectives: To evaluate the current therapeutic choices of dermatologists
and internists for HCV-positive psoriasis patients.
Methods: We surveyed dermatologists in Japan using a questionnaire.
Results: Among 234 dermatologists in Japan, 38% of them treated HCV-
positive psoriasis patients (an average of 0.85 patients per dermatologist).
The patients were mainly treated by topical corticosteroid (97%) and vita-
min D3 (96%), and 24% of the dermatologists were prescribing CyA for
HCV-positive psoriasis patients. Overall, 28% of the dermatologists were
unaware of the hepatitis C therapy their patients were undergoing. Intra-
venous administration of glycyrrhizin was the most frequent therapy
employed by internists (45%), while IFN alpha was chosen in 40% of the
facilities surveyed.
Conclusion: Our data suggested that dermatologists were opting to treat
HCV-positive psoriasis patients with CyA, and that 40% of hepatologists
were prescribing IFN alpha, which has the risk of exacerbating psoriasis.
This is the rst survey to reveal the current situation regarding the treat-
ment of patients with both hepatitis C and psoriasis. Dermatologists and
internists both need to understand the effects and adverse effects of their
therapies.
Disclosure of Interest: None declared.
2010 The Authors
JEADV (2010) 24 (Suppl. 4), 183 Journal Compilation 2010 European Academy of Dermatology and Venereology
54 Poster Abstracts
P 126
Autoimmune phenomena during long-term anti-TNF treatment for
psoriasis: effect on the psoriasis area and severity index
R.E. Schopf,* N. Sapyega*
*Dermatology, Johannes Gutenberg University, Mainz, Germany
Background: Autoimmune phenomena such as the occurrence of antinu-
clear antibodies (ANAs) or double-stranded DNA antibodies (anti-
dsDNA) are well known during anti-TNF treatment.
Objectives: We examined whether the occurrence of such autoantibodies
exerted a negative effect on the psoriasis area-and severity index (PASI) in
patients treated with either Iniximab or Adalimumab.
Methods: During the course of 7 months to7 years 23 patients were trea-
ted with 5 mg/kg Iniximab. 18 patients were treated with Adalimumab
for 3 months to 2.5 years with a loading dose of 80 mg, after one week
with 40 mg every other week.
Results: Among the 23 patients treated with Iniximab, 13 patients
(56%) developed ANAs with a mean titer of 1:320; in 6 patients (26%)
dsDNA antibodies occurred up 200 units. In three patients treatment had
to be stopped after the second or third infusion due to an allergic / ana-
phylactic reaction. During therapy of 18 patients with Adalimumab, 8
patients (44%) developed ANAs, the mean titer was 1:160, in two cases
up to 1:1280; 2 patients (11%) developed anti-dsDNA antibodies up to
200 U. The PASI decreased in all patients treated with either Iniximab
or Adalimumab up to 75% or more regardless of the occurrence of these
autoimmune phenomena.
Conclusion: We conclude that roughly every other patient treated with
Iniximab or Adalimumab is likely to develop ANAs. Antibodies to
dsDNA occur in 10 25% of patients treated. These autoimmune phe-
nomena seem to have no discernible negative effect on treatment success.
Disclosure of Interest: None declared
P 127
Do psoriatic patients have higher proportions of metabolic syndrome
and its components in comparison with controls and patients with
inammatory dermatosis other than psoriasis?
A. Mebazaa,* M. El Asmi,

W. Zidi,

R. Cheikhrouhou,* Y. Zayani,

F. Kanoun,

D. El Euch,* M. Mokni,* H. Slimane,

N. Kaabechi,

A. Ben Osman*
*Dermatology, La Rabta Hospital, Tunis, Tunisia;

Biochemistry, La Rabta
Hospital, Tunis, Tunisia;

Endocrinology, La Rabta Hospital, Tunis, Tunisia
Background: There is evidence that in psoriasis as well as in rheumatoid
arthritis, chronic inammation has a pathogenic role in the metabolic
syndrome and associated comorbidities, and its adequate treatment may
contribute to revert it.
Objectives: To determine the prevalence of metabolic syndrome (MS)
and its components in psoriatic patients in comparison with healthy con-
trols and patients with inammatory dermatoses other than psoriasis.
Methods: We have prospectively included between August 2008 and Jan-
uary 2010, all adult (age 18-years old) psoriatic patients (G1). This
group was compared to a group of adult patients with inammatory der-
matoses other than psoriasis (G2) and to a third group of adult healthy
controls (G3). Concerning the rst group, duration, type and localization
of psoriasis as well as the PASI score (psoriasis with PASI
3
10 was consid-
ered as severe) were determined. Metabolic syndrome was dened accord-
ing to the ATP III.
Results: One hundred fty nine patients from G1 76 male, 83 female, 77
patients (24 male, 53 female) from G2 and 196 (79 male, 117 female)
from G3 were included. The mean ages were similar in the three groups
(4749 years). Mean duration of psoriasis was 8.79 8.46 months. There
was no statistical difference concerning MS proportion in the 3 groups:
37.8% (G1), 43.5% (G2) and 33.7% (G3). If analysed separately, MS com-
ponents have showed statistical differences only for decreased level of
HDL cholesterol in the 2 rst groups compared to the third [60.6% (G1),
64.7% (G2) and 37.5% (G3)] (p < 0.001). If analysed according to gen-
der, only decreased HDL cholesterol was signicantly higher in both
males and females in the two rst groups versus controls (p < 0.001). If
analysed according to psoriasis severity (PASI < 10 versus PASI
3
10),
there was no statistical difference for MS and its components in the three
groups.
Conclusion: Our results have shown a higher decreased level of HDL
cholesterol in psoriatic patients and in patients with inammatory derma-
toses other than psoriasis compared to healthy controls. Similarity of the
results between the two groups of dermatoses brings to light the role of
inammation in the development of metabolic syndrome and increased
cardio-vascular risk.
Disclosure of Interest: None declared
P 128
Relationship between bmi and psoriasis severity of psoriasis
Brazilian center patients
C.Y. Sabbag,* M.Y. Solis

*Diretoria, Centro Brasileiro De Psoriase, Sao Paulo, Brazil;

nutrition,
Centro Brasileiro De Psoriase, Sao Paulo, Brazil
Background: Relationship between BMI and psoriasis severity of Psoriasis
Brazilian Center patients.
Introduction: Chronic plaque psoriasis is frequently associated with
cardio-metabolic disorders including hypertension, type II diabetes,
obesity, dyslipidemia, metabolic syndrome and non-alcoholic steatohep-
atitis. Disease-specic risk factors are a direct consequence of psoriatic
inammation and include hyperhomocysteinaemia, elevated C-reactive
protein, elevated blood inammatory cytokines and platelet activation.
Non-disease-specic risk factors comprise insulin resistance/diabetes,
obesity, dyslipidaemia, hypertension, metabolic syndrome and smoking
habits.
Objectives: The objective of this study was to analyze the prole of
Psoriasis Brazilian Center patients and investigate the relationship
between Body Mass Index (BMI), diseases severity and relates chronic
disorders
Methods: A hundred and fty psoriasis patients, including 70 males and
81 females, with 49 15.9 age were enrolled in this study. Epidemiologi-
cal and clinical parameters were noted by a specic questionnires devel-
oped by the Center. Diseases severity was classied by gentle, moderate
and severe psoriasis and BMI (kg/m
2
) was calculated using weight and
stature.
Results: Forty-three patients were classied with gentle psoriasis, 61 were
moderate and 41 were severe. 42% of moderate psoriasis patient were
overweight ( 25 kg/m
2
) and more than 45% of the severe patients were
related by one or more chronic diseases like hypertension, diabetes, dilipi-
demia, cardiovascular disorder and rheumatologic issues.
Classication Sample %
underweight 3 2.0
Eutrophic 66 43.4
overweight 52 34.2
Moderate Obesity 28 18.4
Total 152 100
2010 The Authors
Journal Compilation 2010 European Academy of Dermatology and Venereology JEADV (2010) 24 (Suppl. 4), 183
Poster Abstracts 55
Conclusion: These data support the hypothesis of the interaction of
psoriasis severity with high BMI increasing the risks of Metabolic
Syndrome.
References:
1. Qureshi A, Chi H. Psoriasis and the Risk of Diabetes and Hyperten-
sion. Arch Dermatol.2009; 145(4):379382.
2. Gisondi P, et al. Prevalence of metabolic syndrome in patients with
psoriasis: a hospital-based case-control study. Br J Dermatol.2007; 157:
6873.
3. Shapiro J, et al. The association between psoriasis, diabetes mellitus,
and atherosclerosis in Israel: a case-control study. J Am Acad Derma-
tol.2007; 56(4); 629634.
4. Setty AR, et al. Obesity, waist circumference, weight change, and the
risk of psoriasis in women: NursesHealth Study II. Arch Inttern
Med.2007; 167: 16701675.
5. Naldi L, et al. Cigarette smoking, body mass index, and stressful life
events as risk factors for psoriasis: results from an Italian case-control
study. J Invest Dermatol.2005; 125: 6167.
6. Saraceno R, et al. Does metabolic syndrome inuence psoriasis? Eur
Rev Med Pharmacol Sci.2008; 12(5): 339341.
Disclosure of Interest: None declared.
P 129
Psoriasis and cardiovascular risk factors - a case control study on
inpatients
J. Shapiro,* A.D. Cohen,

R. Tal,* D. Witsman,

M. David*
*Sakler Medical School Tel Aviv University, Rabin Medical Center, Petah
Tikva, Israel;

Faculty of Health Sciences, Ben-Gurion University,
Beer-Sheva, Israel
Background: Previous reports have demonstrated an association between
psoriasis, cardiovascular disease (CVD) and its risk factors. However,
most of these studies were based on computerized databases of outpatient
clinics which are subjected to information bias due to lack of diagnosis
validation of psoriasis.
Objectives: To study the association between psoriasis and CVD risk fac-
tors among patients who were hospitalized in a department of dermatol-
ogy for psoriasis.
Methods: A case control study was performed utilizing and combining
two computerized medical databases (CMD); the database of Rabin Medi-
cal Center (RMC) and the database of Clalit Health Services (CHS). Inpa-
tients diagnosed with psoriasis were compared with inpatients diagnosed
with any form of dermatitis and without psoriasis for the prevalence of
diabetes, CVD, smoking, hypertension, hyperlipidemia, obesity. Logistic
regression models were used for multivariate analyses.
Results: The study included 1079 inpatients with psoriasis and 1079 age
and gender matched inpatients with dermatitis (control patients). A mul-
tivariate logistic regression model demonstrated that psoriasis was signi-
cantly associated with diabetes (OR 1.60 CI 95% 1.321.95), hypertension
(OR 1.42 CI 95% 1.201.69), smoking and obesity (OR 1.60 CI 95%
1.222.11) and CVD (OR 1.34 CI 95% 1.131.59).
Conclusions: Our study supports previous reports of an association
between psoriasis, CVD and its risk factors and demonstrates higher odd
ratios for the association, possibly due to improved selection of psoriasis
patients. Furthermore, comparing two groups of patients with two dis-
tinct inammatory dermatological conditions emphasizes the possibility
that the inammatory process in psoriasis and not in dermatitis has the
systemic impact resulting in the development of cardiovascular risk
factors.
References:
1. Christophers, E., Comorbidities in psoriasis. Clin Dermatol, 2007.
25(6): p. 529534.
2. Naldi, L., L. Chatenoud, D. Linder, A. Belloni Fortina, A. Peserico,
A.R. Virgili, et al., Cigarette smoking, body mass index, and stressful
life events as risk factors for psoriasis: results from an Italian case-con-
trol study. J Invest Dermatol, 2005. 125(1): p. 6167.
3. Shapiro, J., A.D. Cohen, M. David, E. Hodak, G. Chodik, A. Viner, et
al., The association between psoriasis, diabetes mellitus, and atheroscle-
rosis in Israel: a case-control study. J Am Acad Dermatol, 2007. 56(4):
p. 629634.
4. Sommer, D.M., S. Jenisch, M. Suchan, E. Christophers, and M. Wei-
chenthal, Increased prevalence of the metabolic syndrome in patients
with moderate to severe psoriasis. Arch Dermatol Res, 2006. 298(7): p.
321328.
5. Cohen, A.D., J. Dreiher, Y. Shapiro, L. Vidavsky, D.A. Vardy, B. Da-
vidovici, et al., Psoriasis and diabetes: a population-based cross-sec-
tional study. J Eur Acad Dermatol Venereol, 2008. 22(5): p. 585589.
Disclosure of Interest: None declared.
P 130
The prevalence of metabolic syndrome in psoriasis patients in a
Lebanese population
S. Itani,* A. Arabi,

A.-G. Kibbi*
*Dermatology, American University of Beirut Medical Center, Beirut,
Lebanon;

Internal Medicine - Endocrinology, American University of Beirut
Medical Center, Beirut, Lebanon
Background: Psoriasis is a known chronic inammatory disease that has
been shown to be positively correlated with obesity, cardiovascular risk
factors and metabolic syndrome, the latter being dened as a combination
of dyslipidemia, central obesity, insulin resistance and hypertension.
Objectives: 1. To establish an association between psoriasis and the meta-
bolic syndrome in Lebanese patient population as seen in Western com-
munities.
2. To demonstrate whether one psoriatic subtype and its severity is associ-
ated with the metabolic syndrome more than other subtypes.
3. To demonstrate if there is an age group at which the association
between psoriasis and the metabolic syndrome becomes evident.
Methods: This is a prospective case-controlled study in which consecutive
patients with psoriasis and controls presenting to the department of Der-
matology will be enrolled. Patients under the age of 18 years will be
excluded from the study.
After an informed consent, a total of 340 subjects (170 cases and 170 con-
trols) will provide 80% power to detect a difference between the cases
and controls regarding the prevalence of metabolic syndrome. The calcu-
lation was based on a web-based sample size calculator assuming that the
number of psoriasis patients in Lebanon is 160,000. Each patient will have
his/her weight, height, waist circumference and blood pressure measured.
Fasting blood sugar, triglyceride and HDL blood levels will be taken for
any patient who doesnt have a previous diagnosis of elevated blood tri-
glyceride or sugar, and low HDL or is not taking a drug for these labora-
tory abnormalities.
Results: A total of 40 patients with psoriasis have thus far been included
and analyzed using SPSS 16.0 software. Independent t-test was done to
assess the relationship between PASI score as an objective measurement of
psoriasis severity and metabolic syndrome. The mean PASI score for pso-
riasis patients who had metabolic syndrome was 9.03 7.19 as compared
to 4.20 3.65 in psoriasis patients who did not meet the criteria of meta-
bolic syndrome (p < 0.001).
Conclusion: The establishment of such an association will have denite
future implications while dealing with psoriasis patients such as, the
2010 The Authors
JEADV (2010) 24 (Suppl. 4), 183 Journal Compilation 2010 European Academy of Dermatology and Venereology
56 Poster Abstracts
importance of screening them for risk factors of the metabolic syndrome
and getting aware of the potential drug interactions while choosing a sys-
temic anti-psoriatic medication.
References:
1. Gisondi P, Tessari G, Conti S, et al. Prevalence of metabolic syndrome
in patients with psoriasis: a hospital-based case-control study. Br J Derma-
tol 2007; 157:6873.
2. Sterrry W, Strober BE. Obesity in psoriasis: the metabolic, clinical and
therapeutic implications. Report of an interdisciplinary conference and
review. Br J Dermatol 2007; 157:649655.
Disclosure of Interest: None declared.
P 131
A study of co- morbid conditions in psoriasis
J. Thomas
Department of Dermatology and STD, Sree Balaji Medical College &
Hospital, Chennai, Chennai, India
Background: Psoriasis is newly dened as a systemic disease. Common
co-morbidities associated with psoriasis include diabetes, hypertension,
and metabolic syndromes. Psoriasis can have a signicant impact on a
patients quality of life and is associated with loss of productivity, depres-
sion, and an increased prevalence of malignancy.
Objectives: To study the association of psoriasis with various co-morbid
conditions.
Methods: Hundred consecutive patients with psoriasis were included in
the study. Complete physical examination was done. Blood pressure mon-
itoring was done in all patients. Blood sugar (fasting), fasting lipid prole
and thyroid function test were done in all patients.
Results: Diabetes mellitus was seen in 8% of patients. Hypertension was
present in 13%. Both diabetes and hypertension was seen in 12% of
patients. 7% of patients were obese. Thyroid disorder and ischemic heart
disease were seen in 4% of the patients. Lipid abnormalities were seen in
4% of patients. A total of 52% of patients had some comorbidity in our
study.
Conclusion: All patients with psoriasis should be monitored for associ-
ated comorbid conditions. For effective management of psoriasis and
related comorbidities, an integrated approach targeting both cutaneous
and systemic inammation may be benecial.
Disclosure of Interest: None declared.
P 132
Obesity, diabetes mellitus, hypertension and smoking: hidden
culprits in causing psoriasis.
R. Batra,* S.B. Pujara,

K.B. Patel

*Dermatology, Sir Ganga Ram Hospital, New Delhi, India;

Smt.S.C.L.
Municipal Hospital, Ahmedabad, Gujarat, India
Background: Psoriasis is a common chronic, inammatory disorder
affecting about 23% of the adult population.
It is associated with markers of systemic inammation such as, increased
C-reactive protein levels which have been linked to the development of
atherosclerosis and myocardial infarction. Psoriasis is most common T-
helper cell type-1 (TH-1) immunological disease. Association of TH-1 to
M.I. has been reported. High adiposity has been associated with increased
risk of psoriasis.
Objectives: To study the association of obesity, diabetes mellitus, hyper-
tension, smoking with psoriasis
Methods: Our 750 patients diagnosed with psoriasis were studied and
data comprising age, height, self reported history regarding diabetes,
smoking, hypertension, myocardial infarction was analysed with a similar
control group.
BMI was calculated. The data was assessed for association between psoria-
sis and above mentioned parameters.
Results: About 58.2% were found to be obese or overweight while 35.5%
patients had normal BMI.
Male: Female ratio was 7.2:1 .History of smoking was present in 26.8%.
19.2% had diabetes. 5.4% were having past history of angina or myocar-
dial infarction.23.4% were hypertensive. 27.2% had abnormal lipid prole.
In terms of p value, the association was found to be highly signicant.
Conclusion: The study suggests obesity, hypertension, diabetes and smok-
ing do have an association with psoriasis. Patient should be encouraged
to aggressively address their modiable cardiovascular risk factors and
psoriasis treatment should be planned accordingly. Weight loss may be an
important target for prevention and management of psoriasis. Chronic,
low grade, inammatory state and overproduction of inammatory cyto-
kines associated with adiposity may explain the increased prevalence of
psoriasis among these individuals. More powerful study designs including
randomised control trials of smoking cessation, weight reduction, control
of hypertension and diabetes either or in combination are needed to
establish the true relationship.
Disclosure of Interest: None declared.
P 133
The role of drugs in the induction and/or exacerbation of psoriasis
K.H. Basavaraj*
*Dermatology and Venereology, JSS Medical College, JSS University, Mysore,
India
Background: As psoriasis is a common skin disorder, knowledge of the
factors that may induce, trigger, or exacerbate the disease is of primary
importance in clinical practice.
Objectives: Drug intake is a major concern in this respect, as new drugs
are constantly being added to the list of factors that may inuence the
course of this disease.
Methods: Drug ingestion may result in exacerbation of pre-existing psori-
asis, in induction of psoriatic lesions on clinically uninvolved skin in
patients with psoriasis, or in precipitation of the disease in persons with-
out family history of psoriasis or in predisposed individuals.
Results: In view of their relationship to drug-provoked psoriasis, thera-
peutic agents may be classied as drugs with strong evidence for a causal
relationship to psoriasis, drugs about which there are considerable but
insufcient data to support the induction or aggravation of the disease,
and drugs that are occasionally reported to be associated with aggravation
or induction.
Conclusion: The most common causative agents for drug-induced, drug-
triggered, or drug-aggravated psoriasis are [beta]-blockers, lithium, syn-
thetic antimalarial drugs, nonsteroidal anti-inammatory agents, and tet-
racyclines and the mechanisms of action of these drugs in the
pathogenesis of psoriasis.
References:
1. Dika E, Varotti C, Bardazzi F, Maibach HI. Drug-induced psoriasis: an
evidence-based overview and the introduction of psoriatic drug erup-
tion probability score. Cutan Ocul Toxicol. 2006; 25(1):111.
2. Tsankov N, Angelova I, Kazandjieva J. Drug-induced psoriasis. Recog-
nition and management. Am J Clin Dermatol. 2000; 1(3):159165.
3. Abel EA, DiCicco LM, Orenberg EK, Fraki JE, Farber EM. Drugs in
exacerbation of psoriasis J Am Acad Dermatol.1986 Nov; 15(5 Pt
1):10071022.
4. Wolf R, Ruocco V
Disclosure of Interest: None declared.
2010 The Authors
Journal Compilation 2010 European Academy of Dermatology and Venereology JEADV (2010) 24 (Suppl. 4), 183
Poster Abstracts 57
P 134
The association between psoriasis, diabetes mellitus, hypertension
and obesity in India
T. Aziz, A.S. Kumar,* B. Madhu
*Dermatology, Deccan College of Medical Sciences, Hyderabad, India
Background: Previous reports demonstrated an association between pso-
riasis and other diseases including hypertension, diabetes mellitus and
obesity.
Objectives: Our aim was to describe the association between psoriasis,
diabetes mellitus, hypertension and obesity in India.
Methods: A cross-sectional study was performed and cases and controls
included in the study were those attending the dermatology out-patient
department of Princess Esra Hospital, Hyderabad India. Case patients
were dened as subjects who were diagnosed with psoriasis. The control
group included patients attending dermatology out-patient department
without psoriasis. The proportion of diabetes and hypertension among
case and control groups was compared. Chi-square tests were used to
compare.
Results: The study included 200 patients with psoriasis (case patients)
and 500 subjects without psoriasis (control patients). Our study shows an
increased prevalence of diabetes among psoriasis patients (21.5) when
compared with control group (9.4%) (v
2
= 18.668, p < 0.05). There was
also an increased prevalence of hypertension among psoriasis patients
(27%) when compared with control group (14.2%) (v
2
= 15.957,
p < 0.005).There was not much difference in the prevalence of obesity
among psoriasis (7.5%) and control group patients (8.4%) (v
2
= 0.155,
p > 0.005).
Conclusion: Our study supports previous reports for an association
between psoriasis and hypertension and psoriasis and diabetes. In our
study we have observed a higher prevalence of hypertension and diabetes
among psoriasis patients compared with previous studies.
Disclosure of Interest: None declared.
P 135
Comorbidity and psoriasis
C. Carranza Romero,* J.M. Ferna ndez Vozmediano,* J.C. Armario Hita*
*Dermatology Department, University Hospital of Puerto Real, Cadiz, Spain
Background: Psoriasis is a chronic inammatory disease with a great
implication of immunologic mechanisms. It has even been proposed that
it could be an external indicator for an underlying immune metabolic
dysregulation. Thus, it has been associated to comorbidities. In fact, there
is a relationship between psoriasis, particularly severe forms, and other
diseases; they share a common pathogenic substrate as in the case of
arthritis and Crohns disease. The following has also been stated: increase
of risk of coronary cardiopathy or occlusive cardiovascular disease, as well
as increase of prevalence of obesity, dislipemy, adult diabetes mellitus,
arterial hypertension, alcoholism, nicotine poisoning; these increases mor-
tality related to atherosclerosis. We present morbidity features regarding
severe psoriasis patients in the Photobiology Unit of our Department of
Dermatology.
Objectives: Determine the comordities features in patients with psoriasis
from our sector, especially metabolic syndrome, comorbidities and life
quality. Determine the relationship between severe psoriasis, patients life
quality, patients comorbidities and metabolic syndrome.
Methods: Observational descriptive study including every patient with
psoriasis within 20042010. We included patients with PASI > 10 receiv-
ing treatment with biologics and resistant to systemic drugs. Variables
were: age, sex, weigh, height, abdominal perimeter, H.T.A., diabetes and
insulin resistance, hepatic steatosis, nicotine poisoning and enolism. We
used life quality tests such as HADS, DLQI and SF36. We carried out a
detailed clinical recording, exploration and anthropometric data measure-
ment, analysis controls, iconography and life quality tests assessment.
Results: We included 59 patients (26 female and 33 male), average age
43, with overall plate psoriasis and undergoing treatment with biologic
drugs: 68% receiving iniximab, 29% enbrel and 3% adalimumab.About
42% of patients had IMC > 25, 27% >30 and 10% >35. 25% presented
hypertensive cardiopathy. Besides, 55% were smokers and 32% admitted
being occasional drinker. 95% had family background, psoriasis debut
before 25-years old and aggravation of the disease with stress and anxiety.
Conclusion: We present comorbidities features in patients with severe
psoriasis resistant to systemic drugs and receiving treatment with biologic
drugs from our sector.
References:
1. Christophers E. Comorbidities in psoriasis. Clinics in Dermatology
2007; 25:529534.
2. Kimball Alexa B, Gladman Dafna, Gelfand J, Gordon K, Horn E, Kor-
man N, Korver G, Krueger G, Strober B, Lebwohl M. National Psoria-
sis Foundation clinical consensus on psoriasis comorbidities and
recommendations for screening. J Am Acad Dermatol 2008; 58: 1031
1042.
3. Cohen Arnon D, Gilutz H, Henkin Y, Zahger D, Shapiro J, Bonneh
DY, Vardy D A. Psoriasis and the Metabolic Syndrome. Acta Derm
Venereol 2007; 87:506509.
Disclosure of Interest: None declared.
P 136
Association of psoriasis and obstructive sleep apnea-hypopnea
syndrome: a hospital- based pilot study of 15 psoriatic patients who
underwent polysomnography
E. Papadavid,* K. Vlami,* D. Sgouros,* C. Bamia,* S. Giatrakou,*
S. Gyftopoulos,* H. Boutati,* S. Papiris,* N. Stavrianeas*
*Department of Dermatology and Respiratory Medicin, ATTIKON General
University Hospital, Athens, Greece
Background: Psoriasis is inammatory autoimmune disease of the skin
associated with obesity and metabolic syndrome (1),(3),(4). Obesity has
proven to be a predisposing risk factor for several diseases including Sleep
Apnea-Hypopnea syndrome (2), (5).The relevance of sleep apnea in psori-
asis patients as a potential comorbidity has not been investigated.
Objectives: To investigate the prevalence of Obstructive Sleep Apnea -
Hypopnea Syndrome among psoriasis patients in relation to body mass
index (BMI), PASI score and other comorbidities, such as hypertension,
hyperlipidemia, and diabetes mellitus.
Methods: We performed a hospital based pilot study on 15 adult
patients with mild to severe psoriasis. All patients underwent full Poly-
somnography (PSG) in sleep laboratory of Attikon general university hos-
pital of Athens. An apnea was dened as a cessation of airow (90%
compared with baseline) for 10 seconds. A hypopnea was dened as a
clear amplitude reduction of 5090%, in either the thermistor, or the
nasal pressure transducer channel during sleep that was associated with
either an oxygen desaturation of 3% and/or an arousal. Materials: Fif-
teen adult psoriasis patients, nine males and six females, with chronic pla-
que psoriasis were included in this pilot study. Measurements of BMI,
waist/hip ratio were also undertaken. All patients were under skin direc-
ted therapies (i.e. UVB. phototherapy, topical corticosteroids etc.) and 11
patients were also receiving systemic therapies with MTX, Cyclosporine A,
systemic Retinoids and Biologics.
2010 The Authors
JEADV (2010) 24 (Suppl. 4), 183 Journal Compilation 2010 European Academy of Dermatology and Venereology
58 Poster Abstracts
Results: The patients mean (range) age was 49 years (2661), mean
BMI. 31.96 (21.6341.67) and mean duration of psoriasis 8 years (244).
Six (40%) patients had mild (PASI < 10), and 9 (60%) had of moderate
to severe psoriasis (PASI > 10). Ten patients (66.7%) were diagnosed to
suffer from Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS)
according to the Apnea Hypopnea Index (AHI), measuring >5 events per
hour. Seven of those patients were male and 3 were female and their
mean age was 48 years . Six of these patients (60%) had moderate to
severe psoriasis (PASI > 10). Nine out of 10 patients (90%) were over-
weight/obese (BMI > 25). and the mean duration of psoriasis was 6 years.
Eight (80%) received systemic therapies for psoriasis.
Conclusion: Psoriatic patients in this pilot study had a high prevalence
of OSAHS. patients with OSAHS were overweight/obese and suffered
from severe psoriasis (PASI > 10). These preliminary results indicate that
it may be useful that psoriasis patients be questioned for OSAHS. Larger
clinical studies are necessary to assess the risk of psoriasis and cardiovas-
cular mortality associated with OSAHS and BMI. Awareness of potential
factors impacting sleep in psoriasis patients may provide new avenues for
treatment of recalcitrant disease.
Disclosure of Interest: None declared.
2010 The Authors
Journal Compilation 2010 European Academy of Dermatology and Venereology JEADV (2010) 24 (Suppl. 4), 183
Poster Abstracts 59