Psoriasis: comorbilidades en nuestra población

ResumenIntroduccionLa psoriasis es una enfermedad inmunologica e inflamatoriacronica que afecta la piel, unas y articulaciones. Su incidencia varia del 2 al 4%. Los avances en el conocimiento han llevado a comprender su caracter inflamatorio sistemico. Diversos estudios demostradon una mayor asociacion con algunas comorbilidades como insulinorresistencia, obesidad, hipertension arterial y dislipidemias, asi como mayor incidenciade neoplasias y enfermedades autoinmunes.Objetivo. Analizar si las comorbilidades descriptas estan presentes en los pacientes del consultorio de la Seccion de Psoriasis de nuestro hospital.Materiales y metodos. Se revisaron retrospectivamente las historias clinicas de 120 pacientes en seguimiento por la Seccion de Psoriasis del Hospital Churruca. Se tomaron en cuenta sexo, edad, tiempo de evolucion de la enfermedad, antecedentes familiares y personales, tratamientosrealizados y estudios de laboratorio.Resultados. De los 120 pacientes, 44 fueron mujeres y 76 varones, con edades entre 6 y 87 anos y una media de 46,5. De estos, el 54,5% de las mujeres y el 48,6% de los hombres presentaron artralgias. Con respecto a los valores de laboratorio, 71 pacientes presentaron algun tipo de alteracionen el metabolismo de los carbohidratos y, de estos, solo 12 tenian diagnostico previo de diabetes. Noventa y dos pacientes presentaron alguna alteracion lipidica (colesterol total aumentado: 56 pacientes; HDL disminuido: 58 pacientes; LDL aumentado: 45 pacientes; trigliceridos aumentados: 40 pacientes) y 12 pacientes presentaron alteraciones en todaslas fracciones del lipidograma.Conclusiones. Resulta fundamental un enfoque integrador del paciente con psoriasis por lo que el dermatologo debe conocer sus potenciales comorbilidades lo que permitira la deteccion temprana y eventual derivacion al especialista para el tratamiento apropiado (DermatolArgent 2009;15(5):340-343).Palabras clave: psoriasis, comorbilidades, sindrome metabolico. Title: Psoriasis: comorbidities in our communityAbstractIntroduction. Psoriasis is a chronic, immunologic and inflammatory disease that affects the skin, the nails and the joints. Its incidence varies between 2 to 4%. Advances in the knowledge have allowed us to understand the systemicinflammatory behavior of this disease. Many different studies have demonstrated that psoriasis has an increased association with some comorbidities such as insulin resistance, obesity, hypertension and dyslipidemias as well as a higher incidence of immune mediated disorders and malignancies.Aim. To analyze if the comorbidities previously described as associated to psoriasis are present in the patients of our Hospital.Materials and methods. We reviewed the clinical records of 120 patients whose disease was controlled at the psoriasis clinic in our hospital. We took into account gender, age, personal and family history of psoriasis, duration of the disease and previous treatments. Evaluation of glucose, insulin, lipids and thyroid function were also performed.Results. Out of 120 patients, 44 were women and 76 males, whose ages ranged between 6 and 87 years (mean: 46,5 ys). Of these, 54,5% of the women and 48,6% of men presented articular pain. Seventy one patients presented some type of alteration in the carbohydrate metabolism, with only 12 patients with a history of diabetes. Ninety two patients presented at least one type of alteration in their lipid metabolism. Fifty six patients presented an increase in total cholesterol, 58 presented decreased HDL while 45 had increased LDL, and 40 presented hypertriglyceridemia. Twelve patients showed alterations in all types of lipids.Conclusions. Dermatologists must keep in mind that he will likely be the only physician these patients consult, giving them a fundamental role in the early detection of the potential comorbidities and the likely consultation to the pertinent specialist (Dermatol Argent 2009;15(5):340-343).Key words: psoriasis, comorbidities, metabolic syndrome.