RESUMO OBJETIVO: Estudar a prevalência de SM (Síndrome metabólica) em pacientes com psoríase de nossa localidade, assim como a influência das variáveis da psoríase no seu aparecimento. MÉTODOS: Noventa e sete pacientes com psoríase foram estudados para SM e comparados com 97 controles. Dados sobre o tipo de psoríase, envolvimento de unhas e extensão da lesão cutânea medida pelo PASI (Psoriasis Area and Severity Index) foram obtidas por meio de exame físico. Dados de infarto do miocárdio, angina pectoris e acidente vascular cerebral prévios foram coletados por meio de revisão de prontuários e questionamento direto. RESULTADOS: A comparação da prevalência de SM em pacientes com psoríase (49,4%) com controles (35,0%) apresentou diferença com p = 0,04; OR = 1,8 (IC95% = 1,02-3,23). Pacientes com psoríase apresentaram maior índice de massa corporal (p = 0,02), maior pressão arterial sistólica (p = 0,007), menor colesterol HDL (p = 0,01), maiores valores de glicose (p = 0,04), maior circunferência da cintura (p = 0,003) e mais angina pectoris (p = 0,03; OR = 2,5; IC95% = 1,04-6,15) do que controles. Quando os pacientes de psoríase com e sem SM foram comparados entre si, aqueles com SM eram mais velhos (p = 0,0004), apresentaram início da doença em idade mais avançada (p = 0,02), tinham maior exposição ao fumo (p = 0,02) e tendência a ter menor envolvimento no couro cabeludo (p = 0,06) quando comparados com os sem SM na análise univariada. A regressão logística mostrou que apenas a idade e o envolvimento do couro cabeludo foram independentemente associados à SM na amostra de psoríase. CONCLUSÃO: Na presente amostra de pacientes com psoríase, a prevalência de SM é alta e os itens que merecem mais atenção são obesidade central, baixo HDL, hipertensão e hábito de fumar. No grupo da psoríase, a SM foi associada de forma independente com idade mais avançada e menor envolvimento no couro cabeludo.

SUMMARY BACKGROUND: Psoriasis is associated with higher prevalence of metabolic syndrome (MS). The prevalence of MS varies according to the studied population as it suffers influence of genetics, aging, sedentary behaviour and diet. OBJECTIVE: To study the prevalence of MS in local psoriasis patients and the influence of psoriasis variables on its appearance. METHODS: A group of 97 psoriasis patients were studied for MS and compared with 97 controls. Psoriasis type, nail involvement, psoriasis extension measured by PASI (Psoriasis Area and Severity Index) were obtained through physical examination and history of previous myocardial infarction, angina and stroke were obtained through chart review. RESULTS: Comparison of MS prevalence in psoriasis patients (49.4%) with controls (35.0%) showed difference with p=0.04; OR=1.8 (95%CI=1.02-3.23). Patients with psoriasis had higher body mass index (p=0.02), higher systolic blood pressure (p=0.007), lower HDL cholesterol (p=0.01), higher glucose (p=0.04), higher waist circumference (p=0.003) and more angina pectoris (p=0.03;OR=2.5; 95% 0=1.04-6.15) than controls. When psoriasis sample with and without MS were compared, those with MS were older (p=0.0004), had disease onset at older age (p=0.02), more tobacco exposure (p=0.02), and a tendency to have less scalp involvement (p=0.06) in univariate analysis. Logistic regression showed that only age and scalp involvement were independently associated with MS in the psoriasis sample. CONCLUSION: In our psoriasis sample, MS prevalence is high and the items that deserve more attention are central obesity, low HDL, hypertension and smoking habits. In the psoriasis group, MS was associated independently with older age and less scalp involvement.

Abstract Ectodermal dysplasias are conditions that present primary defects in two or more tissues of ectodermal origin and can be classified as hypohidrotic and hidrotic. Hidrotic ectodermal dysplasia or Clouston syndrome is an autosomal dominant genodermatosis and appears as a triad of clinical findings: palmoplantar keratoderma, nail dystrophy, and hypotrichosis. The hair is sparse and brittle. The nails become thickened and dystrophic, which is an essential characteristic of the syndrome. The diagnosis is made based on clinical findings. This study reports a case of a patient who began with changes in hair, nails and palmoplantar keratoderma in early childhood.

A síndrome das unhas frágeis caracteriza-se por fragilidade da lâmina ungueal, acometendo 27% das mulheres. Realizamos estudo transversal com pacientes dermatológicas sobre a percepção de fragilidade ungueal. Avaliamos 138 pacientes com idade mediana de 36,5 anos. Ao exame, 57% apresentavam alterações e 49% relatavam fragilidade ungueal. Os três primeiros dedos das mãos foram os mais acometidos. A onicosquizia associou-se com onicofagia (OR = 3,29), trabalhos domésticos (OR = 2,95) e contato com água (OR = 2,44). A onicorrexe teve a mais forte associação com a percepção de fragilidade ungueal (OR = 17,89). A fragilidade foi mais percebida em negras, pardas e atópicas e associou-se com humor depressivo.

Brittle Nails Syndrome is characterized by fragility of the nail plate, affecting 27% of women. We evaluated dermatology patients in a cross-sectional study about perception of nail fragility. One hundred and thirtyeight women were included, with median age of 36.5 years. Nail examination showed changes in 57% and 49% reported nail fragility. The first three fingernails were the most affected. Onychoschizia was related to onychophagia (OR = 3.29), housework (OR = 2.95) and water contact (OR = 2.44). Onychorrhexis had the strongest association with nail fragility perception (OR = 17.89). The fragility was more perceived by those who were black, of mixed race and atopic, and was associated with depressed mood.