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Biomedical subjects

P Ena

Publications and source records attributed to P Ena.

31 records · Page 2Linked to original sources

High prevalence of microproteinuria, an early index of renal impairment, in patients with diffuse psoriasis.

Heavy reversible proteinuria induced by antihypertensive treatment with low doses of captopril has recently been reported by our group in psoriatic patients. To ascertain whether an increased permeability of the glomerular basal membrane of psoriatics can lead to an enhanced urinary excretion of albumin independently from the presence or absence of coexisting diabetes or hypertension, the latter parameter was measured in 39 patients affected by diffuse psoriasis. A high prevalence of microalbuminuria was observed in diabetic and hypertensive psoriatics. Moreover, a direct correlation was found between the diastolic blood pressure (BP) values and the urinary excretion of albumin in the entire group of psoriatics, thus suggesting systemic hypertension as one of the factors responsible for proteinuria in these patients. However, more than 50% of normotensive psoriatics showed an enhanced excretion of albumin. Since microalbuminuria has been indicated as a reliable index to predict the development of renal impairment, the finding of an enhanced albumin loss in psoriatics represents a further risk factor in these patients, who are particularly susceptible to experience cardiovascular complications.

Adult↗

Serum angiotensin-converting enzyme activity in psoriasis.

Conflicting data concerning the presence of enhanced serum angiotensin-converting enzyme (SACE) activity in psoriasis are reported in the literature. In order to verify whether this abnormality is a typical pattern of psoriasis, SACE levels were determined in 27 psoriatics as well as in 18 healthy subjects and in 30 patients with essential hypertension. We found that SACE levels were normal in patients affected by psoriasis independently of the presence or the absence of abnormalities in carbohydrate metabolism. Furthermore, SACE levels were not related to the severity of the skin lesions. We conclude that an elevated SACE activity is not a typical pattern of psoriasis, whereas, when present in a psoriatic, it might suggest the possibility of a coexisting unknown systemic sarcoidosis.

Adult↗

Captopril-induced proteinuria in hypertensive psoriatic patients.

We have previously reported on a high prevalence of high renin essential hypertension in psoriasis. Since angiotensin-converting enzyme (ACE) was also reported to be increased in some psoriatics, we found it rational to treat 10 patients with hypertension and diffuse psoriasis with captopril at a dose of 25 mg t.i.d. Five patients had high PRA levels and in 1 of them serum ACE was also increased. Serum creatinine, BUN and urinalysis were normal in all of them. SPB fell from 163 +/- 3 to 138 +/- 3 and DBP from 107 +/- 3 to 86 +/- 2 mm Hg after 1 month of captopril treatment. A surprising clinical improvement of the cutaneous lesions occurred in 3 patients previously resistant to every local or systemic treatment. Unfortunately, however, 3 patients developed heavy proteinuria (greater than 2 g/day) which disappeared after captopril discontinuation. The unexpected incidence of reversible proteinuria induced by low doses of captopril in our patients recommends a careful monitoring of the renal function every time this drug is employed in the treatment of hypertension in a psoriatic.

Adult↗

High prevalence of cardiovascular diseases and enhanced activity of the renin-angiotensin system in psoriatic patients.

We have observed a significant higher prevalence of essential hypertension, cardiovascular diseases and diabetes in a group of 100 psoriatic patients compared with sex and age matched hospitalized controls. Thirty-five psoriatic patients exhibited and enhanced plasma renin activity (PRA), while urinary aldosterone excretion was raised in 27% of the group. The autonomic responsiveness of psoriatic patients, studied by cold pressure test and tilting was normal; this finding supports the hypothesis that the enhanced activity of renin-angiotensin system is not due to an increased sympathetic function in these psoriatic patients. High values of cholesterol, triglycerides and depressed HDL-cholesterol concentrations were also observed. A complete clinical and laboratory examination is very useful in psoriasis in order to initiate an appropriate treatment of the risk factors whenever present.

Aldosterone↗

Surgical treatment of balanitis xerotica obliterans.

Balanitis xerotica obliterans, or kraurosis penis, is a chronic progressive scleroatrophic process of the penis, prepuce, and urethral meatus. This syndrome is due to lichen sclerosus et atrophicus of the genital region. We have observed 32 patients, whose ages ranged from 24 to 78, with different clinical and pathologic findings. Clinical symptomatology consisted of painful erection with secondary impotence, burning, itching, and urinary disorders. The treatment in the early stages is pharmacologic; stenosis of the meatus, phimosis, scar adhesions, fissures, and erosions of glans and prepuce prescribe a surgical treatment. We have performed modified circumcision, meatotomy and meatoplasty, removal of the scleroatrophic tract and subsequent grafting. The functional results were satisfactory.

Adult↗

Pityriasis rotunda in childhood.

Pityriasis rotunda is a rare disease characterized by round or oval patches, localized mainly on the trunk, arms, and legs. The patches are usually lighter than the surrounding skin, but sometimes may be darker, and are covered by fine, adherent scales. Two types of pityriasis rotunda have been described. Type I has been observed mainly in oriental and black patients older than 60 years of age, and is often associated with systemic disease or malignancy. Type II has been observed in white patients younger than 40 years of age, is often familial, and has never been observed in association with malignancy or internal disease. On Sardinia, a cluster of patients with type II pityriasis rotunda has been described. From 1981 until 1998, 51 cases of this disease have been observed in the Department of Dermatology, University of Sassari; 32 of them were children. The great prevalence of pityriasis rotunda on Sardinia, an island which until 40 years ago had limited contact with the Italian mainland, and the presence of a large number of familial cases suggest that type II pityriasis rotunda should be considered a genetically determined disease. The trend toward spontaneous resolution after the age of 20 years suggests that pityriasis rotunda should be considered a genodermatosis with a temporary phenotypic expression.

Adolescent↗

[Papulonecrotic tuberculide. Presentation of 4 cases].

Four young patients simultaneously affected by morphological variations of papulonecrotic tuberculid and lymphnode and pulmonary tuberculosis (three cases) are reported. The clinical, therapeutic, histological and immunological aspects of papulous tuberculid are discussed and the different diagnostic approaches to this rare disease are evaluated.

Adult↗