Michael L. Shelling

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Psoriasis is highly prevalent and is associated with skin-associated complaints as well as arthritis, depression and a lower quality of life. Recently, it has been demonstrated that not only do patients with psoriasis have an increased prevalence of cardiovascular risk factors, but an increased risk of myocardial infarction, and for those with severe(More)
Psoriasis is an immune disease most commonly recognized for its skin and joint manifestations. These produce significant physical, social, and psychological distress in affected patients and resultant reductions in their quality of life. As expected, these concerns are vital in providing symptomatic improvement and in selecting an individualized therapy.(More)
Psoriasis afflicts 2-3% of the world’s population. Affected patients commonly have risk factors for cardiovascular disease (CVD). In addition, psoriasis is independently associated with CVD and mortality. To determine which CVD risk factors are associated with psoriasis independent of confounders, whether psoriasis is associated with CVD independent of CVD(More)
To the Editors:—It was with great interest that we read the study by Scuffham et al. and the accompanying editorial by Larson about the use of n-of-1 trials. Traditional medical training often emphasizes large, randomized, controlled trials as being perched on the highest tier in the hierarchy of research, but as the authors clearly state, these studies’(More)
The development of de novo psoriasis in patients treated with tumor necrosis factor-alpha antagonists is well recognized. The authors hereby report a case of palmplantar pustular psoriasis in a patient with rheumatoid arthritis treated with etanercept. The condition responded to topical steroids but re-occurred upon treating the patient with certolizumab(More)
Sister Mary Joseph nodules represent metastatic cancer of the umbilicus. These malignancies are usually associated with the ovary and gastrointestinal tract. The authors report the case of a Sister Mary Joseph nodule originating from the bifurcation of the common hepatic duct. Umbilical nodules should prompt clinical evaluations, as these tumors are usually(More)