Serkan YAZİCİ, Gülistan MAÇİN, Eda HAŞAL, Emel BÜLBÜL BAŞKAN, Kenan AYDOĞAN, Hayriye SARICAOĞLU, Şaduman BALABAN ADIM

Püstüler Psoriasis Tanılı 152 Olgunun Retrospektif Analizi: Klinik, Demografik Özellikler ve Tedavi Yanıtı ile Sigara İlişkisi

Bu çalışmada, püstüler psoriasis olgularının klinik, demografik özellikleri ve tedavi yanıtı ile sigara ilişkisi araştırılmıştır. Klinik ve histopatolojik olarak generalize püstüler psoriasis ve palmoplantar püstüler psoriasis tanısıyla takip edilen 152 olgunun yaş, cinsiyet, hastalığın başlangıç yaşı, lezyon süresi, lokalizasyonu, tırnak, eklem tutulumu, ailede psoriasis varlığı, tanı öncesi plak psoriasis varlığı, komorbidite varlığı, tetikleyici faktörler (ilaç, infeksiyon, stres), sigara kullanımı, tedavi yanıtı ve rekürrens gibi parametreler dosya kayıtlarından retrospektif elde edildi. 152 olgunun 27’si GPP 125’İ PPPP tanılıydı. Olguların 100’ü bayan 52’si erkek idi. Tanı anındaki yaşları ortalama 41.64±13.58, medyan 42,0(6-73) olarak saptandı. Ailede psoriasis varlığı, malignite varlığı, sigara kullanımı, tesbit edilebilen tetikleyici faktör varlığı, tırnak tutulumu, eklem tutulum özellikleri ile püstüler psoriazis alt grupları arasında istatistiksel fark saptanmadı (P>0,05). Tedavi yanıtı ile sigara kullanımı arası istatistiksel fark saptandı(P=,014). Saptanabilen tetikleyici faktör varlığı ile rekürrens arası istatistiksel anlamlı ilişki saptandı (P=,003). Eklem tutulumu ile rekürrens arasında istatistiksel anlamlı ilişki saptandı(P=,000). Sigara kullanımın önlenmesi ve eklem tutulumunun değerlendirilmesi püstüler psoriasis yönetiminde önemlidir.

Anahtar Kelimeler:

eklem tutulumu, püstüler psoriasis, rekürrens, , sigara

Retrospective analysis of 152 patients with pustular psoriasis: smoking habit with clinical, demographic characteristics and treatment response

In this study, clinical, demographic characteristics and treatment response of pustular psoriasis cases and smoking habit were investigated. Total of 152 patients followed clinically and histopathologically for generalized pustular psoriasis(GPP) and palmoplantar pustular psoriasis(PPPP) were evaluated for age, sex, age of onset, duration of lesion, localization, nail, joint involvement, family history for psoriasis, presence of plaque psoriasis before diagnosis, presence of comorbidity, triggering factors (drug, infection, stress), smoking, treatment response, and recurrence were retrieved from file records, retrospectively. Of the 152 cases, 27 were diagnosed with GPP 125 as PPPP. 100 of the cases were female and 52 were male. The mean age of the cases was 41.64 ± 13.58 and the median was 42,0 (6-73). No statistically significant difference was found between the subgroups of pustular psoriasis and the family history of psoriasis, presence of malignancy, smoking, detectable triggering factor, nail and joint involvement (P>0,05). There was statistically significant difference between treatment response and smoking (P =, 014). There was a statistically significant correlation between the presence of any triggering factor and recurrence (P = ,003). There was a statistically significant correlation between joint involvement and recurrence (P = ,000). Prevention of smoking and assessment of joint involvement is important in pustular psoriasis management.

Keywords:

joint involvement, pustular psoriasis, recurrence, smoking,

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Referans1. Griffiths CE, Christophers E, Barker JN, et al. A classification of psoriasis vulgaris according to phenotype. Br J Dermatol. 2007;156: 258.
Referans2. Benjegerdes KE, Hyde K, Kivelevitch D, Mansouri B. Pustular psoriasis: pathophysiology and current treatment perspectives. Psoriasis (Auckl). 2016;6: 131-144.
Referans3. Bachelez H. Pustular psoriasis and related pustular skin diseases. Br J Dermatol. 2018;178: 614-618.
Referans4. Raychaudhuri SK, Maverakis E, Raychaudhuri SP. Diagnosis and classification of psoriasis. Autoimmun Rev. 2014;13: 490-5.
Referans5. Jin H, Cho HH, Kim WJ, et al. Clinical features and course of generalized pustular psoriasis in Korea. J Dermatol. 2015;42: 674-8.
Referans6. Sevrain M, Richard MA, Barnetche T, et al. Treatment for palmoplantar pustular psoriasis: systematic literature review, evidence-based commendations and expert opinion. J Eur Acad Dermatol Venereol. 2014;28 Suppl 5: 13-6
Referans7. Armstrong AW, Harskamp CT, Dhillon JS, Armstrong EJ. Psoriasis and smoking: a systematic review and meta-analysis. Br J Dermatol. 2014;170: 304-14.
Referans8. Adişen E, Tekin O, Gülekon A, Gürer MA. A retrospective analysis of treatment responses of palmoplantar psoriasis in 114 patients. J Eur Acad Dermatol Venereol. 2009;23: 814-9.
Referans9. Choon SE, Lai NM, Mohammad NA, Nanu NM, Tey KE, Chew SF. Clinical profile, morbidity, and outcome of adult-onset generalized pustular psoriasis: analysis of 102 cases seen in a tertiary hospital in Johor, Malaysia. Int J Dermatol. 2014;53: 676.
Referans 10. Zelickson BD, Muller SA. Generalized pustular psoriasis. A review of 63 cases. Arch Dermatol. 1991;127: 1339.Referans11. Brunasso AM, Puntoni M, Aberer W, Delfino C, Fancelli L, Massone C. Clinical and epidemiological comparison of patients affected by palmoplantar plaque psoriasis and palmoplantar pustulosis: a case series study. Br J Dermatol. 2013;168: 1243-51.
Referans12. Borges-Costa J, Silva R, Gonçalves L, Filipe P, Soares de Almeida L, Marques Gomes M. Clinical and laboratory features in acute generalized pustular psoriasis: a retrospective study of 34 patients. Am J Clin Dermatol. 2011;12: 271-6.
Referans13. Tay YK, Tham SN. The profile and outcome of pustular psoriasis in Singapore: a report of 28 cases. Int J Dermatol. 1997; 36: 266–271.
Referans14. Hellgren L, Mobacken H. Pustulosis palmaris et plantaris. Prevalence, clinical observations and prognosis. Acta Derm Venereol. 1971;51: 284–8.
Referans15. Enfors W, Molin L. Pustulosis palmaris et plantaris. A follow-up study of a ten-year material. Acta Derm Venereol. 1971; 51: 289–94.
Referans16. Burden AD, Kemmett D. The spectrum of nail involvement in palmoplantar pustulosis. Br J Dermatol. 1996;134: 1079–82.
Referans17. Miot HA, Miot LD, Lopes PS, Haddad GR, Marques SA. Association between palmoplantar pustulosis and cigarette smoking in Brazil: a case–control study. J Eur Acad Dermatol Venereol. 2009; 23: 1173–7.
Referans18. Gime´nez-Garcı´a R, Sa´nchez-Ramo´n S, Cuellar-Olmedo LA. Palmoplantar pustulosis: a clinicoepidemiological study. The relationship between tobacco use and thyroid function. J Eur Acad Dermatol Venereol. 2003;17: 276–9.
Referans 19. Elston GE, Charles-Holmes R, Carr RA. Precipitation of generalized pustular psoriasis by prednisolone. Clin Exp Dermatol. 2006;31: 133.
Referans20. Shmidt E, Wetter DA, Ferguson SB, Pittelkow MR. Psoriasis and palmoplantar pustulosis associated with tumor necrosis factor-α inhibitors: the Mayo Clinic experience, 1998 to 2010. J Am Acad Dermatol. 2012;67: e179.Referans21. Duckworth L, Maheshwari MB, Thomson MA. A diagnostic challenge: acute generalized exanthematous pustulosis or pustular psoriasis due to terbinafine. Clin Exp Dermatol. 2012;37: 24.
Referans22. Sugiura K, Shoda Y, Akiyama M. Generalized pustular psoriasis triggered by amoxicillin in monozygotic twins with compound heterozygous IL36RN mutations: comment on the article by Navarini et al. J Invest Dermatol. 2014;134: 578.
Referans23. Richer V, Roubille C, Fleming P, et al. Psoriasis and Smoking: A Systematic Literature Review and Meta-Analysis With Qualitative Analysis of Effect of Smoking on Psoriasis Severity. J Cutan Med Surg. 2016;20: 221-7.