Ardelean, Gavril - Buicu, Florin (szerk.): Satu Mare. Studii şi comunicări. Seria ştiinţele naturale 8. (2007)
Medicină
Satu Mare - Studii şi Comunicări Seria Ştiinţele Naturii\io\. VIII (2007) psoriasis should be encouraged to identify and manage their modifiable cardiovascular risk factors. Psoriasis : Conclussions Psoriasis,chronic skin disease,with genetic determinism, hiperinflamatory and hyperproliferative, of yet unknow ethiology, can present in his course association with variouse disease.Current information also suggest that psoriasis is more frequently associated witir medical conditions such as artiiritis, diabetes mellitus, obesity, chronic liver disease, cardiovascular and endocrinological conditions etc. As far as concerned metabolic changes encountered at patients with psoriasis, a percentage of 10-12% (according to current research) also associated psoriazis widi diabetes mellitus.On the other side, a relativelly growing number of pacients with psoriasis also show obesity in various degreese , so that in tire case of some pacients one can notive the triple association psoriasis-diabetes mellitus-obesity. Taking in to consideration the relativelly freqvent association between psoriasis and diabetes mellitus, is important for all the psoriasis patients, and especially thoes who have family history for diates mellitus ,to cheq on regullary the glycemia values in order to diagnose a case of diates mellitus. In the present it is also considered that the obesity has a major impact on psoriasis, also in what considerate the natural evolution of the disease and keeping it under control, as well as on aspects of public health. Current information also suggest there is no conection beetwen the presence of obesity in youth and die beginning of psoriasis, but psoriasis can have a major contribution in the development of obesity', a specially as a conseqwence of die profounde negative efectts of psoriasis on the genera phisical and mental state of health of the psoriasis patient. Also die over wheighted patients whit psoriasis frequendy show more sever forms of psoriasis compared to the patient with psoriasis who are not obese. The importance of association diabetes mellitus and/or obesity with plaque psoriasis or guttate psoriasis,or pustular psoriasis, or inverse psoriasis, or erythrodermic psoriasis , can be found in the metabolic changes connected to diabetes mellitus or obesity, modification that can have a negative effects on the evolution of psoriasis and on dierapeutical posibilities that can be used as part of the therapy of psoriasis. Based on this study and prior studies, we can advises: as part of good medical care, patients with psoriasis should be encouraged to identify and manage tiieir modifiable cardiovascular risk factors. References 1. Christophers E. Psoriasis—epidemiology and clinical spectrum. Clin Exp Dermatol 2001; 26:314-20. 2. Feier V , Dermato-venerology, Ed. Amarcord, 2000, Timisoara 3. Naldi L, Svensson A, Diepgen T et al. Randomized clinical trials for psoriasis 1977— 2000: the EDEN survey. J Invest Dermatol 2003; 120:738—41. 4. Stem RS. Psoriasis. Lancet 1997; 350:349-53. 5. Glaser R, Mrowietz U, Jenisch S et al. Simultaneous onset of psoriasis vulgaris in monozygotic twins. AmJ Clin Dermatol 2001; 2: 183-6. 6. Pisani M, Ruocco V. ‘Twin1 psoriasis in monozygotic twins. Arch Dermatol 1984; 120:1418-19. 7. Capon F, Munro M, Barker J, Trembath R. Searching for the major histocompatibility complex psoriasis susceptibility gene. J Invest Dermatol 2002; 118:745-51. 8. Gudjonsson JE, Johnston A, Sigmundsdottir H, Valdimarsson H. Immunopathogenic mechanisms in psoriasis. Clin Exp Immunol 2004; 135:1-8. 9. Ghoreschi K, Mrowietz U, Ro cken M. A molecule solves psoriasis? Systemic therapies for psoriasis inducing interleukin 4 and Th2 responses. J Mol Med 2003; 81:471-80. 10. Al-Suwaidan SN, Feldman SR. Clearance is not a realistic expectation of psoriasis treatment. J Am Acad Dermatol 2000; 42:796-802. 11. Palmblad J, Hafstrom I, Ringertz B. Antirheumatic effects of fasting. Rheum Dis Clin North Am 1991; 17:351-62. 12. Muller H, de Toledo FW, Resch KL. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol 2001; 30:1—10. 13. Hsieh EA, Chai CM, De Lumen BO et al. Dynamics of keratinocytes in vivo using HO labeling: a sensitive marker of epidermal proliferation state. J Invest Dermatol 2004; 123:530-6. 14. Rucevic I, Perl A, Barisic-Drusko V, Adam- Perl M. The role of the low energy diet in psoriasis vulgaris treatment. Coll Antropol 2003; 27 (Suppl. 1): 41-8. 15. Lithell H, Bruce A, Gustafsson IB et al. A fasting and vegetarian diet treatment trial on chronic inflammatory disorders. Acta Derm Venereol (Stockh) 1983;63:397-403. 158
