MINISTRY OF EDUCATION MINISTRY OF NATIONAL DEFENCE
AND TRAINING
108 INSTITUTE OF CLINICAL MEDICAL AND PHARMACEUTICAL SCIENCES
HUYNH THI XUAN TAM
STUDYING THE EFFECTIVENESS OF THE COMBINED USE OF
METHOTREXATE AND METFORMIN ON PSORIASIS
CONCOMITANT WITH METABOLIC SYNDROME
Major: Dermatology
Code: 62.72.01.52
EXECUTIVE SUMMARY OF THE DISSERATION
Hà Nội – 2020
The study was accomplished at:
108 INSTITUTE OF CLINICAL MEDICAL AND
PHARMACEUTICAL SCIENCES
Instructors:
1. Bui Thi Van MD. Ph.D.
2. Tran Ngoc Anh MD. Ph.D.
Dissertation Committee:
1.
2.
3.
The dissertation will be protected in a council meeting
at: 108 Institute of Clinical Medical and
Pharmaceutical Sciences
At hour Day Month Year 2020
The dissertation can be found in:
1. National library of Vietnam
2. Library of 108 Institute of Clinical Medical and
pharmaceutical Sciences
3. Central institute for Medical Science
Information and Technology
1
INTRODUCTION
Psoriasis is one of the most common
dermatological condition which 1-3% population got
around the world. This percentage varies in races and
regions. For example, psoriasis in Northern Europe was
reported up to 3%, higher than the United States of
America and China with 2% and 0.3% respectively. In
Viet Nam, until now there has been a serious dearth in
research on the prevalence of this disease, just a few
studies operated in Kinh Mon district, Hai Duong
province showed this figure being 1,5% of population.
Psoriasis in the obese Vietnamese shows the
overexpression of inflammatory factors and
adipocytokines including cytokines IL-6, TNF-α,
adiponectin, and PAI-1. The level of TNF-α increases in
patients with psoriasis, and is positively correlated to the
BMI and insulin resistance.
Controlling metabolic syndrome in patients with
psoriasis is essential to reduce disease burdens.
However, treating psoriasis associated with metabolic
2
syndromes faces many challenges because of
controversial pathology, progression and clinical
evidence.
Research on using the combination of methotrexate
and metformin in psoriasis and metabolic syndrome has
been done around the world but not in Vietnam so for.
Therefore, it is necessary to conduct research on this
type of treatment in Vietnam with the following
objectives:
1. To describe some relating factors and clinical
features of psoriasis concomitant with metabolic
syndrome.
2. To survey the metabolic syndrome in psoriasis
patient and its relationship with clinical features.
3. To identify the effectiveness of the combination
of methotrexate and metformin in the treatment of mild
and moderate psoriasis.
3
Chapter 1: INTRODUCTION
1.1. Clinical and subclinical features of psoriasis:
1.1.1. Clinical features:
- Cutaneous lesion: A specific lesion is a non-infiltrated,
erythematous, well-defined plaque with silvery scales
on the surface. The size of the lesion can vary from
pinpoint papules to plaques covering large area of the
body. Psoriasis has a tendency to be symmetrical, which
is a good characteristic for diagnosis. However,
unilateral lesion can also appear. Common lesions
include: macules, plaques of erythema and scale
(sometime papules with scale).
- Sites of lesion: Lesions are generally symmetrical. The
sites of predilection of the characteristic plaques include
scalp, beyond the hairline, knee, elbow, extensor of the
arms and legs. Psoriasis lesions can appear on cutaneous
injuries, irritation, rubbing (for example scratching,
chafing, injection) called Kebner phenomenon.
- Nail lesions: Nail lesions are very common (30-50%
of all cases). It happens in all or many nails