Psoriasis: Moderne Versorgung braucht einen ganzheitlichen Ansatz

2019 ◽  
pp. 196-197
Author(s):  
Natalia Kirsten

Objective: Psoriasis and depression may have common mechanisms, such as systemic inflammation, dysfunction of the hypothalamic-pituitary-adrenal axis, and vitamin D3 deficiency. Among men with psoriasis, this study examined whether depression severity was associated with serum concentrations of different metabolic and inflammatory markers.Methods: The study included 85 men with psoriasis (mean age ±standard deviation [SD], 47 ±14 years) and 65 men without psoriasis (mean age ±SD, 44 ±13 years). In both groups, we measured the body mass index; blood pressure; and serum concentrations of lipids, uric acid, lipase, interleukins 6 and 18, cortisol, and 25-hydroxyvitamin D3. All participants completed the Beck Depression Inventory. Other variables analyzed included psoriasis duration, the Psoriasis Area Severity Index, and the percentage of body surface area affected by psoriatic lesions.Results: Compared with controls, patients with psoriasis had significantly greater depression severity, higher body mass indices, and higher serum concentrations of total cholesterol and interleukins 6 and 18; moreover, they had significantly lower serum 25-hydroxyvitamin D3 concentrations. In patients with psoriasis, depression severity correlated positively with psoriasis duration, the Psoriasis Area Severity Index, the percentage of body surface area affected by psoriatic lesions, and interleukin-18 concentration. In patients with psoriasis, depression severity correlated negatively with 25-hydroxyvitamin D3 concentration, but it did not correlate significantly with the serum concentrations of interleukin 6 and cortisol. Conclusion: High concentrations of interleukin 18 and low concentrations of 25-hydroxyvitamin D3 may be associated with depression severity in men with psoriasis. Thus, further studies should examine whether effective anti-inflammatory treatments or vitamin D3 supplementation can improve depression outcomes in these patients.

2019 ◽  
Vol 46 (4) ◽  
Author(s):  
Windy Keumala Budianti ◽  
Shafira Anindya ◽  
Arlha Aporia Debinta ◽  
Endi Novianto ◽  
Eyleny Meisyah Fitri ◽  
...  

Psoriasis merupakan peradangan kulit kronik dengan dasar genetik. Untuk mencapai remisi dan kualitas hidup yang baik, pilihan terapi disesuaikan dengan kebutuhan perorangan pasien. Tipe dan derajat keparahan psoriasis perlu ditentukan guna memilih tata laksana yang sesuai karena memengaruhi keberhasilan terapi, masa remisi, serta tingkat morbiditas. Penelitian ini bertujuan menilai kesesuaian tata laksana psoriasis berdasarkan derajat keparahan dengan menggunakan Panduan Praktik Klinis (PPK) RSUPN dr. Cipto Mangunkusumo (RSCM) dan Persatuan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI). Studi retrospektif ini mengambil subjek seluruh pasien baru psoriasis di Divisi Alergi Imunologi, Departemen Ilmu Kesehatan Kulit dan Kelamin RSCM periode Oktober 2017 – Oktober 2018. Keparahan psoriasis dinilai dengan skor body surface area (BSA) dan psoriasis area severity index (PASI). Sebanyak 32 di antara 35 pasien (91,4%), skor BSA dan/atau PASI terdokumentasi pada rekam medis, dan 30 di antara 32 pasien (93,8%), mendapatkan pilihan terapi sesuai dengan tipe psoriasis atau skor BSA dan/atau PASI. Kepatuhan pasien sangat penting sehingga pemilihan tata laksana psoriasis perlu mempertimbangkan kenyamanan pasien terkait efek samping pengobatan, kemudahan pasien untuk mengakses fasilitas, dan aspek ekonomi. Kesesuaian terapi tidak mencapai 100% karena kontraindikasi pemberian terapi standar, penolakan pasien, dan ketidaktersediaan obat misalnya metotreksat. Sebanyak 93,8% pasien psoriasis di RSCM telah ditata laksana sesuai dengan PPK RSCM dan PERDOSKI.Kata Kunci: BSA, PASI, psoriasis, tata laksana


2012 ◽  
Vol 44 (2) ◽  
pp. 203-210 ◽  
Author(s):  
Sina Alipour ◽  
Hagen F. Kennecke ◽  
Ryan Woods ◽  
Howard J. Lim ◽  
Caroline Speers ◽  
...  

2013 ◽  
Vol 38 (5) ◽  
pp. e210-e215 ◽  
Author(s):  
Hongwei Si ◽  
Zhili Lei ◽  
Sijin Li ◽  
Jianzhong Liu ◽  
Jianhua Geng ◽  
...  

2016 ◽  
Vol 62 (1) ◽  
pp. 311-319 ◽  
Author(s):  
A. G. Hirst ◽  
M. K. S. Lilley ◽  
D. S. Glazier ◽  
D. Atkinson

2012 ◽  
Vol 23 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Sion K. Roy ◽  
Irfan Zeb ◽  
Jigar Kadakia ◽  
Dong Li ◽  
Matthew J. Budoff

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