Ardelean, Gavril - Buicu, Florin (szerk.): Satu Mare. Studii şi comunicări. Seria ştiinţele naturale 8. (2007)
Medicină
Satu Mare - Studii şi Comunicări Seria Ştiinţele NaturiiVo\. VIII (2007) Psoriasis: Definition and Epidemiology Psoriasis,chronic skin disease,with genetic determinismjiiperinflamatory and hyperproliferative, of yet unknow ethiology, can present in his course association with variouse disease The estimated prevalence of psoriasis ranges from 0.5% to 4.6% worldwide. The reasons for the geographic variation in prevalence are unknown, but climate and genetics may play a role. Psoriasis is uncommon in blacks in tropical zones, but it is more often seen in blacks in temperate zones. It occurs commonly in Japanese persons but rarely in persons native to North and South America. In the United States, studies have variously reported that 4.5 million adults or 7 million adults and children have psoriasis .In euorope has a incidence from 3- 5%.In Satu Mare county the incidence is 1-2%. Psoriasis can occur at any age, with some cases being reported at birth and others being reported in patients older than 100 years. In Färber and Nall's pioneer study , the average age of onset of psoriasis was 27.8 years; in 35% of patients, onset occurred before 20 years of age, and in 10%, onset occurred before 10 years of age. Psoriasis occurs with equal frequency in men and women, but in Färber and Nall's study, onset occurred later in men. In populations in which there is a high prevalence of psoriasis, onset tends to occur at an earlier age. In the Faroe Islands, for example, the prevalence is 3%, and the average age of onset is 12.5 years. The average age of onset is 23 years in the United States. In persons with earlier age of onset, psoriasis is more likely to be severe, with involvement of a large area of skin surface. Psoriasis: Prognosis Psoriasis is usually lifelong, but tire severity of the disease may vary, with periodic exacerbations and relative remissions in some patients. Although pustular psoriasis and erythrodermic psoriasis can be life-threatening, even stable plaque psoriasis can have a negative impact on overall health, possibly because of comorbid conditions such as psoriatic arthritis or obesity or because of complications of therapy. Severe exacerbation of psoriasis taxes the ingenuity of even the most skilled clinician. Fortunately, because of the wide range of psoriasis therapies now available, clinicians are able to successfully treat almost all patients with psoriasis. The goal of therapy must be to minimize toxicity while achieving satisfactory improvement both in physical signs and symptoms and in patients' quality of life. Psoriasis: Differential Diagnosis The differential diagnosis of psoriasis includes other scaling dermatoses . Such dermatoses include the following: • Seborheic dermatitis that involves the scalp, nasolabial folds, and retroauricular folds. • Pityriasis rosea, which begins with a herald patch and is self-limited. • Lichen simplex chronicus, which is caused by repeated rubbing or scratching. • Parapsoriasis, which is characterized by atrophy, telangiectasia, and pigmentary abnormalities. • Pityriasis rubra pilaris, which is characterized by psoriasiform patches that often begin in sun-exposed areas. Other conditions (e.g., discoid eczema or secondary syphilis) that can be differentiated by clinical and pathologic criteria Psoriasis patients have an increased frequency of a variety of cardiovascular risk factors including diabetes, obesity7, hypertension, hyperlipidemia, and smoking, results of a study confirm. In particular, the current results suggest that psoriasis is associated with key components of the metabolic syndrome and that this association is stronger in cases of severe psoriasis. Psoriasis given that individuals with as few as one or two metabolic syndrome risk factors are at heightened risk for death due to cardiovascular disease. Our studie suggest that, independent of other risk factors, severe psoriasis itself may be a risk factor for heart attack. Therefore, patients with psoriasis should be screened for cardiovascular risk factors, and if these risk factors are present, they should be managed appropriately. We identified 80 patients with mild psoriasis and 30 with severe psoriasis. Each psoriasis patient was matched to up to five psoriasis-free control subjects (fig. 1). 155
