Omer Calka

Several reports have demonstrated an association between psoriasis and cardiovascular diseases such as hypertension, valvular disease and arrhythmia. However, the data is scarce. Forty-seven psoriasis patients and 20 healthy people underwent transthoracic echocardiographic examination including pulse- and tissue Doppler analysis and 24-h ambulatory electrocardiographic monitoring including heart rate variability (HRV) analysis. Patients having systemic hypertension, diabetes mellitus, history of structural or ischemic heart disease, chronic obstructive pulmonary disease and any associated systemic disease were excluded. Psoriasis Area and Severity Index (PASI) was calculated and severe psoriasis was defined in the case of history of hospitalizations for psoriasis and/or getting systemic therapy. Mean age of the patients was 35.7 ± 12.9 years and disease duration was 123.2 ± 84.3 (3–360) months. PASI ranged from 0.4 to 34.0 (mean ± SD: 7.1 ± 6.6) and 20 (42.6%) patients had severe psoriasis. There were no significant differences between psoriasis patients and control group with respect to mean values of blood pressure, body mass index, lipid profile and cardiac dimensions. However, frequency of being overweight was significantly higher in psoriasis patients (42.6 vs. 10.0%, P = 0.011). No patient had valvular disease. Mild pulmonary hypertension (PH) (30–40 mmHg) was significantly more frequent in psoriasis patients (31.9 vs. 0%, P = 0.003). Pulse wave mitral Doppler deceleration and isovolumetric relaxation times were significantly longer in psoriasis patients (195.9 ± 29.7 vs. 191.6 ± 14.7 ms, P = 0.002 and 91.6 ± 14.7 vs. 79.6 ± 10.5 ms, P = 0.001, respectively). However, frequency of diastolic dysfunction was not significantly different than the control group (8.5 vs. 0%, P = 0.309). HRV parameters and frequency of supraventricular and ventricular premature beats were not significantly different between the groups. No patient had ventricular tachycardia. Echocardiographic follow-up of psoriasis patients may be important due to possible association of PH. However, incidences of structural heart disease and arrythmia are not increased in psoriasis according to our results.

Pemphigus vulgaris (PV) is a rare autoimmune bullous skin disorder characterized by frequent involvement of the mucous membranes, usually beginning at the mouth. To investigate the oesophageal involvement in patients with PV and to explore the primary relationship of the disease with symptoms such as dysphagia, odynophagia and retrosternal burning. Oesophageal involvement was investigated by upper gastrointestinal endoscopy and biopsy during the early phase of the attacks in 26 patients with PV (12 men, 14 women, age range 24-63 years). Histopathological examination and direct immunofluorescence of the oesophageal biopsy specimens revealed pemphigus involvement in 12 of 26 patients (46.15%). The oesophagus is an important predilection zone for PV, thus care must be taken to detect these lesions at an early stage.