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The patient is a 59-year-old female with a history of psoriatic arthropathy for 10 years. Her psychiatric history is indicative of emotional stress and obsessive eating disorder with episodes of binge eating. Her regular and usual diet consisted of very high fat and high carbohydrate food items. In her early 20s, she was married, and she was obese at that time. She has a history of verbal abuse from her husband. Her present stress levels are high, and her medication history includes antibiotics and antidepressants.
She is an obese diabetic, and she had a nervous breakdown at 47. She was diagnosed to be having psoriatic arthropathy at 49. At 53, she left her job and changed her diet and lost weight. She is a successful author. For 5 years, she is eating mainly vegetarian diet from ready meals. She has a history of using steroids for 2 years, and during flare-ups of her disease, she takes prednisolone and NSAID, naproxen. For the last 6 years she is on immunosuppressive drug azathioprine, and for her diabetes, she is only on dietary management.
She has a history of a cleansing diet for 3 months during the past year without any aggravation.IntroductionPsoriasis is a chronic, relapsing inflammatory skin disease affecting between 1% and 3% of the world's population. Psoriasis type, disease severity, and lesional locations fluctuate over time, and emissions are not uncommon. Psoriasis is associated with multiple comorbidities including arthritis, obesity, and diabetes, whereas other diseases, such as atopic dermatitis and allergies have been found to be less common in psoriatics (Gladman and Rahman, 2001).
Psoriatic arthritis is the most common comorbidity. Diabetes in psoriatics is especially seen in females, although the high prevalence of obesity in this population may be a confounding factor (Gladman, 2002).
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