1,721,180 research outputs found
Pharmacological management of severe plaque psoriasis in patients with cardiovascular disease
No full textIntroduction There is compelling evidence about the independent association between psoriasis and an increased risk of cardiovascular diseases, in particular myocardial infarction, chronic heart failure and cardiac arrythmia. This is due to both the higher prevalence of traditional cardiovascular risk factors and an independent contribution of chronic inflammation associated with psoriasis. Inflammation is not only important in atherosclerosis, but also is increasingly recognized as a contributing factor to heart failure and arrythmia through microvascular dysfunction and myocardial fibrosis. This enhanced risk should be considered when treating a patient with severe psoriasis. Moreover, the the pro and cons of a systemic treatment in a patient with already existing cardiovascular comorbidities should always be assessed with caution. Areas covered Herein, the authors review the pharmacological management of severe plaque psoriasis in patients with cardiovascular disease, providing their expert opinion and future perspectives on the subject. Expert opinion Theoretically, anti-inflammatory drugs may not only dampen the systemic burden associated with psoriasis, but also potentially contribute to prevent long-term cardiovascular events in psoriasis. On the other hand, some treatments may negatively affect the cardiovascular system. Whether findings from observational studies or ones evaluating surrogates of cardiovascular risk translate into reductions in cardiovascular events needs to be investigated by long-term clinical trials with clinically meaningful endpoints
Cumulative Life Course Impairment in Melanoma and Nonmelanoma Skin CancerDermatological Diseases and Cumulative Life Course Impairment
No full textPatients with skin cancer remain at risk for disease progression or relapse for many years. Therefore, skin cancer may be considered a chronic, life-threatening disease. It could impact on patients lifestyles and social and professional activities. Although no direct study of cumulative life course impairment (CLCI) in skin cancer patients has been carried out, a few studies suggest that skin cancer may strongly impair quality of life and eventually determine a significant CLCI (melanoma more than nonmelanoma skin cancer). Obviously, the life course of patients with melanoma at an advanced stage of the disease may change considerably. A number of cancer-associated problems may determine a CLCI, including familial or professional changes and a reduction of life expectancy may eventually lead to social withdrawal and depressive disorders. Even patients with a low stage disease may experience an important impairment of quality of life and in some cases a CLCI. Some skin cancer patients may have physical and psychological after effects from their cancer surgery. Several patients complain about lymphedema, discomfort experienced from wearing surgical stockings, and diminished range of physical motion postsurgery. A few are concerned about their body image due to surgical scars, and they may consider changing their job position because of the supposed negative impact of scars in visible sites on their ability to perform their job. Some female melanoma survivors may have a reduced desire of having children in the future. Copyright © 2013 S. Karger AG, Base
Comment on: Recovery from COVID-19 in a patient with spondyloarthritis treated with TNF-alpha inhibitor etanercept. A report on a patient with COVID-19 with psoriatic arthritis receiving ustekinumab
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