Background: A sustained inflammatory state of psoriasis causes comorbidities such as psoriatic arthritis, metabolic syndrome (MetS), and cardiovascular disease. Aims: To note the duration and severity of psoriasis, assess prevalence of MetS, and correlate these with indicators of sub-clinical atherosclerosis. Methodology: Thirty-two patients of chronic plaque psoriasis were enrolled in the study. Their demographic particulars, clinical details, results of investigations to assess MetS, and indicators of sub-clinical atherosclerosis, namely, carotid intimal media thickness (CIMT) measured using B-mode USG and epicardial fat thickness (EFT) using 2-D ECHO, were recorded. Results: The study participants were predominantly male (2.5:1); their mean age was 40.45 ± 12.42 years, the median disease duration (DD) was 2 years, and the mean psoriatic area severity index (PASI) score was 8.62 ± 7.49. Mild disease (PASI <5) was present in 12 participants (37.5%), and shorter DD (<5 years) was present in 16 (50%) participants. MetS, detected in 11 (37.5%) study participants, was not significantly associated with CIMT, EFT, DD, and PASI. CIMT and EFT too did not correlate significantly with DD, PASI, or measures of MetS. Neither did there exist any significant correlation between CIMT and EFT. Conclusion: Sub-clinical atherosclerosis in our study participants was not significantly associated with either measures of MetS or duration/severity of psoriasis.

Background: Substantial evidence suggests a higher risk of metabolic syndrome as a result of persistent inflammation in patients with psoriasis. Psoriasis may also be associated with vitamin D deficiency. Aim: To correlate vitamin D deficiency with psoriasis and metabolic syndrome. Materials and Methods: Serum vitamin D levels were quantified, and metabolic syndrome was assessed in 42 cases whose psoriasis severity had been measured by PASI and in an equal number of age/gender-matched controls. The resultant data were analyzed statistically. The odds ratio was calculated wherever applicable and a two-tailed P < 0.05 was considered statistically significant. Results: Vitamin D deficiency (<20 ng/ml) occurred in 43 subjects [(51.19%); 26 (62%), patients and 17 (40.4%), controls] and was statistically significant in patients (OR: 2.39, P = 0.044) though lacking correlation with disease severity. Metabolic syndrome seen in 25 (30%) subjects—15 (36%) patients and 10 (24%) controls—emerged to be significant (OR: 3.71, P = 0.047) in cases with vitamin D deficiency. Hypertension—observed in 31 (37%) subjects; 18 (43%) cases, 9 each (21.4%) with/without metabolic syndrome and 13 (31%) controls, 7 (16.6%) with and 6 (14.3%) without metabolic syndrome ( P = 0.25)—correlated independently with vitamin D deficiency in patients ( P = 0.009). Conclusions: Despite limitations of small sample size and observational nature, our study—probably the first such hereto from India—showed statistically significant associations between vitamin D deficiency, metabolic syndrome, and hypertension in patients with psoriasis. Future larger studies are needed for strengthening this evidence prior to the recommendation of its clinical application in the optimum management of patients.

No abstract

<p class="abstract"><strong>Background:</strong> Topical steroid-modified tinea corporis and tinea cruris is on the rise due to the ease of availability of over-the-counter potent topical corticosteroid preparations and their inappropriate use, alters the true morphology of lesion. As there is paucity of literature about increasing prevalence and varied presentation of this condition, we aimed to study the clinical profile and dermoscopic features of <em>Tinea pseudoimbricata</em> due to topical steroid abuse. We present a case-series of 77 cases of a distinct morphological pattern with central erythematous, scaly, pruritic concentrically spreading plaques with raised and scaly borders known as <em>Tinea pseudoimbricata</em>.</p><p class="abstract"><strong>Methods:</strong> We evaluated 77 clinically diagnosed patients of <em>Tinea pseudoimbricata</em> with positive 10% potassium hydroxide examination and culture. Dermoscopy was performed in all patients. The demographic, clinical, and mycological features of each patient were recorded on a predesigned proforma.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 52 male and 25 female patients with a mean age of 28.66 and a mean disease duration of 7.6 months. There was a history of application of potent or super-potent topical steroid for varying durations. Culture isolates were <em>Trichophyton rubrum</em> species. Dermoscopic analysis showed features of steroid abuse.</p><p class="abstract"><strong>Conclusions:</strong> Injudicious and inappropriate use of topical steroid causes <em>Tinea pseudoimbricata</em>; a special subset of tinea incognito, which is very common now a days. This should alert the dermatologist about the steroid abuse and requires systemic anti-fungal treatment for prolong time.</p>