Autoimmune conditionsDermatologyPsoriasis, Australian Journal of General Practice published by the Royal Australian College of General Practitioners, 100 Wellington Parade, East Melbourne, Victoria 3002, Australia J Dermatolog Treat 2018;29(5):487–95. doi: 10.1080/09546634.2017.1329511. Alcohol dependency was four times as likely in patients with psoriasis.18, Alcohol consumption in young male patients with psoriasis is associated with depression and anxiety.17 Although alcohol and drug intake might be a response to the impaired QoL associated with psoriasis, it also promotes a cytokine inflammatory response that worsens psoriasis, with evidence showing that alcohol abstinence improves psoriasis.17, Gambling is also more likely to occur in patients with psoriasis.18 Patients with psoriasis are more than 30 times likely to gamble than the general population.18, Smoking and exposure to tobacco smoke is associated with the development of psoriasis.19 Patients with psoriasis are also more likely to be smokers, which adds to the increased risk of cardiovascular disease and metabolic syndrome.20  One study showed that 49% of patients with psoriasis were smokers, compared with 30% of the general population.18. A guideline that has received RACGP endorsement will be issued with the RACGP … The results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood. The coroner called for the two professions to trust and respect each other while maintaining their independence after an elderly man died after being prescribed the wrong dose of methotrexate. Moll JM, Wright V. Psoriatic arthritis. Fry L, Baker BS, Powles AV, Fahlen A, Engstrand L. Is chronic plaque psoriasis triggered by microbiota in the skin? 4. Hohenberger M, Cardwell LA, Oussedik E, Feldman SR. Interleukin-17 inhibition: Role in psoriasis and inflammatory bowel disease. Candida superimposed on flexural psoriasis makes treatment difficult, resulting in persistent and severe plaques. Real-world burden of comorbidities in US patients with psoriasis. AMH is jointly owned by the Royal Australian College of General Practitioners (RACGP), the Pharmaceutical Society of Australia (PSA) and the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT). Patients with severe psoriasis were more likely to have suicidal ideation, suicide attempts and completed suicide than the general population.13,14 Clinical trials evaluating the efficacy of newer medications for psoriasis typically incorporate QoL and depression questionnaires to assess the impact on psychiatric health. It is characterised by salmon pink plaques with adherent scale, and the most common locations include the elbows, knees, intergluteal cleft, nails and scalp. In patients with psoriasis, the prevalence of hyperlipidaemia is 46%, hypertension 42%, type 2 diabetes (T2D) 17% and obesity 14%.5 The more severe the psoriasis, the greater the risk and severity of metabolic syndrome.6 Therefore, it is critical that patients with psoriasis are evaluated for the risk factors for metabolic syndrome. Psoriasis is a common immune-mediated skin disorder that affects approximately 2% of the population. Patients with psoriasis typically have a large habitus, an unhealthy diet and risk factors for cardiovascular disease (CVD). The association between psoriasis and hypertension: A systematic review and meta-analysis of observational studies. General practice management of type 2 diabetes https://www.racgp. doi: 10.1016/S0140-6736(18)30830-4. Addiction: An underestimated problem in psoriasis health care. PSA president Shane Jackson says recent findings by a Victorian coroner highlighted the importance of pharmacists and GPs working together. Five of the best AusDoc stories of the year, Long COVID: 'I wouldn't wish it on my worst enemy', Doctors split over compulsory COVID-19 vaccination for health workers. Harmful, hazardous and dependent drinking can lead to increased morbidity and mortality. J Eur Acad Dermatol Venereol 2017;31(8):1308–15. Higher incidence rates of comorbidities in patients with psoriatic arthritis compared with the general population using US administrative claims data. Australas J Dermatol 2019;60(2):91–98. Routinely screening all men to check their prostate-specific antigen (PSA) levels is a controversial subject in the international medical community. RACGP is the latest medical college to endorse the guidelines, which provide health professionals with evidence-based recommendations for using the prostate specific antigen (PSA) blood test to assess prostate cancer risk and manage test-detected patients. Int J Dermatol 2016;55(2):e72–78. GPs are in a prime position to screen and diagnose these common comorbidities and have the experience and knowledge to manage them accordingly. The PSA blood test alone cannot diagnose prostate cancer. J Med Econ 2019;22(12):1290–97. doi: 10.1016/j.det.2014.09.010. A clinical practice narrative. A prostate biopsy may be recommended if there is an elevated PSA or a rapid rise in PSA. Whilst the RACGP recommends against prostate cancer screening (as detailed in our Guidelines for preventive activities in general practice) we recognise many men will be asking their GPs about screening. Like acute rheumatic fever ( arf ), psa is a reactive arthritis characterized by a pharyngeal streptococcal infection, a symptom-free interval and subsequent aseptic inflammation of one or more joints. doi: 10.1111/jdv.13619. QoL scores such as the Dermatology Life Quality Index (DLQI), Health-related quality of life (HRQOL), Psoriasis Disability Index (PDI) and Skindex can be used to assess the impact of psoriasis. Although many believe the skin is the only organ involved in psoriasis, more recent advances have shown a predilection for other diseases and comorbidities (Table 1), likely due to a proinflammatory state with excess circulating cytokines. These toxins are associated with a more severe type of psoriasis.25 There is no evidence to date to support tonsillectomies to reduce the incidence of guttate psoriasis. Depression and suicidality in psoriasis: Review of the literature including the cytokine theory of depression. The RACP will close from Thursday 24 December 2020 and re-open Monday 4 January 2021 (Australia) and Tuesday 5 January 2021 (Aotearoa New Zealand). But most of these cancers do not cause problems. It is common for older men to have some cancer cells in their prostate glands. In addition to treating the skin, it is important to assess patients for psoriasis-related comorbidities by taking a simple history (eg asking about arthralgia and arthritis, alcohol and drug intake/abuse, sexual dysfunction), performing clinical examinations (eg measuring waist circumference, weight, body mass index), performing QoL scales (eg depression and anxiety scales) and ordering laboratory investigations (eg lipid profile, blood sugar levels, liver and renal function).6 A multidisciplinary team approach to patients with psoriasis may include non-GP specialists such as dermatologists, rheumatologists, cardiologists, endocrinologists, gastroenterologists and psychiatrists as well as allied health practitioners (eg psychologists and dietitians). Tintle SJ, Gottlieb AB. A holistic approach to a patient with psoriasis that includes evaluating and assessing comorbidities and risk of morbidity is essential, as psoriasis should be considered a systemic disease rather than cutaneous condition alone. AMH is compiled .. Veale DJ, Fearon U. Serum rheumatoid factor is elevated in 13% of patients with PsA, compared with 80% of those with rheumatoid arthritis.2 Radiographic changes include pencil-in-cup deformity, with digit shortening and bone lysis.2 These changes can occur within two years of disease onset. J Manag Care Spec Pharm 2019;25(1):122–32. Smoking and risk for psoriasis: A population-based twin study. Al-Jefri K, Newbury-Birch D, Muirhead CR, et al. The risk of lymphoma – in particular, Hodgkin’s lymphoma and cutaneous T-cell lymphoma – is at least three times greater in patients with severe psoriasis than the general population.21 The relative risk of any lymphoma in patients with mild psoriasis is 1.34. As an example, he says local GPs supported his pharmacy’s involvement in the recent diabetes screening trial. Of the 80 people screened, five were ultimately referred and started treatment for diabetes. Refer a patient to an allied health professional as part of a care plan and team care arrangement Complete a diabetes annual cycle of care. Br J Dermatol 2013;169(1):47–52. Rademaker M, Agnew K, Anagnostou N, et al. doi: 10.1080/13696998.2019.1638788. Do you know the symptoms of spinal muscular atrophy? J Invest Dermatol 2006;126(10):2194–201. The PSA said the changes mean electronic prescriptions are quickly expected to be in wide use across the whole metropolitan area by prescribers and pharmacies. For this test, a blood sample is sent to a laboratory for analysis. When a patient chooses screening, both [prostate specific antigen] PSA and [digital rectal examination] DRE should be performed. 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