SummaryPsoriasis is an inflammatory skin disease associated with increased cardiovascular comorbidity. Smoking is associated with an increased risk of cardiovascular disease, and prior studies have suggested that patients with psoriasis are more likely to be active smokers. Smoking may also be a risk factor in the development of psoriasis. We conducted a systematic review and meta-analysis to assess the prevalence of smoking among patients with psoriasis, and we reviewed the contribution of smoking to the incidence of psoriasis. A total of 25 prevalence and three incidence studies were identified. The meta-analysis of prevalence studies included a total of 146 934 patients with psoriasis and 529 111 patients without psoriasis. Random effects meta-analysis found an association between psoriasis and current smoking [pooled odds ratio (OR) 1Á78, 95% confidence interval (CI) 1Á52-2Á06], as well as between psoriasis and former smoking (pooled OR 1Á62, 95% CI 1Á33-1Á99). Meta-regression analysis did not reveal any sources of study heterogeneity, but a funnel plot suggested possible publication bias. A subset of studies also examined the association between moderate-to-severe psoriasis and smoking, with a pooled OR of 1Á72 (95% CI 1Á33-2Á22) for prevalent smoking. The three incidence studies found an association between smoking and incidence of psoriasis, with a possible dose-effect of smoking intensity and duration on psoriasis incidence. These findings suggest that smoking is an independent risk factor for the development of psoriasis, and that patients with established psoriasis continue to smoke more than patients without psoriasis.What's already known about this topic?• Psoriasis is associated with a number of cardiovascular risk factors, many of which are influenced by smoking.What does this study add?• Patients with psoriasis are more likely to be current or former smokers.• Smoking is also associated with an increased risk of developing psoriasis.• These findings emphasize that patients with psoriasis should be screened for smoking, and that public health efforts to reduce smoking could also decrease the incidence of psoriasis.Psoriasis is a chronic, immune-mediated skin disease that affects approximately 2-4% of the world population.

The economic burden of psoriasis is substantial and significant in the United States.

Importance: While “omics” studies have advanced our understanding of inflammatory skin diseases, metabolomics is mostly an unexplored field in dermatology. Objective: We sought to elucidate the pathogenesis of psoriatic diseases by determining the differences in metabolomic profiles among psoriasis patients with or without psoriatic arthritis and healthy controls. Design: We employed a global metabolomics approach to compare circulating metabolites from patients with psoriasis, psoriasis and psoriatic arthritis, and healthy controls. Setting: Study participants were recruited from the general community and from the Psoriasis Clinic at the University of California Davis in United States. Participants: We examined metabolomic profiles using blood serum samples from 30 patients age and gender matched into three groups: 10 patients with psoriasis, 10 patients with psoriasis and psoriatic arthritis and 10 control participants. Main outcome(s) and measures(s): Metabolite levels were measured calculating the mean peak intensities from gas chromatography time-of-flight mass spectrometry. Results: Multivariate analyses of metabolomics profiles revealed altered serum metabolites among the study population. Compared to control patients, psoriasis patients had a higher level of alpha ketoglutaric acid (Pso: 288 ± 88; Control: 209 ± 69; p=0.03), a lower level of asparagine (Pso: 5460 ± 980; Control: 7260 ± 2100; p=0.02), and a lower level of glutamine (Pso: 86000 ± 20000; Control: 111000 ± 27000; p=0.02). Compared to control patients, patients with psoriasis and psoriatic arthritis had increased levels of glucuronic acid (Pso + PsA: 638 ± 250; Control: 347 ± 61; p=0.001). Compared to patients with psoriasis alone, patients with both psoriasis and psoriatic arthritis had a decreased level of alpha ketoglutaric acid (Pso + PsA: 186 ± 80; Pso: 288 ± 88; p=0.02) and an increased level of lignoceric acid (Pso + PsA: 442 ± 280; Pso: 214 ± 64; p=0.02). Conclusions and relevance: The metabolite differences help elucidate the pathogenesis of psoriasis and psoriatic arthritis and they may provide insights for therapeutic development.

No abstract

Diabetes is a metabolic disorder classified as chronic hyperglycemia. It is disorder of protein, carbohydrate and fat metabolism, which can result from dysfunction in insulin secretion and the mechanisms of insulin. An estimated 366 million people suffered from DM in 2011Diabetic gangrene arises from complication of DM. It results from infection or wound inflammatory process in advanced phase caused by either less intensive care or degenerative changes. The objective of this study is to assess the incidence of diabetic gangrene in patients with type 2 diabetes mellitus at Royal Prima Hospital This type of research is a retrospective study. The sample of this study was conducted at the Royal Prima Hospital for the period 1 January 2020 - 31 December 2020. The number of respondents used purposive sampling method, with inclusion and exclusion criteria. Data collection in this study is non-probability sampling with purposive sampling technique. The highest proportion of diabetic gangrene sufferers in type 2 diabetes mellitus patients was found at the age of 51-60 years with percentage (54.4%), while the lowest proportion was at age 40 years with a percentage (3.5%), and obtained age 40-50 years with a percentage (19.3%) and 60 years with percentage (22.8%). The proportion of patients with diabetic gangrene in type 2 diabetes mellitus patients was male (63.2%) more than female (36, 8%). The highest proportion of diabetic gangrene sufferers in type 2 diabetes mellitus patients with KGD ranges from 200-300 mg/dl (52.6%) and the lowest is 100 mg/dl (1%)