Diabetes, obesity and psoriasis in a 60-year-old woman

Jose M Varela-Aguilar; Rosa Garcia-Contreras; Ana Calzada-Valle; M Luz Calero-Bernal; Estefania Pererira-Diaz; Fidel Moreno-Verdejo; Abelardo Hurtado-Ganoza; Francisco Ruiz-Ruiz; Enrique Calderon-Sandubete

doi:10.1530/endoabs.37.EP1330

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Endocrine Abstracts (2015) 37 EP1330 | DOI: 10.1530/endoabs.37.EP1330

ECE2015 Eposter Presentations Clinical Cases–Thyroid/Other (101 abstracts)

Diabetes, obesity and psoriasis in a 60-year-old woman

José M Varela-Aguilar ^1, , Rosa García-Contreras ¹ , Ana Calzada-Valle ¹ , M Luz Calero-Bernal ¹ , Estefania Pererira-Díaz ¹ , Fidel Moreno-Verdejo ¹ , Abelardo Hurtado-Ganoza ¹ , Francisco Ruiz-Ruiz ¹ & Enrique Calderón-Sandubete ^1,

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¹Internal Medicine Service, Hospital Virgen del Rocío, Seville, Spain; ²CIBER Epidemiologia y Salud Pública, Seville, Spain.

Psoriasis (PS) is a skin disease of immune T-cell mediated. It is well known that obesity is a risk factor for severity PS and PS is associated with the degree of overweight. In addition, patients with PS have increased risk of metabolic disorders such as diabetes mellitus (DM) and dyslipidaemia. All these processes are characterised by the presence of systemic chronic inflammation. Liraglutide, an agonist receptor GLP-1, is being used in the treatment of obesity and diabetes mellitus with excellent results both in glycaemic control and reduced body weight.

Case report: 60-year-old woman with a history of type 2 diabetes, type II obesity (78 300 kg; BMI 38.39) and moderate psoriasis which was derived from primary care for poor glycaemic control (glycated Hb: 7.3%). Skin: injuries erythematous scaly plaques on back of hands, elbows, knees, trunk and scalp with PASI 5.8 and BSA 7% (Fig. 1).

Treatment was initiated with metformin 850 mg bid and liraglutide 1.2 mg/s, maintaining the same treatment for psoriasis came performing with topical corticosteroids and methotrexate. Three months after treatment change was revised in consultation objectifying optimal glycaemic control (HbA1c 6.1%), reduction of 8.5 kg in weight and improvement of skin lesions with PASI <3 and BSA 2% (Fig. 2).

Conclusions: The improvement in the weight reduction and improved glycaemic control as well as reduced secretion of proinflammatory cytokines placed the receptor agonists of GLP-1 in a special place for treatment of patients with T2DM and psoriasis. These features, which have yet to be demonstrated on a consolidated basis in clinical practice, can play a key role in the individualization of treatment of patients with T2DM.