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"Latar Belakang: Hiperhomosisteinemia merupakan salah satu faktor risiko terjadinya penyakit kardiovaskular (PKV). Psoriasis vulgaris adalah penyakit kulit inflamasi kronis yang berhubungan dengan beberapa penyakit penyerta, misalnya aterosklerosis dan PKV. Defisiensi folat dapat terjadi pada pasien psoriasis, akibat utilisasi yang meningkat di kulit yang mengalami hiperproliferasi dan atau penyerapan oleh usus yang berkurang. Hal ini dapat mengakibatkan peningkatan kadar homosistein dalam darah. Penulis meneliti korelasi antara kadar homosistein serum dan derajat keparahan psoriasis vulgaris, yang diukur dengan metode psoriasis area severity index (PASI) dan luas permukaan tubuh (body surface area, BSA). Metode: penelitian ini menggunakan rancangan potong lintang, pada 36 pasien psoriasis vulgaris. Subyek terdiri dari16 perempuan dan 20 laki-laki. Kadar homosistein serum diukur dengan metode competitive immunoassay dan dikorelasikan dengan derajat keparahan psoriasis. Hasil: pada subyek psoriasis laki-laki, kadar homosistein serum berkorelasi positif dengan derajat keparahan penyakit yang diukur dengan PASI (korelasi Pearson, r = 0.615 , p < 0,05) dan BSA (korelasi Spearman , r = 0,476 , p < 0,05). Tidak ada korelasi antara kadar homosistein serum dengan PASI (korelasi Pearson , p > 0,05 ) dan BSA (korelasi Spearman, p > 0,05) pada subyek psoriasis perempuan. Kesimpulan: Terdapat korelasi positif yang signifikan secara statistik antara kadar homosistein serum dengan derajat keparahan psoriasis yang diukur dengan PASI dan BSA pada subyek psoriasis laki-laki.

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Background: hyperhomocysteinemia is an independent risk factor for the development of cardiovascular disease (CVD). Psoriasis vulgaris is a chronic inflammatory skin disease associated with several comorbidities, such as atherosclerosis and CVD. Psoriatic patients often presents low levels of folic acid as a result of an increasing vitamin utilization in the skin and/or reduced gut absorption. This may result in raised levels of homocysteine. The authors investigated the correlation between serum homocysteine levels and the severity of psoriasis vulgaris measured by psoriasis area and severity index (PASI) and body surface area (BSA). Method: we performed a cross-sectional study in 36 patients with psoriasis vulgaris. The subjects comprised 16 women and 20 men. The serum levels of homocysteine were measured by competitive immunoassay method and were correlated with the severity of psoriasis (PASI and BSA). Result: in male psoriasis subjects, serum homocysteine levels positively correlated with disease severity as measured by PASI (Pearson's correlation; r = 0.615, p < 0.05) and BSA (Spearman's correlation; r = 0.476, p < 0.05). There was no correlation between serum homocysteine levels with PASI (Pearson's correlation, p > 0.05) and BSA (Spearman's correlation, p > 0.05) in female psoriasis subjects. Conclusion: a significant correlation between serum homocysteine levels with disease severity measured by PASI and BSA in male psoriasis subjects was evidenced."

"Psoriasis vulgaris merupakan penyakit inflamasi kronik kulit yang didasari oleh proses imunologi. Derajat keparahan psoriasis vulgaris dinilai secara klinis dengan penilaian body surface area (BSA) dan psoriasis area and severity index (PASI). Inflamasi kulit pada psoriasis vulgaris diperankan oleh berbagai sitokin inflamasi yang dapat meningkatkan inflamasi sistemik dan aktivasi trombosit. High sensitivity c-reactive protein (hs-CRP) sebagai penanda inflamasi sistemik serta mean platelet volume (MPV) sebagai penanda aktivasi trombosit diduga dapat dijadikan prediktor derajat keparahan psoriasis vulgaris. Penelitian ini berdesain observasional analitik potong lintang. Setiap subjek penelitian (SP) dengan psoriasis vulgaris yang memenuhi kriteria inklusi dan eksklusi dilakukan anamnesis, pemeriksaan fisik, dan perhitungan derajat keparahan psoriasis vulgaris dengan PASI dan BSA. Selanjutnya, dilakukan pemeriksaan kadar hs-CRP dan MPV. Dari 32 SP, didapatkan korelasi positif tidak bermakna antara hs-CRP dengan BSA (r=0,118; p=0,518) dan PASI (r=0,322; p=0,073). Korelasi negatif tidak bermakna ditunjukkan antara MPV terhadap BSA (r=-0,035; p=0,848)dan PASI (r=-0,035; p=0,848). Korelasi antara hs-CRP dengan MPV tidak bermakna (r=-0,178; p=0,329). Nilai hs-CRP dan MPV tidak memiliki korelasi bermakna terhadap PASI dan BSA sehingga tidak dapat digunakan sebagai prediktor yang spesifik untuk keparahan psoriasis vulgaris.

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Psoriasis vulgaris is a chronic immunologic inflammatory skin disease. The severity of psoriasis vulgaris is clinically-assessed by using body surface area (BSA) and the psoriasis area and severity index (PASI). Skin inflammation in psoriasis vulgaris is played by various inflammatory cytokines that can perpetuate systemic inflammation and platelet activation. High sensitivity c-reactive protein (hs-CRP) as a marker of systemic inflammation and mean platelet volume (MPV) as a marker of platelet activation are thought to be predictors of psoriasis vulgaris severity.

This is a cross-sectional analytic observational study. Each subject with psoriasis vulgaris who met the inclusion and exclusion criteria underwent anamnesis, physical examination, and assessment of PASI and BSA, then examined for hs-CRP and MPV levels.

Among the 32 subjects, a weak insignificant positive correlation was found between hs-CRP and BSA (r=0.118; p=0.518)and PASI (r=0.322; p=0.073). A weak negative insignificant correlation was shown between MPV and BSA (r=-0.035; p=0.848) and PASI (r=-0.035; p=0.848). No significant correlation was found between hs-CRP and MPV (r=-0.178; p=0.329

The hs-CRP and MPV levels ​​do not have a significant correlation with PASI and BSA, therefore cannot be used as specific predictors of psoriasis vulgaris severity."

"Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with various clinical disorders and frequent exacerbations. Psoriasis vulgaris is a common skin disorder which affect 1-3% of general populations. The pathophysiology regarding the coexistence of these diseases is not fully understood. Therapeutic challenges arise since the treatment one of these diseases may aggravate the other. We reported two cases of SLE with psoriasis vulgaris with clinical manifestations as recurrent erythroderma with photosensitivity. Improvement in clinical condition was observed after treating the patients with methylprednisolone combined with methotrexate. The coexistence SLE and psoriasis are considered very rare. The presence of this overlap syndrome may precede one another or occur simultaneously and is closely related with the presence of anti-Ro/SSA. Thus, it raises new challenge regarding its relationships, diagnosis, therapeutic, and management."

"Latar Belakang: Psoriatic arthritis (PsA) merupakan inflamasi muskuloskeletal yang progresif. Psoriasis kuku merupakan faktor prediktor kuat PsA dengan prevalensi mencapai 87%. Skor modified nail psoriasis severity index (mNAPSI) merupakan salah satu penilaian derajat keparahan psoriasis kuku dengan reliabilitas interrater yang baik. Beberapa penelitian menunjukkan hubungan antara skor mNAPSI dengan PsA serta kerusakan sendi interfalang distal, sehingga dipikirkan bahwa derajat keparahan kuku dapat dijadikan sebagai penapisan kejadian PsA serta kaitannya dengan aktivitas penyakit PsA.Tujuan: Menilai hubungan derajat keparahan kuku menggunakan skor mNAPSI dengan kejadian PsA dan korelasi skor mNAPSI dengan derajat keparahan PsA menggunakan skor clinical disease activity for psoriatic arthritis (cDAPSA). Sebagai hasil tambahan, dilakukan penilaian korelasi skor psoriasis area severity index (PASI) dan cDAPSA. Secara deskriptif menilai proporsi kelainan psoriasis kuku secara klinis maupun dermoskopi pada pasien PsA dan tanpa PsA.Metode: Penelitian observasional analitik. Setiap subyek penelitian (SP) dengan psoriasis kuku yang telah memenuhi kriteria inklusi dan eksklusi dilakukan perhitungan mNAPSI, diagnosis PsA menggunakan classification criteria for psoriatic arthritis (CASPAR), dan menentukan derajat keparahan PsA dengan cDAPSA. Analisis statistik yang sesuai untuk membuktikan hipotesis penelitian. Nilai p <0,05 dianggap signifikan secara statistik.Hasil: Di antara 34 SP terdapat 15 SP yang mengalami PsA. Hubungan antara skor mNAPSI dengan kejadian PsA dianalisis menggunakan ROC dengan hasil nilai area under ROC curve (AUC) 0,58. Korelasi antara skor mNAPSI dengan cDAPSA adalah 0,217 (p=0,437). Terdapat korelasi positif antara PASI dan cDAPSA (r=0,621; p=0,013). Kelainan kuku terbanyak pada penelitian ini adalah onikolisis (72,6%), leukonikia (19,6%), diikuti dengan oil drop dan crumbling masing-masing 12,8%. Seluruh kelainan kuku lebih mudah dilihat dengan dermoskopi, kecuali pitting dan Beau’s line.Kesimpulan: Skor mNAPSI memiliki hubungan lemah dengan kejadian PsA, sehingga tidak dapat digunakan sebagai penapisan kejadian PsA. Selain itu, mNAPSI memiliki korelasi lemah dengan cDAPSA, sehingga derajat kerusakan kuku tidak mencerminkan derajat keparahan PsA.

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Background: Psoriatic arthritis (PsA) is a progressive musculoskeletal inflammation. Nail psoriasis is a strong predictor of PsA with a prevalence of 87%. The modified nail psoriasis severity index (mNAPSI) score is an objective score for evaluating the severity of nail psoriasis and has excellent interrater reliability. Several studies have shown a correlation between mNAPSI scores and PsA and distal interphalangeal joint damage, so it is thought that the severity of the nail can be used as a screening for the incidence of PsA.

Objective: This study aims to assess the relationship between nail severity using the mNAPSI score with the incidence of PsA and to assess the correlation between the mNAPSI score with PsA severity using the clinical disease activity for psoriatic arthritis (cDAPSA) score. In addition, the correlation between psoriasis area severity index (PASI) and cDAPSA scores was also carried out as additional results. This study also descriptively assessed the proportion of psoriasis nail abnormalities both clinically and dermoscopy in patients with PsA and without PsA.

Methods: This research is an analytic observational. All research data are recorded in the research status. Each subject met the inclusion and exclusion criteria, calculated the mNAPSI score, diagnosed PsA using the classification criteria for psoriatic arthritis (CASPAR) score, and determined the severity of PsA with the cDAPSA score. Appropriate statistical analysis was performed to prove the research hypothesis. P value < 0.05 was considered statistically significant.

Results: Among 34 subject, 15 (44%) experienced PsA. The relationship between the mNAPSI score and the incidence of PsA was analyzed using ROC. Based on this analysis, the area under ROC curve (AUC) value was 0.58. The correlation between mNAPSI and cDAPSA scores was 0.217 (p=0.437). There was a positive correlation between the PASI value and cDAPSA and it was statistically significant (r=0.621; p=0.013). The most common nail abnormalities in this study were onycholysis (72.6%), leukonychia (19.6%), followed by oil drop and crumbling (12.8%). All nail abnormalities are easier to see with dermoscopy, except for pitting and Beau's line.

Conclusion: The mNAPSI score has a weak relationship with the incidence of PsA, so it cannot be used as a screening for the incidence of PsA. In addition, this score also has a weak correlation with the cDAPSA score, so the degree of nail damage does not reflect the severity of PsA."