Tag Archives: psoriasis

Innovative approach on monitoring methotrexate induced hepatotoxicity in psoriasis patients – A case report

Ana-Maria Sandu1, Oana Mirela Tiucă2, Radu Stan1, Adina-Maria Andone3, Robert Aurelian Tiucă4, Ovidiu Simion Cotoi5, Silviu Horia Morariu2

1. Dermatology Department, Mures County Hospital, Targu Mures, Romania
2. Dermatology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Gastroenterology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
4. Endocrinology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
5. Pathophysiology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2025-0034

Introduction: Methotrexate is often used as the first line of systemic treatment in patients with moderate to severe psoriasis and psoriatic arthritis.
Case report: We present the case of a 44-year-old male patient with moderate plaque psoriasis who was treated with Methotrexate and diagnosed with mild hepatic steatosis during the first month of treatment. Using FIB-4 (Fibrosis Index Based on 4 factors) as a noninvasive method for assessing the risk of liver fibrosis, the patient was able to take Methotrexate safely, with close monitoring of liver function.
Conclusions: FIB-4 can be used to assess the risk of liver fibrosis in psoriasis patients treated with Methotrexate to ensure better adherence to the treatment.

Keywords: , , ,
Full text: PDF

Single-plaque psoriasis: a single-clue diagnostic challenge

Luminita Emilia Decean1, Roxana Flavia Ilies2, Andreea Sasu3, Iulia Barsan4, Adriana Mihai1

1. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
3. First Psychiatric Clinic, Targu Mures County Hospital, Romania.
4. Elitemed Anatomical Pathology Laboratory, Targu Mures, Romania

DOI: 10.2478/amma-2022-0019

Introduction: Psoriasis is a chronic, common immune inflammatory condition of the skin, affecting 2-3% of the population, with regional variability. Classically, psoriasis presents as one of the following types: plaque, guttate, inverse, pustular or erythrodermic psoriasis. Typically, the patient will present with several symmetric psoriatic plaques on typical areas of the body, leading the clinician towards the diagnosis of psoriasis.
Case report: The present case report series focuses on an atypical presentation of psoriasis noted in 2 patients who presented to our office with a single large, erythematous plaque located on the lower leg. Due to poor response to previous treatment, a biopsy was performed and upon analysis, revealed a diagnosis of psoriasis. The lesions showed significant improvement under local therapy.
Conclusion: In spite of significant research on such a common and seemingly well-understood dermatosis, the present case reports plead for further study with regards to atypical presentations of psoriasis.

Keywords: , , ,
Full text: PDF

The value of Histopathological Diagnosis in Rupoid Psoriasis Accompanied by Fever. A Case Report and a Review of the Literature

Morariu SH1, Badea MA2*, Vartolomei MD3, Badea Iudita Maria4, Cotoi OS5

1 Department of Dermatology, University of Medicine and Pharmacy Tîrgu Mureș, Romania
2 Dermatology Clinic, County Hospital Tîrgu Mureș, Romania
3 Department of Molecular and Cell Biology, University of Medicine and Pharmacy Tîrgu Mureș, Romania
4 Anesthesiology and Intensive Care Medicine Clinic, Emergency County Hospital Tîrgu Mureș, Romania
5 Department of Pathophysiology, University of Medicine and Pharmacy Tîrgu Mureș, Romania

DOI: 10.1515/amma-2015-0010

Psoriasis is a common dermatosis, however the rupoid type is considered as an exceptional form of this disease. Rupoid scabs are very rare in dermatological daily practice, usually being seen as secondary to syphilis in immunosuppressed patients. Rupoid psoriasis is characterized by thick and multilayered crusts that are resistant to local therapy and present a sudden onset. Severe arthropathy is a common manifestation. We did not found in literature any association of rupoid psoriasis with intermittent fever. We present the case of a patient who exhibited a rush of rupoid boards with severe arthralgia accompanied by intermittent fever. The suspicion of malignant syphilis was raised considering the clinical signs and symptoms and the specific social context of STDs. This suspicion was unconfirmed by TPHA negative reaction and histopathological appearance that showed changes typical of psoriasis. Clinical manifestations were successfully controlled with methotrexate.

Keywords: , , ,
Full text: PDF