Decreased Bone Mineral Density in Patients with Pustulosis palmaris et plantaris

Abstract

Background: Focal skeletal changes in patients with pustulosis palmaris et plantaris (PPP) are known to occur in a minority of patients. It is unknown whether these changes are unique events or whether they merely represent more progressed cases. Objective: The study was undertaken in order to investigate possible diffuse bone changes in patients with PPP. Methods: Bone mineral density (BMD) and biochemical markers of bone turnover were studied in 18 female patients and 18 age-matched controls. Results: A significant correlation was found between lower-forearm BMD and disease duration (< 0.05). With increasing age, patients had significantly lower values than controls for both forearm and spine BMD (p < 0.005); patients who had PPP for more than 2 years had significantly reduced forearm BMD (19.8%; 95% CI: 5.6–32.8%)) and spine BMD (17.4%; 95% CI: 0.9–33.8%). No significant differences were observed in biochemical markers of bone turnover, physical activity or body mass index between patients and controls. The proportion of smokers among patients was four times higher than among controls (p < 0.0005). No significant dose effect was found between number of pack-years and BMD. Conclusion: Although we cannot exclude that prolonged use of topical steroids under occlusion is a confounding factor, the study suggests that PPP patients have decreased BMD due to primary pathogenic events, and that osteoporosis may be an additional problem for these patients.

Association between osteoporosis and psoriasis: results from the Longitudinal Health Insurance Database in Taiwan

“…Several of the studies conducted on the association between psoriasis and osteoporosis to date [22][23][24] were characterized by small sample sizes. A significant association has been identified between osteoporosis and palmoplantar pustular psoriasis [22], but not chronic plaque psoriasis [23].…”

“…As the same cytokines also appear to be active in the pathogenesis of psoriasis [19,20], numerous researchers have explored the possible association between these two diseases [19,[21][22][23][24][25][26].…”

UVB and Vitamin D in Psoriasis

“…However, a previous study showed that patients with chronic plaque psoriasis had a low BMD despite risk factors, although the subgroup with joint involvement appeared to be at a higher risk of developing osteoporosis and therefore required prevention therapy (103). Reduced BMD has been linked to palmoplantar pustular psoriasis (104). The existence of less severe periarticular osteoporosis has also been reported (105).…”

A meta-analysis of the effects of cigarette smoking on bone mineral density

“…In terms of the health status of samples, 77 studies either excluded participants who had disorders affecting bone metabolism, or did not select participants based on disorders affecting bone metabolism (e.g., community-based cohorts). Nine studies selected participants for certain disorders known to influence bone metabolism, including osteoporosis [16], amenorrhea [17], anorexia nervosa [18], diabetes [19,20], gastrointestinal disorders [21][22][23], and pustolosis palmaris et plantaris (a dermatologic condition associated with bone metabolic dysfunction) [24].…”