Psoriasis impairs the quality of life of approximately 7.5 million Americans and is associated with serious comorbidities. Because of chronic vascular access and epidermal dysfunction, end-stage renal disease (ESRD) patients with psoriasis may be at greater risk for infection, and psoriasis treatment could affect this risk.A retrospective cohort analysis was performed using the United States Renal Data System from 2004-2011 to investigate the association of psoriasis with infections common to ESRD patients, as well as the effect of psoriasis treatment on infection risk as well as mortality.A total of 8,911 psoriasis patients were identified. Psoriasis was associated with a significantly increased risk for all queried infections, especially cellulitis (adjusted relative risk = 1.55), conjunctivitis (1.47), and onychomycosis (1.36). Psoriasis treatment (systemic, local, and light) was associated with a significantly decreased risk of some infections. Psoriasis treatment was also correlated with a significantly decreased risk of mortality, with systemic therapies (biologics and other immunosuppressants) showing the greatest reduction (adjusted hazard ratio = 0.55).These results suggest that psoriasis-ESRD patients may have an increased risk of infection and treatment of psoriasis is associated with a reduced risk of some infections and improved survival.

L’histamine a été découverte au tout début du 20e siècle. La capacité de synthèse de l’histamine par des cellules immunocompétentes (lymphocyte T, cellule dendritique) a été identifiée récemment ainsi que le rôle de l’histamine dans la régulation de la balance Th1/Th2. Ce rôle immunorégulateur de l’histamine serait lié à sa capacité de polariser les cellules dendritiques vers un phénotype CD2 inducteur de la différenciation des lymphocytes T helper en cellules Th2. L’histamine est principalement métabolisée par la N-méthyl-transférase. Un polymorphisme génétique de cette enzyme, se traduisant par une diminution de l’activité enzymatique, a été trouvé plus fréquemment chez les asthmatiques. L’histamine se fixe sur quatre types de récepteurs dont l’expression varie en fonction des cellules et des organes et sont impliqués dans les multiples actions de l’histamine. Les récepteurs H1 ont une activité intrinsèque qui est inhibée en présence d’antagonistes H1, témoignant d’une propriété agoniste inverse. Par ailleurs, le transport par les glycoprotéines P cérébrales expliquerait l’absence d’effet sédatif des antihistaminiques de deuxième génération.Histamine was discovered at the beginning of the 20th century. It has been recently shown that immunocompetent cells (T lymphocyte, dendritic cell) are capable of histamine synthesis and that histamine can regulate the Th1/Th2 balance. This immune regulation by histamine is related to its activity as a potent polarizing factor for dendritic cells, giving rise to DC2 dendritic cells that are involved in the differentiation of T helper cells towards Th2 phenotype. The majority of histamine is metabolized by N-methyltransferase. A common polymorphism of this enzyme that is associated with decreased enzyme activity has been associated with asthma. Histamine binds to four receptor types that are expressed on different types of cells and that mediate the numerous actions of histamine. H1-receptors exhibit constitutive activity that is inhibited by several H1-receptor antagonists, which therefore display a negative intrinsic activity called inverse agonist activity. In addition, the cerebral P-glycoprotein-mediated efflux of recent H1-receptor antagonists may explain the lack of nervous system side effects of second-generation anti-histamines.

Linear hyperpigmentation following the cutaneous bending lines of the fetal position is rarely reportedCase report - A Senegalese, black, male newborn had presented a pigmentary abnormality since birth. He was born at term and examination revealed extensive linear and retiform pigmentation of the extremities. The hyperpigmentation disappeared completely by two to three months of age. There was a family history in Senegal.Comments, - Our case resembles others found in the literature. A defect of migration of the melanocytes and an ethnic factor may be hypothesized. (C) 2000 Editions scientifiques et medicales Elsevier SAS.