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  1. Patients with psoriasis are insulin resistant

    DEFF Research Database (Denmark)

    Gyldenløve, Mette; Storgaard, Heidi; Holst, Jens Juul

    2015-01-01

    BACKGROUND: Patients with psoriasis have increased risk of type 2 diabetes. The pathophysiology is largely unknown, but it is hypothesized that systemic inflammation causes insulin resistance. Insulin sensitivity has only been sparsely investigated in patients with psoriasis, and previous studies...... no differences between groups in plasma glucose, insulin, C-peptide, and glucagon during the clamp. LIMITATIONS: The classic hyperinsulinemic euglycemic clamp technique does not allow assessment of endogenous glucose production. CONCLUSION: Patients with psoriasis were more insulin resistant compared...... have used suboptimal methodology. The hyperinsulinemic euglycemic clamp remains the gold standard for quantifying whole-body insulin sensitivity. OBJECTIVE: We sought to investigate if normal glucose-tolerant patients with psoriasis exhibit impaired insulin sensitivity. METHODS: Three...

  2. Chronic inflammation, insulin resistance, psoriasis - which have in common?

    Directory of Open Access Journals (Sweden)

    M. S. Rasin

    2016-01-01

    Full Text Available Psoriasis is recognized as system immune inflammatory disease at a certain genetic basis. It was found that psoriasis develops under the influence of chronic systemic inflammation low intensity (low grade inflammation that induced insulin resistance, and is one of the clinical forms of the Immune Metabolic Disease (IMD, along with atherosclerosis, hypertension, type 2 diabetes, obesity and many other diseases, whose tight relationship with psoriasis are installed. Knowledge of the etiology, pathogenesis and molecular mechanisms of communication with other clinical forms of the IMD opens up new ways of prevention and treatment of psoriasis. Please note that other diseases associated with psoriasis, occurring hidden, often have greater predictive value for the life and health of the patient than mild or moderate forms of psoriasis, and be not limited to ascertaining the diagnosis and symptomatic treatment and actively participate in prevention. Debated question of the application of funds, suppressing systemic inflammation and insulin resistance in the treatment of psoriasis.

  3. Psoriasis

    Science.gov (United States)

    ... bleed at times itching, soreness, or a burning sensation where the rash is thick, pitted fingernails What can make a person's psoriasis worse? Certain medicines, being sick, cold weather, and stress can be triggers. Being overweight ...

  4. Psoriasis

    DEFF Research Database (Denmark)

    Linder, Michael Dennis; Piaserico, Stefano; Augustin, Matthias

    2016-01-01

    and patterns of risk. We argue that concepts from LCR and LCE could be widely applied in dermatology, in general, and, more precisely, in the study of chronic inflammatory skin diseases, e.g. atopic eczema and psoriasis. The life course approach can generally be applied in two different ways. It may be used...

  5. Psoriasis comorbidities.

    Science.gov (United States)

    Gottlieb, Alice B; Chao, Chun; Dann, Frank

    2008-01-01

    Psoriasis is a chronic and debilitating inflammatory disease associated with serious comorbidities. Psoriasis can have a significant impact on a patient's quality of life and is associated with loss of productivity, depression, and an increased prevalence of malignancy. Emerging comorbidities of psoriasis include cardiovascular disease and metabolic syndrome. Psoriasis patients have an increased prevalence of the core components of metabolic syndrome, including obesity, dyslipidemia, and insulin resistance. The relationship between psoriasis and comorbidities such as metabolic syndrome and cardiovascular disease is likely linked to the underlying chronic inflammatory nature of psoriasis. The molecular mechanisms involved in psoriasis-associated dysregulation of metabolic function are believed to be due, in large part, to the action of increased levels of proinflammatory factors, such as tumor necrosis factor-alpha, that are central to the pathogenesis of psoriasis. Recent studies investigating the effects of tumor necrosis factor antagonists on the treatment of cardiovascular disease and metabolic syndrome support this concept.

  6. Prevalence of Metabolic Syndrome and Insulin Resistance in Patients with Psoriasis

    Directory of Open Access Journals (Sweden)

    Yeliz Bilir

    2014-03-01

    Conclusion: The incidences of MetS and IR were found to be higher in patients with psoriasis compared to control group. Especially there was a strong association between severe psoriasis and IR risk. Therefore, psoriasis needs to be considered as not only a skin disorder, but also a metabolic and cardiovascular disease. [J Contemp Med 2014; 4(1.000: 1-5

  7. Guttate psoriasis

    Science.gov (United States)

    Psoriasis - guttate; Group A streptococcus - guttate psoriasis; Strep throat - guttate psoriasis ... Guttate psoriasis is a type of psoriasis . Guttate psoriasis is usually seen in people younger than 30, especially in ...

  8. Metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1991-10-01

    Distant metastasis of primary neoplasms is the main factor that limits the success of antineoplastic therapy. It can be regarded as an early or late event in the neoplastic process, and varies considerably with tumor type. The metastatic potential of a given tumor greatly influences prognosis. Tumor metastasis is not a single neoplastic event, rather, it involves several major steps: invasion of cells from the primary tumor into tissue, and penetration of blood and lymph vessels; release of tumor cell emboli into the circulation; arrest of the emboli in capillary beds of distant organs; invasion of the wall of the arresting vessel, infiltration into adjacent tissue, and multiplication; and growth of vascularized stroma into the new tumor as proliferating tumor cells invade the distant organ. Lodgement and invasion are complex events that are not fully defined. Arrest and lodgement appears to require a thromboembolic event in which the metastatic embolis (1 cell) contacts vascular endothelium and adheres to the wall with thrombis formation following aggregation of platelets and fibrin to the tumor cell(s). Invasion may involve: formation of collagenases by tumor cells; mechanical disruption; chemotactic factors. Metastatic patterns depend on the route of metastasis, tumor type, and target organ (favored soil). In general, carcinomas metastasize via lymphatics and sarcomas via hematogenous routes. Others, melanoma, mast cell tumors, etc., show mixed patterns. This knowledge is important when one is attempting to prognostically stage a tumor, especially when thoracic radiographs are negative. The question of enlarged regional lymph nodes will be discussed in lecture relative to specific tumor types. 4 refs., 1 tab.

  9. A study of the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis

    Directory of Open Access Journals (Sweden)

    Rickson R Pereira

    2011-01-01

    Full Text Available Background: The association between psoriasis, diabetes, and cardiovascular disease remains largely unelucidated in the Indian population. Aims: To study the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis. Materials and Methods: Seventy-seven patients of chronic plaque psoriasis and ninety two age- and sex-matched controls were enrolled in the study over a period of one year. Clinical and biometric data were noted and fasting venous blood samples were collected. Nondiabetic patients were subjected to an oral glucose tolerance test with 75 g glucose and postprandial venous blood samples collected at 120 mins. The fasting glucose, insulin, lipid levels, postprandial glucose and postprandial insulin levels were measured in samples from nondiabetic patients whereas fasting lipid levels only were measured in diabetic patients. Results: The prevalence of impaired fasting glucose, impaired glucose tolerance, and diabetes mellitus in psoriatics was 5.2%, 9.1%, and 32.5%, respectively, as compared to 6.5%, 3.3%, and 15.2%, respectively, in the controls. The difference was statistically significant. The odds ratio of having an abnormal glucose metabolism in psoriasis was 2.63. Smoking had a positive association with insulin resistance in psoriatic cases. The serum cholesterol levels were elevated in 29 (37.7% cases with a mean of 186.27 ± 43.18 and 34 (37% controls with a mean of 194.38 ± 57.20. The serum HDL-cholesterol levels were reduced in 50 (64.9% cases with a mean of 53.29 ± 15.90 as compared to 71 (74.7% in controls with a mean of 48.76 ± 12.85. The serum LDL-cholesterol levels were elevated in 38 (49.4% cases with a mean of 102.56 ± 44.02 and 36 controls with a mean of 115.62 ± 54.37. The serum triglyceride levels were elevated in 25 (32.5% cases with a mean of 129.99 ± 61.32 and 38 (41.3% controls with a mean of 141.04 ± 80.10. The differences

  10. Inhibition of type I insulin-like growth factor receptor signaling attenuates the development of breast cancer brain metastasis.

    Directory of Open Access Journals (Sweden)

    Sandra M Saldana

    Full Text Available Brain metastasis is a common cause of mortality in cancer patients, yet potential therapeutic targets remain largely unknown. The type I insulin-like growth factor receptor (IGF-IR is known to play a role in the progression of breast cancer and is currently being investigated in the clinical setting for various types of cancer. The present study demonstrates that IGF-IR is constitutively autophosphorylated in brain-seeking breast cancer sublines. Knockdown of IGF-IR results in a decrease of phospho-AKT and phospho-p70s6k, as well as decreased migration and invasion of MDA-MB-231Br brain-seeking cells. In addition, transient ablation of IGFBP3, which is overexpressed in brain-seeking cells, blocks IGF-IR activation. Using an in vivo experimental brain metastasis model, we show that IGF-IR knockdown brain-seeking cells have reduced potential to establish brain metastases. Finally, we demonstrate that the malignancy of brain-seeking cells is attenuated by pharmacological inhibition with picropodophyllin, an IGF-IR-specific tyrosine kinase inhibitor. Together, our data suggest that the IGF-IR is an important mediator of brain metastasis and its ablation delays the onset of brain metastases in our model system.

  11. Psoriasis inversa

    DEFF Research Database (Denmark)

    Omland, Silje Haukali; Gniadecki, Robert

    2015-01-01

    Psoriasis is a chronic skin disorder affecting approximately 2% of the European and American population. The most common form of psoriasis is the chronic plaque type. Inverse psoriasis, also named flexural or intertriginous psoriasis, is not considered a separate disease entity but rather a special...... site of involvement of plaque psoriasis, characterized by its localization to inverse/intertriginous/flexural body sites. We review current evidence and establish whether inverse psoriasis is a separate disease entity based on characteristics in terms of epidemiology, pathogenesis, clinical...

  12. [Psoriasis and comorbidity--literature review].

    Science.gov (United States)

    Owczarczyk-Saczonek, Acnieszka; Nowicki, Roman

    2014-01-01

    Nowadays we know that psoriasis is more than "skin deep": it is considered a systemic disease. An increasing number of studies on the pathogenesis of psoriasis have shown that this disease is associated with metabolic disorders such as obesity, diabetes and cardiovascular diseases. Psoriasis appears to be a risk factor for the development of these diseases. That is why the concept of "psoriatic march" was proposed to demonstate that severe psoriasis may cause cardiovascular diseases. Many epidemiological studies have shown frequent coexistence of metabolic syndrome (insulin resistance, atherogenic dyslipidemia, obesity, hypertension and diseases of the cardiovascular system) in patients with severe course of psoriasis. Additionally, we observe a frequent coexistence of autoimmune disorders and cancers in patients with psoriasis. Suffering from psoriasis causes impaired self-esteem and depressive disorders. It is a source of stress for the patients, making them more likely to use alcohol or cigarettes.

  13. The type I insulin-like growth factor receptor regulates cancer metastasis independently of primary tumor growth by promoting invasion and survival

    Science.gov (United States)

    Sachdev, Deepali; Zhang, Xihong; Matise, Ilze; Gaillard-Kelly, Martine; Yee, Douglas

    2009-01-01

    The type I insulin-like growth factor receptor (IGF1R) regulates multiple aspects of malignancy and is the target of several drugs currently in clinical trials. While IGF1R’s role in proliferation and survival is well-studied, the regulation of metastasis by IGF1R is not as clearly delineated. Previous work showed that disruption of IGF1R signaling via overexpression of a dominant negative IGF1R inhibited metastasis. To establish a clinically applicable approach to inhibition of metastasis by targeting IGF1R, the effect of an inhibitory antibody against IGF1R, EM164 and its humanized version, AVE1642 on metastasis of cancer cells was examined. EM164 and AVE1642 did not affect primary tumor growth of MDA-435A/LCC6 cells but inhibited metastasis of these cells. Consistent with this inhibition in the formation of metastatic nodules, disruption of IGF1R also resulted in a decreased number of circulating tumor cells in blood of tumor-bearing mice. Disruption of IGF1R with a dominant negative construct or antibody inhibited invasion across Matrigel in vitro. When tumor cells were directly injected into the circulation via the lateral tail vein of mice, IGF1R disruption also resulted in significant reduction of pulmonary nodules, suggesting that regulation of invasion is not the only function of IGF1R signaling. Further, disruption of IGF1R rendered cells more susceptible to anoikis. Thus, IGF1R regulated metastasis independently of tumor growth. The multiple phenotypes regulated by IGF1R must be considered during development of this therapeutic strategy as inhibition of metastasis independent of inhibition of tumor growth is not easily assessed in phase II clinical trials. PMID:19838209

  14. Insulin

    Science.gov (United States)

    ... Information by Audience For Women Women's Health Topics Insulin Share Tweet Linkedin Pin it More sharing options ... medicines. You can do it. Back to Top Insulin Safety Tips Never drink insulin. Do not share ...

  15. What Is Psoriasis?

    Science.gov (United States)

    ... Outreach Initiative Breadcrumb Home Health Topics English Español Psoriasis Basics In-Depth Download Download EPUB Download PDF What is it? Points To Remember About Psoriasis Psoriasis is an autoimmune disease that causes red, ...

  16. Naevoid psoriasis

    Directory of Open Access Journals (Sweden)

    Mittal R

    1999-01-01

    Full Text Available A 6-year-old male child had linear scaly erythematous band on the penis, undersuface of penis, extending to the scrotum since birth. He was diagnosed clinically as well as histopathologically as a case of naevoid psoriasis.

  17. Cardiovascular risk factors in subjects with psoriasis

    DEFF Research Database (Denmark)

    Jensen, Peter; Thyssen, Jacob P; Zachariae, Claus

    2013-01-01

    Background Epidemiological data have established an association between cardiovascular disease and psoriasis. Only one general population study has so far compared prevalences of cardiovascular risk factors among subjects with psoriasis and control subjects. We aimed to determine the prevalence...... of cardiovascular risk factors in subjects with and without psoriasis in the general population. Methods During 2006-2008, a cross-sectional study was performed in the general population in Copenhagen, Denmark. A total of 3471 subjects participated in a general health examination that included assessment of current...... smoking status, weight, height, waist and hip circumferences, systolic and diastolic blood pressures, resting heart rate, and plasma lipids, hemoglobin A1c, fasting glucose, and insulin levels. Results Physician-diagnosed psoriasis was reported by 238 (7.1%) of 3374 participants. There were no differences...

  18. Psoriasis (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Psoriasis KidsHealth / For Parents / Psoriasis What's in this article? ... treatment doesn't work, another probably will. About Psoriasis Psoriasis (suh-RYE-uh-sus) is a non- ...

  19. Psoriasis and Obesity

    DEFF Research Database (Denmark)

    Jensen, Peter; Skov, Lone

    2017-01-01

    Psoriasis is a common chronic inflammatory skin disease with a complex pathogenesis consisting of a genetic component, immune dysfunction, and environmental factors. It is associated with numerous comorbidities including psoriatic arthritis, cardiovascular disease, metabolic syndrome, and obesity....... Evidence suggests that obesity is a risk factor for incident psoriasis, aggravates existing psoriasis, and that weight reduction may improve the severity of psoriasis in overweight individuals. Excess body weight may interfere with the medical treatment used in psoriasis and adds to the cardiovascular risk...... profile in these patients, which underscores the importance of effective weight control regimens. In this review we examine the current literature with regard to the association between obesity and psoriasis....

  20. Psoriasis og aterotrombotisk sygdom

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar H; Skov, Lone

    2010-01-01

    Psoriasis and atherosclerosis share immunoinflammatory mechanisms and patients with psoriasis may carry an excess of cardiovascular risk factors (hypercholesterolemia, hypertension, obesity, metabolic syndrome, diabetes mellitus, smoking etc.) and increased risk of atherothrombotic disease...

  1. Overview of psoriasis

    NARCIS (Netherlands)

    de Rie, Menno A.; Goedkoop, Amber Y.; Bos, Jan D.

    2004-01-01

    Psoriasis is a chronic disease that affects the skin and joints. Clinical hallmarks comprise erythematous plaques covered by silvery scaling and a chronic recurrent course. Histologically, psoriasis is characterized by the hyperproliferation of the epidermis, elongated and prominent blood vessels

  2. Stem cells in psoriasis.

    Science.gov (United States)

    Hou, Ruixia; Li, Junqin; Niu, Xuping; Liu, Ruifeng; Chang, Wenjuan; Zhao, Xincheng; Wang, Qiang; Li, Xinhua; Yin, Guohua; Zhang, Kaiming

    2017-06-01

    Psoriasis is a complex chronic relapsing inflammatory disease. Although the exact mechanism remains unknown, it is commonly accepted that the development of psoriasis is a result of multi-system interactions among the epidermis, dermis, blood vessels, immune system, neuroendocrine system, metabolic system, and hematopoietic system. Many cell types have been confirmed to participate in the pathogenesis of psoriasis. Here, we review the stem cell abnormalities related to psoriasis that have been investigated recently. Copyright © 2016. Published by Elsevier B.V.

  3. Psoriasis: changing clinical patterns.

    Science.gov (United States)

    Rotstein, H

    1996-05-01

    Although psoriasis has been recognized at least since Biblical times new forms, associations and influences continue to be described in the twentieth century. New forms include the rupioid erythema annulare centrifugum-like and follicular patterns. Associations with vitiligo bullous pemphigoid and lupus erythematosus have been recently described. Endoscopic surgery has increased para umbilical psoriasis while Sun Smart campaign have reduced photo-aggravated psoriasis. Infections such as paediatric perianal streptococcal cellulitis and drugs including angiotensin converting enzyme inhibitors and cytokines exacerbate psoriasis.

  4. Psoriasis og aterotrombotisk sygdom

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar H; Skov, Lone

    2010-01-01

    Psoriasis and atherosclerosis share immunoinflammatory mechanisms and patients with psoriasis may carry an excess of cardiovascular risk factors (hypercholesterolemia, hypertension, obesity, metabolic syndrome, diabetes mellitus, smoking etc.) and increased risk of atherothrombotic disease....... The current review summarises the available evidence in this area of research and calls for increased awareness of cardiovascular risk assessment and treatment in patients with psoriasis....

  5. CLINICAL PRESENTATION OF PSORIASIS

    Directory of Open Access Journals (Sweden)

    F. Ayala

    2011-09-01

    Full Text Available SUMMARY Psoriasis is a chronic, inflammatory disease affecting 1-3% of the world’s population. Joints can be affected in up to 30% of patients. About one third of patients have either severe or moderate (involving more than 10% of body surface area disease. Patients affected with extensive psoriasis have an impaired quality of life. Psoriasis has a large spectrum of clinical features and evolution, so no complete agreement on the classification of the clinical variants exists. Plaque psoriasis is the commonest form (more than 80% of affected patients. The course of plaque psoriasis varies. Spontaneous resolution is possible, but rarely occurs. Plaques tend to remain static or slowly enlarge. Flexural (inverse, intertriginous psoriasis manifests with lesions thinner than those of plaque form with no or minimal scaling, and is localized in the skin folds. Guttate (eruptive psoriasis has frequently a sudden onset and frequently appears abruptly after a bacterial or viral febrile episode of inflammation of the upper ways. Pustular and erythrodermic psoriasis are the most severe clinical variants. In the diffuse pustular form recurrent episodes of fever occur, followed by new outbreaks of pustules. Erythrodermic psoriasis corresponds to the generalized form of the disease. The entire skin is bright red and is covered by superficial scales. Fatigue, myalgia, shortness of breath, fever and chills may also occur. In sebopsoriasis (seborrheic dermatitis + psoriasis the lesions tend to occur at the same sites as seborrheic dermatitis; greasy scales predominate, but silvery scales can be found in some areas. Nail psoriasis shows various features: nail pits; oil spots; subungual hyperkeratosis; onycholysis. Rare forms include psoriasis circinata, lip psoriasis and oral psoriasis. Differential diagnosis includes many other dermatological conditions. Key words: Psoriasis, nail, quality of life

  6. Biochemical markers of psoriasis as a metabolic disease

    Directory of Open Access Journals (Sweden)

    Agnieszka Gerkowicz

    2012-07-01

    Full Text Available Psoriasis is a chronic immune mediated inflammatory skin disease with a population prevalence of 2–3%. In recent years, psoriasis has been recognized as a systemic disease associated with metabolic syndrome or its components such as: obesity, insulin resistance, hypertension and atherogenic dyslipidemia. Many bioactive substances have appeared to be related to metabolic syndrome. Based on current literature, we here discuss the possible role of adiponectin, leptin, ghrelin, resistin, inflammatory cytokines, plasminogen activator inhibitor 1, uric acid, C-reactive protein and lipid abnormalities in psoriasis and in metabolic syndrome.

  7. Severe deterioration of psoriasis due to an insulinoma.

    LENUS (Irish Health Repository)

    Field, S

    2008-03-01

    We report a case of a 56-year-old woman who presented with a severe exacerbation of psoriasis with concurrent hypoglycaemic episodes. Methotrexate 17.5 mg weekly was required to control her psoriasis. Investigation of her hypoglycaemia showed raised levels of insulin, C-peptide and proinsulin. Radiological investigation showed a tumour at the tail of the pancreas and the diagnosis was insulinoma. A spleen-preserving distal pancreatectomy was performed and the hypoglycaemic symptoms resolved. Immediately following the pancreatectomy, methotrexate was stopped and the patient\\'s psoriasis went into remission. During a 2-year follow-up, she has required only minimal topical treatment for her skin.

  8. Psoriasis: the visible killer.

    Science.gov (United States)

    Torres, Tiago; Bettencourt, Nuno

    2014-02-01

    Psoriasis is a common chronic inflammatory disease associated with serious comorbidities. In recent years, increased mortality due to cardiovascular disease (myocardial infarction and stroke) has been documented in patients with severe psoriasis. Patients with psoriasis have a higher prevalence of traditional cardiovascular risk factors such as diabetes, hypertension, dyslipidemia and obesity, but it has been suggested that the chronic inflammatory nature of psoriasis is also a contributing and potentially an independent risk factor for the development of cardiovascular disease. The authors highlight the need for early identification and treatment of psoriasis-related comorbidities and cardiovascular disease, as well as effective treatment of psoriasis, in order to reduce the underlying systemic inflammation, and also the importance of a multidisciplinary approach of severe psoriasis patients to optimize the diagnosis, monitoring and treatment of various comorbidities, so as to prevent cardiovascular events. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  9. Metabolic Changes and Serum Ghrelin Level in Patients with Psoriasis

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    Haydar Ucak

    2014-01-01

    Full Text Available Background. Serum ghrelin levels may be related to metabolic and clinical changes in patients with psoriasis. Objective. This study was performed to determine the possible effects of serum ghrelin in patients with psoriasis. Methods. The study population consisted of 25 patients with plaque psoriasis. The patients were questioned with regard to age, gender, age of onset, duration of disease, height, weight, and body mass index (BMI. In addition, fasting blood sugar, triglyceride, cholesterol levels, insulin, and ghrelin levels were measured. Results. The mean serum ghrelin level was 45.41 ± 22.41 in the psoriasis group and 29.92 ± 14.65 in the healthy control group. Serum ghrelin level was significantly higher in the psoriasis group compared with the controls (P=0.01. The mean ghrelin level in patients with a lower PASI score was significantly higher than in those with a higher PASI score (P=0.02. Conclusion. The present study was performed to determine the effects of ghrelin in psoriasis patients. We found a negative correlation between severity of psoriasis and ghrelin level. Larger and especially experimental studies focusing on correlation of immune system-ghrelin levels and severity of psoriasis may be valuable to clarify the etiopathogenesis of the disease.

  10. Treating Psoriasis During Pregnancy

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Rørbye, Christina; Skov, Lone

    2015-01-01

    Psoriasis is a chronic inflammatory disease with a well-documented negative effect on the quality of life of affected patients. Psoriasis often occurs in the reproductive years, during which the issue of pregnancy needs to be addressed. The course of psoriasis during pregnancy is unpredictable......, and many patients face the challenge of needing treatment during pregnancy. In this review we provide an overview of the key considerations for managing psoriasis in pregnant women, covering the potential effects of active psoriasis and co-morbid conditions on the health of the mother and fetus, as well...... as the effects of psoriasis treatment options on the developing fetus. Although there are no robust data on the safety of systemic treatment of pregnant women, increasing evidence regarding the safety of cyclosporine (ciclosporin) treatment as well as anti-tumor necrosis factor-α is available and should...

  11. Psoriasis and psoriasic arthritis

    International Nuclear Information System (INIS)

    Cortes Vera, Sandra Liliana; Iglesias Gamarra, Antonio; Restrepo Suarez, Jose Felix

    2003-01-01

    The psoriasis is an skin inflammatory disease characterized by chronic and recurrent red skin covered with silver scales. In their pathogenesis, immunogenetic and environmental factors are conjugated. Psoriatic arthritis. That is a seronegative arthropathy. In the greater part of cases follow to a chronic course of cutaneous psoriasis. In this paper, we analyzed the most frequent forms of presentation of cutaneous psoriasis and we revised the psoriatic arthropathy, with some indications about its treatment

  12. Compounds of psoriasis with obesity and overweight

    Directory of Open Access Journals (Sweden)

    Agnieszka Owczarczyk-Saczonek

    2017-08-01

    Full Text Available Many epidemiological studies have confirmed the relationship of obesity and psoriasis, and it is believed that obesity is an independent risk factor for its development and is associated with a worse prognosis. Furthermore, the reduction of body weight, using low-calorie diet combined with exercise, reduces the severity of psoriasis.Visceral adipose tissue is the largest endocrine organ, producing proinflammatory cytokines (TNF-α, IL-6, IL-17 and adipokines (adiponectin, omentin, chemerin. They participate in the development of dyslipidemia, insulin resistance, diabetes, and consequently of the cardiovascular diseases. Macrophages of visceral adipose tissue have a special role and they increase significantly in obesity. They are responsible for the development of inflammation in adipose tissue and produce inflammatory cytokines (TNF alpha, IL-6, Il-8, Il-17, Il-18, MCP-1 and other adipokines: resistin, visfatin, retinol-binding protein 4. This explains the concept of «psoriatic march «and observations of the frequent coexistence of psoriasis with obesity. Inflammation associated with systemic disease, fanned by pro-inflammatory cytokines and adipokines produced by the visceral adipose tissue lead to the development of insulin resistance, endothelial cell damage. Endothelial dysfunction predisposes to the formation of atherosclerotic plaques and faster development of cardiovascular events. Complication of obesity is the development of non-alcoholic fatty liver disease (NAFLD, which states twice as likely in patients with plaque psoriasis and is associated with the severity of the disease. Another consequence is the development of depression. Probably the proinflammatory cytokines can interact with metabolism of neurotransmitters. Obesity also has a significant impact on the treatment of psoriasis, increasing the risk of adverse effects of systemic drugs, reducing the efficacy of biological agents which dose should be adjusted to the weight of

  13. Compounds of psoriasis with obesity and overweight.

    Science.gov (United States)

    Owczarczyk-Saczonek, Agnieszka; Placek, Waldemar

    2017-08-24

    Many epidemiological studies have confirmed the relationship of obesity and psoriasis, and it is believed that obesity is an independent risk factor for its development and is associated with a worse prognosis. Furthermore, the reduction of body weight, using low-calorie diet combined with exercise, reduces the severity of psoriasis.Visceral adipose tissue is the largest endocrine organ, producing proinflammatory cytokines (TNF-α, IL-6, IL-17) and adipokines (adiponectin, omentin, chemerin). They participate in the development of dyslipidemia, insulin resistance, diabetes, and consequently of the cardiovascular diseases. Macrophages of visceral adipose tissue have a special role and they increase significantly in obesity. They are responsible for the development of inflammation in adipose tissue and produce inflammatory cytokines (TNF alpha, IL-6, Il-8, Il-17, Il-18, MCP-1) and other adipokines: resistin, visfatin, retinol-binding protein 4. This explains the concept of «psoriatic march «and observations of the frequent coexistence of psoriasis with obesity. Inflammation associated with systemic disease, fanned by pro-inflammatory cytokines and adipokines produced by the visceral adipose tissue lead to the development of insulin resistance, endothelial cell damage. Endothelial dysfunction predisposes to the formation of atherosclerotic plaques and faster development of cardiovascular events. Complication of obesity is the development of non-alcoholic fatty liver disease (NAFLD), which states twice as likely in patients with plaque psoriasis and is associated with the severity of the disease. Another consequence is the development of depression. Probably the proinflammatory cytokines can interact with metabolism of neurotransmitters. Obesity also has a significant impact on the treatment of psoriasis, increasing the risk of adverse effects of systemic drugs, reducing the efficacy of biological agents which dose should be adjusted to the weight of the patient. It

  14. Interventions for nail psoriasis

    NARCIS (Netherlands)

    de Vries, Anna Christa Q.; Bogaards, Nathalie A.; Hooft, Lotty; Velema, Marieke; Pasch, Marcel; Lebwohl, Mark; Spuls, Phyllis I.

    2013-01-01

    Psoriasis is a common skin disease that can also involve the nails. All parts of the nail and surrounding structures can become affected. The incidence of nail involvement increases with duration of psoriasis. Although it is difficult to treat psoriatic nails, the condition may respond to therapy.

  15. Interventions for nail psoriasis

    NARCIS (Netherlands)

    Vries, A.C. de; Bogaards, N.A.; Hooft, L.; Velema, M.; Pasch, M.C.; Lebwohl, M.; Spuls, P.I.

    2013-01-01

    BACKGROUND: Psoriasis is a common skin disease that can also involve the nails. All parts of the nail and surrounding structures can become affected. The incidence of nail involvement increases with duration of psoriasis. Although it is difficult to treat psoriatic nails, the condition may respond

  16. Psoriasis: Comorbidity and Treatment

    NARCIS (Netherlands)

    M. Wakkee (Marlies)

    2010-01-01

    textabstractPsoriasis is universal in occurrence, although the worldwide prevalence varies between 0.6% and 4.8%.The prevalence of psoriasis in people of Caucasian descend is approximately 2%. In the Netherlands it is therefore estimated that approximately 300,000 people are diagnosed as having

  17. Psoriasis and Obesity

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Gürer

    2012-03-01

    Full Text Available In recent years, it has been thought that a strong association exists between metabolic syndrome, specifically obesity, and psoriasis. Obesity is a multifactorial disease affected by both genetic and environmental factors. Adipokines (e.g. leptin secreted by the adipose tissue are believed to play a role in the pathogenesis of psoriasis. The main role of leptin is to adjust metabolism by controlling appetite. Serum leptin levels in patients with severe and moderate psoriasis were found to be higher than in normal control groups. In many similar studies, leptin secretion has been found to stimulate keratinocyte proliferation, which is one of the characteristics of psoriasis. Although many studies showed increased prevalence of obesity in psoriasis patients, few others reported development of obesity in psoriasis patients. Additionally, obesity was found to affect treatment responses not only in classical systemic/topical treatment approaches in psoriasis, but also in newer biological treatments. Overall, increasing epidemiological evidence suggests strong association between obesity and psoriasis, increase in serum leptin levels is thought to have a major role, and weight loss may have significant impact on response to treatment.

  18. Laserbehandeling bij psoriasis

    NARCIS (Netherlands)

    Sewbaransingh. A., [No Value

    2000-01-01

    Aan de Wetenschapswinkel Geneeskunde en Volksgezondheid werd een vraag voorgelegd van de Nederlandse Bond van Psoriasis Patiënten Verenigingen (NBPV) betreffende een folder genaamd 'de behandeling van psoriasis met laser' (zie Bijlage I). De vraag van de NBPV was om na te gaan in hoeverre de in de

  19. Psoriasis : implications of biologics

    NARCIS (Netherlands)

    Lecluse, L.L.A.

    2010-01-01

    Since the end of 2004 several specific immunomodulating therapies: ‘biologic response modifiers’ or ‘biologics’ have been registered for moderate to severe psoriasis in Europe. This thesis is considering the implications of the introduction of the biologics for psoriasis patients, focusing on safety

  20. Psoriasis: Comorbidity and Treatment

    OpenAIRE

    Wakkee, Marlies

    2010-01-01

    textabstractPsoriasis is universal in occurrence, although the worldwide prevalence varies between 0.6% and 4.8%.The prevalence of psoriasis in people of Caucasian descend is approximately 2%. In the Netherlands it is therefore estimated that approximately 300,000 people are diagnosed as having psoriasis. Its prevalence is equal in men and women and can first appear at any age, from infancy to elderly, although the mean age of development has suggested to be around 30 years old. Some studies ...

  1. Cardiovascular comorbiditiy in psoriasis

    Directory of Open Access Journals (Sweden)

    Gurcharan Singh

    2011-01-01

    Full Text Available The chronic inflammatory nature of psoriasis is also thought to predispose patients to other diseases with an inflammatory component, the most notable being cardiovascular and metabolic (cardiometabolite disorders. This concept is supported by studies showing that psoriasis is associated with cardiovascular risk factors like diabetes, obesity, hypertension, dyslipidemia, smoking and diseases including MI. Given the increased prevalence of cardiovascular co morbidities in patients, dermatologists treating psoriasis need to approach the disease as a potentially multisystem disorder and must alert these patients to the potentially negative effects of their disease.

  2. [Psoriasis taking center stage].

    Science.gov (United States)

    Conrad, C; Lapointe, A-K

    2011-04-06

    Psoriasis is a chronic, inflammatory, T cell-mediated auto-immune disease mainly affecting skin and joints. It is a multisystem disease associated with a multitude of co-morbidities and thus, has become increasingly important for all medical fields, beyond dermatology and rheumatology. Psoriasis has also become more and more important as a model disease for scientist working on chronic inflammation and autoimmunity. And psoriasis has become increasingly relevant as a first-choice disease for proof of concept studies investigating the efficacy of newer pathogenesis-based treatments.

  3. Psoriasis and Sleep Apnea

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Khalid, Usman; Gislason, Gunnar Hilmar

    2015-01-01

    STUDY OBJECTIVES: Psoriasis and sleep apnea are associated with significant morbidity and mortality. Although both diseases have been linked with systemic inflammation, studies on their potential bidirectional association are lacking. We investigate the potential association between psoriasis...... and sleep apnea. METHODS: All Danish citizens age 18 y or older between January 1, 1997 and December 31, 2011 (n = 5,522,190) were linked at individual level in nationwide registries. Incidence rates (IRs) per 10,000 person-years were calculated and incidence rate ratios (IRRs) adjusted for age, sex......, socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression. RESULTS: There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval...

  4. Psoriasis and Sleep Apnea

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Khalid, Usman; Gislason, Gunnar Hilmar

    2016-01-01

    STUDY OBJECTIVES: Psoriasis and sleep apnea are associated with significant morbidity and mortality. Although both diseases have been linked with systemic inflammation, studies on their potential bidirectional association are lacking. We investigate the potential association between psoriasis...... and sleep apnea. METHODS: All Danish citizens age 18 y or older between January 1, 1997 and December 31, 2011 (n = 5,522,190) were linked at individual level in nationwide registries. Incidence rates (IRs) per 10,000 person-years were calculated and incidence rate ratios (IRRs) adjusted for age, sex......, socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression. RESULTS: There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval...

  5. Living with psoriasis

    DEFF Research Database (Denmark)

    Bak, Kirsten Tarri

    2004-01-01

    Living with psoriasis is a considerable burden and quality of life in patients is deeply affected, yet compliance with therapy is a major problem. The literature is abundant in quantitative studies stating the incidence of decrease in quality of life and related, measurable terms, and in efforts...... directed at the improvement of therapies. However, it is sparse concerning the experiences of patients. This study aims to promote an understanding of the daily life of patients with psoriasis with particular regard to how they manage the disease, ultimately to improve nursing care to these patients....... A qualitative, collective case study design was applied. The participants were 4 adult patients with a long and complicated psoriasis history. They were interviewed in depth focusing on their experiences related to psoriasis and its treatment. The patients suffered physically from itch and pain. However...

  6. Psoriasis and cardiovascular events

    DEFF Research Database (Denmark)

    Raaby, Line; Ahlehoff, Ole; de Thurah, Annette

    2017-01-01

    Register databases. In total, 13 high-quality observational studies estimating the incidence of CVD were included. Patients with mild psoriasis had an increased risk of stroke [Hazard ratio (HR) = 1.10, 95% CI: 1.0-1.19] and myocardial infarction (MI) (HR = 1.20, 95% CI: 1.06-1.35), but not cardiovascular...... death. The risks of both stroke (HR = 1.38, 95% CI: 1.20-1.60), MI (HR = 1.70, 95% CI: 1.18-2.43) and cardiovascular death (HR = 1.37, 95% CI: 1.13-1.67) were increased in patients with severe psoriasis. In conclusion, this updated meta-analysis confirmed that patients with psoriasis have an increased...... risk of CVD, especially those with severe psoriasis....

  7. The role of uric acid in metabolic syndrome in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Berna Solak

    2017-06-01

    Full Text Available Background and Design: Psoriasis patients have increased risk of obesity, metabolic syndrome and cardiovascular disease. Uric acid is a metabolic marker associated with metabolic syndrome and cardiovascular diseases. Uric acid levels increase in psoriasis as well. The aim of this study was to investigate the role of uric acid in metabolic syndrome in patients with psoriasis. Materials and Methods: Chronic plaque psoriasis patients who presented to the dermatology outpatient clinics in a university-affiliated training and research hospital and age- and gender-matched healthy individuals were included in the study. Waist circumference, height and weight measurements in both groups were recorded, and body mass index was calculated. Serum uric acid, urea, creatinine, C-reactive protein, fasting blood glucose, high-density lipoprotein cholesterol, total cholesterol, triglyceride and insulin levels were determined. Metabolic syndrome and insulin resistance status were evaluated. The findings were compared statistically. Results: Seventy patients with chronic plaque psoriasis (37 females, 33 males and 60 healthy individuals (31 females, 29 males were included in the study. The prevalence of metabolic syndrome and uric acid levels were found to be higher in the psoriasis group than in control group (p=0.003 and p=0.008, respectively. Serum uric acid levels and Psoriasis Area and Severity Index scores were higher in psoriasis patients with metabolic syndrome than in those without metabolic syndrome when psoriasis patients were evaluated separately (p=0.041, p=0.024, respectively. A positive correlation was observed between abdominal circumference and serum uric acid levels in psoriasis patients (p=0.003, r=0.350 Conclusion: The results of this study show that uric acid levels are elevated in psoriasis patients with metabolic syndrome. The prevalence of metabolic syndrome was also significantly higher. Hence, patients should be followed up for development

  8. Psoriasis in children

    Directory of Open Access Journals (Sweden)

    Pinson R

    2016-10-01

    Full Text Available Roxanne Pinson,1 Bahman Sotoodian,2 Loretta Fiorillo2,3 1School of Medicine, 2Division of Dermatology and Cutaneous Sciences, Department of Medicine, 3Division of Pediatric Dermatology, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada Abstract: The clinical presentation, disease associations, and diverse treatment modalities in overcoming the challenges of managing pediatric psoriasis have been extensively summarized in this article. An extensive literature review revealed the differences in presentation of psoriasis during infancy, childhood, and adolescence. We also summarized the latest topical, systemic, and biological modalities in treating recalcitrant psoriasis. The association of psoriasis with juvenile arthritis and obesity and the significant influence of the disease on the children's quality of life were explored. The clinical presentation of psoriasis can evolve during the child's lifespan. While many treatment modalities already exist for treating pediatric psoriasis, some of the new biologics that are approved for adult patients have not been investigated in the pediatric population and no algorithm exists for their use in this population. Large clinical studies in the future will enhance our understanding with regards to their safety and potential implications in pediatric populations. Keywords: pediatric, epidemiology, juvenile arthritis, topical treatment, systemic treatment, phototherapy, biologics

  9. [Psoriasis migrans : Erythema migrans as Koebner phenomenon in psoriasis].

    Science.gov (United States)

    Ständer, S; Ständer, M; Thomas, P; Prinz, J C; Wolf, R

    2016-07-01

    Psoriasis is a chronic inflammatory disorder of the epidermis, which can be induced by systemic factors, such as streptococci infections or drugs. In addition, psoriasis can be caused by a local cutaneus trauma, known as Koebner phenomenon. Here, we describe a woman with psoriasis in remission, who developed a new psoriatic lesion due to a cutaneous infection with Borrelia burgdorferi. After causal therapy with doxycycline, the erythema migrans and psoriasis lesions disappeared.

  10. Psoriasis and comorbidities. Epidemiological studies

    DEFF Research Database (Denmark)

    Egeberg, Alexander

    2016-01-01

    Psoriasis is a prevalent chronic inflammatory disease whose exact aetiology is not fully understood, but both genetic and environmental factors have been implicated in the onset and progression of the disease. At the skin level, psoriasis is characterized by localized or widespread thick raised...... silvery-white scaling and pruritic plaques and studies have shown that psoriasis negatively affects patients' quality of life, and depression occurs more often in patients with psoriasis. However, data have shown that psoriasis is a systemic disease which affects the joints, vasculature, and other tissues...... as well. Indeed, approximately one-third of patients with psoriasis develop psoriatic arthritis, and patients with severe psoriasis have a shortened life expectancy. Although our knowledge of the pathogenesis of psoriasis has advanced significantly in the past decade, as have the pharmacological treatment...

  11. Psoriasis: classical and emerging comorbidities*

    Science.gov (United States)

    de Oliveira, Maria de Fátima Santos Paim; Rocha, Bruno de Oliveira; Duarte, Gleison Vieira

    2015-01-01

    Psoriasis is a chronic inflammatory systemic disease. Evidence shows an association of psoriasis with arthritis, depression, inflammatory bowel disease and cardiovascular diseases. Recently, several other comorbid conditions have been proposed as related to the chronic inflammatory status of psoriasis. The understanding of these conditions and their treatments will certainly lead to better management of the disease. The present article aims to synthesize the knowledge in the literature about the classical and emerging comorbidities related to psoriasis. PMID:25672294

  12. The concept of psoriasis as a systemic inflammation: implications for disease management.

    Science.gov (United States)

    Reich, K

    2012-03-01

    Psoriasis is a systemic, immune-mediated disorder, characterized by inflammatory skin and joint manifestations. A range of co-morbidities is associated with psoriasis, including metabolic diseases, such as diabetes, and psychological disorders. Although the systemic nature of psoriasis often remains unrecognized, the inflammatory processes involved may be associated with the development of co-morbidities, which, themselves, have a significant impact on the patient's health and quality of life. The relative risks of myocardial infarction (MI) and stroke are increased in patients with psoriasis compared with the general population. These are especially seen in younger patients with more severe disease, and are believed to contribute to the 3- to 4-year reduction in life expectancy among patients with severe psoriasis. The recent results of large studies indicate that the increased cardiovascular (CV) risk is at least partially attributable to psoriasis and independent of the presence of metabolic co-morbidities. The possible interplay between psoriasis and CV disease is complex. Metabolic diseases such as obesity and diabetes have overlapping genetic predispositions with psoriasis. Both conditions are likely to also interact at a functional level because obesity and the up-regulation of pro-inflammatory mediators in psoriasis appear to influence adipocyte homoeostasis, inducing non-professional immune functions. This may perpetuate psoriatic inflammation, displaying similarities to the immunopathogenesis of atherosclerosis. Finally, the disturbed adipokine profile and inflammation associated with psoriasis enhances insulin resistance, causing subsequent endothelial dysfunction, atherosclerosis and eventual coronary events. The differential contribution of psoriasis and uncontrolled classical CV risk factors to the increased CV risk seen in psoriasis patients is not clear. Successful treatment with methotrexate appears to lower the rates of MI in patients with

  13. Psoriasis and autoimmunity.

    Science.gov (United States)

    Sticherling, Michael

    2016-12-01

    Psoriasis is one of the most common chronic inflammatory human skin diseases. Though clinically well characterized, the exact etiological and pathogenic mechanisms are still not known in detail. Current knowledge indicates distinct overlap to other inflammatory as well as autoimmune disorders. However, the one or more relevant autoantigens could not be characterized so-far. On the other side, several autoimmune diseases were shown to be associated with psoriasis. In addition, serological autoimmune phenomena, namely diverse circulating specific autoantibodies could be demonstrated in the past. A matter of current debate is if psoriasis is a primary autoimmune disease or secondarily evolving into autoimmunity as seen in other chronic inflammatory diseases. Related to this aspect is the concept of autoinflammation versus autoimmunity where psoriasis shares mechanisms of both entities. Though T-cells remain among the most important cellular players in the pathogenesis of psoriasis and current therapeutic strategies successfully target these cells or their products irrespective of these concepts, autoimmunity if relevant will add to the treatment armamentarium by using protective and prophylactic antigen-specific modalities. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Bone scintigraphy in psoriasis

    International Nuclear Information System (INIS)

    Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.; Frankfurt Univ.

    1980-01-01

    Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones. (orig.) [de

  15. HIV-Associated Psoriasis.

    Science.gov (United States)

    Queirós, N; Torres, T

    2018-01-17

    Human immunodeficiency virus (HIV) prevalence is increasing worldwide as people on antiretroviral therapy are living longer. These patients are often susceptible to debilitating inflammatory disorders that are frequently refractory to standard treatment. Psoriasis is a systemic inflammatory disorder, associated with both physical and psychological burden, and can be the presenting feature of HIV infection. In this population, psoriasis tends to be more severe, to have atypical presentations and higher failure rates with the usual prescribed treatments. Management of moderate and severe HIV-associated psoriasis is challenging. Systemic conventional and biologic agents may be considered, but patients should be carefully followed up for potential adverse events, like opportunist infections, and regular monitoring of CD4 counts and HIV viral loads. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Significance of selected inflammatory factors in metabolic disorders in association with psoriasis

    Directory of Open Access Journals (Sweden)

    Paulina Kiluk

    2017-03-01

    Full Text Available Psoriasis is a systemic disease in which chronic inflammation predisposes to the development of cardiovascular and metabolic disorders. This relationship is determined by the concept of psoriatic march. We present the characteristics of selected inflammatory factors – paraoxonase 1, galectin 3 and pentraxin 3 – involved in inflammatory processes, in the development of insulin resistance and cardiovascular diseases. Attention is drawn to their potential role in the pathogenesis of psoriasis and the possibility of their use as markers of early development of metabolic disorders. Early diagnosis and prevention of the development of metabolic complications in patients with psoriasis can help to extend and improve the comfort of their living.

  17. Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment

    Science.gov (United States)

    Hu, Stephen Chu-Sung; Lan, Cheng-Che E.

    2017-01-01

    Psoriasis is a common and chronic inflammatory disease of the skin. It may impair the physical and psychosocial function of patients and lead to decreased quality of life. Traditionally, psoriasis has been regarded as a disease affecting only the skin and joints. More recently, studies have shown that psoriasis is a systemic inflammatory disorder which can be associated with various comorbidities. In particular, psoriasis is associated with an increased risk of developing severe vascular events such as myocardial infarction and stroke. In addition, the prevalence rates of cardiovascular risk factors are increased, including hypertension, diabetes mellitus, dyslipidemia, obesity, and metabolic syndrome. Consequently, mortality rates have been found to be increased and life expectancy decreased in patients with psoriasis, as compared to the general population. Various studies have also shown that systemic treatments for psoriasis, including methotrexate and tumor necrosis factor-α inhibitors, may significantly decrease cardiovascular risk. Mechanistically, the presence of common inflammatory pathways, secretion of adipokines, insulin resistance, angiogenesis, oxidative stress, microparticles, and hypercoagulability may explain the association between psoriasis and cardiometabolic disorders. In this article, we review the evidence regarding the association between psoriasis and cardiovascular comorbidities, focusing on severe vascular events, cardiovascular risk factors and implications for treatment. PMID:29065479

  18. Effect of weight loss on the severity of psoriasis

    DEFF Research Database (Denmark)

    Jensen, P; Zachariae, Claus; Christensen, R

    2013-01-01

    Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis.......Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis....

  19. Management of psoriasis in adolescence

    Directory of Open Access Journals (Sweden)

    Fotiadou C

    2014-03-01

    Full Text Available Christina Fotiadou, Elizabeth Lazaridou, Demetrios Ioannides First Department of Dermatology–Venereology, Aristotle University Medical School, Thessaloniki, Greece Abstract: Psoriasis is a chronic inflammatory cutaneous disorder affecting 2%–4% of the world's population. The prevalence of the disease in childhood and adolescence ranges between 0.5% and 2%. The management of psoriasis in adolescence is an intriguing and complicated task. Given the paucity of officially approved therapies, the very limited evidence-based data from randomized controlled trials, and the absence of standardized guidelines, physicians must rely on published experience from case reports both from the field of dermatology as well as from the application of these drugs for other pediatric conditions coming from the disciplines of rheumatology, gastroenterology, and oncology. Psoriatic adolescents deal with a potentially disfiguring and lifelong disease that could permanently impair their psychological development. It must be clarified to them that psoriasis does not have a permanent cure, and therefore the main goal of treatments is to establish disease control and prolonged periods between flares. The majority of adolescents suffer from mild psoriasis, and thus they are treated basically with topical treatment modalities. Phototherapy is reserved for adolescents with mild-to-moderate plaque disease and/or guttate psoriasis when routine visits to specialized centers do not create practical problems. Systemic agents and biologics are administered to patients with moderate-to-severe plaque psoriasis, pustular psoriasis, or erythrodermic psoriasis. Keywords: adolescent psoriasis, pediatric psoriasis, treatment, systemic treatment, biologic agents

  20. Biosimilars for psoriasis

    DEFF Research Database (Denmark)

    Cohen, A D; Wu, J J; Puig, L

    2017-01-01

    The introduction of biological drugs for the treatment of patients with psoriasis has revolutionized treatment paradigms and enabled numerous patients to achieve disease control with an acceptable safety profile. However, the high cost of biologics limits access to these medications for the major...

  1. Delayed Hypersensitivity in Psoriasis

    Directory of Open Access Journals (Sweden)

    Bhushan Kumar

    1981-01-01

    Full Text Available Twenty two adult male patients of psoriasis and 100 normal Volunteers Were skin-tested ′ with DNC-B, mumps skin antigen, candidin coccidiodin, PPD, croton Oil and histamine hate Except for ′decreased mine phosphate sensitization seen: with DNCB, the response of psoriabics to, skin testing was comparable with the normals.

  2. Biologic fatigue in psoriasis.

    Science.gov (United States)

    Levin, Ethan C; Gupta, Rishu; Brown, Gabrielle; Malakouti, Mona; Koo, John

    2014-02-01

    Over the past 15 years, biologic medications have greatly advanced psoriasis therapy. However, these medications may lose their efficacy after long-term use, a concept known as biologic fatigue. We sought to review the available data on biologic fatigue in psoriasis and identify strategies to help clinicians optimally manage patients on biologic medications in order to minimize biologic fatigue. We reviewed phase III clinical trials for the biologic medications used to treat psoriasis and performed a PubMed search for the literature that assessed the loss of response to biologic therapy. In phase III clinical trials of biologic therapies for the treatment of psoriasis, 20-32% of patients lost their PASI-75 response during 0.8-3.9 years of follow-up. A study using infliximab reported the highest percentage of patients who lost their response (32%) over the shortest time-period (0.8 years). Although not consistently reported across all studies, the presence of antidrug antibodies was associated with the loss of response to treatment with infliximab and adalimumab. Biologic fatigue may be most frequent in those patients using infliximab. Further studies are needed to identify risk factors associated with biologic fatigue and to develop meaningful antidrug antibody assays.

  3. Psoriasis and ultraviolet radiation

    International Nuclear Information System (INIS)

    Farber, E.M.; Nall, L.

    1993-01-01

    Prevention and detection screening programs as a public health service in curtailing the ever-increasing incidence of all forms of skin cancer are reviewed. The effect of solar and artificial ultraviolet radiation on the general population and persons with psoriasis is examined. 54 refs

  4. Immunology of Psoriasis

    Science.gov (United States)

    Lowes, Michelle A.; Suárez-Fariñas, Mayte; Krueger, James G.

    2014-01-01

    The skin is the front line of defense against insult and injury and contains many epidermal and immune elements that comprise the skin-associated lymphoid tissue (SALT). The reaction of these components to injury allows an effective cutaneous response to restore homeostasis. Psoriasis vulgaris is the best-understood and most accessible human disease that is mediated by T cells and dendritic cells. Inflammatory myeloid dendritic cells release IL-23 and IL-12 to activate IL-17-producing T cells, Th1 cells, and Th22 cells to produce abundant psoriatic cytokines IL-17, IFN-γ, TNF, and IL-22. These cytokines mediate effects on keratinocytes to amplify psoriatic inflammation. Therapeutic studies with anticytokine antibodies have shown the importance of the key cytokines IL-23, TNF, and IL-17 in this process. We discuss the genetic background of psoriasis and its relationship to immune function, specifically genetic mutations, key PSORS loci, single nucleotide polymorphisms, and the skin transcriptome. The association between comorbidities and psoriasis is reviewed by correlating the skin transcriptome and serum proteins. Psoriasis-related cytokine-response pathways are considered in the context of the transcriptome of different mouse models. This approach offers a model for other inflammatory skin and autoimmune diseases. PMID:24655295

  5. Psoriasis y nuevas terapias

    Directory of Open Access Journals (Sweden)

    Edgardo N. Chouela R., Dr.

    2011-11-01

    Esta reseña de las nuevas terapias disponibles de la psoriasis y de las que están en camino de ser aprobadas por las autoridades sanitarias, permitirá al lector tener una idea del estado actual del tratamiento de esta enfermedad.

  6. Psoriasis y dermatomicosis Psoriasis ad dermatomycosis

    Directory of Open Access Journals (Sweden)

    Maria E. Vargas

    1994-01-01

    Full Text Available

    Se realizó estudio micológico a 52 pacientes que tenían diagnóstico clínico e histopatológico de psoriasis, pertenecientes al servicio de dermatología del Hospital Universitario San Vicente de Paúl, de Medellín, entre agosto de 1991 y febrero de 1993. Se tomaron 109 muestras a partir de las placas psoriáticas y de las lesiones sospechosas de dermatomicosis. En 10 casos (19.2% se corroboró el diagnóstico de dermatomicosis; en 5 de ellos se encontró onicomicosis por Candida albicans sin asociación con la edad, el sexo, el oficio O el tratamiento de los pacientes. En 4 hombres se aisló E. floccosum de diferentes localizaciones y en una mujer 7: tonsurans de lesiones interdigitales en los pies. Se demostró una asociación estadísticamente significativa entre la Infección por dermatofitos y el uso de esteroides sistémlcos (p = 0.021 . No se obtuvo crecimiento de dermatofitos a partir de las placas psoriáticas ni se vieron cambios histológicos típicos de la enfermedad en las lesiones producidas por los hongos. En conclusión, es baja la frecuencia de dermatomicosis en personas con psoriasis; usualmente la piel comprometida por los hongos está libre de cambios psoriáticos y el riesgo de contraer la dermatofitomicosis se incrementa en unas 30 veces en los pacientes tratados con esteroides sistémicos.

    Mycological study was performed on 52 patients with clinical and histopathological diagnosis of psoriasis; they were attending the Dermatology Service at Hospital Universitario San Vicente de Paúl, Medellín, Colombia, between August 1991 and February 1993. One hundred and nine specimens were obtained from either psoriatic plaques or lesions suggestive of dermatomycosis. The diagnosis of dermatomycosis  was established in 10 patients (19.2%; 5 of them had Candida albicans

  7. Turkey Psoriasis Treatment Guide-2016

    Directory of Open Access Journals (Sweden)

    Melih Akyol

    2016-08-01

    Full Text Available Psoriasis is a common, chronic, recurrent, inflammatory disease of the skin with unknown etiology. In addition to skin involvement, joint involvement is often seen in psoriasis; however as comorbidities including metabolic syndrome, cardiovascular diseases, psychological/psychiatric disorders and inflammatory bowel disease accompany psoriasis, the inflammatory process underlying has been shown to damage several organs. It is also known that the risk of mortality is increased in patients with severe psoriasis. What’s more, psoriasis significantly affects the patients quality of life. According to physical/psychological examinations, the quality of life is affected from psoriasis as much as other chronic diseases like cancer or diabetes. Psoriasis leads to massive performance loss because of time and work loss at business and daily life as a result of either disease itself or its treatment. Psoriasis has several treatment modalities either topical or systemic. Topical treatment is sufficient and successful for mild psoriasis but early systemic therapy is recommended for moderate and severe psoriasis to prevent comorbidites due to increased inflammatory effect and to manage psoriatic arthritis. Topical treatment is usually applied alone for mild cases and in combination with systemic therapy or phototherapy for moderate or severe cases. Indications for the systemic therapy includes erythrodermic psoriasis, generalized pustular psoriasis, psoriatic arthritis and moderate-severe plaque psoriasis that causes serious decrease at quality of life which is irresponsive-incompatible to topical modalities or phototherapy. As the role of the immunology in pathophysiology of psoriasis is better understood, new generation of biological therapies affecting molecular mechanisms which take role at onset of psoriasis have been developed. Today, cyclosporine, methotrexate, and acitretin are used systemically; etanercept, infliximab, adalimumab or ustekinumab are

  8. Features of arterial hypertension course in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    V. A. Vizir

    2017-04-01

    Full Text Available Risk of cardiovascular and cerebrovascular events development in psoriasis patients is higher than in population as a whole. Combination of arterial hypertension and psoriasis is widespread and understudied state, thus the objective of our work was to reveal features of this comorbid pathology formation and course. Material and Methods. For the implementation of the set task specific features of clinical picture of arterial hypertension (presented by essential hypertension and psoriasis were studied. Two groups of patients included 47 persons suffering from essential hypertension and 98 persons suffering from psoriasis and essential hypertension simultaneously. Dermatosis course severity was estimated clinically using PASI index, 24-hour blood pressure index was determined by means of 24-hour blood pressure monitoring. Levels of cytokines, cortisol, and insulin were determined by immunoenzymatic methods. Results. As the result it was revealed that patients with comorbid pathology have severe and moderate degree of arterial hypertension more often than in case of arterial hypertension without dermatosis (95 % vs. 85 %. In this group of patients the specific feature of blood pressure circadian rhythm was revealed in form of its insufficient decrease in the evening and at night (non-dipper and night-peaker groups; total number of such patients made 63.64 %. Levels of cytokines (IL-β,IL-1α, IL-6, TNF-α in the group with comorbid pathology greatly exceed the similar indices of patients without dermatosis. This fact can be explained by available severe form of psoriasis (exudative, arthropica with expressed systemic inflammatory reactions. Interleukins levels critically increased in patients with the 3 degree of arterial hypertension in case of combined pathology. It has been found that duration of disease especially in case of psoriasis and arterial hypertension severe form combination had negative influence on adaptive mechanisms. This fact was

  9. Disturbed postprandial glucose metabolism and gut hormone responses in non-diabetic patients with psoriasis

    DEFF Research Database (Denmark)

    Gyldenløve, M; Lauritsen, Tina Vilsbøll; Holst, Jens Juul

    2016-01-01

    Patients with psoriasis have increased risk of developing type 2 diabetes.(1-4) Though the aetiology is not fully understood, overrepresentation of traditional diabetes risk factors, shared genetics, and chronic inflammation likely explain some of the increased susceptibility. Glucose metabolism...... in patients with psoriasis has only been sparsely investigated. Previous studies are based on fasting blood samples analysed for glucose and insulin or various forms of glucose and/or insulin challenges.(5-11) The results are generally difficult to compare due to methodological differences and limitations...

  10. Integrative Approach to Psoriasis Vulgaris.

    Science.gov (United States)

    Ljubenovic, Milanka; Lazarevic, Viktor; Golubovic, Masa; Binic, Ivana

    2017-12-19

    In this article, we present a literature review of the most popular and commonly used therapeutic procedures belonging to complementary and alternative medicine, which is part of the modern concept of integrative medicine, used in the treatment of psoriasis. Psoriasis is a chronic, systemic, inflammatory disease wherein skin changes are the most visible sign. It occurs in approximately 1% to 3% of the world population, and the National Psoriasis Foundation of the United States estimates the number of patients in the whole world at about 125 million. Psoriasis primarily affects the skin, burdening patients with inflamed, pruritic, and sometimes painful lesions covered with whitish scales that last for years. Because of its prevalence in the general population, diversity of the clinical picture (from minimal and localized lesions without subjective symptoms to life-threatening conditions), and disease duration (practically a lifetime), psoriasis is a disease that has become a focus of modern medicine, and therapeutic options for the treatment of psoriasis are currently very numerous and diverse. Conventional treatment of psoriasis is guided by the so-called principle of "steps," where treatment options are applied according to the severity of illness assessed by a physician. Apart from the official therapy for psoriasis, as it is defined and understood in modern developed societies, there exists in parallel a great number of traditional, complementary, and alternative psoriasis treatments, which are based on the beliefs, experiences, and theories inherent to different cultures; in this article, we have analyzed the literature related to some of these procedures.

  11. Pruritus in psoriasis: An update.

    Science.gov (United States)

    Szepietowski, J C; Reich, A

    2016-01-01

    Psoriasis is one of the most common chronic inflammatory skin diseases, found in about 1-3% of the general population. Pruritus affects about 60-90% of patients with psoriasis. The aim of this review was to summarize current knowledge about the pathogenesis and treatment of this symptom in psoriasis patients. Majority of psoriatic patients consider pruritus as the most bothersome symptom. The pathogenesis of pruritus is still unknown but the major concept of its origin is focused on neurogenic inflammation. Possible itch mediators include neuropeptides released from dermal nerve endings upon various stimuli, which were found to be abnormally expressed in itchy psoriatic plaques. Another important phenomenon supporting the idea of neurogenic inflammation as a key player in pruritus accompanying psoriasis is abnormal innervations of psoriatic skin. Possibly increased innervation density in psoriasis may decrease the threshold for pruritic stimuli. It is also suggested that pruritus in psoriasis might be related to abnormal functioning of the peripheral opioid system. Despite the high frequency of pruritus in psoriasis, to date there is no single antipruritic therapy dedicated specifically to treat itch in this disease. Neurogenic inflammation seems to be important for itchiness in psoriasis. Treatment of pruritus in patients with psoriasis should be directed towards the resolution of skin lesions, as disease remission usually is linked with pruritus relief. © 2015 European Pain Federation - EFIC®

  12. Skin microbiota in patients with psoriasis vulgaris and pustular psoriasis

    Directory of Open Access Journals (Sweden)

    E. A. Bakhlykova

    2016-01-01

    Full Text Available In the dermatological community there is no consensus regarding the role of infectious factors in the origin, course, exacerbation of psoriasis. the authors conducted a study on frequency of detection, quantitative and qualitative composition of the microbiota of the skin, mucous membranes of the throat and nose of patients with various forms of psoriasis, the relationship with the clinical picture. The goal of the study was to examine of the composition of the microbiota of the skin, the mucous membranes of the throat and nose of patients with various forms of psoriasis compared with healthy individuals. Materials and methods: inducted bacteriological examination of the surface of psoriatic elements, the contents of the pustules, the mucous membranes of the throat and nose in 49 patients, of them with generalized pustular psoriasis, palmoplantar pustular psoriasis, common exudative psoriasis, and vulgar psoriasis, mainly affecting the palms and soles. Was to study the intensity of the sensation of itching in patients on a 10 - points scale. Results: bacteriological examination of pathological lesions on the skin in patients with various forms of psoriasis highlighted various microorganisms in the diagnostically relevant concentrations with a predominance of gold and epidermal staphylococci. Shows the functional, statistically significant relations hip between the degree of intensity of itching and frequency of detection of Staphylococcus aureus. Conclusion: detection of diagnostically significant quantities of conditionally pathogenic microorganisms with a predominance of gold and epidermal staphylococci shows the possible role of infection in the development of immune inflammation in psoriasis. this regularity of the intensity of itching and detection of Staphylococcus aureus on the surface of the skin of patients with psoriasis may be an important factor in the current understanding of the significance of the role of infection in the

  13. Biological therapy of psoriasis

    Directory of Open Access Journals (Sweden)

    Sivamani Raja

    2010-01-01

    Full Text Available The treatment of psoriasis has undergone a revolution with the advent of biologic therapies, including infliximab, etanercept, adalimumab, efalizumab, and alefacept. These medications are designed to target specific components of the immune system and are a major technological advancement over traditional immunosuppressive medications. These usually being well tolerated are being found useful in a growing number of immune-mediated diseases, psoriasis being just one example. The newest biologic, ustekinumab, is directed against the p40 subunit of the IL-12 and IL-23 cytokines. It has provided a new avenue of therapy for an array of T-cell-mediated diseases. Biologics are generally safe; however, there has been concern over the risk of lymphoma with use of these agents. All anti-TNF-α agents have been associated with a variety of serious and "routine" opportunistic infections.

  14. Psoriasis y nuevas terapias

    OpenAIRE

    Chouela R., Edgardo N.

    2011-01-01

    La psoriasis es una enfermedad compleja, sistémica y crónica, que compromete la calidad de vida de los pacientes desde muy temprana edad y que requiere del compromiso del médico tratante para su manejo terapéutico. El mejor conocimiento de la fisiopatología de la enfermedad ha permitido el desarrollo de nuevas terapéuticas, algunas ya disponibles y otras en vías de serlo en los próximos años. Esta reseña de las nuevas terapias disponibles de la psoriasis y de las que están en camino de ...

  15. Poliosis overlying psoriasis

    Directory of Open Access Journals (Sweden)

    Sevgi Akarsu

    2013-03-01

    Full Text Available Poliosis is the term used to describe a localized area of hypopigmented or depigmented hairs. It is believed that this condition is a result of the destruction of follicular melanocytes by an inflammatory or autoimmune mechanism. Poliosis can occur in several hereditary syndromes or is acquired after inflammation, irradiation or infection and some medications. Additionally, it has also been reported that it can overlie some benign and malignant lesions, including some nevi, melanoma and neurofibroma. On the other hand, there has been no prior data of an association between psoriasis, which is a T-cell-mediated autoimmune inflammatory disease, and poliosis in the literature. Here, we describe an 11-year-old female with poliosis of the scalp overlying a plaque of psoriasis.

  16. Dermatoglyphics in Psoriasis

    Directory of Open Access Journals (Sweden)

    K C Verma

    1980-01-01

    Full Text Available Forty cases of psoriasis and same number of controls were subjected to dermatoglyphic studies. Control cases did not show any arch pattern on 4th and 5th fingers. Increased incinerate of whorl pattern was observed in psoriatic females and incidence was decreased in psoriatic males. Whorl pattern was more commonly seen on 4th finger, and more on right hand in psoriatic cases. Total ridge count was found to be decreased in psoriatic males.

  17. Nystatin in Psoriasis

    Directory of Open Access Journals (Sweden)

    Bhushan Kumar

    1989-01-01

    Full Text Available The hypothesis of the role of Candida in the gut for provoking psoriasis was tested by treating 9 males and 6 females having stable psoriasis with 200,000 units of nystatin orally 4 times a day for a minimum of 6 weeks. Intradermal candidin test and throat swab and stool samples for culture of Candida were taken before and twice after (between 4 and 8 weeks institution of the therapy. Various Candida species isolated before therapy in 11 patients, disappeared after the therapy in 6. In the other 5 the colony counts came down. Only scaling became less in 4 patients. More than 50% clearance was noted in 2 patients. No improvement occurred in 9 patients. No obivous correlation between isolation and disappearance of Candida and persistence or clearance of lesions was observed. Immediate (Type-1 hypersensitivity response to candidin was positive in only 3 patients. Immediate hypersensitivity to Candida antigens -or its metabolic products does not appear to have any role in the pathogenesis of psoriasis.

  18. Balneotherapy of Psoriasis

    Directory of Open Access Journals (Sweden)

    Golušin Zoran

    2014-09-01

    Full Text Available Application of different kinds of mineral waters and peloids on the skin exerts mechanical, thermal and chemical effects. Significant reduction of inflammation and increased differentiation of keratinocytes may explain why balneotherapy has positive clinical effects in psoriatic patients. In vitro models have shown that thermal water stimulates interleukin-2 production after cell stimulation by staphylococcal enterotoxin B, and reduces interleukin-4 secretion. After balneotherapy, a significant decrease in Psoriasis Area Severity Index (PASI, associated with a significant reduction of interleukin-8, Staphylococcus aureus colonization and enterotoxin N, have been reported in patients with psoriasis. Mineral water was found to have inhibitory in vitro effects on substance P, TNF-α release and antigen-induced cell degranulation. Immunomodulatory effects of water depend on its content. Sulfur waters have beneficial anti-inflammatory, keratolytic, and antipruriginous effects and also possess antibacterial and antifungal properties. The effectiveness of balneotherapy in the treatment of psoriasis has been reported in many studies conducted all over the world. The majority of studies were conducted at the Dead Sea coast. Investigations showed that balneotherapy factors are important therapeutic factors in the treatment of psoriatic patients. The first and only comparable study of this kind in Serbia, was conducted in Prolom Spa with satisfactory therapeutic results.

  19. Impaired incretin effect is an early sign of glucose dysmetabolism in nondiabetic patients with psoriasis

    DEFF Research Database (Denmark)

    Gyldenløve, M; Lauritsen, Tina Vilsbøll; Zachariae, Claus

    2015-01-01

    BACKGROUND: Patients with psoriasis have an increased risk of type 2 diabetes. The gastrointestinal system plays a major role in normal glucose metabolism, and in healthy individuals, postprandial insulin secretion is largely mediated by the gut incretin hormones. This potentiation is termed...... the incretin effect and is reduced in type 2 diabetes. The impact of psoriasis on gastrointestinal factors involved in glucose metabolism has not previously been examined. OBJECTIVE: To investigate whether the incretin effect, gastrointestinal-mediated glucose disposal (GIGD) and/or secretion of glucagon...... and gut incretin hormones are impaired in normal glucose-tolerant patients with psoriasis. METHODS: Oral glucose tolerance tests and intravenous isoglycaemic glucose infusions were performed in 12 patients with moderate-to-severe psoriasis and 12 healthy matched control subjects. RESULTS: In patients...

  20. The 'psoriatic march': a concept of how severe psoriasis may drive cardiovascular comorbidity.

    Science.gov (United States)

    Boehncke, Wolf-Henning; Boehncke, Sandra; Tobin, Anne-Marie; Kirby, Brian

    2011-04-01

    There is increasing awareness that psoriasis is more than 'skin deep'. Several recent reviews focussed on biomarkers indicating the systemic dimension of psoriasis and the aspect of comorbidity psoriasis shares with other chronic inflammatory diseases, such as Crohn's disease and rheumatoid arthritis. Of emerging significance is the relationship to cardiovascular disease, as this contributes substantially to the patients' increased mortality. In this viewpoint, we examine currently available evidence favouring the concept of a causal link between psoriasis and cardiovascular disease: systemic inflammation may cause insulin resistance, which in turn triggers endothelial cell dysfunction, leading to atherosclerosis and finally myocardial infarction or stroke. While this 'psoriatic march' is not yet formally proven, it raises clinically and academically relevant questions, and gains support by recent observations of numerous investigators. © 2011 John Wiley & Sons A/S.

  1. The 'psoriatic march': a concept of how severe psoriasis may drive cardiovascular comorbidity.

    LENUS (Irish Health Repository)

    Boehncke, Wolf-Henning

    2011-04-01

    There is increasing awareness that psoriasis is more than \\'skin deep\\'. Several recent reviews focussed on biomarkers indicating the systemic dimension of psoriasis and the aspect of comorbidity psoriasis shares with other chronic inflammatory diseases, such as Crohn\\'s disease and rheumatoid arthritis. Of emerging significance is the relationship to cardiovascular disease, as this contributes substantially to the patients\\' increased mortality. In this viewpoint, we examine currently available evidence favouring the concept of a causal link between psoriasis and cardiovascular disease: systemic inflammation may cause insulin resistance, which in turn triggers endothelial cell dysfunction, leading to atherosclerosis and finally myocardial infarction or stroke. While this \\'psoriatic march\\' is not yet formally proven, it raises clinically and academically relevant questions, and gains support by recent observations of numerous investigators.

  2. Promising New Treatments for Psoriasis

    Directory of Open Access Journals (Sweden)

    Sarah Dubois Declercq

    2013-01-01

    Full Text Available Psoriasis is a chronic, proliferative, and inflammatory skin disease affecting 2-3% of the population and is characterized by red plaques with white scales. Psoriasis is a disease that can affect many aspects of professional and social life. Currently, several treatments are available to help control psoriasis such as methotrexate, ciclosporin, and oral retinoids. However, the available treatments are only able to relieve the symptoms and lives of individuals. The discovery of new immunological factors and a better understanding of psoriasis have turned to the use of immunological pathways and could develop new biological drugs against specific immunological elements that cause psoriasis. Biological drugs are less toxic to the body and more effective than traditional therapies. Thus, they should improve the quality of life of patients with psoriasis. This review describes new psoriasis treatments, which are on the market or currently in clinical trials that are being used to treat moderate-to-severe plaque psoriasis. In addition, this paper describes the characteristics and mechanisms in detail. In general, biological drugs are well tolerated and appear to be an effective alternative to conventional therapies. However, their effectiveness and long-term side effects need to be further researched.

  3. Asthma in patients with psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, A S; Skov, L; Skytthe, A

    2015-01-01

    We read with interest the report by Fang and colleagues of the relationship between psoriasis and asthma in a large retrospective case-control study from Taiwan [1]. The study found a 1.38-fold increased risk of asthma among patients with psoriasis, and with an increasing risk according to higher...

  4. Psoriasis and high blood pressure.

    Science.gov (United States)

    Salihbegovic, Eldina Malkic; Hadzigrahic, Nermina; Suljagic, Edin; Kurtalic, Nermina; Sadic, Sena; Zejcirovic, Alema; Mujacic, Almina

    2015-02-01

    Psoriasis is a chronic skin ailment which can be connected with an increased occurrence of other illnesses, including high blood pressure. A prospective study has been conducted which included 70 patients affected by psoriasis, both genders, older than 18 years. Average age being 47,14 (SD= ±15,41) years, from that there were 36 men or 51,43 and 34 women or 48,57%. Average duration of psoriasis was 15,52 (SD=±12,54) years. Frequency of high blood pressure in those affected by psoriasis was 54,28%. Average age of the patients with psoriasis and high blood pressure was 53,79 year (SD=±14,15) and average duration of psoriasis was 17,19 years (SD=±13,51). Average values of PASI score were 16,65. Increase in values of PASI score and high blood pressure were statistically highly related (r=0,36, p=0,0001). Psoriasis was related to high blood pressure and there was a correlation between the severity of psoriasis and high blood pressure.

  5. Smoking and risk for psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, Ann Sophie; Skov, Lone; Skytthe, Axel

    2016-01-01

    BACKGROUND: Smoking is a potential risk factor for psoriasis. Both psoriasis and smoking habits are partly explained by genetic factors. However, twin studies investigating the association between these traits are limited. METHODS: Questionnaire-based data on smoking habits and psoriasis were...... collected for 34,781 twins, aged 20-71 years, from the Danish Twin Registry. A co-twin control analysis was performed on 1700 twin pairs discordant for lifetime history of smoking. Genetic and environmental correlations between smoking and psoriasis were estimated using classical twin modeling. RESULTS......: After multivariable adjustment, age group (50-71 vs. 20-49 years) and childhood exposure to environmental tobacco smoke (ETS) were significantly associated with psoriasis in the whole population (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.02-1.29 [P = 0.021] and OR 1.28, 95% CI 1.10-1.49 [P...

  6. Psoriasis in the pediatric population

    International Nuclear Information System (INIS)

    Vindas Calderon, Wendy

    2013-01-01

    A scientific and updated bibliographic review is realized for handling and care of a pediatric patient with psoriasis disease. Health personnel related with this pathology must to know the different perspectives and angles of psoriasis, as well as clinical criteria, therapeutic and emotional in the treatment of patients. The incidence of psoriasis is recognized globally. Ethnic groups have developed with most frequently this disorder. The different clinical faces of psoriasis are studied. The morphological and topographical manifestations have presented a variety very similar to that of adults, and have made for the doctor difficult to make the diagnostic. Clinical studies that were realized in the last years, have reported etiological and pathogenic evidence, both genetic and immunological of this illness. Children with psoriasis usually have presented a mild illness, where psoriasis type plaque has been the predominant variant. Psoriasis in the population has required a special attention in triggers or aggravating factors of this disease such as infections, exposure to snuff, obesity, stress and interactions with other drugs. The discovery and use of new drugs have led to different etiological factors for the handling of psoriasis; so it is important to know the function, availability and adverse effects that can to cause new therapies. Treatments must to include the provision of a safe and effective therapy for the maintenance for free long periods of lesions, reducing the severity of the disease, and inhibiting structural damage of joints. The topical treatment has been the therapy of first choice in mild psoriasis and localized. An interrogatory is recommended to decide objectively a systemic treatment, because the infant population has been a sensitive group of possible adverse effects. Methotrexate has been the treatment of choice for psoriasis related to arthropathy both adults and children. Phototherapy, including UVB, PUVA light and excimer laser is

  7. Change of Oral to Topical Corticosteroid Therapy Exacerbated Glucose Tolerance in a Patient with Plaque Psoriasis.

    Science.gov (United States)

    Hongo, Yui; Ashida, Kenji; Ohe, Kenji; Enjoji, Munechika; Yamaguchi, Miyuki; Kurata, Tsuyoshi; Emoto, Akiko; Yamanouchi, Hiroko; Takagi, Satoko; Mori, Hitoe; Kawata, Nozomi; Hisata, Yoshio; Sakanishi, Yuta; Izumi, Kenichi; Sugioka, Takashi; Anzai, Keizo

    2017-11-13

    BACKGROUND Psoriasis is known as the most frequent disease treated by long-term topical steroids. It is also known that patients with thick, chronic plaques require the highest potency topical steroids. However, the treatment is limited to up to four weeks due to risk of systemic absorption. CASE REPORT An 80-year-old man was diagnosed with type 2 diabetes 16 years before, and was being administered insulin combined with alpha glucosidase inhibitor. He was diagnosed with plaque psoriasis and his oral steroid treatment was switched to topical steroid treatment due to lack of improvement and poorly controlled blood glucose level. The hypoglycemic events improved after the psoriatic lesions improved. CONCLUSIONS Control of blood glucose level is difficult at the very beginning of topical steroid treatment for psoriasis especially if a patient is receiving insulin treatment. Intense monitoring of blood glucose level during initiation of topical steroid treatment is necessary to prevent unfavorable complications.

  8. An Expert's Advice: What To Do If You Have Psoriasis

    Science.gov (United States)

    ... on. Feature: Living with Psoriasis An Expert's Advice: What To Do If You Have Psoriasis Past Issues / ... the Dermatology Foundation, and the American Skin Association. What is psoriasis? Psoriasis is a chronic (long-term) ...

  9. I Live with Psoriasis | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Living with Psoriasis I Live with Psoriasis Past Issues / Fall 2013 Table of Contents Kristin ... equally. "Know as much as you can about psoriasis..." —Kristin Donahue Psoriasis first flared into Kristin Donahue's ...

  10. What is Psoriasis? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Living with Psoriasis What is Psoriasis? Past Issues / Fall 2013 Table of Contents What Is Psoriasis? There are several forms of psoriasis. The typical ...

  11. Biosimilars for psoriasis

    DEFF Research Database (Denmark)

    Blauvelt, A; Puig, L; Chimenti, S

    2017-01-01

    Biosimilars are drugs that are similar, but not identical, to originator biologics. Pre-clinical analytical studies are required to show similarity on a molecular and structural level, but efficacy and safety studies in humans are essential to ultimately determine biosimilarity. In this review wr...... written by members of the International Psoriasis Council, we discuss how biosimilars are evaluated in a clinical setting, with emphasis on extrapolation of indication, interchangeability, and optimal clinical trial design. This article is protected by copyright. All rights reserved....

  12. Indirect costs of absenteeism due to rheumatoid arthritis, psoriasis, multiple sclerosis, insulin-dependent diabetes mellitus, and ulcerative colitis in 2012: a study based on real-life data from the Social Insurance Institution in Poland.

    Science.gov (United States)

    Malinowski, Krzysztof Piotr; Kawalec, Paweł Piotr; Moćko, Paweł

    2016-01-01

    The aim of this study is to assess the indirect costs of six major autoimmune diseases including seropositive rheumatoid arthritis, other types of rheumatoid arthritis, psoriasis, multiple sclerosis, Type 1 diabetes, and ulcerative colitis. Relevant data for 2012 on sick leave and short- and long-term work disabilities were obtained from the Social Insurance Institution in Poland. Indirect costs were estimated using the human capital approach based on gross domestic product per capita, gross value added per worker, and gross income per worker in Poland in 2012 and expressed in euro. We recorded data on the total number of 45,500 patients. The total indirect costs were EUR 146,862,569; 353,683,508; and 108,154,271, calculated using gross domestic product, gross value added, and gross income, respectively. Considering only data on absenteeism collected by the Social Insurance Institution in Poland, we can conclude that the selected autoimmune diseases are associated with great indirect costs.

  13. Bimodal immune activation in psoriasis.

    Science.gov (United States)

    Christophers, E; Metzler, G; Röcken, M

    2014-01-01

    Psoriasis is an immune-regulated skin disease with various clinical subtypes and disease activities. The majority of patients present with predominantly stable plaques. At the onset of new lesions, plaque-type psoriasis frequently demonstrates pin-sized and highly inflammatory papules sometimes with an inflammatory border. The histopathology of initial psoriasis differs from stable plaque-type psoriasis. Early lesions demonstrate innate immune cells with neutrophils, degranulating mast cells and macrophages. These are followed by interleukin (IL)-1-dependent T helper (Th)17 cells, finally resulting in the Th1-dominated immunopathology of stable plaque-type psoriasis, where mononuclear cells predominate with interspersed neutrophilic (Munro) microabscesses. These features suggest a bimodal immune pathway where alternate activation of either innate (autoinflammatory) or adaptive (autoimmune) immunity predominates. Neutrophilic infiltrations appear during early psoriasis with Munro abscesses. They are time limited and occur periodically, clinically best seen in linear nail pitting. These features strongly suggest a critical role for an IL-1-Th17-dominated autoinflammation in the initiation of psoriasis, followed by a Th1-dominated late-phase reaction. The concept of bimodal immune activation helps to explain results from therapeutic interventions that are variable and previously only partly understood. © 2013 British Association of Dermatologists.

  14. Deciphering psoriasis. A bioinformatic approach.

    Science.gov (United States)

    Melero, Juan L; Andrades, Sergi; Arola, Lluís; Romeu, Antoni

    2018-02-01

    Psoriasis is an immune-mediated, inflammatory and hyperproliferative disease of the skin and joints. The cause of psoriasis is still unknown. The fundamental feature of the disease is the hyperproliferation of keratinocytes and the recruitment of cells from the immune system in the region of the affected skin, which leads to deregulation of many well-known gene expressions. Based on data mining and bioinformatic scripting, here we show a new dimension of the effect of psoriasis at the genomic level. Using our own pipeline of scripts in Perl and MySql and based on the freely available NCBI Gene Expression Omnibus (GEO) database: DataSet Record GDS4602 (Series GSE13355), we explore the extent of the effect of psoriasis on gene expression in the affected tissue. We give greater insight into the effects of psoriasis on the up-regulation of some genes in the cell cycle (CCNB1, CCNA2, CCNE2, CDK1) or the dynamin system (GBPs, MXs, MFN1), as well as the down-regulation of typical antioxidant genes (catalase, CAT; superoxide dismutases, SOD1-3; and glutathione reductase, GSR). We also provide a complete list of the human genes and how they respond in a state of psoriasis. Our results show that psoriasis affects all chromosomes and many biological functions. If we further consider the stable and mitotically inheritable character of the psoriasis phenotype, and the influence of environmental factors, then it seems that psoriasis has an epigenetic origin. This fit well with the strong hereditary character of the disease as well as its complex genetic background. Copyright © 2017 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

  15. Ixekizumab for treatment of psoriasis

    DEFF Research Database (Denmark)

    Dyring-Andersen, Beatrice; Skov, Lone; Zachariae, Claus

    2015-01-01

    Psoriasis is a prevalent chronic inflammatory skin disease of unknown etiology. Recent advances in understanding the pathogenesis of psoriasis suggest that IL-17 is a key proinflammatory mediator present in the skin. Several agents targeting IL-17 or its receptor are in clinical trials...... for the treatment of psoriasis. This review focuses on the biological rationale and the results of clinical trials with ixekizumab, a humanized IgG4 monoclonal antibody. Ixekizumab binds the IL-17A homodimer, thereby blocking the binding of IL-17A to the IL-17 receptor. The currently available Phase I-III data...

  16. Natural killer cells in psoriasis.

    LENUS (Irish Health Repository)

    Tobin, A M

    2012-02-01

    Psoriasis is one of the most common immune-mediated disorders. There is evidence that it is mediated by Th1 and, more recently, Th17 cells. The cytokine pattern, particularly the dominance of TNF-alpha, implicates the innate immune system in psoriasis pathogenesis. Of the many components of the innate immune system known to be involved in psoriatic lesions, natural killer and natural killer T cells appear to have a unique role. We review the evidence supporting a role for natural killer cells in psoriasis.

  17. Psoriasis Diet: Can Changing Your Diet Treat Psoriasis?

    Science.gov (United States)

    ... Gibson, M.D. Although there's no special psoriasis diet, some people find that certain foods worsen their symptoms or that others improve skin inflammation. It can be difficult to determine what ...

  18. Highlighting Interleukin-36 Signalling in Plaque Psoriasis and Pustular Psoriasis.

    Science.gov (United States)

    Furue, Kazuhisa; Yamamura, Kazuhiko; Tsuji, Gaku; Mitoma, Chikage; Uchi, Hiroshi; Nakahara, Takeshi; Kido-Nakahara, Makiko; Kadono, Takafumi; Furue, Masutaka

    2018-01-12

    Plaque psoriasis and pustular psoriasis are overlapping, but distinct, disorders. The therapeutic response to biologics supports the pivotal role of the tumour necrosis alpha (TNF-?)/ interleukin (IL)-23/IL-17/IL-22 axis in the pathogenesis of these disorders. Recently, functional activation of the IL-36 receptor (IL-36R) was discovered to be another driving force in the pathogenesis of psoriasis. This was first highlighted by the discovery that a loss-of-function mutation of the IL-36R antagonist (IL-36Ra) causes pustular psoriasis. Although the TNF-?/IL-23/IL-17/IL-22 axis and the functional activation of IL-36R are fundamentally involved in plaque psoriasis and pustular psoriasis, respectively, the 2 pathways are closely related and mutually reinforced, resulting in full-blown clinical manifestations. This review summarizes current topics on how IL-36 agonists (IL-36?, IL-36?, IL-36?) signal IL-36R, the pathological expression of IL-36 agonists and IL-36Ra in plaque and pustular psoriatic lesions, and the cross-talk between the TNF-?/IL-23/IL-17/IL-22 axis and the functional activation of IL-36R in the epidermal milieu.

  19. Significance of the S100A4 protein in psoriasis

    DEFF Research Database (Denmark)

    Zibert, John R; Skov, Lone; Thyssen, Jacob P

    2010-01-01

    the expression and significance of S100A4 in psoriasis. We found significant upregulation of S100A4 in the dermis of psoriatic skin compared with normal skin. This pattern of S100A4 expression differs considerably from that of other S100 proteins, S100A7 and S100A8/9, with predominant expression in the epidermis...... in the pathogenesis of psoriasis, we analyzed the effect of S100A4 blocking antibodies in a human psoriasis xenograft SCID mouse model and observed a significant reduction of the epidermal thickness and impairment in cell proliferation and dermal vascularization. In conclusion, we showed strong upregulation......The S100A4 protein is reported as a pivotal player in the tumor microenvironment with a metastasis-promoting function. Moreover, the upregulation of S100A4 is found in other non-malignant human disorders as cardiac and pulmonary systems and rheumatoid arthritis. In this study, we investigated...

  20. Sarcoidosis in patients with psoriasis

    DEFF Research Database (Denmark)

    Khalid, Usman; Gislason, Gunnar Hilmar; Hansen, Peter Riis

    2014-01-01

    PURPOSE: Psoriasis is a chronic inflammatory disease characterized by a systemic immunological response which is mainly driven by activated T helper (Th) 1 and Th17 lymphocytes. Like psoriasis, sarcoidosis is a chronic inflammatory disorder with Th1/Th17-driven inflammation. Therefore, we...... investigated the risk of sarcoidosis in patients with psoriasis compared to the background population in a nationwide cohort. METHODS: The study included the entire Danish population aged ≥10 years followed from 1st January 1997 until diagnosis of sarcoidosis, death or 31st December 2011. Patients...... with a history of psoriasis and/or sarcoidosis at baseline were excluded. Information on comorbidity and concomitant medication was identified by individual-level linkage of administrative registers. Incidence rates of sarcoidosis were calculated and adjusted hazard ratios (HRs) were estimated by multivariable...

  1. Co-morbidity in psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, Ann Sophie; Skov, Lone

    2017-01-01

    INTRODUCTION: Psoriasis is a common, chronic, immune-mediated inflammatory disorder. The disease is associated with several co-morbidities including cardiovascular disease, metabolic syndrome, and psychiatric disorders. It is important to identify and treat these co-morbidities because they have...... a strongly negative effect on the overall health of patients with psoriasis. Unfortunately, these co-morbidities are often overlooked and/or left untreated. Therefore, the aim of this review is to discuss the mechanisms of how co-morbidities are associated with psoriasis as well as implications...... for the clinic to be able to recognize such co-morbidities. Areas covered: This is a review of studies investigating and discussing co-morbidities of psoriasis and screening. Literature was retrieved by searching on the PubMed database using individual and combined search terms related to relevant co...

  2. Decoding Melanoma Metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Damsky, William E. Jr. [Department of Dermatology, Yale School of Medicine, New Haven, Connecticut (United States); Department of Pathology, University of Vermont College of Medicine, Burlington, Vermont (United States); Rosenbaum, Lara E.; Bosenberg, Marcus, E-mail: Marcus.Bosenberg@yale.edu [Department of Dermatology, Yale School of Medicine, New Haven, Connecticut (United States)

    2010-12-30

    Metastasis accounts for the vast majority of morbidity and mortality associated with melanoma. Evidence suggests melanoma has a predilection for metastasis to particular organs. Experimental analyses have begun to shed light on the mechanisms regulating melanoma metastasis and organ specificity, but these analyses are complicated by observations of metastatic dormancy and dissemination of melanocytes that are not yet fully malignant. Additionally, tumor extrinsic factors in the microenvironment, both at the site of the primary tumor and the site of metastasis, play important roles in mediating the metastatic process. As metastasis research moves forward, paradigms explaining melanoma metastasis as a step-wise process must also reflect the temporal complexity and heterogeneity in progression of this disease. Genetic drivers of melanoma as well as extrinsic regulators of disease spread, particularly those that mediate metastasis to specific organs, must also be incorporated into newer models of melanoma metastasis.

  3. DCB - Tumor Metastasis Research

    Science.gov (United States)

    Tumor metastasis research examines the mechanisms that allow cancer cells to leave the primary tumor and spread to another part of the body. Learn about recent tumor metastasis research studies supported by the Division of Cancer Biology.

  4. How much of the productivity losses among psoriasis patients are due to psoriasis

    OpenAIRE

    Mustonen, Anssi; Mattila, Kalle; Leino, Mauri; Koulu, Leena; Tuominen, Risto

    2015-01-01

    Background In previous studies, productivity losses have been measured specifically due to psoriasis or generally due to health problems in psoriasis patients. There is no information on the proportion of health related productivity losses that are due to psoriasis. The aim of this study was to estimate the proportion of productivity losses due to psoriasis and due to other medical problems among employed psoriasis patients. Methods Patients visiting a tertiary level dermatological clinic dur...

  5. Scalp psoriasis, clinical presentations and therapeutic management

    NARCIS (Netherlands)

    van de Kerkhof, P. C.; de Hoop, D.; de Korte, J.; Kuipers, M. V.

    1998-01-01

    The scalp is a well-known predilection site for psoriasis. Many patients indicate that scalp psoriasis is both psychologically and socially distressing. The aim of the present investigation is to provide epidemiological data on the various manifestations of scalp psoriasis, as well as on its

  6. Insulin Secretagogues

    Science.gov (United States)

    ... the Spikes Is mealtime insulin right for you? Insulin Secretagogues September 2017 Download PDFs English Espanol Editors ... Additional Resources Affordable Insulin Project FDA What are insulin secretagogues? Insulin secretagogues are one type of medicine ...

  7. Economic considerations in psoriasis management.

    Science.gov (United States)

    Radtke, Marc Alexander; Augustin, Matthias

    2008-01-01

    With a prevalence of 2% to 3%, psoriasis is a very common chronic disease worldwide and generates therapy costs and continuing cost for health insurance and patients and their families. Cost-political changes in health care and the ever increasing health-economic demands in all areas of the health system make it necessary to differentiate between the two when recording the expenses for a disease. The main characteristics of the pharmacoeconomic evaluation are the record of costs, the cost-benefit and cost-effectiveness ratio, and efficiency of various treatment forms. Numerous publications discuss the cost of individual forms of therapy in the treatment of psoriasis, but there are fewer studies on the total cost of psoriasis therapy, especially studies that take both direct and indirect costs into account. The scientific articles on pharmacoeconomy and quality of life in psoriasis have proven (without a doubt) that, despite the lack of a vital threat, psoriasis is highly important to the national economy and to those who have the disease. This justifies appropriate monetary expenditure for treatment. Studies that address the cost of therapies (especially for chronic diseases) will be necessary in the future and will create the required transparency to guarantee reasonable medical care that takes the cost-benefit ratio and the best outcome for the patient's quality of life into account.

  8. Skin-infiltrating, interleukin-22-producing T cells differentiate pediatric psoriasis from adult psoriasis.

    Science.gov (United States)

    Cordoro, Kelly M; Hitraya-Low, Maria; Taravati, Keyon; Sandoval, Priscila Munoz; Kim, Esther; Sugarman, Jeffrey; Pauli, Mariela L; Liao, Wilson; Rosenblum, Michael D

    2017-09-01

    Evidence from adult psoriasis studies implicates an imbalance between regulatory and effector T cells, particularly T H -17-producing T cells, in the pathogenesis of psoriasis. Little is known about the immunopathology of psoriasis in children. We sought to functionally characterize the inflammatory cell profiles of psoriatic plaques from pediatric patients and compare them with healthy, age-matched controls and adult psoriasis patients. Skin samples from pediatric psoriasis patients and healthy controls were analyzed by multiparameter flow cytometry to determine the dominant immune cell subsets present and cytokines produced. Lesional tissue from pediatric psoriasis patients had significantly increased interleukin (IL) 22 derived from CD4 + and CD8 + cells compared with the tissues from healthy pediatric controls and adult psoriasis patients. Tissue from pediatric psoriasis patients had significantly less elevation of IL-17 derived from CD4 + and CD8 + cells compared with the tissue from adult psoriasis patients. In contrast with the lesions from adult patients, lesional skin in pediatric patients with psoriasis did not have increases in regulatory T cells. This is a pilot study, thus the sample size is small. Significant differences in IL-17 and IL-22 expression were observed in the pediatric psoriasis patients compared with pediatric healthy controls and adult psoriasis patients. IL-22 might be relevant in the pathogenesis of pediatric psoriasis and represents a potential treatment target unique to pediatric psoriasis. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Dipeptidyl peptidase-4 inhibition and narrow-band ultraviolet-B light in psoriasis (DINUP): study protocol for a randomised controlled trial.

    LENUS (Irish Health Repository)

    Lynch, Maeve

    2016-01-15

    Moderate to severe psoriasis is a systemic inflammatory disease associated with insulin resistance, obesity and type 2 diabetes (T2DM). Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that improves glycaemia and has a marketing authorisation for the treatment of T2DM. Non-immunosuppressive therapies that are effective for psoriasis and its associated comorbidities would be a significant advance in the treatment of this chronic disease.

  10. Association between antidiabetic drugs and psoriasis risk in diabetic patients: results from a nationwide nested case-control study in Taiwan.

    Science.gov (United States)

    Wu, Chun-Ying; Shieh, Jeng-Jer; Shen, Jui-Lung; Liu, Yi-Ya; Chang, Yun-Ting; Chen, Yi-Ju

    2015-01-01

    The risk of psoriasis in diabetic patients has rarely been explored. We sought to investigate the association between antidiabetic therapies and psoriasis. The incidence of psoriasis was compared between a representative diabetic cohort and a matched nondiabetic cohort. We next conducted a nationwide cohort study with 1,659,727 diabetic patients using the National Health Insurance Research Database of Taiwan 1997 through 2011. Multivariate conditional logistic regression was used for nested case-control analyses. Incidence rates of psoriasis among diabetic patients and nondiabetic matched control subjects were 70.2 (95% confidence interval [CI] 59.5-80.9) and 42.3 (95% CI 39.5-45.5) per 100,000 person-years, respectively (P diabetic patients without history of insulin use, frequent use of thiazolidinedione was associated with lower risk of psoriasis (adjusted odds ratio 0.87, 95% CI 0.77-0.99). The National Health Insurance Research Database did not contain information regarding disease severity, diet, body mass index, lifestyle, or family history. Among diabetic patients, regular insulin use is associated with psoriasis development. Frequent use of thiazolidinedione may be associated with modest reduction in psoriasis risk. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  11. Implementing Best Practice in Psoriasis

    DEFF Research Database (Denmark)

    Kragballe, Knud; Gniadecki, Robert; Mørk, Nils-Jørgen

    2014-01-01

    In the absence of Nordic-wide guidelines on the best practice management of psoriasis, this paper aims to provide Nordic recommendations for treatment goals, evaluation of quality of life impact and assessment/management of co-morbidities. This Delphi approach consisted of telephone interviews......, local Nordic face-to-face meetings, and a Nordic-wide meeting, in which questions on treatment goals, quality of life impact and assessment/management of co-morbidities were posed to 17 dermatologists with psoriasis-treatment experience to gain consensus (≥ 90% agreement). The dermatologists agreed...... on the individualisation of treatment goals using Psoriasis Area and Severity Index and Dermatology Life Quality Index, which should be measured at the same frequency. Training of healthcare professionals on the use of these tools and psychological assessments were considered important, along with the referral...

  12. Insulin and Insulin Resistance

    Science.gov (United States)

    2005-01-01

    As obesity and diabetes reach epidemic proportions in the developed world, the role of insulin resistance and its consequences are gaining prominence. Understanding the role of insulin in wide-ranging physiological processes and the influences on its synthesis and secretion, alongside its actions from the molecular to the whole body level, has significant implications for much chronic disease seen in Westernised populations today. This review provides an overview of insulin, its history, structure, synthesis, secretion, actions and interactions followed by a discussion of insulin resistance and its associated clinical manifestations. Specific areas of focus include the actions of insulin and manifestations of insulin resistance in specific organs and tissues, physiological, environmental and pharmacological influences on insulin action and insulin resistance as well as clinical syndromes associated with insulin resistance. Clinical and functional measures of insulin resistance are also covered. Despite our incomplete understanding of the complex biological mechanisms of insulin action and insulin resistance, we need to consider the dramatic social changes of the past century with respect to physical activity, diet, work, socialisation and sleep patterns. Rapid globalisation, urbanisation and industrialisation have spawned epidemics of obesity, diabetes and their attendant co-morbidities, as physical inactivity and dietary imbalance unmask latent predisposing genetic traits. PMID:16278749

  13. Drug-induced psoriasis: clinical perspectives

    Directory of Open Access Journals (Sweden)

    Balak DMW

    2017-12-01

    Full Text Available Deepak MW Balak, Enes Hajdarbegovic Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands Abstract: Exposure to certain drugs can elicit an induction or exacerbation of psoriasis. Although well-conducted systematic studies on drug-related psoriasis are mostly lacking, traditionally strong associations have been documented for beta-blockers, lithium, antimalarial drugs such as (hydroxychloroquine, interferons, imiquimod, and terbinafine. More recently, new associations have been reported for monoclonal antibody- and small-molecule-based targeted therapies used for oncological and immunological indications, such as tumor necrosis factor-alpha antagonists and anti-programmed cell death protein 1 immune checkpoint inhibitors. Recognizing potential drug-related psoriasis is of clinical relevance to allow an optimal management of psoriasis. However, in clinical practice, identifying medication-related exacerbations and induction of psoriasis can be challenging. The clinical and histopathological features of drug-provoked psoriasis may differ little from that of “classical” nondrug-related forms of psoriasis. In addition, the latency period between start of the medication and onset of psoriasis can be significantly long for some drugs. Assessment of the Naranjo adverse drug reaction probability scale could be used as a practical tool to better differentiate drug-related psoriasis. The first step in the management of drug-related psoriasis is cessation and replacement of the offending drug when deemed clinically possible. However, the induced psoriasis skin lesions may persist after treatment withdrawal. Additional skin-directed treatment options for drug-related psoriasis follows the conventional psoriasis treatment guidelines and includes topical steroids and vitamin D analogs, ultraviolet phototherapy, systemic treatments, such as acitretin, methotrexate, and fumaric acid esters, and biological treatments

  14. Pustular psoriasis: pathophysiology and current treatment perspectives

    Directory of Open Access Journals (Sweden)

    Benjegerdes KE

    2016-09-01

    Full Text Available Katie E Benjegerdes,1 Kimberly Hyde,2 Dario Kivelevitch,3 Bobbak Mansouri1,4 1Texas A&M Health Science Center College of Medicine, Temple, 2Texas A&M Health Science Center College of Medicine, Round Rock, 3Division of Dermatology, Baylor University Medical Center, Dallas, 4Department of Dermatology, Scott and White Hospital, Texas A&M Health Science Center College of Medicine, Temple, TX, USA Abstract: Psoriasis vulgaris is a chronic inflammatory disease that classically affects skin and joints and is associated with numerous comorbidities. There are several clinical subtypes of psoriasis including the uncommon pustular variants, which are subdivided into generalized and localized forms. Generalized forms of pustular psoriasis include acute generalized pustular psoriasis, pustular psoriasis of pregnancy, and infantile and juvenile pustular psoriasis. Localized forms include acrodermatitis continua of Hallopeau and palmoplantar pustular psoriasis. These subtypes vary in their presentations, but all have similar histopathologic characteristics. The immunopathogenesis of each entity remains to be fully elucidated and some debate exists as to whether these inflammatory pustular dermatoses should be classified as entities distinct from psoriasis vulgaris. Due to the rarity of these conditions and the questionable link to the common, plaque-type psoriasis, numerous therapies have shown variable results and most entities remain difficult to treat. With increasing knowledge of the pathogenesis of these variants of pustular psoriasis, the development and use of biologic and other immunomodulatory therapies holds promise for the future of successfully treating pustular variants of psoriasis. Keywords: psoriasis, pustular psoriasis, generalized pustular psoriasis, von Zumbusch, impetigo herpetiformis, acrodermatitis continua of Hallopeau, palmoplantar pustulosis, biologic

  15. Psoriasis, chronic eczema and atopic dermatitis in males: functioning of sympathoadrenal and vagoinsular systems

    Directory of Open Access Journals (Sweden)

    N. Yu. Reznichenko

    2016-10-01

    Full Text Available Psoriasis, chronic eczema and atopic dermatitis are the most common diseases among patients of dermatovenereological profile. The study of the etiology and pathogenesis of chronic dermatoses, and the grounded choice of their treatment are extremely important problems of modern medicine. The objective of this work was to study the peculiarities of functioning of sympathoadrenal and vagal-insular systems in male patients with psoriasis, chronic eczema and atopic dermatitis. Materials and methods. 115 healthy males and males who suffered from psoriasis, chronic eczema and atopic dermatitis were examined. The men were distributed in the study groups depending on their age and the presence of chronic dermatoses. We investigated levels of adrenaline, norepinephrine, dioxyphenylalanine, dopamine in urine, as well as the levels of insulin and cortisol in blood. The calculation of hormones and mediators ratios of the sympathoadrenal and autonomic systems was performed. Results. Sympathoadrenal system was less active and its reserve capacity was lower in males with psoriasis, chronic eczema and atopic dermatitis. We also fixed the acceleration of biosynthesis of catecholamines. The speed of transformation of dioxyphenilalanine and dopamine to their metabolites was higher in patients with psoriasis, chronic eczema and atopic dermatitis. The high tension of glucocorticoid function of adrenal glands and increased activity of autonomic system; the intensive violations of autonomic homeostasis; the reduction of activity of compensatory organism reactions were found in male patients with chronic dermatoses. The discoordinated relationships in neurogenic link of adaptation in patients with chronic dermatoses were fixed. An antagonistic relationship was also revealed between different branches of nervous system in patients with psoriasis, chronic eczema and atopic dermatitis. These data reflected the violations of adaptation in patients with chronic dermatoses

  16. MicroRNAs-from metastasis prediction to metastasis prevention?

    Science.gov (United States)

    Abba, Mohammed; Patil, Nitin; Leupold, Jörg Hendrik; Allgayer, Heike

    2016-03-01

    Recently, we suggested the microRNA (miR) landscape defining metastasis. The first miR-driven network orchestrating invasion, intravasation, and metastasis was confirmed independently across several malignancies, suggesting a rather general principle for metastasis regulation. We hope that our data will stimulate the field in terms of further hypothesis generation, metastasis prediction, and metastasis prevention.

  17. Psoriasis is the independent factor for early atherosclerosis: A prospective study of cardiometabolic risk profile

    Directory of Open Access Journals (Sweden)

    Dinić Miroslav Ž.

    2016-01-01

    Full Text Available Background/Aim. Psoriasis as multisystemic inflammatory dis-ease is related with an increased cardiometabolic risk. The aim of the study was to analyze risk biomarkers, peripheral and renal arteries ultrasonography and echocardiography for subclinical atherosclerosis and metabolic disease in 106 subjects (66 psoriasis patients and 40 controls, 20 eczema patients and 20 healthy volunteers. Methods. In all exameenes following parameters were analyzed: body mass index (BMI, C-reactive protein, D-dimer, serum amyloid A (SAA, apolipoprotein (Apo A1, ApoB, ApoB/Apo A1 index, fasting glucose, C-peptide, fasting insulinemia, homeostatic model assessment-insulin resistance (HOMA-IR, HOMA-β-cell, lipid profile, serum uric acid concentration (SUAC, 24-h proteinuria and microalbuminuria. Carotid, brachial, femoral and renal arteries ultrasonography, as well as echocardiography was also performed. Results. Five of 66 (7.6% psoriasis patients had metabolic syndrome (not present in both control groups. The following variables were increased in patients with psoriasis compared to both control groups: BMI (p = 0.012, insulinemia (p < 0.001, HOMA-IR (p = 0.003, HOMA-β cell (p < 0.001, SUAC (p = 0.006, ApoB/ApoA1 ra-tio (p = 0.006 and microalbuminuria (p < 0.001. Also, increased C-peptide (p = 0.034, D-dimer (p = 0.029, triglycerides (p = 0.044, SAA (p = 0.005 and decreased ApoA1 (p = 0.014 were found in the psoriasis patients compared to healthy controls. HDL cholesterol was decreased in the psoriasis patients compared to the control group of eczema patients (p = 0.004. Common carotid (CIMT and femoral artery intima-media thickness (FIMT was significantly greater (p < 0.001 and the maximal flow speed (cm/s in brachial artery significantly de-creased (p = 0.017 in the patients with psoriasis in comparison to both control groups. In multivariate logistic regression analysis, after the adjustment for confounding variables, the most important predictor of CIMT and

  18. Spotlight on Psoriasis: Preventing Patches of Itchy, Sore Skin

    Science.gov (United States)

    ... Subscribe August 2016 Print this issue Spotlight on Psoriasis Preventing Patches of Itchy, Sore Skin En español ... Sun Damage Sun and Skin Wise Choices Avoid Psoriasis Triggers Factors that may trigger psoriasis or make ...

  19. Drug-induced psoriasis: clinical perspectives

    Science.gov (United States)

    Balak, Deepak MW; Hajdarbegovic, Enes

    2017-01-01

    Exposure to certain drugs can elicit an induction or exacerbation of psoriasis. Although well-conducted systematic studies on drug-related psoriasis are mostly lacking, traditionally strong associations have been documented for beta-blockers, lithium, antimalarial drugs such as (hydroxy)chloroquine, interferons, imiquimod, and terbinafine. More recently, new associations have been reported for monoclonal antibody- and small-molecule-based targeted therapies used for oncological and immunological indications, such as tumor necrosis factor-alpha antagonists and anti-programmed cell death protein 1 immune checkpoint inhibitors. Recognizing potential drug-related psoriasis is of clinical relevance to allow an optimal management of psoriasis. However, in clinical practice, identifying medication-related exacerbations and induction of psoriasis can be challenging. The clinical and histopathological features of drug-provoked psoriasis may differ little from that of “classical” nondrug-related forms of psoriasis. In addition, the latency period between start of the medication and onset of psoriasis can be significantly long for some drugs. Assessment of the Naranjo adverse drug reaction probability scale could be used as a practical tool to better differentiate drug-related psoriasis. The first step in the management of drug-related psoriasis is cessation and replacement of the offending drug when deemed clinically possible. However, the induced psoriasis skin lesions may persist after treatment withdrawal. Additional skin-directed treatment options for drug-related psoriasis follows the conventional psoriasis treatment guidelines and includes topical steroids and vitamin D analogs, ultraviolet phototherapy, systemic treatments, such as acitretin, methotrexate, and fumaric acid esters, and biological treatments. PMID:29387611

  20. Treatment of psoriasis with cyclosporin

    African Journals Online (AJOL)

    and ketoconazole). All topical and systemic treatment for psoriasis was discontinued for 2 weeks before starting CyA. The only female patient had had a hysterectomy, obviating the need for.contraception. The patients were treated with CyA at a randomly selected starting dosage of either 2,5 mg/kg/d (6 patients, Nos 1, 3,.

  1. Psoriasis: dysregulation of innate immunity

    NARCIS (Netherlands)

    Bos, J. D.; de Rie, M. A.; Teunissen, M. B. M.; Piskin, G.

    2005-01-01

    The current understanding of the function of natural killer (NK) T cells in innate immunity and their potential to control acquired specific immunity, as well as the remarkable efficacy of antitumour necrosis factor-alpha biological treatments in psoriasis, forces us to refine the current T-cell

  2. Psoriasis & Comorbidities: Unraveling the Maze

    NARCIS (Netherlands)

    E.A. Dowlatshahi (Emmilia)

    2014-01-01

    markdownabstract__Abstract__ In this thesis we used a multifaceted approach to analyzing depression in psoriasis, by investigating Health Related Quality of Life (HRQoL), depressive symptoms, clinical depression and antidepressant use, using various data sources and statistical methods. These

  3. Cytokine network in psoriasis revisited.

    Science.gov (United States)

    Michalak-Stoma, Anna; Pietrzak, Aldona; Szepietowski, Jacek C; Zalewska-Janowska, Anna; Paszkowski, Tomasz; Chodorowska, Grażyna

    2011-12-01

    Psoriasis is a chronic genetically determined, erythemato-squamous disease associated with many comorbidities. Evidence from clinical studies and experimental models support the concept that psoriasis is a T cell-mediated inflammatory skin disease and T helper (Th) cells - Th1, Th17 and Th22 - play an important role in the pathogenesis. Th1 cytokines IFNγ, IL-2, as well as Th17 cytokines IL-17A, IL-17F, IL-22, IL-26, and TNFα (Th1 and Th17 cytokine) are increased in serum and lesional skin. IL-22 produced by Th17 and new subset of T helper cells, Th22, is also increased within psoriatic lesions and in the serum. Other recently recognized cytokines of significant importance in psoriasis are IL-23, IL-20 and IL-15. The IL-23/Th17 pathway plays a dominant role in psoriasis pathogenesis. Currently due to enormous methodological progress, more and more clinical and histopathological psoriatic features could be explained by particular cytokine imbalance, which still is one of the most fascinating dermatological research fields stimulating new and new generations of researchers.

  4. Insulin Pumps

    Science.gov (United States)

    ... Size: A A A Listen En Español Insulin Pumps Insulin pumps are small computerized devices that deliver insulin in ... tissue and is taped in place. The insulin pump is not an artificial pancreas (because you still ...

  5. Insulin receptors

    International Nuclear Information System (INIS)

    Kahn, C.R.; Harrison, L.C.

    1988-01-01

    This book contains the proceedings on insulin receptors. Part A: Methods for the study of structure and function. Topics covered include: Method for purification and labeling of insulin receptors, the insulin receptor kinase, and insulin receptors on special tissues

  6. How much of the productivity losses among psoriasis patients are due to psoriasis.

    Science.gov (United States)

    Mustonen, Anssi; Mattila, Kalle; Leino, Mauri; Koulu, Leena; Tuominen, Risto

    2015-03-04

    In previous studies, productivity losses have been measured specifically due to psoriasis or generally due to health problems in psoriasis patients. There is no information on the proportion of health related productivity losses that are due to psoriasis. The aim of this study was to estimate the proportion of productivity losses due to psoriasis and due to other medical problems among employed psoriasis patients. Patients visiting a tertiary level dermatological clinic during a one-year period due to psoriasis or psoriasis arthritis, who were employed, were selected to the study. A questionnaire was used to assess productivity losses during the previous month. Psoriasis accounted for 38% of the total lost productivity costs. One fifth of patients had been on sick leave (absenteeism) due to psoriasis and a third of patients worked despite being sick with psoriasis (presenteeism). Men had higher costs of presenteeism, but the costs of absenteeism due to psoriasis were lower for men than for women. Productivity losses should be assessed disease specifically to avoid overestimations of the role of the disease on indirect costs. Our study shows that about a third of the lost productivity costs are due to psoriasis.

  7. Long-term management of scalp psoriasis: perspectives from the International Psoriasis Council

    NARCIS (Netherlands)

    Kragballe, K.; Menter, A.; Lebwohl, M.; Tebbey, P.W.; Kerkhof, P.C.M. van de; et al.,

    2013-01-01

    The scalp is a well-known predilection site for psoriasis. Epidemiological data on the various manifestations of scalp psoriasis as well as on its therapeutic management are sparse. The understanding of the natural course of scalp psoriasis is relevant for its therapeutic management. In over 25% of

  8. Radioimmunoassay for determination of the hormonal and immune states in patients aczema; psoriasis and neurodermatitis

    International Nuclear Information System (INIS)

    Baltabaev, T.S.

    1989-01-01

    The hormonal and immune status was investigated by a radioimmunoassay in 105 patiets with dermatosis (55 female and 50 male patients aged 15 to 80): 51 suffered frm ecsema, 41 -from psoriasis, and 13 - from neurodermatitis. Serum concentrations of T 3 , T 4 , TSH, insulin, trypsin, C-peptide, cortisol, and IgE were investigated. Disorders of the hormonal and immune status were noted in the examinees with relation to sez, type of disease, season, time-period and extent of disease

  9. Infantile psoriasis treated successfully with topical calcipotriene

    Directory of Open Access Journals (Sweden)

    Neerja Puri

    2013-04-01

    Full Text Available Infantile psoriasis is a benign disease. Systemic features are rare and spontaneous remission occurs. There is a hazard of viral infection particularly in steroid treated children. Psoriasis in infancy is often more therapeutically challenging than atopic and seborrheic dermatitis. We report a case of nine month old infant treated with topical calcipotriene for infantile psoriasis who experienced greater benefit than he had with standard corticosteroid medications.

  10. On the guestion of comorbidity in psoriasis

    Directory of Open Access Journals (Sweden)

    Bakulev A.L.

    2014-09-01

    Full Text Available Goal: analysis of comorbidity in patients with various forms of psoriasis. Material and methods. The study involved 105 patients with various forms of psoriasis. Comorbidities were established on the basis of medical history, clinical findings, laboratory tests and consultation with other specialists. Results. Among the most common comorbidities in psoriasis encountered pathology of the cardiovascular system, gastrointestinal tract, endocrinopathy, metabolic syndrome, psoriatic arthritis and depressive disorders. Conclusion. In most patients, psoriasis is combined with certain comorbid conditions that must be considered when choosing the tactics of treatment

  11. Psoriasis er associeret med type 2-diabetes

    DEFF Research Database (Denmark)

    Gyldenl�ve, Mette; Knop, Filip Krag; Vilsb�ll, Tina

    2013-01-01

    Psoriasis is a chronic inflammatory skin disease with a global prevalence of 2-3%. In recent years it has been established that patients with psoriasis carry an increased risk of type 2 diabetes, but the underlying pathophysiological mechanisms remain unclear. The association is most likely due...... to a combination of shared genes, immunoinflammatory mechanisms and a number of diabetes risk factors in patients with psoriasis. The current review summarises the evidence in the field and calls for attention on diabetes risk assessment, preventive measures and treatment in patients with psoriasis....

  12. Pulmonary function in subjects with psoriasis

    DEFF Research Database (Denmark)

    Hansen, P. R.; Isaksen, Jonas Lynggaard; Jemec, G. B.

    2018-01-01

    Psoriasis is a prevalent chronic inflammatory disease associated with comorbidities, e.g. cardiometabolic diseases, inflammatory bowel disease, and depression that may share an inflammatory origin. Smoking increases the risk of psoriasis and the disease has also been linked to chronic obstructive...... pulmonary disease (COPD) and asthma, with evidence of shared inflammatory cytokine-mediated mechanisms. Moreover, subjects with psoriasis display increased risk of infections, especially respiratory infections including pneumonia. However, only a small single-center study of pulmonary function in subjects...... with psoriasis is available. This article is protected by copyright. All rights reserved....

  13. Genetic polymorphisms associated with psoriasis and development of psoriatic arthritis in patients with psoriasis

    DEFF Research Database (Denmark)

    Loft, Nikolai Dyrberg; Skov, Lone; Rasmussen, Mads Kirchheiner

    2018-01-01

    BACKGROUND: Psoriasis (PsO) is a chronic inflammatory disease with predominantly cutaneous manifestations. Approximately one third of patients with PsO develop psoriatic arthritis (PsA), whereas the remaining proportion of patients has isolated cutaneous psoriasis (PsC). These two phenotypes share...... (rs6887695) was associated with PsO. CONCLUSION: Among a cohort of Danish patients with moderate-to-severe psoriasis, two SNPs in the IL12B and TNF genes were associated with susceptibility of psoriasis. None of the SNPs were specifically associated with isolated cutaneous psoriasis or psoriatic...

  14. Reliability and validity of the Psoriasis Itch Visual Analog Scale in psoriasis vulgaris.

    Science.gov (United States)

    Pedersen, Claus Bang; McHorney, Colleen A; Larsen, Lotte Seiding; Lophaven, Katja Wendicke; Moeller, Anders Holmen; Reaney, Matthew

    2017-05-01

    The single-item Psoriasis Itch VAS was developed to measure itch intensity within the last 24 hours in psoriasis vulgaris to assess treatment benefit. Its psychometric properties were explored in two trials. Data from two randomized, parallel-group phase 3 trials with subjects suffering from psoriasis vulgaris on the body (n = 426, 463) were analyzed. Cross-sectional distributional properties and construct validity of the Psoriasis Itch VAS as well as longitudinal test-retest reliability and sensitivity to change of the Psoriasis Itch VAS were investigated. All statistical tests were two-tailed. Across both trials, acceptable distributional properties were observed. Convergent-validity correlations between the Psoriasis Itch VAS and other patient-reported and clinician-reported outcomes provided strong endorsement for construct validity as did tests of known-groups validity. Longitudinal measurement properties, involving test-retest reliability and sensitivity to change, also offered evidence for the measurement integrity of the Psoriasis Itch VAS. Results from the assessment of validity, reliability, and sensitivity to change support the use of the Psoriasis Itch VAS to measure itch intensity in psoriasis vulgaris. Data from two trials provided evidence that the Psoriasis Itch VAS is well-defined and reliable for measuring itch in psoriasis vulgaris to assess treatment benefit (i.e. therapeutic response).

  15. Psoriasis in pregnancy: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Vena GA

    2015-05-01

    Full Text Available Gino Antonio Vena,1 Nicoletta Cassano,1 Gilberto Bellia,2 Delia Colombo,2 1Dermatology and Venereology Private Practice, Bari and Barletta, 2Novartis Farma SpA, Origgio, Varese, Italy Abstract: The available information about the effects of pregnancy on psoriasis and those of psoriasis on pregnancy is almost limited, despite the high frequency of the disease in the general population, as well as in women in reproductive years. Considering the existing evidence, pregnancy does not tend to have a negative influence on psoriasis, as in most women who experience a change in the severity and course of their psoriasis during pregnancy, the change is more likely to be reported as an improvement. This assumption can be applied more convincingly to plaque-type psoriasis, while an exception may be represented by generalized pustular psoriasis, which has been somehow linked to impetigo herpetiformis. Conflicting findings emerged from the few available studies that explored the effect of psoriasis on pregnancy outcomes. Recent studies found an association between moderate-to-severe psoriasis and some pregnancy complications, including pregnancy-induced hypertensive diseases, and have emphasized a trend toward a newborn with low birth weight in patients with psoriasis, especially in those suffering from severe forms. The safety profile during pregnancy is not completely known for many drugs used to treat psoriasis. Moisturizers and low- to moderate-potency topical steroids or ultraviolet B phototherapy represent the first-line therapy for pregnant patients. Many dermatologists may, however, recommend discontinuing all drugs during pregnancy, in consideration of medico-legal issues, and also taking into account that common forms of psoriasis do not compromise the maternal and fetal health. Anyway, for those women whose psoriasis improves during pregnancy, the interruption of any therapy for psoriasis can be a reasonable strategy. The objective of this paper

  16. Psoriasis as an autoimmune disease

    OpenAIRE

    Agnieszka Owczarczyk-Saczonek; Waldemar Placek

    2014-01-01

    Nowadays it is known that psoriasis belongs to the group of autoimmune diseases and may coexist with other diseases in this group. Most often patients have psoriatic arthritis, rheumatoid arthritis, inflammatory bowel disease, autoimmune thyroid diseases and multiple sclerosis. The coexistence of these disorders can be a diagnostic and therapeutic problem (there is controversy over the use of corticosteroids). The common pathogenesis is still not explained. We know that the loss of immunotole...

  17. A clinical review of phototherapy for psoriasis.

    Science.gov (United States)

    Zhang, Ping; Wu, Mei X

    2018-01-01

    Psoriasis is an autoimmune inflammatory skin disease. In the past several decades, phototherapy has been widely used to treat stable psoriatic lesions, including trunk, scalp, arms and legs, and partial nail psoriasis. A variety of light/lasers with different mechanisms of action have been developed for psoriasis including ultraviolet B (UVB), psoralen ultraviolet A (PUVA), pulsed dye laser (PDL), photodynamic therapy (PDT), intense pulsed light (IPL), light-emitting diodes (LED), and so on. Because light/laser each has specific therapeutic and adverse effects, it is important to adequately choose the sources and parameters in management of psoriasis with different pathogenic sites, severities, and duration of the disorder. This review aims at providing most updated clinic information to physicians about how to select light/laser sources and individual therapeutic regimens. To date, UV light is primarily for stable plaque psoriasis and PDL for topical psoriatic lesions with small area, both of which are safe and effective. On the other hand, PUVA has better curative effects than UVB for managing refractory psoriasis plaques, if its side effects can be better controlled. PDL provides optimal outcomes on nail psoriasis compared with other lasers. Although the trails of low-level light/laser therapy (LLLT) are still small, the near infrared (NIR) and visible red light with low energy show promise for treating psoriasis due to its strong penetration and encouraging photobiomodulation. IPL is rarely reported for psoriasis treatment, but PDT-IPL has been found to offer a moderate effect on nail psoriasis. In brief, various phototherapies have been used either in different combinations or as monotherapy. The modality has become a mainstay in the treatment of mild-to-moderate psoriasis without systemic adverse events in today's clinical practice.

  18. Biologics in pediatric psoriasis - efficacy and safety.

    Science.gov (United States)

    Dogra, Sunil; Mahajan, Rahul

    2018-01-01

    Childhood psoriasis is a special situation that is a management challenge for the treating dermatologist. As is the situation with traditional systemic agents, which are commonly used in managing severe psoriasis in children, the biologics are being increasingly used in the recalcitrant disease despite limited data on long term safety. Areas covered: We performed an extensive literature search to collect evidence-based data on the use of biologics in pediatric psoriasis. The relevant literature published from 2000 to September 2017 was obtained from PubMed, using the MeSH words 'biologics', 'biologic response modifiers' and 'treatment of pediatric/childhood psoriasis'. All clinical trials, randomized double-blind or single-blind controlled trials, open-label studies, retrospective studies, reviews, case reports and letters concerning the use of biologics in pediatric psoriasis were screened. Articles covering the use of biologics in pediatric psoriasis were screened and reference lists in the selected articles were scrutinized to identify other relevant articles that had not been found in the initial search. Articles without relevant information about biologics in general (e.g. its mechanism of action, pharmacokinetics and adverse effects) and its use in psoriasis in particular were excluded. We screened 427 articles and finally selected 41 relevant articles. Expert opinion: The available literature on the use of biologics such as anti-tumor necrosis factor (TNF)-α agents, and anti-IL-12/23 agents like ustekinumab suggests that these are effective and safe in managing severe pediatric psoriasis although there is an urgent need to generate more safety data. Dermatologists must be careful about the potential adverse effects of the biologics before administering them to children with psoriasis. It is likely that with rapidly evolving scenario of biologics in psoriasis, these will prove to be very useful molecules particularly in managing severe and recalcitrant

  19. How Is Psoriasis Treated? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Living with Psoriasis How Is Psoriasis Treated? Past Issues / Fall 2013 Table of Contents ... nih.gov/ Clinical Trials — www.clinicaltrials.gov National Psoriasis Foundation — www.psoriasis.org American Academy of Dermatology — ...

  20. Association between Contact allergy and Psoriasis

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie

    2011-01-01

    6. SUMMERY 6.1 Summery in English Allergic contact dermatitis (ACD) and psoriasis are the two most prevalent skin diseases in the western world. ACD is the clinical manifestation of contact allergy. Contact allergy and psoriasis are both due to inflammatory mechanisms involving the innate...

  1. Key elements of psoriasis immunogenetics: A review

    Directory of Open Access Journals (Sweden)

    Duque Cardona, Leidy Yohana

    2014-10-01

    Full Text Available Psoriasis is one of the most common skin diseases, affecting 2% to 3% of the world population. It occurs at any stage of life. “Early” psoriasis or type I manifests before 40 years, and “late” psoriasis or type II, after 40 years. It has a strong genetic basis and the probability of inheriting the disease when both parents are affected is up to 50%. Different susceptibility regions associated with psoriasis, called PSORS, have been described, PSORS-1 being the most frequent one. It is in chromosome 6 and in this region HLA-Cw6 is located, which is until now the gene more associated with psoriasis. The role of HLA-Cw6 in psoriasis is not fully understood, but it has a relationship with type I psoriasis, guttate psoriasis and presentation of an array of antigens including those derived from Streptococcus pyogenes. Furthermore, some single nucleotide polymorphisms in genes encoding cytokines such as IL-12, IL-23, TNF-α or its receptors are associated with the immunopathogenesis of the disease.

  2. Psoriasis, innate immunity, and gene pools

    NARCIS (Netherlands)

    Bos, Jan D.

    2007-01-01

    Recently, emphasis has shifted from T cells to innate (natural) immunity as the possible major culprit in psoriasis. All known elements of innate immune responses are up-regulated in psoriasis lesions, which must have a polygenetic origin. We hypothesize that urbanized populations have been under

  3. The management of psoriasis through diet

    Directory of Open Access Journals (Sweden)

    Duarte G

    2012-08-01

    Full Text Available Gleison Duarte,1 Luan Oliveira Barbosa,2 Maria Elisa A Rosa11Dermatology Division, Alergodermoclin, Salvador, Bahia, Brazil; 2Escola Bahiana de Medicina e Saúde Pública Salvador, Bahia, BrazilAbstract: Diet is an important factor in the management of several dermatological diseases, such as dermatitis herpetiformis, acne vulgaris, gout, phrynoderma, pellagra, psoriasis, and acrodermatitis enteropathica. New concepts have emerged concerning the influence of diet on psoriasis. For example, diet has an adjuvant role in the management of several cardiovascular comorbidities that exhibit a higher-than-expected prevalence in psoriatic patients. Functional foods, such as yellow saffron and fish oil, may exert favorable effects on immune and cardiovascular functions. A gluten-free diet may promote significant clinical and histologic improvement. Folate supplementation may induce clinical improvement of psoriasis, but side effects may also occur. Diets rich in fresh fruits and vegetables are associated with a lower prevalence of psoriasis, and vegetarian diets were associated with clinical improvement. Additionally, many drug-diet interactions (retinoids, methotrexate, cyclosporine must be considered in patients with psoriasis. Therefore, in addition to current nutritional advice given to psoriasis patients, further studies are necessary in the role of diet in psoriasis therapy.Keywords: diet, lifestyle, psoriasis, recommendations, supplementation

  4. Psoriasis: epidemiology, natural history, and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Basko-Plluska JL

    2012-09-01

    Full Text Available Juliana L Basko-Plluska, Vesna Petronic-RosicDepartment of Medicine, Section of Dermatology, University of Chicago, Chicago, IL, USAAbstract: Psoriasis is a chronic, immune-mediated, inflammatory disease which affects primarily the skin and joints. It occurs worldwide, but its prevalence varies considerably between different regions of the world. Genetic susceptibility as well as environmental factors play an important role in determining the development and prognosis of psoriasis. Genome-wide association studies have identified many genetic loci as potential psoriasis susceptibility regions, including PSORS1 through PSORS7. Histocompatibility antigen (HLA studies have also identified several HLA antigens, with HLA-Cw6 being the most frequently associated antigen. Epidemiological studies identified several modifiable risk factors that may predispose individuals to developing psoriasis or exacerbate pre-existing disease. These include smoking, obesity, alcohol consumption, diet, infections, medications and stressful life events. The exact mechanism by which they trigger psoriasis remains to be elucidated; however, existing data suggest that they are linked through Th1-mediated immunological pathways. The natural history of psoriasis varies depending on the clinical subtype as well as special circumstances, including pregnancy and HIV infection. In general, psoriasis is a chronic disease with intermittent remissions and exacerbations. The differential diagnosis is vast and includes many other immune-mediated, inflammatory disorders.Keywords: psoriasis, epidemiology, natural history, differential diagnosis

  5. Nail psoriasis: a questionnaire-based survey

    NARCIS (Netherlands)

    Klaassen, K.M.G.; Kerkhof, P.C.M. van de; Pasch, M.C.

    2013-01-01

    BACKGROUND: Skin manifestations are the most characteristic finding of psoriasis. However, nail involvement is also a clinical feature of disease although it is often overlooked. The documented prevalence of nail psoriasis varies between 10.0% and 81.1%. OBJECTIVES: The aim of this investigation is

  6. Psoriasis of the face and flexures.

    NARCIS (Netherlands)

    Kerkhof, P.C.M. van de; Murphy, G.M.; Austad, J.; Ljungberg, A.; Cambazard, F.; Duvold, L.B.

    2007-01-01

    Facial and flexural psoriasis may impair the quality of life of psoriatic patients considerably. For the adequate management of psoriasis it is important to pay attention to lesions at these sensitive sites, which require an approach different to that for lesions on other sites in several respects.

  7. Oxidative stress in the pathogenesis of psoriasis.

    Science.gov (United States)

    Zhou, Qiang; Mrowietz, Ulrich; Rostami-Yazdi, Martin

    2009-10-01

    Psoriasis is a chronic immune-mediated hyperproliferative inflammatory skin disease in which a cytokine network concept is well established. Skin is a major target of oxidative stress mainly due to reactive oxygen species (ROS) originating from the environment and skin metabolism itself. Although endogenous antioxidants attenuate the harmful effects of ROS, increased or prolonged presence of free radicals can override ROS defense mechanisms and mediate numerous cellular responses that contribute to the development of a variety of skin disorders, including psoriasis. Regarding psoriasis, antioxidant strategies have proven to be beneficial therapeutics. The cellular signaling pathways such as mitogen-activated protein kinase/activator protein 1, nuclear factor kappaB, and Janus kinase-signal transducers and activators of transcription are known to be redox sensitive and proven to be involved in the progress of psoriasis. This review summarizes the current knowledge of the role of the redox system in regulating these signaling pathways related to the pathogenesis of psoriasis.

  8. Psoriasis: characteristics, psychosocial effects and treatment options.

    LENUS (Irish Health Repository)

    Ryan, Sheila

    2012-02-01

    Psoriasis is a complex chronic non-infectious inflammatory skin disease with a variety of different presentations. The classic presentation is of well-defined red plaques with silver scale. The characteristic scale makes the disorder highly visible and intrusive on the patient\\'s lifestyle. The visible nature of the disease ensures that psoriasis has both physical and psychosocial effects. In normal skin, epidermal cell reproduction and proliferation takes 28 days. In psoriasis this process is considerably accelerated to approximately 4 days, resulting in the deposit of immature cells on the skin. While the exact cause of this process is unknown, certain environmental and genetic factors are known to be triggers. Disease management depends on disease severity, psychosocial effects and the patient\\'s lifestyle. To effectively treat this disease the nurse must be skilled in psoriasis management, and in patient education and motivation. This article reviews the characteristics, aetiology, psychosocial effects and treatment strategies of psoriasis.

  9. Association between psoriasis and inflammatory bowel disease

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Mallbris, L; Warren, R B

    2016-01-01

    BACKGROUND: Psoriasis, Crohn disease (CD) and ulcerative colitis (UC) are chronic inflammatory disorders with overlapping genetic architecture. However, data on the frequency and risk of CD and UC in psoriasis are scarce and poorly understood. OBJECTIVES: To investigate the association between CD...... and UC in patients with psoriasis. METHODS: All Danish individuals aged ≥ 18 years between 1 January 1997 and 31 December 2012 were linked in nationwide registers. Psoriasis severity was defined in two models: hospital visits and medication. Incidence rates per 10 000 person-years were calculated......, and incidence rate ratios (IRRs) were estimated by Poisson regression. RESULTS: In the total cohort (n = 5 554 100) there were 75 209 incident cases of psoriasis, 11 309 incident cases of CD and 30 310 incident cases of UC, during follow-up. The adjusted IRRs (95% confidence intervals) of CD were 1·28 (1...

  10. Psoriasis and New-Onset Diabetes

    DEFF Research Database (Denmark)

    Khalid, Usman; Hansen, Peter Riis; Gislason, Gunnar Hilmar

    2013-01-01

    OBJECTIVE Psoriasis is associated with increased risk of cardiovascular events and increased prevalence of cardiovascular risk factors. Diabetes mellitus (DM) is a major contributor to cardiovascular morbidity and mortality that may be associated with psoriasis, but conflicting results have been...... presented and nationwide data on the risk of new-onset DM in patients with psoriasis have not been reported. RESEARCH DESIGN AND METHODS The study comprised a Danish population ≥10 years of age on 1 January 1997 who were followed until new-onset DM, death, or 31 December 2009. Information on comorbidity...... regression. RESULTS A total of 4,614,807 subjects were eligible for analysis, with a maximum follow-up of 13 years. In the study period, 52,613 patients with psoriasis, including 6,784 patients with severe psoriasis, were identified. The overall incidence rates for new-onset DM were 3.67 (CI 3.65-3.69), 6...

  11. Association between Contact allergy and Psoriasis

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie

    2011-01-01

    6. SUMMERY 6.1 Summery in English Allergic contact dermatitis (ACD) and psoriasis are the two most prevalent skin diseases in the western world. ACD is the clinical manifestation of contact allergy. Contact allergy and psoriasis are both due to inflammatory mechanisms involving the innate...... and adaptive immune system. Psoriasis is conceived to be an autoimmune disease. Recent studies have suggested an inverse relation between contact allergy and autoimmune diseases. The association between contact allergy and psoriasis could reveal mechanistic insights into both inflammatory processes....... The overall aim of this PhD study was to investigate the association between contact allergy and autoimmune disease, with focus on psoriasis. The work was done in three study parts. Part I Epidemiological studies. Part II Sensitization study and Part III Experimental studies. In part I the association between...

  12. Insulin Therapy

    Science.gov (United States)

    ... Your Health Resources Drugs, Procedures & Devices Prescription Medicines Insulin Therapy Insulin Therapy Share Print When you digest food, your ... you eat into glucose (a form of sugar). Insulin allows this glucose to enter all the cells ...

  13. Molecular and Cellular Profiling of Scalp Psoriasis Reveals Differences and Similarities Compared to Skin Psoriasis

    Science.gov (United States)

    Ruano, Juan; Suárez-Fariñas, Mayte; Shemer, Avner; Oliva, Margeaux

    2016-01-01

    Scalp psoriasis shows a variable clinical spectrum and in many cases poses a great therapeutic challenge. However, it remains unknown whether the immune response of scalp psoriasis differs from understood pathomechanisms of psoriasis in other skin areas. We sought to determine the cellular and molecular phenotype of scalp psoriasis by performing a comparative analysis of scalp and skin using lesional and nonlesional samples from 20 Caucasian subjects with untreated moderate to severe psoriasis and significant scalp involvement and 10 control subjects without psoriasis. Our results suggest that even in the scalp, psoriasis is a disease of the inter-follicular skin. The immune mechanisms that mediate scalp psoriasis were found to be similar to those involved in skin psoriasis. However, the magnitude of dysregulation, number of differentially expressed genes, and enrichment of the psoriatic genomic fingerprint were more prominent in skin lesions. Furthermore, the scalp transcriptome showed increased modulation of several gene-sets, particularly those induced by interferon-gamma, compared with that of skin psoriasis, which was mainly associated with activation of TNFα/L-17/IL-22-induced keratinocyte response genes. We also detected differences in expression of gene-sets involving negative regulation, epigenetic regulation, epidermal differentiation, and dendritic cell or Th1/Th17/Th22-related T-cell processes. PMID:26849645

  14. Clinical characteristics of patients with facial psoriasis in Malaysia.

    Science.gov (United States)

    Syed Nong Chek, Sharifah Rosniza; Robinson, Suganthy; Mohd Affandi, Azura; Baharum, Nurakmal

    2016-10-01

    Psoriasis involving the face is visible and can cause considerable emotional distress to patients. Its presence may also confer a poorer prognosis for the patient. This study sought to evaluate the characteristics of facial psoriasis in Malaysia. A cross-sectional study conducted using data from the Malaysian Psoriasis Registry from 2007 to 2011. Specific risk factors, i.e., age, age of onset, gender, duration of disease, obesity group, body surface area, Dermatology Life Quality Index (DLQI), family history of psoriasis, nail involvement, psoriatic arthritis, phototherapy, systemic therapy, clinic visit, days of work/school, and hospital admission due to psoriasis in the last 6 months were analyzed. A total of 48.4% of patients had facial psoriasis. Variables significantly associated with facial psoriasis are younger age, younger age of onset of psoriasis of ≤ 40 years, male, severity of psoriasis involving >10% of the body surface area, higher DLQI of >10, nail involvement, and history of hospitalization due to psoriasis. This study found that facial psoriasis is not as rare as previously thought. Ambient ultraviolet light, sebum, and contact with chemicals from facial products may reduce the severity of facial psoriasis, but these factors do not reduce the prevalence of facial psoriasis. The association with younger age, younger age of onset, higher percentage of body surface area involvement, higher DLQI of > 10, nail involvement, and hospitalization due to psoriasis support the notion that facial psoriasis is a marker of severe disease. © 2016 The International Society of Dermatology.

  15. Psoriasis as an autoimmune disease

    Directory of Open Access Journals (Sweden)

    Agnieszka Owczarczyk-Saczonek

    2014-09-01

    Full Text Available Nowadays it is known that psoriasis belongs to the group of autoimmune diseases and may coexist with other diseases in this group. Most often patients have psoriatic arthritis, rheumatoid arthritis, inflammatory bowel disease, autoimmune thyroid diseases and multiple sclerosis. The coexistence of these disorders can be a diagnostic and therapeutic problem (there is controversy over the use of corticosteroids. The common pathogenesis is still not explained. We know that the loss of immunotolerance leads to formation of autoreactive Th1 and Th17 lymphocytes which recognize self-antigens and lead to their destruction in the target organ. Some features of immune mechanisms, observed in psoriasis, suggest its autoimmune background. In psoriasis the main role is played by the activation of the axis IL-12/Th1/IFN- and Th17/Il-23. Il-12 probably acts on naive T cells and the Th1 response is initiated. Il-23 maintains the Th1-mediated inflammatory reaction, stimulates maturation and effects of Th17, and maintains a certain amount of memory cells. We also observe dysfunction of Treg cells, which are responsible for the destruction of autoreactive lymphocytes. In addition, psoriatic keratinocytes have increased resistance to apoptosis, which eliminate damaged cells so that they cannot be recognized as a foreign antigen. However, researchers have suggested that initially the polyclonal activation of T lymphocytes is induced by superantigens (e.g. streptococcal M protein, peptidoglycan or skin trauma (Koebner phenomenon, whereas in the later phase self-antigens in the epidermis are recognized by autoreactive T cells (keratin K 17, HPV 5 proteins L1, Pso p27, leading to autoimmunity.

  16. Diminished ovarian reserve in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Burcu Tuğrul Ayanoğlu

    2018-04-01

    Full Text Available Objective: Psoriasis is a multi-systemic chronic inflammatory skin disease. Previous data suggests that women with some chronic inflammatory diseases have diminished ovarian reserve. This study explores ovarian reserve in patients with psoriasis. Materials and methods: We prospectively analyzed 14 female patients with psoriasis and 35 healthy age and body mass index matched controls. An interview explored demographic characteristics, obstetrical history and menstrual characteristics. Psoriatic area severity index (PASI in patients was assessed. Estrogen, follicle-stimulating hormone (FSH, luteinizing hormone (LH, thyroid stimulating hormone and with gynecologic ultrasonography, ovarian volume and antral follicular count (AFC were measured in both study and control groups. These values were analyzed with changes of the PASI in the patient group. Results: Patients with psoriasis had significantly higher levels of FSH and FSH/LH ratio than healthy controls (p = 0.039, p = 0.005 respectively. AFC of psoriasis patients were significantly lower than healthy controls (p = 0.002.There were no significant difference among other hormone levels and ovarian volumes (p > 0.05. The hormone levels, ovarian volume and AFC were not correlated with PASI of the patients. Conclusion: The results of the study suggest that patients with psoriasis may have diminished ovarian reserve. Keywords: Psoriasis, Ovarian reserve, Psoriatic area severity index, Antral follicular count, Follicle-stimulating hormone

  17. The role of IL-17 in psoriasis.

    Science.gov (United States)

    Malakouti, Mona; Brown, Gabrielle Elena; Wang, Eva; Koo, John; Levin, Ethan C

    2015-02-01

    Psoriasis is a chronic skin condition traditionally believed to involve the Th1 pathway. Recently, the IL-23/Th17/IL-17 pathway has been highlighted in the pathogenesis of psoriasis and other autoimmune inflammatory conditions. From a clinician's perspective, we sought to review the basic science data relevant to IL-17's role in psoriasis pathogenesis. We performed a Pubmed and Web of Knowledge search for English articles starting from 1990 that discussed the Th17 pathway. Search terms such as "IL-17" and "psoriasis" were utilized. The IL-17 pathway is regulated by IL-23, a cytokine that is vital for the expansion and maintenance of the Th17 cell population. Th17 derived cytokines (IL-17A, IL-17F, IL-17A/F and IL-22) were elevated in both psoriasis-like murine models and human psoriatic lesional biopsies. Ixekizumab (anti-IL-17A) treatment of psoriasis was found to normalize levels of IL-17 downstream gene products. Both preclinical and clinical studies support the central role of IL-17 in the pathogenesis of psoriasis.

  18. Psoriasis is not an autoimmune disease?

    Science.gov (United States)

    Fry, Lionel; Baker, Barbara S; Powles, Anne V; Engstrand, Lars

    2015-04-01

    The concept that psoriasis is an autoimmune disease needs to be questioned. The autoimmune label has been based on molecular mimicry between streptococcal and keratin proteins and the existence of homologous peptides between these proteins. However, it is only peripheral blood CD8, and not CD4, T lymphocytes that respond to the homologous peptides. This ignores the fact that it is CD4 T cells which are necessary to initiate psoriasis. Recent studies on skin bacterial microbiota have found a variety of bacteria in both normal skin and psoriatic lesions. In biopsy specimens, the most common phylum was Firmicutes and the most common genus streptococcus in both psoriasis and normal skin. The innate immune system is activated in psoriasis, and recent genetic findings have shown the majority of susceptibility loci are associated with innate immunity. There is a known clinical relationship between both Crohn's disease (CD) and periodontitis, and psoriasis, and patients with psoriasis share mutations in some innate immunity genes with individuals with CD. It is now accepted that CD is due to a breakdown of immune tolerance (dysbiosis) to bacteria in the intestine. These findings suggest that psoriasis is initiated by an abnormal response to bacteria in the skin due to genetic factors. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Psoriasis and New-onset Depression

    DEFF Research Database (Denmark)

    Jensen, Peter; Ahlehoff, Ole; Egeberg, Alexander

    2016-01-01

    Psoriasis is associated with an increased risk of depression, but results are inconsistent. This study examined the risk of new-onset depression in patients with psoriasis in a nationwide Danish cohort including some 5 million people in the period 2001-2011. A total of 35,001 patients with mild...... psoriasis and 7,510 with severe psoriasis were identified. Incidence rates per 1,000 person-years and incidence rate ratios (IRRs) were calculated. Incidence rates for depression were 20.0 (95% confidence interval 19.9-20.0), 23.9 (23.1-24.7) and 31.6 (29.5-33.8) for the reference population, mild......, and severe psoriasis, respectively. Adjusted for age, sex, and inclusion year, IRRs were 1.08 (1.04-1.12) in mild and 1.36 (1.27-1.46) in severe psoriasis. After adjustment for comorbidity, the IRR was significant in only patients psoriasis (IRR 1.23 (1.03-1.46)). In conclusion...

  20. Self-management in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Pathak SN

    2014-07-01

    Full Text Available Swetha Narahari Pathak,1 Pauline L Scott,1 Cameron West,1 Steven R Feldman,1–3 1Center for Dermatology Research, Departments of Dermatology, 2Center for Dermatology Research, Departments of Pathology, 3Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA Abstract: Psoriasis is a chronic inflammatory disorder effecting the skin and joints. Additionally, multiple comorbidities exist, including cardiovascular, metabolic, and psychiatric. The chronic nature of psoriasis is often frustrating for both patients and physicians alike. Many options for treatment exist, though successful disease management rests largely on patients through the application of topical corticosteroids, Vitamin D analogs, and calcineurin inhibitors, amongst others and the administration of systemic medications such as biologics and methotrexate. Phototherapy is another option that also requires active participation from the patient. Many barriers to effective self-management of psoriasis exist. Successful treatment requires the establishment of a strong doctor-patient relationship and patient empowerment in order to maximize adherence to a treatment regimen and improve outcomes. Improving patient adherence to treatment is necessary in effective self-management. Many tools exist to educate and empower patients, including online sources such as the National Psoriasis Foundation and online support group, Talk Psoriasis, amongst others. Effective self management is critical in decreasing the physical burden of psoriasis and mitigating its multiple physical, psychological, and social comorbidities, which include obesity, cardiovascular disease, alcohol dependence, depression, anxiety, and social anxiety. Keywords: psoriasis, adherence, self management, compliance

  1. Biologics in the management of psoriasis

    Directory of Open Access Journals (Sweden)

    Jennifer D Bahner

    2009-07-01

    Full Text Available Jennifer D Bahner1, Lauren Y Cao2, Neil J Korman11Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio, USA; 2Case Western Reserve University School of Medicine, Cleveland, Ohio, USAAbstract: Psoriasis is a chronic inflammatory systemic disease for which there exist topical, ultraviolet, systemic, and biologic treatments. Biologic agents selectively interfere with the immune mechanisms responsible for psoriasis. Etanercept, infliximab, and adalimumab target tumor necrosis factor-alpha and have demonstrated efficacy in the treatment of psoriasis and psoriatic arthritis. Alefacept and efalizumab target T lymphocytes, are effective in the treatment of psoriasis, but are not approved for psoriatic arthritis. Finally, ustekinumab and ABT-874 target interleukin-12 and interleukin-23, and they have demonstrated efficacy in the treatment of psoriasis. The objective of this review is to present efficacy and safety data from randomized controlled trials of the biologic agents in the treatment of psoriasis.Keywords: biologics, psoriasis, tumor necrosis factor, interleukin-12/23

  2. Digestive system in psoriasis: an update.

    Science.gov (United States)

    Pietrzak, Daniel; Pietrzak, Aldona; Krasowska, Dorota; Borzęcki, Andrzej; Franciszkiewicz-Pietrzak, Kinga; Polkowska-Pruszyńska, Beata; Baranowska, Maja; Reich, Kristian

    2017-11-01

    Psoriasis is a chronic inflammatory immune-mediated disorder associated and often coexisting with many other immune-related clinical conditions including those affecting the gastrointestinal tract. Data obtained from the reviewed literature suggest an association between psoriasis and pathologies of the oral cavity, both psoriasis-specific lesions, as well as non-specific, such as geographic tongue or fissured tongue. These findings show the importance of thorough examination of oral mucosa in psoriatic patients. Inflammatory bowel diseases (IBD) are also linked with psoriasis. Crohn's disease and ulcerative colitis share a common genetic background, inflammatory pathways and have an evident iatrogenic anti-TNF treatment link, necessitating dermatological or gastroenterological care in patients with IBD or psoriasis, respectively, as well as treatment adjusted to manifestations. The presence of celiac disease-specific antibodies in psoriatic patients and their correlation with the severity of the disease show the association between these disorders. The linking pathogenesis comprises vitamin D deficiency, immune pathway, genetic background and increase in the intestinal permeability, which suggests a potential benefit from gluten-free diet among psoriatic patients. The link between psoriasis and non-alcoholic fatty liver disease implies screening patients for components of metabolic syndrome and lifestyle changes necessity. Some studies indicate increased prevalence of cancer in patients with psoriasis, probably due to negative influence of skin lesion impact on lifestyle rather than the role of psoriasis in carcinogenesis. However, there are no sufficient data to exclude such an oncogenic hit, which is yet to be confirmed. Therefore, all psoriasis-associated comorbidities establish the importance of a multidisciplinary approach in the treatment of these patients.

  3. Coexistence of Metabolic Syndrome and Psoriasis Vulgaris

    Directory of Open Access Journals (Sweden)

    Reyhan Çelik

    2010-12-01

    Full Text Available Background and Design: Psoriasis is one of the chronic inflammatory systemic diseases, such as rheumatoid arthritis, systemic lupus erythematosus and Crohn's disease, in which the inflammation is responsible for the pathogenesis. Recently, some studies reported the importance of chronic inflammation in the pathogenesis of atherosclerosis and an association of chronic inflammatory systemic diseases with atherosclerosis and metabolic syndrome. The aim of this study is to determine coexistence of psoriasis vulgaris with various severity and metabolic syndrome.Material and Method: One hundred psoriasis vulgaris patients and one hundred sex- and age-matched healthy controls were included in this study. The Psoriasis Area and Severity Index (PASI was used for evaluating the disease severity in psoriasis patients. A PASI score below 7 was accepted as mild, between 7-12 as moderate, and above 12 as severe. We evaluated metabolic syndrome in both patient and control groups by using the Adult Treatment Panel III (ATP III metabolic syndrome criteria. SPSS 10.0 for Windows was used in analyzing data. For comparison, the student’s-t test, the Mann-Whitney U test and the chi-square test were used. A p-value less than 0.05 was considered statistically significant.Results: Metabolic syndrome, hypertension, elevated fasting plasma glucose and triglyceride levels, high waist circumference and lower high-density lipoprotein levels were more common in patients with psoriasis than in controls. However, there was no statistically significant difference in these parameters between these two groups (p>0.05. We found that the mean value of triglyceride levels was statistically higher in the psoriasis group (p0.05.Conclusion: No significant difference was observed between patients with mild, moderate, severe psoriasis and controls for the prevalence of metabolic syndrome. However, the mean value of triglyceride levels in psoriasis patients was higher and the mean value

  4. Psoriasis herpeticum due to Varicella zoster virus: A Kaposi′s varicelliform eruption in erythrodermic psoriasis

    Directory of Open Access Journals (Sweden)

    Geeta Garg

    2012-01-01

    Full Text Available Kaposi′s varicelliform eruption (KVE or eczema herpeticum is characterized by disseminated papulovesicular eruption caused by a number of viruses like Herpes simplex virus I and II, Coxsackie virus, and Vaccinia and Small pox viruses in patients with pre-existing skin disease. The occurrence of KVE with psoriasis has been reported recently as a new entity psoriasis herpeticum. The rare causation of psoriasis herpeticum due to Varicella zoster virus in a patient with underlying psoriasis is being reported for the first time.

  5. Psoriasis strikes back! Epicardial adipose tissue: another contributor to the higher cardiovascular risk in psoriasis.

    Science.gov (United States)

    Raposo, Inês; Torres, Tiago

    2015-10-01

    For many years psoriasis was considered an inflammatory condition restricted to the skin. However, nowadays it is considered an immune-mediated, systemic inflammatory condition associated with numerous medical comorbidities, particularly cardiometabolic diseases, and overall cardiovascular mortality. Several studies have suggested that psoriasis may be an independent risk factor for atherosclerosis, indicating that psoriasis itself poses an intrinsic risk for cardiovascular disease, probably due to the disease's inflammatory burden. However, other causes beyond systemic inflammation and traditional cardiovascular risk factors may be implicated in cardiovascular disease in psoriasis. Recently, epicardial adipose tissue, an emerging cardiovascular risk factor, has been shown to be increased in psoriasis patients and to be associated with subclinical atherosclerosis, providing another possible link between psoriasis and atherosclerosis. The reason for the increase in epicardial adipose tissue in patients with psoriasis is unknown, but it is probably multifactorial, with genetic, immune-mediated and behavioral factors having a role. Thus, along with the increased prevalence of cardiometabolic risk factors and systemic inflammation in psoriasis, epicardial adipose tissue is probably another important contributor to the higher cardiovascular risk observed in psoriasis. Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  6. Nail psoriasis treated with pulsed dye laser*

    Science.gov (United States)

    Peruzzo, Juliano; Garbin, Gabriela Czarnobay; Maldonado, Gabriela; Cestari, Tania Ferreira

    2017-01-01

    Nail changes are present in about 50% of psoriasis patients and tend to be refractory to conventional treatments. Pulsed dye laser has emerged as an alternative therapy. Our aim is to evaluate the efficacy of pulsed dye laser in nail psoriasis and the impact of treatment on quality of life. Fourteen patients were treated in monthly sessions for three months. The outcome assesment was made by the Nail Psoriasis Severity Index (NAPSI). The median improvement in the scores of the overall NAPSI, nail bed NAPSI, and nail matrix NAPSI were 44.2% (P = 0.002), 50% (P = 0.033) and 65.1% (P = 0.024), respectively. PMID:29364458

  7. Et liv med psoriasis - et litteratur review

    DEFF Research Database (Denmark)

    Kjær, Lone; Glasdam, Stinne

    2011-01-01

    Psoriasis is a non-contagious skin disease affecting the patient’s physical, mental and social well-being. But what do we know about living with psoriasis? The aim of this article is to review published research literature dealing with the impact psoriasis has on a patient’s life in general...... to the feeling of quality of life. The conclusion is that the results are inconclusive and pointing in many directions. Research in this area is limited and difficult to compare because of differences in measuring scales, and the results are constructed without context in mind. Especially qualitative research...

  8. Experience of Being Young With Psoriasis

    DEFF Research Database (Denmark)

    Rasmussen, Gitte Susanne; Kragballe, Knud; Maindal, Helle Terkildsen

    2018-01-01

    Psoriasis is a long-term condition with a possibly cumulative life course impairment. Young people struggle to minimize its effects on appearance and functioning. To date, the self-management needs of adolescents suffering from psoriasis have been underinvestigated. Using focus groups...... and individual interviews, we present an interpretive description of young people's experiences of living with psoriasis, the challenges they face, and the support they need to relieve suffering and come to terms with their condition. This process is characterized by loneliness, the self...

  9. Nail psoriasis - what a rheumatologist should know about.

    Science.gov (United States)

    Nieradko-Iwanicka, Barbara

    2017-01-01

    Psoriasis is a chronic recurrent inflammatory skin disease with prevalence of 1-3%. Nail psoriasis affects 10-90% of patients with plaque psoriasis. The aim of the article is to review the literature for the correlation between nail psoriasis and psoriatic arthritis (PsA) to provide rheumatologists a short review on features of nail psoriasis, methods of their assessment and possible clinical repercussions. The PubMed database was searched using the key words 'nail psoriasis' and 'psoriatic arthritis'. Psoriasis involving the nail matrix shows up as changes such as pitting, Beau lines, leukonychia, red spots in the lunula, or nail plate crumbling. Nail bed psoriasis manifests as onycholysis, oil drops (or salmon patches), dyschromia, splinter hemorrhages, or subungual hyperkeratosis. Nail psoriasis and psoriatic lesions in the gluteal cleft and on the scalp usually accompany PsA, especially in adult men.

  10. Prognosis after percutaneous coronary intervention in patients with psoriasis

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Lindhardsen, Jesper; Gislason, Gunnar

    2012-01-01

    ABSTRACT: BACKGROUND: Psoriasis is an inflammatory disease associated with increased risk of coronary artery disease. However, the potential impact of psoriasis on the prognosis following percutaneous coronary revascularization (PCI) is unknown. METHODS: The study comprised the entire Danish....... RESULTS: A total of 53,141 patients with first-time PCI in the study period were identified. Of these, 1074 had mild psoriasis and 315 had severe psoriasis. Patients with severe psoriasis, but not those with mild disease had increased risk of both endpoints compared to patients without psoriasis...... and severe psoriasis, respectively. Patients with severe psoriasis were less likely to receive secondary prevention pharmacotherapy with betablockers, statins and platelet inhibitors. CONCLUSION: This first study of the prognosis following PCI in patients with psoriasis demonstrated an increased risk of all...

  11. Evidence and suggested therapeutic approach in psoriasis of difficult-to-treat areas: Palmoplantar psoriasis, nail psoriasis, scalp psoriasis, and intertriginous psoriasis

    Directory of Open Access Journals (Sweden)

    Nilendu Sarma

    2017-01-01

    Full Text Available Psoriasis is resistant to treatment and it shows frequent relapse; systemic treatment is often associated with toxicities, and long-term safety data are lacking for most of the newer drugs like biologics. Moreover, some body areas such as hands, feet, intertriginous areas, scalp, and nails are even more resistant. Frequently, systemic treatments are necessary considering the higher psychological impact on the patient. There is a lack of agreement on the best therapeutic modalities in the management of psoriasis involving difficult-to-treat locations. At present, there are no Indian guidelines for these conditions. Available literature has been reviewed extensively on the treatment of psoriasis involving difficult-to-treat locations; level of evidence has been evaluated as per the Oxford Centre for Evidence-Based Medicine 2011 guideline, and therapeutic suggestions have been developed. Best care has been employed to consider socioeconomic, cultural, genetic, and ethnic factors to prepare a therapeutic suggestion that is appropriate and logical to be used among Indian population and people of similar ethnic and socioeconomic background.

  12. Polyphenotypic Psoriasis: A Report from the GRAPPA 2016 Annual Meeting.

    Science.gov (United States)

    Kaskas, Nadine; Merola, Joseph F; Qureshi, Abrar A; Paek, So Yeon

    2017-05-01

    Recent groundbreaking therapies for psoriasis target specific pathways that drive this systemic inflammatory disease. However, patients with nonplaque psoriasis phenotypes often do not qualify for these therapies and are currently undertreated because of the criteria used during the development of novel agents. We propose use of the phrase "polyphenotypic psoriasis" to describe both plaque and nonplaque subtypes, as well as single and multiple phenotype involvement in individual patients. The goal of using the phrase "polyphenotypic psoriasis" is to remind clinicians about the heterogeneous manifestations of psoriasis in addition to chronic plaque psoriasis.

  13. Lung Metastasis Mimicking Fingertip Infection

    Science.gov (United States)

    Soylemez, Salih; Demiroglu, Murat; Yayla, Mehmet Ali; Ozkan, Korhan; Alpan, Bugra; Ozger, Harzem

    2015-01-01

    Metastasis fingers (acral metastasis) are finding a poor prognosis. Past medical history should be questioned and metastasis from primary tumor should be kept in mind in patients with pain, swelling, and hyperemia in fingers. Successful surgical treatment on acral metastasis does not extend the life expectancy; however, it reduces the patient's pain during his terminal period, saves the functions of the limb, and increases life comfort. PMID:26236517

  14. Lung Metastasis Mimicking Fingertip Infection

    Directory of Open Access Journals (Sweden)

    Salih Soylemez

    2015-01-01

    Full Text Available Metastasis fingers (acral metastasis are finding a poor prognosis. Past medical history should be questioned and metastasis from primary tumor should be kept in mind in patients with pain, swelling, and hyperemia in fingers. Successful surgical treatment on acral metastasis does not extend the life expectancy; however, it reduces the patient’s pain during his terminal period, saves the functions of the limb, and increases life comfort.

  15. Radiation therapy of psoriasis and parapsoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Wiskemann, A.

    1982-09-15

    Selective UV-Phototherapy with lambda 300-320 nm (SUP) as well as oral photochemotherapy with 8-methoxy-psoralen plus UVA-radiation (PUVA intern) are very effective in clearing the lesions of the generalized psoriasis and those of the chronic forms of parapsoriasis. Being treated with 4 suberythemal doses per week psoriasis patients are free or nearly free of symptoms after averagely 6.3 weeks of SUP-therapy or after 5.3 weeks of PUVA orally. The PUVA-therapy is mainly indicated in pustular, inverse and erythrodermic psoriasis as well as in parapsoriasis en plaques and variegata. In all other forms of psoriasis and in pityriasis lichenoides-chronica, we prefer the SUP-therapy because of less acute or chronic side effects, and because of its better practicability. X-rays are indicated in psoriais of nails, grenz-rays in superficial psoriatic lesions of the face, the armpits, the genitals and the anal region.

  16. Psoriasis and risk of heart failure

    DEFF Research Database (Denmark)

    Khalid, Usman; Ahlehoff, Ole; Gislason, Gunnar Hilmar

    2014-01-01

    AIMS: Psoriasis is a common inflammatory disease that is associated with increased risk of cardiovascular disease, including myocardial infarction. Heart failure (HF) is independently associated with several cardiovascular risk factors and is a major cause of cardiovascular morbidity and mortality...

  17. The role of lipids in psoriasis

    Directory of Open Access Journals (Sweden)

    Anna Baran

    2017-12-01

    Full Text Available Psoriasis, affecting 2–4% of the world’s population, is a chronic recurrent inflammatory skin disease. Its multifactorial aetiopathogenesis consists of, for example, abnormal epidermal proliferation, immune disturbances, and genetic, psychosomatic, environmental and hormonal factors. Psoriasis is also considered to be a systemic disorder closely associated with cardiovascular diseases, atherosclerosis, diabetes mellitus, obesity or metabolic syndrome. Lipids have a variety of biological functions. They participate not only in energy storage and expenditure or the formation of cell membranes, but also in inflammatory and metabolic signalling pathways. Disturbances in their homeostasis lead to the development of immunometabolic disorders, including psoriasis. Based on the available literature, this article presents selected molecular and clinical aspects involved in the multidirectional effect of lipids on psoriasis.

  18. Innovative therapies and new targets in psoriasis

    NARCIS (Netherlands)

    de Groot, M.

    2011-01-01

    Marjan de Groot onderzocht het effect van biologicals (kunstmatig gemaakte eiwitten) bij psoriasis en keek in hoeverre bepaalde chemokinereceptoren als aangrijpingspunt kunnen dienen voor nieuwe behandelingen. Het middel etanercept werkt in de praktijk minder goed dan in onderzoekssituaties,

  19. Patient Adherence to Biologic Agents in Psoriasis

    DEFF Research Database (Denmark)

    Hsu, Der Yi; Gniadecki, Robert

    2016-01-01

    BACKGROUND: Low adherence to therapies in psoriasis decreases treatment outcomes and increases the total health care costs. In spite of the wide use of biologic agents, patients' adherence to these drugs has not been extensively investigated. OBJECTIVE: The aim of this study is to measure adherence...... to the biologic drugs in a population of patients treated for psoriasis vulgaris using the medication possession ratio (MPR) index and to survey patients' attitudes to the treatment. METHODS: This is a single-center study on 247 patients with psoriasis vulgaris treated with adalimumab (n = 113), etanercept (n...... = 39), and ustekinumab (n = 95). MPR calculation was calculated monthly based on the hospital records documenting the dispensing of biologics to the patients. Clinical data [Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), presence of psoriatic arthritis, concomitant...

  20. Skin cancer in patients with psoriasis

    DEFF Research Database (Denmark)

    Egeberg, A; Thyssen, J P; Gislason, G H

    2016-01-01

    BACKGROUND: Psoriasis is a chronic inflammatory skin disease that is commonly treated with ultraviolet phototherapy and systemic immunosuppressant drugs, which may confer a risk of skin cancer. Previous studies on the risk of skin cancer in patients with psoriasis have shown conflicting results....... OBJECTIVES: We investigated the risk of new-onset melanoma and non-melanoma skin cancer (NMSC), respectively, in a large cohort of patients with psoriasis and psoriatic arthritis. METHODS: Data on all Danish individuals aged ≥18 years between 1 January 1997 and 31 December 2012 were linked at individual......-level in nationwide registers. Incidence rates per 10 000 person-years were calculated, and incidence rate ratios (IRRs) were estimated by Poisson regression models. RESULTS: The study comprised 5 559 420 individuals with a maximum follow-up time of 16 years. There were 75 410 patients with psoriasis, and 25 087...

  1. Innate immunity in the pathogenesis of psoriasis.

    LENUS (Irish Health Repository)

    Sweeney, Cheryl M

    2011-12-01

    Psoriasis is a common, immune-mediated inflammatory skin disorder. T helper(h)1 and Th17 lymphocytes contribute to the pathogenesis of psoriasis through the release of inflammatory cytokines that promote further recruitment of immune cells, keratinocyte proliferation and sustained inflammation. The innate immune system is the first line of defence against infection and plays a crucial role in the initiation of the adaptive immune response. The presence of innate immune cells and their products in psoriatic skin plaques suggests a role for innate immunity in this disease. In addition, the innate immune system can direct the development of pathogenic Th cells in psoriasis. In this article, we will summarise the role of the innate immune system in psoriasis with particular emphasis on the role of cytokines, signalling pathways and cells of the innate immune system.

  2. Vaginal metastasis of pancreatic cancer.

    Science.gov (United States)

    Benhayoune, Khadija; El Fatemi, Hinde; El Ghaouti, Meryem; Bannani, Abdelaziz; Melhouf, Abdelilah; Harmouch, Taoufik

    2015-01-01

    Vaginal metastasis from pancreatic cancer is an extreme case and often indicates a poor prognosis. We present a case of pancreatic carcinoma with metastasis to the vagina that was discovered by vaginal bleeding. To our knowledge, this is the third case in the world of a primary pancreatic adenocarcinoma discovered of symptoms from a vaginal metastasis.

  3. New Drugs and Treatment Targets in Psoriasis

    DEFF Research Database (Denmark)

    Kofoed, Kristian; Skov, Lone; Zachariae, Claus

    2015-01-01

    , and phosphodiesterase inhibitors. We review published clinical trials, and conference abstracts presented during the last years, concerned with new drugs under development for the treatment of psoriasis. In conclusion, our psoriasis armamentarium will be filled with several new effective therapeutic options the coming...... years. We need to be aware of the limitations of drug safety data when selecting new novel treatments. Monitoring and clinical registries are still important tools....

  4. Drug-induced psoriasis: clinical perspectives

    OpenAIRE

    Balak DMW; Hajdarbegovic E

    2017-01-01

    Deepak MW Balak, Enes Hajdarbegovic Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands Abstract: Exposure to certain drugs can elicit an induction or exacerbation of psoriasis. Although well-conducted systematic studies on drug-related psoriasis are mostly lacking, traditionally strong associations have been documented for beta-blockers, lithium, antimalarial drugs such as (hydroxy)chloroquine, interferons, imiquimod, and terbinafine. More recent...

  5. Enfermedad coronaria en pacientes con psoriasis

    Directory of Open Access Journals (Sweden)

    Walter Masson

    2013-10-01

    Full Text Available Comunicaciones previas asociaron la psoriasis con la enfermedad coronaria. Desconocemos si en nuestro país o región existe dicha asociación. Se realizó un estudio transversal analizando los datos de la historia clínica electrónica de un sistema de salud de Buenos Aires. Analizamos todos los pacientes mayores de 18 años con diagnóstico de psoriasis entre el 1 de enero de 2003 y el 31 de julio de 2011 y los comparamos con un grupo control, en una relación 2:1, obtenido en forma aleatoria del mismo sistema de salud, apareados por edad y sexo. Determinamos la prevalencia de los factores de riesgo cardiovascular y de enfermedad coronaria. Analizamos la asociación entre la enfermedad coronaria y la psoriasis mediante análisis uni y multivariado. Se incluyeron 3 833 sujetos (1 286 pacientes con psoriasis y 2 547 controles. La prevalencia de hipertensión arterial (50% vs. 38%, p < 0.001, tabaquismo (25% vs. 17%, p < 0.001, diabetes (12% vs. 8%, p < 0.001 y enfermedad coronaria (4.98% vs. 3.06%, p = 0.003 fue mayor en los sujetos con psoriasis en comparación con el grupo control. Independientemente de la edad, la presencia de diabetes, hipertensión arterial o tabaquismo, hubo una asociación significativa entre la enfermedad coronaria y la psoriasis (OR 1.48, IC95% 1.04-2.11, p = 0.03. En conclusión, en esta población de Buenos Aires, los pacientes con psoriasis tuvieron una mayor prevalencia de diabetes, hipertensión arterial, tabaquismo y enfermedad coronaria. La asociación entre la psoriasis y la enfermedad coronaria fue independiente de los factores de riesgo explorados.

  6. TREATMENT OF PSORIASIS WITH HOMEOPATHIC MEDICINES

    Directory of Open Access Journals (Sweden)

    V. A. Molochkov

    2014-01-01

    Full Text Available Background: Psoriasis is a disease with growing incidence predominantly affecting young and middle-aged patients. It is characterized by frequent exacerbations, insufficient efficacy of the routine therapy and common adverse effects. Thus, use of alternative therapies is of great importance. Aim: To assess efficacy and safety of homeopathic medicine Loma Lux Psoriasis in patients with different forms of psoriasis. Materials and methods: 45 patients with progressive (n=17 and stable (n=28 psoriasis and mean PASI (Psoriasis Area and Severity Index value 17.3 (5–30 were treated with homeopathic medicine Loma Lux Psoriasis in combination with topical medicines: salicylic Vaseline 2%, tar and naphthalane preparations, ointments with fluocinolone acetonide and mometasone, betametasone/salicylic acid combinations. Diet was also recommended. Results: After 12 weeks, significant improvement (PASI decrease 75–100% was demonstrated in 40%  of the patients including completely absent skin desquamation, resorption of psoriatic papules and patches with residual hyper- or depigmentation. 57.8% of the patient had moderate improvement (PASI decrease 25–75%. In one patient with only slight improvement (PASI decrease less than 25% treatment was prolonged for 4  weeks and significant improvement was achieved. Therapy was well tolerated in all patients. No side effects or treatment-related complications were reported. Clinical recover was associated with marked tendency to improvement of blood biochemistry and immunology: elevation of immunoregulatory index up to 1.6 and T-helpers content up to 44.3%. Conclusion: Homeopathic medicine Loma Lux Psoriasis is characterized by good efficacy and safety profile and may be recommended as addon to comprehensive treatment of stable and progressing psoriasis.

  7. Association of Streptococcus with Plaque Type of Psoriasis

    Directory of Open Access Journals (Sweden)

    Mohammad Akram Hossain

    2015-05-01

    Full Text Available Background: Guttate psoriasis has a well-known association with streptococcal throat infections, but the effects of these infections in patients with chronic plaque type of psoriasis remains to be evaluated. In Bangladesh several studies were done on psoriasis but no data about association between streptococcal throat infection and plaque type psoriasis are available so far. Considering the co-morbidities of psoriasis patients, it might be justifiable to find out the events that provoke the initiation or exacerbation of psoriatic disease process. Objective: To observe the association of streptococcus with plaque type of psoriasis. Materials and Methods: This observational study was conducted in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka. Forty seven patients clinically and histopathologically diagnosed as having plaque psoriasis were selected as cases and patients with skin diseases other than psoriasis were selected as controls. Results: In this study majority of subjects (55% were diagnosed as chronic plaque psoriasis. Among the subjects with guttate flare of chronic plaque psoriasis 64.2% gave a positive history of sore throat. ASO titer was raised (>200 IU/mL in 28 (59.5% patients of chronic plaque psoriasis and 7 (17.9% patients of non-psoriatic respondents. The difference between two groups was significant (p0.05. Conclusion: This study shows that streptococcal throat infections are associated with plaque psoriasis and early treatment of throat infections may be beneficial for plaque type of psoriasis patients.

  8. Concept of Remission in Chronic Plaque Psoriasis.

    Science.gov (United States)

    Gisondi, Paolo; Di Mercurio, Marco; Idolazzi, Luca; Girolomoni, Giampiero

    2015-11-01

    Psoriasis is a lifelong chronic inflammatory disease affecting 2-3% of the worldwide population. Current understanding of the pathogenesis of psoriasis assigns central importance to an interaction between acquired and innate immunity. The disease is characterized by a series of linked cellular changes in the skin, including hyperplasia of epidermal keratinocytes, angiogenesis, and infiltration of T lymphocytes, neutrophils, and other types of leukocytes in the affected skin. Plaque psoriasis is the most common clinical form and is characterized by red and scaly plaques generally localized at extensor sites such as elbows and knees. Major determinants of psoriasis severity include the extent of skin involvement; localization in highly affected areas such as scalp, palms, and soles; pruritus; presence of comorbidities including psoriatic arthritis; and impairment on quality of life. About one-third of patients have moderate to severe psoriasis defined as PASI (Psoriasis Area and Severity Index) and/or Dermatology Life Quality Index>10, and/or affected body surface area>10%. The optimal treatment goal is to safely achieve complete or almost complete skin clearance. Treatments available are various and they are chosen according to disease features, comorbidities, and patient characteristics and priorities. Topical treatments including corticosteroids and Vitamin D analogs are reserved for mild disease. Phototherapy, cyclosporine, methotrexate, acitretin, or biologics such as tumor necrosis factor-α antagonists and ustekinumab are reserved for the moderate to severe forms.

  9. Identifying targets for topical RNAi therapeutics in psoriasis: assessment of a new in vitro psoriasis model

    NARCIS (Netherlands)

    Bracke, S.; Desmet, E.; Guerrero-Aspizua, S.; Tjabringa, S.; Schalkwijk, J.; Gele, M. Van; Carretero, M.; Lambert, J.

    2013-01-01

    Diseases of the skin are amenable to RNAi-based therapies and targeting key components in the pathophysiology of psoriasis using RNAi may represent a successful new therapeutic strategy. We aimed to develop a straightforward and highly reproducible in vitro psoriasis model useful to study the

  10. Validation of the Simplified Psoriasis Index in Dutch children and adolescents with plaque psoriasis

    NARCIS (Netherlands)

    Geel, M.J. van; Otero, M.E.; Jong, E.M.G.J. de; Kerkhof, P.C.M. van de; Seyger, M.M.B.

    2017-01-01

    BACKGROUND: The Simplified Psoriasis Index (SPI) is a three-domain assessment measure for psoriasis, including separate indicators of current severity (SPI-s), psychosocial impact (SPI-p), and past history and interventions (SPI-i). There are two complementary versions available designed for

  11. Etiology and Pathogenesis of Psoriasis.

    Science.gov (United States)

    Boehncke, Wolf-Henning

    2015-11-01

    Psoriasis is a common, chronic inflammatory skin disease most often appearing in the form of well-demarcated, scaly plaques. These lesions highlight the fundamental processes underlying its pathogenesis, namely, inflammation and epidermal hyperproliferation. Both phenomena are considered consequences of an intimate interplay between the innate and the adaptive immune system. This concept is supported by results of genetic studies, pointing toward the signaling pathways of nuclear factor-κB, interferon-γ, and interleukin (IL)-23 as well as antigen presentation as central axes of the psoriatic inflammation. Efficacy of biologics targeting tumor necrosis factor-α, IL-23, or IL-17 provides further evidence in favor of this model. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Increased risk of migraine in patients with psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Mallbris, Lotus; Hilmar Gislason, Gunnar

    2015-01-01

    BACKGROUND: Psoriasis and migraine are common conditions with potential overlap of pathophysiological mechanisms. Both these diseases have been associated with increased cardiovascular risk but little is known about their interplay. OBJECTIVE: We sought to investigate the link between psoriasis, ...

  13. Scalp Psoriasis vs. Seborrheic Dermatitis: What's the Difference?

    Science.gov (United States)

    ... does a doctor tell the difference between scalp psoriasis and seborrheic dermatitis of the scalp? Answers from ... such as pitting. Compare signs and symptoms Scalp psoriasis Red skin covered with flakes and silvery scales ...

  14. Psoriasis and smoking: links and risks

    Directory of Open Access Journals (Sweden)

    Naldi L

    2016-05-01

    Full Text Available Luigi Naldi1,2 1Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy; 2Study Centre of the Italian Group for Epidemiologic Research in Dermatology (GISED, Bergamo, Italy Abstract: Smoking is a complex environmental exposure influenced by genetic, environmental, and social factors. Nicotine is the principal alkaloid in tobacco that mediates the addicting effects of tobacco products. Tobacco is a mixture of more than 7,000 chemicals, and smoking is recognized as a risk factor for many diseases in humans, including cardiovascular and pulmonary disease and several cancers, and is the single most preventable cause of mortality worldwide. A number of inflammatory immune-related conditions have been associated with smoking, including psoriasis. Smoking affects the onset of psoriasis. In a pooled analysis of 25 case–control studies, the odds ratio of psoriasis among smokers was 1.78 (95% confidence interval [CI]: 1.53–2.06. A dose–effect relationship is also documented. In a pooled analysis of three cohort studies, the risk of incident psoriasis was 1.81 (95% CI: 1.38–2.36 in those who smoked 1–14 cigarettes per day, and 2.29 (95% CI: 1.74–3.01 in those who smoked ≥25 cigarettes per day. Smoking also impacts on the clinical severity of psoriasis, its response to treatment, and explains some of the associated comorbidities, eg, cardiovascular disease, inflammatory bowel disease, and several cancers (especially those of the respiratory tract. Data on the role of smoking in psoriatic arthritis are less consistent compared with those concerning psoriasis. Several pathophysiological mechanisms may explain the association of psoriasis with smoking, including oxidative stress, interaction with signaling pathways active in psoriasis, and vascular influences. In conclusion, psoriasis is just one of the many diseases associated with smoking, but it is visible and disabling. Dermatologists could play a major role in

  15. Autoimmune disease in children and adolescents with psoriasis

    DEFF Research Database (Denmark)

    Blegvad, Christoffer; Egeberg, Alexander; Tind Nielsen, Tilde E.

    2017-01-01

    and adolescents. The study population consisted of all individuals living in Denmark, age under 18 years on 31 December 2012. A total of 1,925 children and adolescents with psoriasis and 1,194,712 without psoriasis were identified. Psoriatic arthritis (adjusted odds ratio (OR) 10.08; 7.97–12.74), rheumatoid...... with children and adolescents without psoriasis. Clinicians should be aware of extracutaneous symptoms when treating children and adolescents with psoriasis....

  16. Familial association of pseudohypoparathyroidism and psoriasis: case report

    OpenAIRE

    Montenegro Junior,Renan Magalhães; Paula,Francisco José Albuquerque de; Foss,Norma Tiraboshi; Foss,Milton Cesar

    2002-01-01

    CONTEXT: The association between psoriasis and hypoparathyroidism has been reported by several authors, and it has been suggested that abnormalities in calcium homeostasis may be involved in the development or exacerbation of psoriasis. However, so far there have only been two reports of pseudohypoparathyroidism associated with psoriasis. OBJECTIVE: To describe the familial occurrence of this association for the first time. CASE REPORTS: Two siblings with psoriasis associated with pseudohypop...

  17. Clobetasol Propionato en el tratamiento de la psoriasis en placas

    OpenAIRE

    Feliz, Beatriz; Musicco, Felice; Alvarez, Raquel

    2017-01-01

    Psoriasis is a common chronic disease with significant impairment in quality of life. As there is no cure, it often requires lifelong disease control to minimize the development of skin lesions and to relieve symptoms./nPsoriasis vulgaris, also called mild / moderate, is a type of psoriasis characterized by manifest localized involvement of a skin surface <10%. For this type of psoriasis, clinical studies have shown increased efficiency based on a combination treatment of topical corticost...

  18. Internalized stigma in psoriasis: A multicenter study.

    Science.gov (United States)

    Alpsoy, Erkan; Polat, Mualla; FettahlıoGlu-Karaman, Bilge; Karadag, Ayse Serap; Kartal-Durmazlar, Pelin; YalCın, Basak; Emre, Selma; Didar-Balcı, Didem; Bilgic-Temel, Asli; Arca, Ercan; Koca, Rafet; Gunduz, Kamer; Borlu, Murat; Ergun, Tulin; Dogruk-Kacar, Seval; Cordan-Yazici, Ayca; Dursun, Pınar; BilgiC, Ozlem; Gunes-Bilgili, Serap; Sendur, Neslihan; Baysal, Ozge; Halil-Yavuz, Ibrahim; Yagcioglu, Gizem; Yilmaz, Ertan; Kavuzlu, Ufuk; Senol, Yesim

    2017-08-01

    Internalized stigma is the adoption of negative attitudes and stereotypes of the society regarding a person's illness. It causes decreased self-esteem and life-satisfaction, increased depression and suicidality, and difficulty in coping with the illness. The primary aim of this study was to investigate the internalized stigma state of psoriatic patients and to identify the factors influencing internalized stigma. The secondary aim was to identify the correlation of internalized stigma with quality of life and perceived health status. This multicentre, cross-sectional study comprised 1485 patients. There was a significant positive correlation between mean values of Psoriasis Internalized Stigma Scale (PISS) and Psoriasis Area and Severity Index, Body Surface Area, Dermatological Life Quality Index and General Health Questionnaire-12 (P percieved health score (P = 0.001), early onset psoriasis (P = 0.016), family history of psoriasis (P = 0.0034), being illiterate (P < 0.001) and lower income level (P < 0.001) were determinants of high PISS scores. Mean PISS values were higher in erythrodermic and generalized pustular psoriasis. Involvement of scalp, face, hand, genitalia and finger nails as well as arthropathic and inverse psoriasis were also related to significantly higher PISS scores (P = 0.001). Our findings imply that psoriatic patients experience high levels of internalized stigma which are associated with psoriasis severity, involvement of visible body parts, genital area, folds or joints, poorer quality of life, negative perceptions of general health and psychological illnesses. Therefore, internalized stigma may be one of the major factors responsible from psychosocial burden of the disease. © 2017 Japanese Dermatological Association.

  19. Psoriasis: rationale for targeting interleukin-17.

    Science.gov (United States)

    Girolomoni, G; Mrowietz, U; Paul, C

    2012-10-01

    The exact pathogenesis of plaque psoriasis remains to be fully determined, but it is thought to depend on environmental and genetic factors that stimulate dysregulated innate and adaptive immune responses in the skin. The cytokine interleukin (IL)-17A plays a key role in host defence against extracellular bacteria and fungi. An increasing body of evidence suggests that IL-17A is also important in psoriasis pathogenesis. While IL-17A is a key product of Th17 cells, it is also produced by neutrophils, mast cells and Tc17 cells. Each of these cell types is found in psoriatic lesions. IL-17A acts on keratinocytes to increase expression of chemokines (e.g. CCL20, CXCL1, CXCL3, CXCL5, CXCL6 and CXCL8) involved in recruiting myeloid dendritic cells, Th17 cells and neutrophils to the lesion site. IL-17A induces production of antimicrobial peptides and proinflammatory cytokines that, in turn, may help sustain immune responses in the skin. Blocking IL-17A improved psoriasis-like pathology in experimental models, and reductions in IL-17 signalling have been associated with response to tumour necrosis factor-α blockers in patients with psoriasis. Agents that inhibit IL-17 are in development and preliminary clinical results for IL-17 inhibitors indicate the importance of IL-17A in psoriasis pathophysiology. In a proof-of-concept and two phase II trials, three agents markedly reduced disease severity in patients with moderate-to-severe plaque psoriasis. One agent downregulated cytokines, chemokines and proteins associated with inflammatory responses in lesional skin. In summary, IL-17A is an attractive therapeutic target, which may allow selective intervention to address the dysregulated immune system in plaque psoriasis. © 2012 The Authors. BJD © 2012 British Association of Dermatologists.

  20. Juvenile psoriasis in European and Asian children: similarities and differences

    NARCIS (Netherlands)

    Chiam, L.Y.; Jager, M.E.A. de; Giam, Y.C.; Jong, E.M. de; Kerkhof, P.C. van de; Seijger, M.M.B.

    2011-01-01

    BACKGROUND: The first manifestations of psoriasis begin in childhood in more than one-third of patients. However, epidemiological data of juvenile psoriasis are lacking. OBJECTIVES: To compare Dutch (NL group) and Singaporean (SG group) children with psoriasis with the aim of studying the

  1. Chronic plaque psoriasis | Luba | South African Family Practice

    African Journals Online (AJOL)

    Chronic plaque psoriasis, the most common form of psoriasis, is a papulosquamous disease defined by erythematous plaques with a silvery scale. The diagnosis usually is clinical, but occasionally a biopsy is necessary. Psoriasis affects 0.6 to 4.8 percent of the U.S. population, and about 30 percent of affected patients have ...

  2. Psoriasis

    Science.gov (United States)

    ... and Nutrition Healthy Food Choices Weight Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health ...

  3. Psoriasis

    Science.gov (United States)

    ... Registration General information Housing & travel Education Exhibit hall Mobile app 2019 Annual Meeting Derm Exam Prep Course ... SkinPAC State societies Scope of practice Truth in advertising NP/PA laws Action center Public and patients ...

  4. Brain metastasis from colorectal cancer

    International Nuclear Information System (INIS)

    Bamba, Yoshiko; Itabashi, Michio; Hirosawa, Tomoichiro; Ogawa, Shinpei; Noguchi, Eiichiro; Takemoto, Kaori; Shirotani, Noriyasu; Kameoka, Shingo

    2007-01-01

    The present study was performed to clarify the clinical characteristics of brain metastasis from colorectal cancer. Five patients with brain metastasis from colorectal cancer treated at our institute between 2001 and 2005 were included in the study. Clinical findings and survival time were determined and an appropriate system for follow-up in such cases was considered. Brain metastasis was found after surgery for colorectal cancer in 4 cases. In addition, colorectal cancer was found after diagnosis of brain metastasis in 1 case. At the time of diagnosis of brain metastasis, all patients had lung metastasis and 3 had liver metastasis. The mean periods between surgery for colorectal cancer and lung and brain metastases were 19.5 and 38.2 months, respectively. In all cases, brain metastasis was diagnosed by imaging after the appearance of neurological symptoms. Brain metastases were multiple in 1 case and focal in 4 cases. We performed gamma knife radiation therapy, and the symptoms disappeared or decreased in all cases. Mean survival time after brain metastasis was 3.0 months. Prognosis after brain metastasis is poor, but gamma knife radiation therapy contributed to patients' quality of life. (author)

  5. Psychological differences between early- and late-onset psoriasis: a study of personality traits, anxiety and depression in psoriasis.

    Science.gov (United States)

    Remröd, C; Sjöström, K; Svensson, A

    2013-08-01

    Onset of psoriasis may occur at any age. Early negative experiences often influence personality development, and may lead to physical disease, anxiety and depression in adulthood. Knowledge about onset of psoriasis and psychopathology is limited. To examine whether patients with early-onset psoriasis differ psychologically from patients with late-onset psoriasis, regarding personality traits, anxiety and depression. A descriptive cross-sectional study was conducted among 101 consecutively recruited outpatients with psoriasis. A psychosocial interview was performed followed by self-assessment of validated questionnaires: Swedish Universities Scales of Personality (SSP), Spielberger State-Trait Anxiety Inventory and Beck Depression Inventory. Psoriasis severity was assessed by the Psoriasis Area and Severity Index. Patients with early-onset psoriasis (age personality traits: SSP-embitterment, -trait irritability, -mistrust and -verbal trait aggression. Our results indicate that early detection of psychological vulnerability when treating children and adolescents with psoriasis seems to be of great importance. Traits of psychological vulnerability and pessimistic personality traits were found to be significantly associated with the early onset of psoriasis, but not with disease duration in this study. These traits may be seen as a consequence of psoriasis, and/or as individual traits modulating and impairing clinical course and efforts to cope with psoriasis. © 2013 The Authors BJD © 2013 British Association of Dermatologists.

  6. Psoriasis or not? Review of 51 clinically confirmed cases reveals an expanded histopathologic spectrum of psoriasis.

    Science.gov (United States)

    Chau, Thinh; Parsi, Kory K; Ogawa, Toru; Kiuru, Maija; Konia, Thomas; Li, Chin-Shang; Fung, Maxwell A

    2017-12-01

    Psoriasis is usually diagnosed clinically, so only non-classic or refractory cases tend to be biopsied. Diagnostic uncertainty persists when dermatopathologists encounter features regarded as non-classic for psoriasis. Define and document classic and non-classic histologic features in skin biopsies from patients with clinically confirmed psoriasis. Minimal clinical diagnostic criteria were informally validated and applied to a consecutive series of biopsies histologically consistent with psoriasis. Clinical confirmation required 2 of the following criteria: (1) classic morphology, (2) classic distribution, (3) nail pitting, and (4) family history, with #1 and/or #2 as 1 criterion in every case RESULTS: Fifty-one biopsies from 46 patients were examined. Classic features of psoriasis included hypogranulosis (96%), club-shaped rete ridges (96%), dermal papilla capillary ectasia (90%), Munro microabscess (78%), suprapapillary plate thinning (63%), spongiform pustules (53%), and regular acanthosis (14%). Non-classic features included irregular acanthosis (84%), junctional vacuolar alteration (76%), spongiosis (76%), dermal neutrophils (69%), necrotic keratinocytes (67%), hypergranulosis (65%), neutrophilic spongiosis (61%), dermal eosinophils (49%), compact orthokeratosis (37%), papillary dermal fibrosis (35%), lichenoid infiltrate (25%), plasma cells (16%), and eosinophilic spongiosis (8%). Psoriasis exhibits a broader histopathologic spectrum. The presence of some non-classic features does not necessarily exclude the possibility of psoriasis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Epidemiology and treatment of psoriasis: a Chinese perspective

    Directory of Open Access Journals (Sweden)

    Pan R

    2014-10-01

    Full Text Available Ran Pan, Jianzhong Zhang Department of Dermatology, Peking University People's Hospital, Beijing, People's Republic of China Background: Psoriasis is a chronic inflammatory skin disease that has a negative impact on quality of life. Prevalence and management of psoriasis varies among different ethnic groups. Objectives: To evaluate the epidemiology and treatment of psoriasis from a Chinese perspective. Methods: A systematic search was performed on PubMed and the China National Knowledge Infrastructure using the following MeSH terms: "psoriasis" and ("prevalence" or "epidemiology" and "risk factor" and ("management" or "treatment". The search included all citations from 1975 to 2013. Data were sorted by prevalence, age of onset, sex distribution, type, severity, risk factors, and management and treatment. Severity of psoriasis was classified as mild, moderate, or severe. The studies cited in this review involved Chinese subjects. Results: The prevalence of psoriasis in the People's Republic of China ranged from 0.11% to 0.47%. Genetic and environmental factors played an important role in initiation and exacerbation of psoriasis. Results showed that psoriasis can occur at any age but is more common in young and middle-aged individuals and occurs more often in men and earlier in women. Psoriasis vulgaris accounted for 82.6%–97.1% of psoriasis patients. More than 90% of patients with psoriasis were classified as mild or moderately severe. Risk factors are numerous. Management and treatment was based on classification level. Conclusion: The prevalence of psoriasis in Chinese patients is lower than that in Caucasians. A cold and dry climate, bacterial infection, diet, and stress are important risk factors for developing psoriasis. There are a variety of management and treatment options available. As such, Chinese patients with psoriasis can receive effective, safe, and individualized treatment. Keywords: psoriasis, epidemiology, risk factors

  8. Psoriasis and ischemic coronary artery disease.

    Science.gov (United States)

    Mahiques-Santos, L; Soriano-Navarro, C J; Perez-Pastor, G; Tomas-Cabedo, G; Pitarch-Bort, G; Valcuende-Cavero, F

    2015-03-01

    Psoriasis is a chronic inflammatory disease associated with an increased risk of ischemic coronary artery disease (CAD) in some populations. We aimed to determine the association between these 2 diseases in our geographic area. We performed a cross-sectional study of patient records between 2005 and 2012 in the database (Abucacis, Datamart) that contains all medical case histories in the province of Castellón, Spain. Patients diagnosed with psoriasis were compared with a control group of patients diagnosed with melanocytic nevus. The prevalence of CAD and the presence or absence of the main cardiovascular risk factors were analyzed in each group. A total of 9181 patients with psoriasis and 21925 with melanocytic nevus were studied. Univariate logistic regression analysis showed that CAD was significantly associated with psoriasis, age (in years), sex, hypertension, diabetes mellitus, dyslipidemia, and obesity (P<.05). On adjustment for age, sex, and the other cardiovascular risk factors, multivariate regression analysis established that psoriasis was independently associated with CAD (P<.029). Our findings in a large sample of patients in a Mediterranean area support the hypothesis that patients in this population have an increased risk of ischemic CAD. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  9. Salivary electrolytes in psoriasis: A preliminary study

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    Singh Gurcharan

    2006-01-01

    Full Text Available Background: There have been few isolated studies on alteration of salivary electrolytes in psoriasis but this subject has not been pursued extensively. Purpose: The present study was conducted to assess any alteration in the levels of salivary electrolytes in psoriasis and to correlate the same with type and severity of the disease. Materials and Methods: Fifteen patients of uncomplicated psoriasis and 12 age and sex matched controls attending the outpatient department of R.L.J.H. and S.N.R. Hospitals, Kolar, India were included for analysis of salivary electrolytes. PASI scoring was used to assess the severity of the disease. Student′s t-test ( P < 0.05; significant was utilized for statistical evaluation of results. Results: Salivary sodium levels were significantly elevated in psoriasis ( P value 0.002, whereas there was no significant rise in levels of salivary potassium. However, potassium levels correlated significantly with severity of the disease ( P value 0.043. Conclusion: There was elevation of salivary sodium levels in patients of psoriasis and potassium levels correlated with severity of the disease. Limitation: Unicentre hospital based study with small sample size; hence the results cannot be generalized.

  10. Serum irisin levels in patients with psoriasis.

    Science.gov (United States)

    Baran, Anna; Myśliwiec, Hanna; Kiluk, Paulina; Świderska, Magdalena; Flisiak, Iwona

    2017-06-01

    Irisin has been proposed to regulate metabolic diseases such as obesity, diabetes or metabolic syndrome which are common comorbidities in psoriasis. The aim of this study was to evaluate the serum irisin level in psoriasis and elucidate possible associations with disease activity, inflammatory or metabolic parameters and topical treatment. Thirty-seven individuals with active plaque-type psoriasis and 15 healthy controls were enrolled. Blood samples were collected before and after two weeks of therapy. Serum irisin concentrations were examined by enzyme-linked immunosorbent assay (ELISA). The results were correlated with psoriasis area and severity index (PASI), body mass index (BMI), inflammatory and biochemical markers, lipid profile and effectiveness of topical treatment. Irisin serum levels were insignificantly increased in psoriatic patients in comparison to the controls (p = 0.38). No significant correlations between investigated adipokine and several indicators of metabolic disorders, nor BMI (p = 0.37) or PASI (p = 0.5) were found. Significant positive correlations with C-reactive protein (CRP) (0.009), lipocalin-2 (p = 0.02), age (p = 0.02) and disease duration (p = 0.008) were noted. After topical treatment, serum irisin level did not significantly change (p = 0.31), despite clinical improvement. Irisin might be a marker of inflammation in psoriatic patients, but may not be a reliable indicator of metabolic conditions, severity of psoriasis nor efficacy of antipsoriatic treatment.

  11. Body mass index and psoriasis area and severity index relation in Turkish psoriasis population

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    Dilek Bıyık Özkaya

    2014-09-01

    Full Text Available Background and Design: Psoriasis is a chronic immune-mediated inflammatory disease affecting 1-3% of the general population. Recently, it has been suggested that chronic inflammation in psoriasis may cause metabolic and vascular disorders. Most of recent studies focused on the comorbidities and the mechanisms of comorbidities associated with psoriasis. Obesity may lead to cardiovascular disorders, diyabetes mellitus, hypertension, malignancies, musculoskeleteal system diseases, impaired quality of life, and death. In this study, we aimed to investigate the prevalence of obesity in patients with psoriasis and the relationship between the disease severity and body mass index (BMI in Turkish psoriasis population. Materials and Methods: The patients who attended the Dermatovenerology outpatient clinics at Bezmialem Vakıf University Medical Faculty between February 2007 and March 2013 were enrolled in the study. We retrospectively evaluated the medical records of the patients obtained from the PSR-TR psoriasis follow-up system. Results: Five hundred forty-five women and 474 men were included in the study. The mean age of the female and male patients was 41.3 years, 43.3 years, respectively. The mean body mass index of the patients was 27.5 (26.7 for men and 28.2 for women. 54.6% of obese patients had a psoriasis area and severity index (PASI score of less than 5, 20.5% had PASI scores between 5-10 and 24.8% had a PASI score of more than 10. Conclusion: In our study, there was a poor relationship between obesity and severity of psoriasis. The prevalence of obesity in psoriasis patients was similar to that in the Turkish population.

  12. Insulin Lispro Injection

    Science.gov (United States)

    ... diabetes, insulin lispro is always used with another type of insulin, unless it is used in an external insulin ... diabetes, insulin lispro may be used with another type of insulin or with oral medication(s) for diabetes. Insulin lispro ...

  13. Subcutaneous blood flow in psoriasis

    International Nuclear Information System (INIS)

    Klemp, P.

    1985-01-01

    The simultaneously recorded disappearance rates of 133 xe from subcutaneous adipose tissue in the crus were studied in 10 patients with psoriasis vulgaris using atraumatic labeling of the tissue in lesional skin (LS) areas and symmetrical, nonlesional skin (NLS) areas. Control experiments were performed bilaterally in 10 younger, healthy subjects. The subcutaneous washout rate constant was significantly higher in LS, 0.79 +/- 0.05 min-1 x 10(2) compared to the washout rate constant of NLS, 0.56 +/- 0.07 min-1. 10(2), or the washout rate constant in the normal subjects, 0.46 +/- 0.17 min-1 x 10(2). The mean washout rate constant in NLS was 25% higher than the mean washout rate constant in the normal subjects. The difference was, however, not statistically significant. Differences in the washout rate constants might be due to abnormal subcutaneous tissue-to-blood partition (lambda) in the LS--and therefore not reflecting the real differences in the subcutaneous blood flow (SBF). The lambda for 133 Xe was therefore measured--using a double isotope washout method ( 133 Xe and [ 131 I]antipyrine)--in symmetrical sites of the lateral crus in LS and NLS of 10 patients with psoriasis vulgaris and in 10 legs of normal subjects. In LS the lambda was 4.52 +/- 1.67 ml/g, which was not statistically different from that of NLS, 5.25 +/- 2.19 ml/g, nor from that of normal subcutaneous tissue, 4.98 +/- 1.04 ml/g. Calculations of the SBF using the obtained lambda values gave a significantly higher SBF in LS, 3.57 +/- 0.23 ml/100 g/min, compared to SBF in the NLS, 2.94 +/- 0.37 ml/100 g/min. There was no statistically significant difference between SBF in NLS and SBF in the normal subjects. The increased SBF in LS of psoriatics might be a secondary phenomenon to an increased heat loss in the lesional skin

  14. Critical roles of p53 in epithelial-mesenchymal transition and metastasis of hepatocellular carcinoma cells.

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    Zheng Wang

    Full Text Available Hepatocellular carcinoma (HCC is one of the most malignant tumors and the biggest obstacle in curing HCC is its high metastasis potential. Alteration of p53 is the most frequent genetic change found in HCC. Although the biological function of p53 in tumor initiation and progression has been well characterized, whether or not p53 is implicated in metastasis of HCC is largely unknown. In this study, we analyzed the potential functions of p53 in epithelial-mesenchymal transition (EMT and metastasis of HCC cells. Both insulin- and TGF-β1-induced changes of critical EMT markers were greatly enhanced by p53 knockdown in HCC cells. The insulin- and TGF-β1-stimulated migration of HCC cells were enhanced by p53 knockdown. Furthermore, in vivo metastasis of HCC cells using different mouse models was robustly enhanced by p53 knockdown. In addition, we found that p53 regulation on EMT and metastasis involves β-catenin signaling. The nuclear accumulation and transcriptional activity of β-catenin was modulated by p53. The enhanced EMT phenotype, cell migration and tumor metastasis of HCC cells by p53 knockdown were abrogated by inhibiting β-catenin signal pathway. In conclusion, this study reveals that p53 plays a pivotal role in EMT and metastasis of HCC cells via its regulation on β-catenin signaling.

  15. The Immunogenetics of Psoriasis and Implications for Drug Repositioning

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    Xuan Xu

    2017-12-01

    Full Text Available Psoriasis is a genetically-regulated, T lymphocyte-mediated autoimmune skin disease that causes systemic damage, seriously affecting patient quality of life and survival. Psoriasis treatments, which aim to control the disease’s development, are greatly limited because its etiology and pathogenesis have not yet been fully elucidated. A large number of studies have demonstrated that immunogenetic elements are the most important factors responsible for psoriasis susceptibility. This paper delineates the immunogenetic mechanisms of psoriasis and provides useful information with regards to performing drug repositioning for the treatment of psoriasis.

  16. PSORIASIS OF THE SCALP: METHODS OF TREATMENT AND CARE

    Directory of Open Access Journals (Sweden)

    A. I. Ermilova

    2013-01-01

    Full Text Available The results of the analysis of modern views on etiology, pathogenesis, classification and clinical manifestation of psoriasis are discussed in this article. The authors described the algorithm of assessment of severity of psoriasis by the means of PASI calculation. The data on different approaches to systematic and topical treatment of psoriasis according to the PASI values, as well as peculiarities of complications and disease course in patients with psoriasis of the scalp are shown. Assessment of efficacy of modern emollients as drugs of choice for the basic care of the skin of patients with psoriasis of the scalp is given.

  17. Therapy of moderate and severe psoriasis

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    Werfel, Thomas

    2006-04-01

    Full Text Available Objective and methods: This health technology assessment (HTA report synthesises systematically randomized controlled studies (RCT on the therapy of moderate and severe psoriasis vulgaris which were published between 1999 and 2004; it includes some important clinical studies which have been published after 2004 and thus updates the English HTA report by Griffiths et al. [1]. The major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany. Results: The major conclusions from the results of medical RCT on moderate and severe psoriasis vulgaris are: Oral fumarates are effective in the treatment of moderate to severe psoriasis vulgaris. However, fumarates quiet frequently cause moderate side effects. Cyclosporine and methotrexate are both effective in the treatment of severe psoriasis vulgaris. Both substances have a different spectrum of side effects which may limit the individual applicability. Acetritin is only moderately effective in the treatment of severe psoriasis of the plaque type. Calcipotriol or UV-radiation used at the same time can increase the clinical effectiveness of acetritin. Systemic PUVA, balneo-PUVA and UVB therapy are all effective for the treatment of severe psoriasis. The combination of UV therapy with vitamin D3 analogues or with topical steroids is more effective than the treatment with UV radiation alone. Saltwater baths increase the effectiveness of UVB therapy. No RCT on the therapeutical effects of topical tar or of dithranol in combination with UV therapy have been published so far. A continuous therapy with PUVA should not be applied due to its proven photocarcinogenicity. Three substances from the group of biologicals (Efalizumab, Etanercept, and Infliximab are now available in Europe and a further substance (Alefacept is available in the USA for the treatment of moderate to severe psoriasis. All biologicals have been

  18. Therapy of moderate and severe psoriasis.

    Science.gov (United States)

    Claes, Christa; Kulp, Werner; Greiner, Wolfgang; von der Schulenburg, Johann-Matthias; Werfel, Thomas

    2006-04-26

    This health technology assessment (HTA) report synthesises systematically randomized controlled studies (RCT) on the therapy of moderate and severe psoriasis vulgaris which were published between 1999 and 2004; it includes some important clinical studies which have been published after 2004 and thus updates the English HTA report by Griffiths et al. [1]. The major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany. The major conclusions from the results of medical RCT on moderate and severe psoriasis vulgaris are: Oral fumarates are effective in the treatment of moderate to severe psoriasis vulgaris. However, fumarates quiet frequently cause moderate side effects. Cyclosporine and methotrexate are both effective in the treatment of severe psoriasis vulgaris. Both substances have a different spectrum of side effects which may limit the individual applicability. Acetritin is only moderately effective in the treatment of severe psoriasis of the plaque type. Calcipotriol or UV-radiation used at the same time can increase the clinical effectiveness of acetritin. Systemic PUVA, balneo-PUVA and UVB therapy are all effective for the treatment of severe psoriasis. The combination of UV therapy with vitamin D3 analogues or with topical steroids is more effective than the treatment with UV radiation alone. Saltwater baths increase the effectiveness of UVB therapy. No RCT on the therapeutical effects of topical tar or of dithranol in combination with UV therapy have been published so far. A continuous therapy with PUVA should not be applied due to its proven photocarcinogenicity. Three substances from the group of biologicals (Efalizumab, Etanercept, and Infliximab) are now available in Europe and a further substance (Alefacept) is available in the USA for the treatment of moderate to severe psoriasis. All biologicals have been effective in placebo controlled studies. The

  19. Tailoring psoriasis therapy: Towards a safer and more effective systemic treatment

    NARCIS (Netherlands)

    Menting, S.P.

    2016-01-01

    Plaque type psoriasis, the focus of this thesis, is by far the most common clinical form of psoriasis with 80% of psoriasis patients suffering from it. Plaque type psoriasis, also known as psoriasis vulgaris, can occur everywhere on the skin and is characterized by well-defined, indurated

  20. Coping With Psoriasis : Need for Consultation - Liaison

    Directory of Open Access Journals (Sweden)

    Patil Anand

    2002-01-01

    Full Text Available A comparative study between patients of psoriasis and matched control group was carried out at a municipal hospital. They were administered a semistructured proforma and psychiatric comorbidity was clinically assessed. The scales used were: Hospital Anxiety and Depression Scale, Hindi version of Factor C of the 16PF questionnaire, presumptive Stressful Life Events Scale and Mechanism of Coping Scale. It was found that psoriasis had a significant impact on the patient’s day life in various areas. There was a significant prevalence of anxiety and depression in these patients. As compared to the control group, emotional factor and coping skills rather than stressful events played important role in the development of psychopathology. The significant psychiatric comorbidity in patients of psoriasis greatly affects the quality of life and the course of the disease. The clinical implications of the study are discussed in the paper.

  1. Psoriasis in pregnancy: a review (II).

    Science.gov (United States)

    Ruiz, V; Manubens, E; Puig, L

    2014-11-01

    Scarce scientific evidence is available to define the precise effects that certain drugs might have on embryonic and fetal development if taken by pregnant women with psoriasis, given the ethical concerns that preclude enrolling such women in clinical trials. The little information on the use of biologics during gestation that has been published is based on retrospective and observational studies, and experience with these drugs in this context in psoriasis is still very limited. The literature seems to suggest that biologic therapy is safe during pregnancy, but there is no certainty. This detailed review of accumulated experience with biologic therapy during pregnancy relies mainly on descriptions of the management of other types of rheumatic disease, although the use of these agents in psoriasis is growing steadily. Copyright © 2013 Elsevier España, S.L.U. y AEDV. All rights reserved.

  2. Immunomodulators in the treatment of psoriasis

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    Thappa Devinder

    2004-01-01

    Full Text Available The efficacy of cyclosporine and related drugs in the treatment of psoriasis was the key to the development of the concept that psoriasis is an immune mediated disorder. These therapies demonstrably reduce the number of activated T-lymphocytes, which correlates with clinical remission. Monoclonal antibodies directed against key components of the inflammatory process have been studied in an attempt to produce safer, more effective and selective immunosuppressive agents. This review summarizes the information available on cyclosporine and related drugs, and cytokine therapy, including monoclonal antibodies directed against T-cell mediated inflammation. It should be realized that biologic therapies for psoriasis are very new and that efficacy and safety information from clinical trials is just becoming available.

  3. Value of bone scintigraphy in psoriasis

    International Nuclear Information System (INIS)

    Nakayama, Chikashi; Nakata, Hajime; Kimoto, Tatsuya; Nakayama, Takashi; Yokomizo, Yu

    1982-01-01

    We performed bone scintigraphy on 16 cases of psoriasis to evaluate its possible value in this disease and obtained the following results: 1) Bone scintigraph was abnormal in 15 of 16 cases and the frequent association of arthritis in psoriasis was confirmed. 2) Abnormal uptake on bone scintigraph was noted in various joints including peripheral joints of extremities, sternoclavicular joint, shoulder and rib. Abnormality of sacroiliac joint or ankle was less frequent than previously reported. 3) Findings of bone scintigraph were not necessarily related with clinical symptoms or laboratory data. Abnormal uptake was also noted in many joints whose X-ray examinations were negative. Bone scintigraphy thus seems to be useful in early detection of arthritis and to become an initial therapeutic indicator of arthritis in psoriasis. (author)

  4. Psoriasis and risk of malignant lymphoma

    DEFF Research Database (Denmark)

    Kamstrup, M R; Skov, L; Zachariae, C

    2018-01-01

    In patients with psoriasis, the risk of lymphoma has been a subject of controversy and data from larger studies are limited1-4 . We therefore investigated the 5-year risk of new-onset Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL) (excluding cutaneous T-cell lymphoma [CTCL]), and CTCL, respect......In patients with psoriasis, the risk of lymphoma has been a subject of controversy and data from larger studies are limited1-4 . We therefore investigated the 5-year risk of new-onset Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL) (excluding cutaneous T-cell lymphoma [CTCL]), and CTCL......, respectively, in patients with psoriasis. This article is protected by copyright. All rights reserved....

  5. Management of guttate psoriasis in patients with associated streptococcal infection

    Directory of Open Access Journals (Sweden)

    Karabudak Abuaf O

    2012-11-01

    Full Text Available Özlem Karabudak Abuaf, Bilal DoganDepartment of Dermatology, GATA Haydarpasa Teaching Hospital, Istanbul, TurkeyAbstract: Psoriasis is a T cell-mediated inflammatory skin disease. It can be provoked or exacerbated by environmental factors, particularly medications and infections. Guttate psoriasis is a distinctive acute form of psoriasis that generally occurs in children and young adults. The association between guttate psoriasis and Streptococcus pyogenes is well established in medical literature; however, the exact mechanism can only be theorized. Treatment guidelines are not established, and it is unclear how necessary antibiotics are for acute state guttate psoriasis. Many dermatologists have recommended using antibiotic therapy or tonsillectomy, especially for patients with recurrent streptococcal infections. This paper briefly summarizes the possible mechanisms of pathogenesis and the recent research results on this topic and examines under what conditions a curative treatment of streptococcal infection by tonsillectomy or antibiotic treatment may benefit psoriasis patients.Keywords: guttate, psoriasis, treatment, Streptococcus pyogenes

  6. Targeting IL-17 with ixekizumab in patients with psoriasis

    DEFF Research Database (Denmark)

    Dyring Andersen, Beatrice; Skov, Lone; Zachariae, Claus

    2015-01-01

    Psoriasis is a multifactorial chronic inflammatory skin disease of unknown etiology. Knowledge of the pathophysiology of psoriasis has evolved and identified IL-17 as a key pro-inflammatory mediator in psoriasis creating new medical avenues. Several agents targeting IL-17 or its receptor are in c......Psoriasis is a multifactorial chronic inflammatory skin disease of unknown etiology. Knowledge of the pathophysiology of psoriasis has evolved and identified IL-17 as a key pro-inflammatory mediator in psoriasis creating new medical avenues. Several agents targeting IL-17 or its receptor...... are in clinical trials for the treatment of moderate-to-severe psoriasis. This review focuses on the biological rationale and the results of clinical trials with ixekizumab, a humanized IgG4 monoclonal antibody. The currently available Phase I to III data indicate that ixekizumab is a well-tolerated promising...

  7. Psoriasis: cardiovascular risk factors and other disease comorbidities.

    Science.gov (United States)

    Wu, Ying; Mills, Douglas; Bala, Mohan

    2008-04-01

    The risk factors of cardiovascular disease and other disease comorbidities appear to be more common in patients with psoriasis compared with the general population. To support this concept, the association between psoriasis and cardiovascular disease and other comorbidities was analyzed using data collected from 40 730 patients in the National Health and Wellness Survey (NHWS) during May and June 2004. A case-control study was conducted with data from 1127 patients with psoriasis and a matched cohort of nonpsoriasis patients. Psoriasis patients were significantly more likely to have cardiovascular comorbidities, including hypertension, hypercholesterolemia, and diabetes, compared with nonpsoriasis patients. Other comorbidities significantly associated with psoriasis were arthritis, depression, sleep disorder/insomnia, chronic obstructive pulmonary disease, and gastroesophageal reflux disease. Responses to this large survey confirm that patients with psoriasis have a higher rate of cardiovascular risk factors and other comorbidities compared with patients without psoriasis.

  8. Possible Triggering Effect of Influenza Vaccination on Psoriasis

    Directory of Open Access Journals (Sweden)

    Ali Tahsin Gunes

    2015-01-01

    Full Text Available Psoriasis is a chronic, recurrent, immune-mediated inflammatory disease and it can be provoked or exacerbated by a variety of different environmental factors, particularly infections and drugs. In addition, a possible association between vaccination and the new onset and/or exacerbation of psoriasis has been reported by a number of different authors. The aim of this study is to investigate the effects of influenza vaccination on patients with psoriasis. Here, we report the findings from 43 patients suffering from psoriasis (clinical phenotypes as mixed guttate/plaque lesions, palmoplantar or scalp psoriasis whose diseases had been triggered after influenza vaccination applied in the 2009-2010 season. The short time intervals between vaccination and psoriasis flares in our patients and the lack of other possible triggers suggest that influenza vaccinations may have provocative effects on psoriasis. However, further large and controlled studies need to be carried out to confirm this relationship.

  9. Psoriasis - The Life Course Approach.

    Science.gov (United States)

    Linder, Michael Dennis; Piaserico, Stefano; Augustin, Matthias; Fortina, Anna Belloni; Cohen, Arnon D; Gieler, Uwe; Jemec, Gregor B E; Kimball, Alexa Boer; Peserico, Andrea; Sampogna, Francesca; Warren, Richard B; de Korte, John

    2016-08-23

    Over the last decades, Life Course Research (LCR), predominantly the domain of sociology, has been increasingly applied in health research, as Life Course Epidemiology (LCE). The latter is concerned with disease patterns over time, accumulation of exposures over time, critical time periods and patterns of risk. We argue that concepts from LCR and LCE could be widely applied in dermatology, in general, and, more precisely, in the study of chronic inflammatory skin diseases, e.g. atopic eczema and psoriasis. The life course approach can generally be applied in two different ways. It may be used in the more traditional manner, in which the disease and its patterns over time are examined as the outcome vari-able. Conversely, it can examine life course as the outcome variable, which is dependent on the disease course, the treatments administered, and other physical or psychosocial environmental exposures. In dermatology, this second application of the LCR concepts is both promising and relevant because of the notable impact of chronic skin diseases on the patients' quality of life. In particular, we argue how LCR may be conducive to a better understanding of the concept of 'Cumulative Life Course Impairment', which is increasingly gaining acceptance. This approach helps identifying not only individuals at risk and particularly vulnerable patients but also critical periods for optimising interventions in order to avoid life course impairment. It also may facilitate more appropriate treatment decisions in clinical practice.

  10. Identification of new biomarker candidates for glucocorticoid induced insulin resistance using literature mining

    NARCIS (Netherlands)

    Fleuren, W.W.M.; Toonen, E.J.M.; Verhoeven, S.; Frijters, R.J.J.M.; Hulsen, T.; Rullmann, T.; Schaik, R. van; Vlieg, J. de; Alkema, W.

    2013-01-01

    BACKGROUND: Glucocorticoids are potent anti-inflammatory agents used for the treatment of diseases such as rheumatoid arthritis, asthma, inflammatory bowel disease and psoriasis. Unfortunately, usage is limited because of metabolic side-effects, e.g. insulin resistance, glucose intolerance and

  11. Psoriasis causes significant economic burden to patients.

    Science.gov (United States)

    Mustonen, A; Mattila, K; Leino, M; Koulu, L; Tuominen, R

    2014-06-01

    Psoriasis results in expenses to patients from many cost sources. Psoriasis treatments may result in considerable time and traveling costs, yet many studies fail to account for these costs. The objective of this study was to evaluate the multidimensional economic burden of psoriasis to patients. The study was based on 232 Finnish patients with psoriasis or psoriatic arthritis visiting a tertiary level dermatological clinic during a 1-year study period between October 1, 2009 and September 30, 2010. The data were based on a patient questionnaire, clinical data from the medical records and reimbursement data from the Finnish Social Insurance Institution. Item costs were based on true costs charged from the patients and all time cost estimates were based on the Human Capital Approach method. 199 patients with psoriasis and 33 with psoriatic arthritis were included in the study. Total costs were higher for patients receiving traditional systemic medications or phototherapy than those not receiving such treatment. Travel costs and travel time costs accounted for more than 60% of the costs of phototherapy. Skin care at home was time consuming and thus caused significant burden to patients. The majority of the visit costs arose from hospital visits and only a small proportion were attributed to visiting primary health care providers. Visit charges and other patient co-payments were estimated to play a minor role in the total cost of psoriasis incurred by patients, while travel costs and lost time comprised the majority of the costs, which should not be omitted in future studies regarding costs of treatments.

  12. Significance of clinicopathological correlation in psoriasis

    Directory of Open Access Journals (Sweden)

    Gopal Ambadasrao Pandit

    2015-01-01

    Full Text Available Context: Psoriasis affects about 1.5% to 3% of world′s population. Other papulosquamous dermatoses are Pityriasis rosea, Lichen planus, Seborrheic dermatitis, Pityriasis rubra pilaris and Parapsoriasis. Drug eruptions, tinea corporis, and secondary syphilis may also have papulosquamous morphology. Because all papulosquamous disorders are characterized by scaling papules, clinical confusion may result during their diagnosis. Separation of each of these becomes important because the treatment and prognosis for each tends to be disease-specific. Aim: To study the pattern of clinical and histopathological features of psoriasis of the skin with clinicopathological correlation. Material and methods: The present study of 42 cases of psoriasis of the skin was carried out in the Department of Pathology of a tertiary care centre from December 2009 to October 2011. In this study, the patients which were clinically diagnosed as psoriasis of skin, before starting the treatment and attending the outdoor skin department were selected. Histopathological findings were interpreted in light of clinical details. Results: Out of 42 cases of psoriasis 24 (57.14% were males, 18 (42.86% were females with male to female ratio of 1.33:1. Mean age was 34.45 years. Maximum number of cases 22 (52.38% were encountered in 3rd and 4th decade of life. Histopathological findings: parakeratosis, acanthosis, suprapapillary thinning, Munro microabscesses and hypogranulosis were noted in most of the cases. Conclusion: Histopathology serves as a diagnostic tool and rules out other lesions which mimic psoriasis. The most accurate diagnosis is the one that most closely correlates with clinical outcome and helps to direct the most appropriate clinical intervention.

  13. Psoriasis in pregnancy: a review (I).

    Science.gov (United States)

    Ruiz, V; Manubens, E; Puig, L

    2014-10-01

    Psoriasis is a complex inflammatory disease, and in women the incidence is high in child-bearing years. Treatment during pregnancy presents genuine challenges since management requires adequate assessment of the extent of disease, comorbidity, and potential risk to the fetus. Scientific evidence is scarce on the effects that certain drugs have on fetal development given the ethical concerns about enrolling pregnant women in clinical trials. This review presents up-to-date information on the course of psoriasis during gestation and discusses associated conditions and the therapeutic protocols recommended for use during pregnancy. Copyright © 2013 Elsevier España, S.L.U. and AEDV. All rights reserved.

  14. Importance of basic therapy in psoriasis.

    Science.gov (United States)

    Thaçi, Diamant; Augustin, Matthias; Krutmann, Jean; Luger, Thomas

    2015-05-01

    Basic therapy plays an important role in the management of psoriasis, regardless of disease severity or the therapeutic concept used. It helps reduce symptoms such as pruritus and scaling, decreases exacerbations, and may therefore prolong the remission period after successful antipsoriatic treatment. Accordingly, adequate basic therapy can also have a positive effect on patients' severely impaired quality of life. Unfortunately, the importance of basic therapy in psoriasis is still underestimated. Based on clinical trial data, the present review highlights the efficacy and potential of basic therapy, and focuses on new data and developments in this field.

  15. Multispectral recordings and analysis of psoriasis lesions

    DEFF Research Database (Denmark)

    Clemmensen, Line Katrine Harder; Ersbøll, Bjarne Kjær

    2006-01-01

    An objective method to evaluate the severeness of psoriasis lesions is proposed. In order to obtain objectivity multi-spectral imaging is used. The multi-spectral images give rise to a large p, small n problem which is solved by use of elastic net model selection. The method is promising for furt......An objective method to evaluate the severeness of psoriasis lesions is proposed. In order to obtain objectivity multi-spectral imaging is used. The multi-spectral images give rise to a large p, small n problem which is solved by use of elastic net model selection. The method is promising...

  16. Clinical symptoms and self-reported disease severity among patients with psoriasis - Implications for psoriasis management.

    Science.gov (United States)

    Korman, Neil J; Zhao, Yang; Li, Yunfeng; Liao, Minlei; Tran, Mary Helen

    2015-01-01

    Pain, itching, burning and irritation are common symptoms of psoriasis but have not been well characterized by overall psoriasis severity. Using 2012 syndicated psoriasis patient survey data, 1050 subjects were classified into mild (n = 610) and moderate-to-severe (n = 440) psoriasis severity groups based on self-reporting. Demographics, comorbid medical conditions and patient-reported key symptoms (i.e. flare-up frequency, psoriasis-related pain, itching, burning, hurting, irritation) were compared between groups. Multiple regressions were employed to examine the impact of overall psoriasis severity on each key symptom, controlling for demographics and comorbidities. Mild patients were older; more than 20% in both groups had joint pain and depression. Over 35 and 68% of the moderate-to-severe patients reported severe pain between or during flare-ups, respectively, and over 79% reported frequent bothersome itching. Controlling for between-group differences, moderate-to-severe patients had worse pain, were more likely to have continual flare-ups (odds ratio = 3.0) and flare-ups more than once monthly (odds ratio = 3.0), and reported more bothersome symptoms than patients with mild disease (all p management.

  17. Glucagon-like peptide-1 (GLP-1) receptor agonists, obesity and psoriasis: diabetes meets dermatology.

    Science.gov (United States)

    Drucker, D J; Rosen, C F

    2011-11-01

    Type 2 diabetes mellitus is characterised by beta cell failure, which frequently develops in the setting of insulin resistance. Inflammation contributes to the pathophysiology of type 2 diabetes by impairing insulin action in peripheral tissues and via reduction of beta cell function. Inflammation may also play an important role in the development of complications that arise in patients with type 2 diabetes. Hence, the anti-inflammatory actions of commonly used glucose-lowering drugs may contribute, indirectly, to their mechanisms of action and therapeutic benefit. Herein we highlight the anti-inflammatory actions of glucagon-like peptide-1 (GLP-1), which exerts direct and indirect actions on immune function. The observations that GLP-1 receptor agonists exert anti-inflammatory actions in preclinical studies, taken together with case reports linking improvements in psoriasis with GLP-1 receptor agonist therapy, illustrates the emerging clinical implications of non-classical anti-inflammatory actions of incretin-based therapeutics.

  18. Vulvar Metastasis from Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-01-01

    Full Text Available Vulvar metastasis of urothelial carcinoma of the bladder is a very rare entity; few cases are reported in the English literature. In this paper, we describe the clinical and pathological characteristics, evolution, and treatment of a patient with vulvar metastasis of urothelial carcinoma of the bladder followed by a brief review of the reported cases in the literature.

  19. Infliximab in the treatment of plaque type psoriasis

    Directory of Open Access Journals (Sweden)

    Rosita Saraceno

    2009-04-01

    Full Text Available Rosita Saraceno, Andrea Saggini, Lucia Pietroleonardo, Sergio ChimentiDepartment of Dermatology, University of Rome Tor Vergata, Rome, Viale Oxford 81, Rome, ItalyAbstract: Psoriasis is a chronic and immunomediated skin disease characterized by erythematous scaly plaques. Psoriasis affects approximately 1% to 3% of the Caucasian population. Tumor necrosis factor alpha (TNF-α is a proinflammatory cytokine that plays a critical role in the pathogenesis of psoriasis. Infliximab is an anti-TNF-α drug widely used for the treatment of plaque type psoriasis and psoriatic arthritis. Controlled clinical trials demonstrated that infliximab is characterized by a high degree of clinical response in moderate to severe plaque psoriasis. Moreover infliximab showed rapid efficacy in nail psoriasis which represents a therapeutic challenge for dermatologists and a relevant source of distress for patients with plaque psoriasis. This anti-TNF-α has an encouraging safety profile, especially as long as physicians are watchful in prevention and early diagnosis of infections and infuse reactions. The efficacy, tolerability and safety profiles suggest infliximab as a suitable anti-psoriatic drug in the long-term treatment of a chronic disease such as plaque-type psoriasis.Keywords: psoriasis, nail psoriasis, infliximab, long-term treatment

  20. Optimal management of nail disease in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Piraccini BM

    2015-01-01

    Full Text Available Bianca Maria Piraccini, Michela Starace Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy Abstract: Psoriasis is a common skin disease, with nail involvement in approximately 80% of patients. Nail psoriasis is often associated with psoriatic arthropathy. Involvement of the nails does not always have relationship with the type, gravity, extension, or duration of skin psoriasis. Nail psoriasis can occur at any age and all parts of the nails and the surrounding structures can be affected. Two clinical patterns of nail manifestations have been seen due to psoriasis: nail matrix involvement or nail bed involvement. In the first case, irregular and deep pitting, red spots of the lunula, crumbling, and leukonychia are seen; in the second case, salmon patches, onycholysis with erythematous border, subungual hyperkeratosis, and splinter hemorrhages are observed. These clinical features are more visible in fingernails than in toenails, where nail abnormalities are not diagnostic and are usually clinically indistinguishable from other conditions, especially onychomycosis. Nail psoriasis causes, above all, psychosocial and aesthetic problems, but many patients often complain about functional damage. Diagnosis of nail psoriasis is clinical and histopathology is necessary only in selected cases. Nail psoriasis has an unpredictable course but, in most cases, the disease is chronic and complete remissions are uncommon. Sun exposure does not usually improve and may even worsen nail psoriasis. There are no curative treatments. Treatment of nail psoriasis includes different types of medications, from topical therapy to systemic therapy, according to the severity and extension of the disease. Moreover, we should not underestimate the use of biological agents and new therapy with lasers or iontophoresis. This review offers an investigation of the different treatment options for nail

  1. Increased incidence and prevalence of psoriasis in multiple sclerosis.

    Science.gov (United States)

    Marrie, Ruth Ann; Patten, Scott B; Tremlett, Helen; Wolfson, Christina; Leung, Stella; Fisk, John D

    2017-04-01

    Psoriasis and multiple sclerosis (MS) share some risk factors, and fumarates are effective disease-modifying therapies for both psoriasis and MS, suggesting a common pathogenesis. However, findings regarding the occurrence of psoriasis in the MS population are inconsistent. We aimed to estimate the incidence and prevalence of psoriasis in the MS population versus a matched cohort from the general population. We used population-based administrative data from the Canadian province of Manitoba to identify 4911 persons with MS and 23,274 age-, sex- and geographically-matched controls aged 20 years and older. We developed case definitions for psoriasis using ICD-9/10 codes and prescription claims. These case definitions were compared to self-reported psoriasis diagnoses. The preferred definition was applied to estimate the incidence and prevalence of psoriasis over the period 1998-2008. We used multivariable Cox regression to estimate the risk of psoriasis in the MS population at the individual level, adjusting for sex, age at the index date, socioeconomic status and physician visits. In 2008, the crude incidence of psoriasis per 100,000 person-years was 466.7 (95%CI: 266.8-758.0) in the MS population, and 221.3 in the matched population (95%CI: 158.1-301.4). The crude prevalence of psoriasis per 100,000 persons was 4666.1 (95%CI: 3985.2-5429.9) in the MS population, and 3313.5 (95%CI: 3057.4-3585.3) in the matched population. The incidence and prevalence of psoriasis rose slightly over time. After adjusting for sex, age at the index date, socioeconomic status and physician visits, the risk of incident psoriasis was 54% higher in the MS population (HR 1.54; 95%CI: 1.07-2.24). Psoriasis incidence and prevalence are higher in the MS population than in the matched population. Copyright © 2017. Published by Elsevier B.V.

  2. Psoriasis in systemic lupus erythematosus: a single-center experience.

    Science.gov (United States)

    Tselios, Konstantinos; Yap, Kristy Su-Ying; Pakchotanon, Rattapol; Polachek, Ari; Su, Jiandong; Urowitz, Murray B; Gladman, Dafna D

    2017-04-01

    The coexistence of psoriasis with systemic lupus erythematosus (SLE) has been reported in limited case series, raising hypotheses about shared pathogenetic mechanisms. Nevertheless, important differences regarding treatment do exist. The aim of the present study was to determine the prevalence and characteristics of psoriasis in a defined cohort of lupus patients. Patients with psoriasis were retrieved from the University of Toronto Lupus Clinic from its inception in 1970 up to 2015. Charts were hand-searched to collect information concerning demographic, clinical, and therapeutic variables. Patients were matched with non-psoriasis lupus patients to identify the impact of supervening psoriasis on lupus activity, damage accrual, and venous thromboembolic (VTEs) and cardiovascular events (CVEs). Psoriasis was diagnosed in 63 patients (49 females, 14 males) for a prevalence of 3.46% (63/1823). The male-to-female ratio was significantly higher in non-psoriasis patients (0.286 vs. 0.138, p = 0.017). Plaque psoriasis was the most prominent type (55/63, 87.3%) whereas three patients had pustular disease; one had psoriatic arthritis. Nine patients (14.3%) were administered systemic treatment with methotrexate (n = 5), azathioprine (n = 1), ustekinumab (n = 3), and etanercept (n = 1). Psoriasis was definitely deteriorated by hydroxychloroquine in one patient. There was no significant impact of psoriasis on disease activity, damage accrual, VTEs, and CVEs. The prevalence of psoriasis was twice as high as that of the general Canadian population in this lupus cohort. Plaque psoriasis was the most prominent subtype, and topical treatment was adequate in the majority of patients. Supervening psoriasis had no significant impact on lupus activity and damage accrual.

  3. Psoriasis and suicidality: A systematic review and meta-analysis.

    Science.gov (United States)

    Singh, Sanminder; Taylor, Catherine; Kornmehl, Heather; Armstrong, April W

    2017-09-01

    Psoriasis is associated with psychiatric comorbidities; however, the relationship between psoriasis and suicidality is not well understood. To perform a systematic review and meta-analysis that elucidates the relationship between psoriasis and suicidality. Applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched the PubMed, EMBASE, PsycINFO, and Cochrane databases. We searched literature published between 1946 and 2017. We identified 18 studies with a total of 1,767,583 participants, of whom 330,207 had psoriasis. On the basis of random effects modeling, the pooled odds ratio (OR) for suicidal ideation among patients with psoriasis was 2.05 (95% confidence interval [CI], 1.54-2.74). Patients with psoriasis were more likely to exhibit suicidal behaviors (combined attempted and completed suicides) with a pooled OR of 1.26 (95% CI, 1.13-1.40). Subgroup analysis showed that patients with psoriasis were more likely to attempt suicides (OR, 1.32; 95% CI, 1.14-1.54) and complete suicide (OR, 1.20; 95% CI, 1.04-1.39) than those without psoriasis. More severe psoriasis and younger age were associated with greater likelihood of suicidality. There are few studies examining suicidality in conjunction with psoriasis severity. Patients with psoriasis have a significantly higher likelihood of suicidal ideation, suicide attempts, and completed suicides. Among patients with psoriasis, those who are younger and whose psoriasis is more severe are at particular risk for suicidality. Copyright © 2017. Published by Elsevier Inc.

  4. Biologic drug survival in Israeli psoriasis patients.

    Science.gov (United States)

    Shalom, Guy; Cohen, Arnon D; Ziv, Michael; Eran, Cohen Barak; Feldhamer, Ilan; Freud, Tamar; Berman, Eitan; Oren, Shirley; Hodak, Emmilia; Pavlovsky, Lev

    2017-04-01

    Drug survival is defined as the time period of treatment with a certain drug until its cessation. The role of previous exposure to traditional systemic treatments in biologic survival is still unknown. To investigate the drug survival rates of biologic treatments in patients with psoriasis and to identify predictor factors. Survival analysis was performed on patients with severe psoriasis who received adalimumab, infliximab, etanercept, and ustekinumab for treatment of psoriasis, drawn from the Clalit Health Services database. Multivariate analysis was performed adjusting for demographic variables; metabolic syndrome and its components; psoriatic arthritis; biologic naivety; coadministration of methotrexate, acitretin, or cyclosporine; and previous standard systemic treatment exposure. Among 907 patients treated with 1575 biologic treatments, ustekinumab had a significantly higher survival rate than tumor necrosis factor inhibitors. Biologic naivety and concomitant methotrexate intake were positive predictors for drug survival, whereas the female sex and the duration of previous systemic treatments were negative predictors. Data regarding disease severity or duration could not be drawn from the Clalit Health Services database. Ustekinumab had better retention rates in comparison with other investigated biologics in patients with severe psoriasis, most of whom used it as a third line therapy. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Society. Part II: moderate to severe psoriasis

    Directory of Open Access Journals (Sweden)

    Jacek Szepietowski

    2014-11-01

    Full Text Available Psoriasis is a chronic inflammatory skin disease affecting about 1–3% of the general population. Recent years have seen great development in the treatment of this dermatosis, especially regarding moderate to severe psoriasis. More numerous and more widely available systemic therapies raise new challenges for all physicians treating patients with psoriasis. New questions arise about patients’ follow-up and long-term safety of such therapies. To meet the expectations of Polish dermatologists, we have prepared a second part of guidelines on the treatment of psoriasis, particularly concentrated on the therapy of severe forms of this disease. We hope that our suggestions will be valuable for physicians in their daily clinical practice. However, we would like to underline that every guideline is characterized by some vagueness, and the final decision about diagnosis and therapy should always be made individually for every patient based on the patient’s current clinical status and the most up-to-date scientific literature data.

  6. Nail Psoriasis, the unknown burden of disease

    NARCIS (Netherlands)

    Klaassen, K.M.G.; Kerkhof, P.C.M. van de; Pasch, M.C.

    2014-01-01

    BACKGROUND: Psoriasis can be found at several different localizations which may be of various impact on patients' quality of life (QoL). One of the easy visible, and difficult to conceal localizations are the nails. OBJECTIVE: To achieve more insight into the QoL of psoriatic patients with nail

  7. Proinflammatory cytokine responses in patients with psoriasis.

    Science.gov (United States)

    Kouris, Anargyros; Pistiki, Aikaterini; Katoulis, Alexandros; Georgitsi, Marianna; Giatrakou, Sofia; Papadavid, Evangelia; Netea, Mihai G; Stavrianeas, Nikolaos; Giamarellos-Bourboulis, Evangelos J

    2014-01-01

    Psoriasis is one of the most common, immune-mediated, chronic inflammatory skin diseases. Proinflammatory cytokines play an important pathogenetic role at a local level. To assess whether the proinflammatory cytokines IL-1β, IL-6, IL-17, IL-22 and TNF-α are released systemically during psoriasis. Peripheral blood mononuclear cells (PBMCs) were isolated from 30 patients with psoriasis and 30 healthy volunteers. Cytokine production was assessed in supernatants using an enzyme immunoassay after stimulation of PBMCs with microbial stimuli. In addition, flow cytometry was used to determine the subsets of monocytes involved and the intracellular TNF-α production in monocytes. IL-17 levels were significantly higher in the supernatants of PBMCs from psoriatic patients after stimulation with phytohemagglutinin. TNF-α production was also significantly higher in cells from psoriatic patients after stimulation with all stimuli, as compared with health volunteers. Similar changes were not found for the other cytokines. A statistically significant difference was observed between patients and controls for inflammatory CD14(+)/CD16(+) monocytes (ppsoriasis. These results support the concept that there is a systemic, proinflammatory component in psoriasis.

  8. Håndtering af dagliglivet med psoriasis

    DEFF Research Database (Denmark)

    Rasmussen, Gitte Susanne

    2010-01-01

    This study investigates factors that, according to the literature, may impact psoriasis patients’ needs for patient education to support self-management in daily life. The study was carried out as an inte-grative review. This design allows for a combination of diverse methodologies and is well...

  9. A hierarchical classification scheme of psoriasis images

    DEFF Research Database (Denmark)

    Maletti, Gabriela Mariel; Ersbøll, Bjarne Kjær

    2003-01-01

    A two-stage hierarchical classification scheme of psoriasis lesion images is proposed. These images are basically composed of three classes: normal skin, lesion and background. The scheme combines conventional tools to separate the skin from the background in the first stage, and the lesion from...

  10. Principal component analysis of psoriasis lesions images

    DEFF Research Database (Denmark)

    Maletti, Gabriela Mariel; Ersbøll, Bjarne Kjær

    2003-01-01

    A set of RGB images of psoriasis lesions is used. By visual examination of these images, there seem to be no common pattern that could be used to find and align the lesions within and between sessions. It is expected that the principal components of the original images could be useful during future...

  11. Radiation therapy of psoriasis and parapsoriasis

    International Nuclear Information System (INIS)

    Wiskemann, A.

    1982-01-01

    Selective UV-Phototherapy with lambda 300-320 nm (SUP) as well as oral photochemotherapy with 8-methoxy-psoralen plus UVA-radiation (PUVA intern) are very effective in clearing the lesions of the generalized psoriasis and those of the chronic forms of parapsoriasis. Being treated with 4 suberythemal doses per week psoriasis patients are free or nearly free of symptoms after averagely 6.3 weeks of SUP-therapy or after 5.3 weeks of PUVA orally. The PUVA-therapy is mainly indicated in pustular, inverse and erythrodermic psoriasis as well as in parapsoriasis en plaques and variegata. In all other forms of psoriasis and in pityriasis lichenoides-chronica, we prefer the SUP-therapy because of less acute or chronic side effects, and because of its better practicability. X-rays are indicated in psoriais of nails, grenz-rays in superficial psoriatic lesions of the face, the armpits, the genitals and the anal region. (orig.) [de

  12. Pustular psoriasis of pregnancy: current perspectives

    Directory of Open Access Journals (Sweden)

    Trivedi MK

    2018-02-01

    Full Text Available Megha K Trivedi,1,2 Alexandra R Vaughn,3 Jenny E Murase1,4 1Department of Dermatology, University of California, San Francisco, CA, USA; 2Medical School, University of Michigan, Ann Arbor, MI, USA; 3College of Medicine, Drexel University, Philadelphia, PA, USA; 4Department of Dermatology, Palo Alto Medical Foundation, Palo Alto, CA, USA Abstract: Pustular psoriasis of pregnancy (PPP is a life-threatening condition for both the pregnant mother and fetus, and must be efficiently and accurately diagnosed and treated. This condition has historically been classified as a unique, separate dermatosis of pregnancy. However, current opinion and data suggest that it may be a variant of generalized pustular psoriasis. PPP typically occurs in the third trimester and is characterized by widespread coalescent pustules, desquamation, and systemic symptoms. Clinical features and histopathologic evaluation aid in diagnosis. Treatments during pregnancy include high-dose corticosteroids, cyclosporine, narrow-band ultraviolet B radiation, infliximab, granulocyte and monocyte adsorptive apheresis, and systemic antibiotics. Both the mother and fetus should be closely monitored with appropriate laboratory studies for the duration of the pregnancy and postpartum. Keywords: pustular psoriasis of pregnancy, impetigo herpetiformis, generalized pustular psoriasis, dermatoses of pregnancy

  13. In-vivo optical investigation of psoriasis

    Science.gov (United States)

    Kapsokalyvas, Dimitrios; Cicchi, Riccardo; Bruscino, Nicola; Alfieri, Domenico; Massi, Daniela; Lotti, Torello; Pavone, Francesco S.

    2011-03-01

    Psoriasis is an autoimmune disease of the skin characterized by hyperkeratosis, hyperproliferation of the epidermis, inflammatory cell accumulation and increased dilatation of dermal papillary blood vessels. Cases of psoriasis were investigated in vivo with optical means in order to evaluate the potential of in vivo optical biopsy. A Polarization Multispectral Dermoscope was employed for the macroscopic observation. Features such as the 'dotted' blood vessels pattern was observed with high contrast. The average size of dot vessels in Psoriasis was measured to be 974 μm2 which is much higher compared to healthy skin. High resolution image sections of the epidermis and the dermis were produced with a custom made Multiphoton Microscope. Imaging extended from the surface of the lesion down to the papillary dermis, at a depth of 200 μm. In the epidermis, a characteristic morphology of the stratum corneum found only in Psoriasis was revealed. Additionally, the cytoplasmic area of the cells in the stratum spinosum layer was found to be smaller than normal. In the dermis the morphological features were more pronounced, where the elongated dermal papillae dominated the papillary layer. Their length exceeds 100μm, which is a far greater value compared to that of healthy skin. These in vivo observations are consistent with the ex vivo histopathological observations, supporting both the applicability and potentiality of multispectral dermoscopy and multiphoton microscopy in the field of in vivo optical investigation and biopsy of skin.

  14. Biologisk behandling af psoriasis og psoriasisartritis

    DEFF Research Database (Denmark)

    Kragballe, Knud; Deleuran, Bent

    2008-01-01

    Psoriasis is an immune-mediated inflammatory skin disease which may be associated with psoriatic arthritis. Biological therapy is indicated in patients who do not respond to, or are intolerant to, or have contraindication against traditional therapy. TNFalpha antagonists are used for both skin...

  15. Incidence and prevalence of psoriasis in Denmark

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Skov, Lone; Gislason, Gunnar H.

    2017-01-01

    The incidence and temporal trends of psoriasis in Denmark between 2003 and 2012 were examined. There was a female predominance ranging between 50.0% (2007) and 55.4% (2009), and the mean age at time of diagnosis was 47.7-58.7 years. A total of 126,055 patients with psoriasis (prevalence 2.2%) were...... identified. Incidence rates of psoriasis (per 100,000 person years) ranged from 107.5 in 2005 to a peak incidence of 199.5 in 2010. Incidence rates were higher for women, and patients aged 60-69 years, respectively. Use of systemic non-biologic agents, i.e. methotrexate, cyclosporine, retinoids, or psoralen...... plus ultraviolet A (PUVA) increased over the study course, and were used in 15.0% of all patients. Biologic agents (efalizumab, etanercept, infliximab, adalimumab, or ustekinumab) were utilized in 2.7% of patients. On a national level, incidence of psoriasis fluctuated during the 10- year study course...

  16. Shopping for psoriasis medications on the Internet.

    Science.gov (United States)

    Mahé, E; Saiag, P; Aegerter, P; Beauchet, A

    2009-09-01

    Numerous consumer products, including medicines, can be bought over the Internet. Previous reports indicate that patients are able to purchase the current available treatments, including expensive systemic and biological agents with side-effects, available for use on an outpatient basis. In France, as in most industrialized countries, these drug treatments are available only by prescription. Objective To evaluate whether psoriatic outpatients can buy the full range of psoriasis medications, including biological therapies, without a prescription, via the Internet. One investigator acted as a consumer to purchase psoriasis treatments and complementary medicines over the Internet. The website search was limited to a 4-h period. All products had to be available for delivery in France, without a prescription, and be suitable for outpatient use. Key words for the Internet search were combinations of medicinal product names, 'psoriasis', 'shopping', 'pharmacy', 'parapharmacy', entered into two major search engines, Google and Yahoo. The investigator identified 47 websites offering a total of 340 products. All treatments, including biological therapies (etanercept, adalumimab and efaluzimab), were available for purchase with the exception of calcitriol and alefacept, with median prices being higher than the French price. This study shows that it is possible for consumers to purchase the majority of treatments for psoriasis via the Internet, including systemic therapies and even the most recent and expensive products such as biological agents, without a prescription.

  17. Meeting report: Metastasis Research Society-Chinese Tumor Metastasis Society joint conference on metastasis.

    Science.gov (United States)

    Bankaitis, Katherine; Borriello, Lucia; Cox, Thomas; Lynch, Conor; Zijlstra, Andries; Fingleton, Barbara; Gužvić, Miodrag; Anderson, Robin; Neman, Josh

    2017-04-01

    During September 16th-20th 2016, metastasis experts from around the world convened for the 16th Biennial Congress of the Metastasis Research Society and 12th National Congress of the Chinese Tumor Metastasis Society in Chengdu, China to share most current data covering basic, translational, and clinical metastasis research. Presentations of the more than 40 invited speakers of the main congress and presentations from the associated Young Investigator Satellite Meeting are summarized in this report by session topic. The congress program also included three concurrent short talk sessions, an advocacy forum with Chinese and American metastatic patient advocates, a 'Meet the Professors Roundtable' session for young investigators, and a 'Meet the Editors' session with editors from Cancer Cell and Nature Cell Biology. The goal of integrating expertise and exchanging the latest findings, ideas, and practices in cancer metastasis research was achieved magnificently, thanks to the excellent contributions of many leaders in the field.

  18. Ampullary carcinoma with cutaneous metastasis

    Directory of Open Access Journals (Sweden)

    I-Ting Liu

    2016-06-01

    Full Text Available Carcinoma of the ampulla of Vater is a rare gastrointestinal tumor. Additionally, cutaneous metastasis from such an internal malignancy is also uncommon. We reported the case of a 55-year-old man afflicted with ampullary carcinoma with cutaneous metastasis. The patient did not undergo the standard Whipple procedure but received chemotherapy due to apparent left neck lymph node metastasis noted by initial PET/CT imaging. The skin metastasis presented as a left neck infiltrating purpuric lesion, which was confirmed by skin biopsy approximately one year after the patient's disease was first diagnosed. Thereafter, the patient received further chemotherapy pursuant to his course of medical management. Skin metastasis usually represents a poor patient prognosis. In these cases, treatment of cutaneous metastasis typically includes systemic chemotherapy and local management such as radiation therapy or tumor excision. And when choosing a chemotherapy regimen for the ampullary cancer, the histological subtypes (intestinal or pancreatobiliary should be comprehensively considered. In our review of the literature, the intestinal type seems to have less distant lymph node metastasis, advanced local invasion, as well as recurrence than pancreatobiliary type of ampullary cancer.

  19. Validation of the Simplified Psoriasis Index in Dutch children and adolescents with plaque psoriasis.

    Science.gov (United States)

    van Geel, M J; Otero, M E; de Jong, E M G J; van de Kerkhof, P C M; Seyger, M M B

    2017-03-01

    The Simplified Psoriasis Index (SPI) is a three-domain assessment measure for psoriasis, including separate indicators of current severity (SPI-s), psychosocial impact (SPI-p), and past history and interventions (SPI-i). There are two complementary versions available designed for completion by a health professional (proSPI) or by patient self-assessment (saSPI). The validity and reliability of the proSPI vs. saSPI have already been demonstrated in adults. To date, validated severity measures for paediatric psoriasis do not exist. To validate the current severity (SPI-s) and psychosocial impact (SPI-p) domains of the proSPI and saSPI in children and adolescents with psoriasis. All patients aged psoriasis visiting the dermatology outpatient department of Radboud University Medical Center, the Netherlands, between September 2013 and April 2014 were asked to complete Dutch versions of the saSPI and the Children's Dermatology Life Quality Index (CDLQI). The original English versions of the proSPI and Psoriasis Area and Severity Index (PASI) were completed by the physician at the same visit. In total, 113 patients (median age 12·0 years, range 4-17) were included. There was a close correlation between the proSPI-s and PASI (r = 0·87), which was higher than between the saSPI-s and PASI (r = 0·69). The correlation between the SPI-p and CDLQI was 0·78. The full range of scores was utilized in both proSPI-s and SPI-p, although the highest saSPI-s score was 30 (maximum 50). In paediatric psoriasis, the proSPI and saSPI are shown to be valid and usable. The SPI-s and SPI-p can be readily introduced into routine clinical practice. © 2016 British Association of Dermatologists.

  20. Psoriasis in those planning a family, pregnant or breast-feeding. The Australasian Psoriasis Collaboration.

    Science.gov (United States)

    Rademaker, Marius; Agnew, Karen; Andrews, Megan; Armour, Katherine; Baker, Chris; Foley, Peter; Frew, John; Gebauer, Kurt; Gupta, Monisha; Kennedy, Debra; Marshman, Gillian; Sullivan, John

    2017-05-23

    The Australasian Psoriasis Collaboration has reviewed the evidence for managing moderate to severe psoriasis in those who are pregnant or are breast-feeding, or planning a family. The severity of the psoriasis, associated comorbidities and specific anti-psoriasis treatment, along with other exposures, can have a deleterious effect on pregnancy outcomes. Psoriasis itself increases the risk of preterm and low birthweight babies, along with spontaneous and induced abortions, but no specific birth defects have been otherwise demonstrated. The baseline risk for a live born baby to have a major birth defect is 3%, and significant neuro-developmental problem is 5%. In Australia, pregnant women with psoriasis are more likely to be overweight or obese, depressed, or smoke in their first trimester, and are also less likely to take prenatal vitamins or supplements. Preconception counselling to improve maternal, pregnancy and baby health is therefore strongly encouraged. The topical and systemic therapies commonly used in psoriasis are each discussed separately, with regards to pregnancy exposure, breast-feeding and effects on male fertility and mutagenicity. The systemic therapies included are acitretin, adalimumab, apremilast, certolizumab, ciclosporin, etanercept, infliximab, ixekizumab, methotrexate, NBUVB, prednisone, PUVA, secukinumab and ustekinumab. The topical therapies include dithranol (anthralin), calcipotriol, coal tar, corticosteroids (weak, potent and super-potent), moisturisers, salicylic acid, tacrolimus, and tazarotene. As a general recommendation, effective drugs that have been widely used for years are preferable to newer alternatives with less foetal safety data. It is equally important to evaluate the risks of not treating, as severe untreated disease may negatively impact both mother and the foetus. © 2017 The Australasian College of Dermatologists.

  1. Oral Candida colonization and candidiasis in patients with psoriasis.

    Science.gov (United States)

    Bedair, Ahmad A; Darwazeh, Azmi M G; Al-Aboosi, Mustafa M

    2012-11-01

    The objective of this study was to investigate oral Candida colonization and candidosis in a group of patients with psoriasis and controls. A total of 100 patients with psoriasis and matched controls underwent the concentrated oral rinse test for Candida isolation. Candida species were identified by the VITEK 2 Identification System. Categorical variables were evaluated using the χ(2) test. The median Candida count was compared using the Mann-Whitney U test. Oral candidiasis was diagnosed in 3% of the patients with psoriasis. The Candida count and prevalence were significantly higher in the patients with psoriasis compared with controls (69% vs 44%, P Oral Candida was significantly higher in late-onset (at age ≥30 years) compared with early-onset psoriasis (at age oral Candida colonization and candidiasis. Further studies are needed to clarify the predisposing factor(s) for oral Candida in patients with psoriasis. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Prevalence of psoriasis in patients with alcoholic liver disease.

    LENUS (Irish Health Repository)

    Tobin, A M

    2012-02-01

    BACKGROUND: Excessive alcohol use has been implicated as a risk factor in the development of psoriasis, particularly in men. Despite this, little is known of the incidence or prevalence of psoriasis in patients who misuse alcohol. OBJECTIVE: To assess the prevalence of psoriasis in patients with alcoholic liver disease. METHODS: In total, 100 patients with proven alcoholic liver disease were surveyed for a history of psoriasis and a full skin examination was performed if relevant. RESULTS: Of the 100 patients, 15 reported a history of psoriasis and another 8 had evidence of current activity, suggesting a prevalence (past or present) of 15% in this group of patients. CONCLUSION: It would appear that the prevalence of psoriasis in patients who misuse alcohol is much higher than the 1-3% variously quoted in the general population.

  3. Apremilast for the management of moderate to severe plaque psoriasis.

    Science.gov (United States)

    Vangipuram, Ramya; Alikhan, Ali

    2017-04-01

    Psoriasis is a chronic inflammatory skin disease characterized by erythematous plaques on extensor surfaces, scalp, and back. Current therapies for psoriasis are limited by route of administration, side effects, and cost. Apremilast is the first oral phosphodiesterase inhibitor approved for moderate-to-severe plaque psoriasis. It is a small molecule inhibitor of phosphodiesterase-4, and decreases the inflammatory activity associated with psoriasis. Areas covered: This review will discuss the pharmacology of apremilast, mechanism of action, results from key clinical trials, and its use in managing psoriasis. Currently approved treatments are also discussed. Expert commentary: The advantages of apremilast include convenient oral administration and dosing, a favorable safety and tolerability profile, and significant efficacy in moderate-to-severe plaque psoriasis.

  4. Dermoscopic features of nail psoriasis treated with biologics.

    Science.gov (United States)

    Hashimoto, Yuki; Uyama, Miki; Takada, Yuko; Yoshida, Kenji; Ishiko, Akira

    2017-05-01

    Although psoriatic nail lesions are small, they cause considerable discomfort for patients and adversely affect quality of life. Few studies have evaluated the dermoscopic features of psoriatic nails. The aim of this study was to clarify the dermoscopic features of nail psoriasis and identify those that reflect psoriatic activity. During biologic treatment of psoriasis, six patients with psoriatic nails twice underwent dermoscopic examination, with an interval of 17-42 weeks. We used the modified Nail Psoriasis Severity Index score and Psoriasis Area and Severity Index score to identify and assess dermoscopic features. We identified 10 dermoscopic findings, of which disappearance of diffuse scaling of the nail plate, transverse step-like notches and splinter hemorrhages of the nail bed, and appearance of erythematous borders of the onycholytic area were associated with improvement in Psoriasis Area and Severity Index score. Dermoscopy can detect nail changes during psoriasis treatment and should be used to evaluate treatment success. © 2017 Japanese Dermatological Association.

  5. Review of U.S. registries for psoriasis.

    Science.gov (United States)

    Amin, Mina; No, Daniel J; Wu, Jashin J

    2017-12-01

    Patient registries are databases comprised of standardized clinical data for a specific population of patients with a particular disease or medical condition. Information from patient registries allows clinicians to assess long-lasting outcomes in patients with a specific disease, such as psoriasis. Our primary objective was to identify available psoriasis registries in the United States (U.S.) and evaluate the application of patient registries compared to clinical trials. We searched Google, the Registry of Patient Registries, Orphanet and ClinicalTrials.gov to create a list of U.S. psoriasis registries. We also performed a literature review on the application of psoriasis registries using PubMed. We identified 6 psoriasis patient registries in the United States. Patient registries are frequently used for psoriasis in the U.S. and provide important information about the safety, efficacy and long-term effects of systemic therapies.

  6. Risk of periodontitis in patients with psoriasis and psoriatic arthritis

    DEFF Research Database (Denmark)

    Egeberg, A; Mallbris, L; Gislason, G

    2017-01-01

    BACKGROUND: Psoriasis and periodontitis are chronic inflammatory disorders with overlapping inflammatory pathways, but data on risk of periodontitis in psoriasis are scarce and a possible pathogenic link is poorly understood. OBJECTIVE: We investigated the association between psoriasis...... and periodontitis in a nationwide cohort study. METHODS: All Danish individuals aged ≥18 years between 1 January 1997 and 31 December 2011 (n = 5,470,428), including 54 210 and 6988 patients with mild and severe psoriasis, and 6428 with psoriatic arthritis, were linked through administrative registers. Incidence...... rate ratios (IRRs) were estimated by Poisson regression. RESULTS: Incidence rates of periodontitis per 10 000 person-years were 3.07 (3.03-3.12), 5.89 (1.07-6.84), 8.27 (5.50-12.45) and 11.12 (7.87-15.73) for the reference population, mild psoriasis, severe psoriasis and psoriatic arthritis...

  7. LIVER DAMAGE IN PSORIASIS AND PSORIATIC ARTHRITIS: A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Yu. L. Korsakova

    2017-01-01

    Full Text Available Psoriasis (Ps is a chronic systemic disease that affects the skin. Investigation could reveal the high prevalence of nonalcoholic fatty liver disease (NAFLD in patients with Ps compared with the general population, especially in those who have moderate to severe Ps with a high Ps area severity index (PASI. Similar pathogenic processes play a definite role in this relationship. The most likely causes are recognized to be insulin resistance and elevated levels of proinflammatory cytokines. According to recent evidence, the prevalence of NAFLD and metabolic syndrome in patients with Ps is higher than that in the general population. In addition, patients with NAFLD and Ps are at higher risk of severe liver fibrosis than those with NAFLD without Ps. Therapy for this condition certainly needs not only to modify traditional risk factors, but also to reliably suppress inflammation. Obesity and NAFLD have a negative impact on the results of treatment in patients with psoriatic arthritis with biological agents.

  8. Nasopharyngeal carcinoma with pericardial metastasis

    Directory of Open Access Journals (Sweden)

    Shang-Wen Chen

    2011-07-01

    Full Text Available Nasopharyngeal carcinoma (NPC is prevalent in Taiwan and is characterized by a high frequency of nodal metastasis. The most common organs with distal metastases are the bones, lungs, and liver, with extremely rare cases to the pericardium. Herein, we report a rare case with NPC who presented with dyspnea and orthopnea. Serial studies, including pericardial biopsy, revealed NPC with pericardial metastasis and pericardial effusion. The tumor cells of both the original and metastatic tumors were positive for Epstein–Barr virus by in situ hybridization. This is the first histologically confirmed case of NPC with pericardial metastasis.

  9. Patients with psoriasis have an increased risk of cardiovascular diseases

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar; Lindhardsen, Jesper

    2012-01-01

    Psoriasis is a chronic immunoinflammatory disease that affects 2-3% of the population and shares pathophysiologic mechanisms and risk factors with cardiovascular diseases. Studies have suggested psoriasis as an independent risk factor for cardiovascular disease and Danish guidelines...... on cardiovascular risk factor modification in patients with psoriasis and psoriatic arthritis have recently been published. We provide a short review of the current evidence and the Danish guidelines....

  10. Psoriasis vulgaris and digestive system disorders: is there a linkage?

    OpenAIRE

    Maria Juszkiewicz-Borowiec; Ewa Dybiec; Ryszard Maciejewski; Grazyna Chodorowska; Iwona Jastrzebska; Aldona Pietrzak; Dorota Krasowska; Robert A Schwartz

    2010-01-01

    Psoriasis is well-known immune-mediated skin disease often associated with co-morbidities, including dyslipidaemia and obesity. Few reports imply that the disease might be also related to pathology of mucosal surfaces, especially that of the digestive system. The authors present a case of psoriasis and concurrent digestive system abnormalities, and review the literature regarding the topic. A 40-year-old man suffered from an exacerbation of exudative psoriasis for about 6 months. Topical anti...

  11. Increased risk of aortic valve stenosis in patients with psoriasis

    DEFF Research Database (Denmark)

    Khalid, Usman; Ahlehoff, Ole; Gislason, Gunnar Hilmar

    2015-01-01

    AIM: Psoriasis is a chronic inflammatory disease associated with increased risk of cardiovascular disease including atherosclerosis. The pathogenesis of aortic valve stenosis (AS) also includes an inflammatory component. We therefore investigated the risk of AS in patients with psoriasis compared...... with mild and severe disease, respectively. CONCLUSION: In a nationwide cohort, psoriasis was associated with a disease severity-dependent increased risk of AS. The mechanisms underlying this novel finding require further study....

  12. Autoimmune Disease in Children and Adolescents with Psoriasis

    DEFF Research Database (Denmark)

    Blegvad, Christoffer; Egeberg, Alexander; Tind Nielsen, Tilde E.

    2017-01-01

    Psoriasis is an immune-mediated inflammatory disease, which, in studies among adults, have been shown to cluster with autoimmune disease. The aim of this cross-sectional register study was to examine possible associations between 9 pre-selected autoimmune diseases and psoriasis in children...... arthritis (adjusted OR 6.61; 2.75-15.87) and vitiligo (adjusted OR 4.76; 1.71-13.20) showed strong associations with psoriasis. In addition to increased risk of selected autoimmune diseases, the presence of psoriasis was associated with increased risk of multiple concurrent autoimmune diseases compared...

  13. The sensitivity of patch test in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Yavuz Yeşilova

    2010-09-01

    Full Text Available Objectives: Allergic diseases play an important role in the natural course of psoriasis. Atopic sensitization and con-tact dermatitis are common in patients with psoriasis. Since the symptoms are prolonged in patients who are resistant to therapy and exposure to itchy and external factors are common among these patients, the effects of contact aller-gens on triggering psoriasis are investigated. Contact allergens have an important role in activation and remission of psoriasis. We aimed to investigate contact sensitization rates in patients with psoriasis in the study.Material and Methods: Contact sensitization was investigated with the application of European standard series in twenty patients with psoriasis, twenty patients with contact dermatitis, and twenty healthy persons. Results: Among the whole study cases, positivity rate of patch test against one allergen at least was 25%. rate of patch test was 25% in patients with psoriasis, 35% in patients with contact dermatitis, and 15% in healthy persons. There were no significant differences between the groups according to sensitization to one or more allergens (p>0.05. There were no significant difference in clinical subgroup of psoriatic patients according to contact sensitiza-tion (p>0.05. The allergens in patients with psoriasis on patch test were as the followings: phenyldiamine, potassium dichromat, nickel, and cobalt.Conclusion: We think that the patch test has a major role in the diagnosis and elimination of allergens in patients with the chronic and resistant diseases and palmoplantar and flexural psoriasis.

  14. Is chronic plaque psoriasis triggered by microbiota in the skin?

    Science.gov (United States)

    Fry, L; Baker, B S; Powles, A V; Fahlen, A; Engstrand, L

    2013-07-01

    There is a known association between psoriasis and Crohn disease (CD). Patients with CD are five times more likely to develop psoriasis, and, conversely, patients with psoriasis are more likely to develop CD. Many gastroenterologists now accept that CD results from a breakdown of immune tolerance to the microbiota of the intestine in genetically susceptible individuals. The microbiota of the skin have recently been investigated in psoriasis. Firmicutes was the most common phylum, and Streptococcus the most common genus identified. Beta-haemolytic streptococci have been implicated in both guttate and chronic plaque psoriasis. Furthermore, the innate immune system has been shown to be activated in psoriasis, and many of the genes associated with the disease are concerned with the signalling pathways of the innate immune system, notably interleukin-23 and nuclear factor κB. Patients with psoriasis also have an increased incidence of periodontitis, a disease thought to be due to an abnormal response to normal oral commensals. Based on the similarities between CD and psoriasis, we propose that psoriasis is due to a breakdown of immune tolerance to the microbiota of the skin. In support of this hypothesis we provide evidence for microbiota in the skin, activation of the innate immune system, and genetic abnormalities involving the innate immune system. © 2013 The Authors BJD © 2013 British Association of Dermatologists.

  15. "Inflammatory skin march" in atopic dermatitis and psoriasis.

    Science.gov (United States)

    Furue, Masutaka; Kadono, Takafumi

    2017-10-01

    Comorbidities of cardiovascular diseases (CVDs), metabolic syndrome and autoimmune diseases with systemic inflammation are recent topics in medicine. Inflammatory skin diseases such as atopic dermatitis and psoriasis are an active source of diverse proinflammatory cytokines and chemokines, which are readily detectable in the circulation and are likely to be involved in developing comorbidities. Both atopic dermatitis and psoriasis are frequently comorbid with CVD, metabolic syndrome and autoimmune diseases, the consequence of which is called "inflammatory skin march", "psoriatic march" or "march of psoriasis". In this review, we summarize the epidemiological evidence and pathogenetic concepts regarding inflammatory skin march in atopic dermatitis and psoriasis.

  16. Heritability of psoriasis in a large twin sample.

    Science.gov (United States)

    Lønnberg, A S; Skov, L; Skytthe, A; Kyvik, K O; Pedersen, O B; Thomsen, S F

    2013-08-01

    Previous twin studies have shown greater concordance rates for psoriasis in MZ than in DZ twins, and heritability estimates between 66% and 90%. This supports a genetic influence on psoriasis, but also highlights the fact that genes are not the only explanation for the disease. To study the concordance of psoriasis in a population-based twin sample. Data on psoriasis in 10 725 twin pairs, aged 20-71 years, from the Danish Twin Registry was collected via a questionnaire survey. The concordance and heritability of psoriasis were estimated. In total, 4·1% of the men and 4·2% of the women had a lifetime history of psoriasis. The proband-wise concordance for psoriasis was larger in monozygotic than in dizygotic twins, 0·33 vs. 0·17. Genetic factors explained 68% (60-75%) of the variation in the susceptibility to psoriasis, whereas the rest of the variation was explained by nonshared environmental factors. The results confirm that psoriasis is a complex multifactorial disease controlled by both exogenous and endogenous factors. © 2013 The Authors BJD © 2013 British Association of Dermatologists.

  17. Contemporary management of moderate to severe plaque psoriasis.

    Science.gov (United States)

    Wu, Jashin J

    2017-12-01

    Psoriasis is a multisystem inflammatory disease that is often underdiagnosed, leaving many patients untreated. Plaque psoriasis, the most common form of the disease, affects approximately 80% to 90% of patients with psoriasis. Formulating a treatment plan can be complicated when various factors are considered. For example, type of therapy is dependent on the severity of the disease. Topical agents are preferred for mild disease, while phototherapy alone or in combination with systemic agents is recommended for the treatment of moderate to severe plaque psoriasis. Traditional systemic agents have the convenience of oral dosing; however, their toxicity profile can be a limiting factor. Newer biologic agents haven proven efficacious, if not superior to traditional oral agents, but their high cost can be a substantial disadvantage. Psoriasis has also been associated with increased risk of developing comorbidities, such as cardiovascular disease, obesity, and psoriatic arthritis, all of which increase the patient's overall mortality and further worsen their overall physical well-being. Management of these comorbidities is often overlooked. Moreover, psoriasis may affect a patient's psychological and social well-being. Patients with psoriasis are at a higher risk of developing clinical depression than patients without psoriasis. Inadequate management of comorbidities inevitably leads to poor outcomes, which increases the economic burden to the patient and society. Prevention and management of comorbidities, including cardiovascular and mental health, must be addressed as a part of a patient's overall treatment plan. Specialist coordination may be beneficial for patients with psoriasis. Improved patient care may lead to better clinical and economical outcomes.

  18. Epidemiology and treatment of psoriasis: a Brazilian perspective

    Directory of Open Access Journals (Sweden)

    Duarte GV

    2015-04-01

    Full Text Available Gleison V Duarte,1 Larissa Porto-Silva,2 Maria de Fátima Paim de Oliveira1 1Dermatology Department, Federal University of Bahia, Salvador, 2Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil Abstract: Psoriasis is a chronic immune-mediated systemic disease that is influenced by genetic and environmental factors, is associated with comorbidities, and has a negative impact on the quality of life of affected individuals. The prevalence of psoriasis varies among different ethnic groups, but this topic has not been studied in Brazil to date. In this review, we evaluate the epidemiology and treatment of psoriasis from a Brazilian perspective. We focused on studies that involved Brazilian subjects. The prevalence of psoriasis in Brazil is estimated to be 2.5%, but no population study has been performed previously. Environmental factors, such as tropical climate, in association with genetic factors, such as miscegenation, may exert a beneficial impact on the course and frequency of psoriasis in Brazil. A number of studies have advanced our understanding of the cardiovascular, ophthalmic, and oral comorbidities that are associated with psoriasis. Concerns about biological therapy, such as endemic leprosy, human T-cell lymphotropic virus (HTLV, and tuberculosis infections, are discussed. The nonavailability of treatment options for psoriasis in the public health system contradicts the Brazilian Society of Dermatology guidelines, stimulating the judicialization of access to medicines in psoriasis care. Keywords: psoriasis, epidemiology, comorbidities, health services accessibility, health care disparities, insurance, health care costs

  19. Methotrexate treatment provokes apoptosis of proliferating keratinocyte in psoriasis patients.

    Science.gov (United States)

    Elango, Tamilselvi; Thirupathi, Anand; Subramanian, Swapna; Ethiraj, Purushoth; Dayalan, Haripriya; Gnanaraj, Pushpa

    2017-08-01

    Psoriasis is a chronic inflammatory skin disease characterized by hyper proliferation of keratinocytes. Recent data show that the epidermis thickening in psoriasis may be related to imbalance of homeostasis caused by abnormal apoptotic process. Maintenance of keratinocyte apoptotic process is very important in psoriasis. Methotrexate (MTX) has been used for many years to restore the normal skin in psoriasis condition. However, the exact mechanism of MTX in psoriasis condition is poorly understood. The aim of this study was to examine the role of MTX on keratinocyte apoptosis pathway in psoriasis patients. A total of 58 psoriasis vulgaris patients were recruited for this study. Nonlesional skin biopsies served as control. Skin biopsies of psoriatic patients were collected and analyzed for cytosolic, mitochondria and total cytochrome c by ELISA. Expression of caspase-9, NFκBp65, pAkt1 by western blot, real-time PCR and immunohistochemical analysis of c-FLIP protein was analyzed in nonlesional and lesional skin biopsies before (day 0) and after (at the end of 6 and 12 weeks) MTX treatment. After MTX treatment, a significant increase in cytochrome c was observed when compared with before MTX treatment in psoriasis patients (p psoriasis by controlling the acanthosis.

  20. Association analysis identifies ZNF750 regulatory variants in psoriasis

    Directory of Open Access Journals (Sweden)

    Birnbaum Ramon Y

    2011-12-01

    Full Text Available Abstract Background Mutations in the ZNF750 promoter and coding regions have been previously associated with Mendelian forms of psoriasis and psoriasiform dermatitis. ZNF750 encodes a putative zinc finger transcription factor that is highly expressed in keratinocytes and represents a candidate psoriasis gene. Methods We examined whether ZNF750 variants were associated with psoriasis in a large case-control population. We sequenced the promoter and exon regions of ZNF750 in 716 Caucasian psoriasis cases and 397 Caucasian controls. Results We identified a total of 47 variants, including 38 rare variants of which 35 were novel. Association testing identified two ZNF750 haplotypes associated with psoriasis (p ZNF750 promoter and 5' UTR variants displayed a 35-55% reduction of ZNF750 promoter activity, consistent with the promoter activity reduction seen in a Mendelian psoriasis family with a ZNF750 promoter variant. However, the rare promoter and 5' UTR variants identified in this study did not strictly segregate with the psoriasis phenotype within families. Conclusions Two haplotypes of ZNF750 and rare 5' regulatory variants of ZNF750 were found to be associated with psoriasis. These rare 5' regulatory variants, though not causal, might serve as a genetic modifier of psoriasis.

  1. Psoriasis lesions are associated with specific types of emotions. Emotional profile in psoriasis.

    Science.gov (United States)

    Martín-Brufau, Ramón; Romero-Brufau, Santiago; Martín-Gorgojo, Alejandro; Brufau Redondo, Carmen; Corbalan, Javier; Ulnik, Jorge

    2015-01-01

    At present there is still controversy about the relationship between emotional stress and psoriasis lesions. Most of the published literature does not include the broad spectrum of emotional response. The aim of this study was to evaluate the association between skin lesions and emotional state in a large sample of patients with psoriasis. 823 psoriasis patients were recruited (mean age 45.9 years, 55.7% female) and answered two online questionnaires: lesion severity and current extension were evaluated using a self-administered psoriasis severity index (SAPASI); emotional state was assessed using the positive and negative affect schedule (PANAS). Second order factors were calculated and correlated with the SAPASI. We found positive associations between the extent and severity of skin lesions and the negative and submissive emotions, a negative correlation with dominance emotions and no association with positive emotions. Our data supports the relationship between emotions and skin lesions. It also allows for discrimination of the associations between psoriasis lesions and the specific type of emotions.

  2. Insight into psoriasis management: commercial perspectives for the U.S. psoriasis market.

    Science.gov (United States)

    Tran, Bryant; Feldman, Steven R

    2011-02-01

    Psoriasis is a chronic skin condition that has a significant impact on quality of life, self-esteem and comorbidities. Management of this condition is complicated and heavily influenced by psychosocial and economic realities. Addressing psychosocial and treatment education issues can be facilitated by use of the National Psoriasis Foundation. Localized disease is generally treated with topical treatment for which good generic medications are available. Somewhat higher priced branded vehicles are helpful for enhancing patients' treatment adherence, and may help avoid the need for far more toxic and expensive systemic treatment. Patients with extensive disease are best managed with phototherapy as a first-line option, and there is room for improvement in how insurers promote the use of this approach. Biologic treatments continue to offer new, safer options for patients with severe disease, albeit at higher cost. This review addresses practical issues in psoriasis management that would be of interest to organizations that are involved in the delivery of care for patients with psoriasis, such as managed care pharmacists and pharmaceutical companies that develop products for psoriasis.

  3. Genetic polymorphisms associated with psoriasis and development of psoriatic arthritis in patients with psoriasis.

    Science.gov (United States)

    Loft, Nikolai Dyrberg; Skov, Lone; Rasmussen, Mads Kirchheiner; Gniadecki, Robert; Dam, Tomas Norman; Brandslund, Ivan; Hoffmann, Hans Jürgen; Andersen, Malene Rohr; Dessau, Ram Benny; Bergmann, Ann Christina; Andersen, Niels Møller; Abildtoft, Mikkel Kramme; Andersen, Paal Skytt; Hetland, Merete Lund; Glintborg, Bente; Bank, Steffen; Vogel, Ulla; Andersen, Vibeke

    2018-01-01

    Psoriasis (PsO) is a chronic inflammatory disease with predominantly cutaneous manifestations. Approximately one third of patients with PsO develop psoriatic arthritis (PsA), whereas the remaining proportion of patients has isolated cutaneous psoriasis (PsC). These two phenotypes share common immunology, but with different heredity that might in part be explained by genetic variables. Using a candidate gene approach, we studied 53 single nucleotide polymorphisms (SNPs) in 37 genes that regulate inflammation. In total, we assessed 480 patients with PsO from DERMBIO, of whom 151 had PsC for 10 years or more (PsC10), 459 patients with PsA from DANBIO, and 795 healthy controls. Using logistic regression analysis, crude and adjusted for age and gender, we assessed associations between genetic variants and PsO, PsC10, and PsA, as well as associations between genetic variants and development of PsA in PsO. Eleven polymorphisms in 10 genes were nominally associated with PsO and/or PsC and/or PsA (P psoriasis, two SNPs in the IL12B and TNF genes were associated with susceptibility of psoriasis. None of the SNPs were specifically associated with isolated cutaneous psoriasis or psoriatic arthritis.

  4. Angiogenesis Regulates Prostate Cancer Metastasis

    National Research Council Canada - National Science Library

    Pettaway, Curtis

    1999-01-01

    .... We are evaluating the relationship of the expression of the angiogenesis factors bFGF, VEGF, and IL-8 with prostate cancer growth and metastasis, using our orthotopic model of metastatic prostate cancer in nude mice...

  5. Oral candidiasis in patients with psoriasis: correlation of oral examination and cytopathological evaluation with psoriasis disease severity and treatment.

    Science.gov (United States)

    Picciani, Bruna Lavinas Sayed; Michalski-Santos, Bruna; Carneiro, Sueli; Sampaio, Ana Luisa; Avelleira, Joao Carlos Regazzi; Azulay, David Rubem; Pinto, Jane Marcy Neffa; Dias, Eliane Pedra

    2013-06-01

    Infections are known to trigger and exacerbate psoriasis. Although oral candidiasis is often clinically diagnosed, it is not always confirmed by laboratory tests such as oral cytopathology. The aims of this study were to determine the prevalence of oral candidiasis in patients with psoriasis through clinical and cytopathological diagnosis and to investigate the association between oral candidiasis and psoriasis with regards to the severity of the clinical presentation and the type of treatment for psoriasis. A total of 140 patients with psoriasis and 140 healthy control subjects received an oral examination. Scrapings of the tongue were also obtained for a cytopathological examination. The oral examination and the results of the cytopathological smear revealed 37 (26%) cases of candidiasis in the patients with psoriasis and no cases of candidiasis in the healthy control subjects. There was no correlation between the type of psoriasis treatment and the presence of oral candidiasis (P = .616). There was a statistically significant association (P = .033) between the clinical severity of psoriasis and the presence of Candida. This study was limited by the small number of subjects and the lack of follow-up to determine the development of psoriasis after treatment for oral candidiasis. The presence of oral candidiasis is higher in patients with psoriasis and it is associated with disease severity. This increased presence of oral candidiasis was apparent despite any type of treatment for the psoriasis. Cytopathology to rule out oral candidiasis should be used in the routine medical workup of patients with psoriasis. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  6. Insulin Test

    Science.gov (United States)

    ... Syndrome Staph Infections and MRSA Stroke Testicular Cancer Thalassemia Thyroid Cancer Thyroid ... Get Tested? To help evaluate insulin production by the beta cells in the pancreas; to help diagnose the ...

  7. Insulin Basics

    Science.gov (United States)

    ... for Association Events Messaging Tools Recruiting Advocates Local Market Planning Training Webinars News & Events Advocacy News Call ... be imported for personal use. Inside the pancreas, beta cells make the hormone insulin. With each meal, ...

  8. Getting under the skin: Report from the International Psoriasis Council workshop on the role of stress in psoriasis

    Directory of Open Access Journals (Sweden)

    Julia eSchwartz

    2016-02-01

    Full Text Available Psoriasis is a chronic inflammatory skin condition with significant physical and psychosocial comorbidity. A workshop of leading experts in dermatology and psychology with the purpose of better understanding the current role of psychological comorbidities in psoriasis was held by the International Psoriasis Council in November 2013. The role of stress reactivity with a focus on the hypothalamic-pituitary-adrenal axis was emphasized. While cognitive behavioral therapy remains the most extensively studied and successful treatment strategy in patients with psoriasis and various psychological comorbidities, new and innovative interventions such as online-based therapies have recently emerged. Strategies and recommendations towards approaching psychological comorbidities are discussed.

  9. TRACE ELEMENTS HOMEOSTATIC IMBALANCE IN MILD AND SEVERE PSORIASIS: A NEW INSIGHT IN BIOMARKER DIAGNOSTIC VALUE FOR PSORIASIS

    Directory of Open Access Journals (Sweden)

    Nagat Sobhy Mohamad

    2013-10-01

    Full Text Available Introduction: The pathogenesis of psoriasis remains elusive and is a subject of interest to clinicians and scientists. Many studies have thrown light on the etiopathogenesis of psoriasis at both molecular and tissue concentrations. Of these, the role of trace metals has been of interest. Objective: To evaluate the possible role of trace elements in mild and severe psoriasis. Patients: Sixty patients suffering from psoriasis were included in the study and 30 healthy subject served as a control. Methods: Serum sample analysis for some trace elements namely Na, K, Ca, P, Cu, Zn, and Fe using inductively coupled plasma-atomic emission spectroscopy (ICP-AES. In psoriatic patients and control, the severity of psoriasis was assessed by psoriasis area severity score (PASI score. Results: In psoriatic patients the level of serum calcium and zinc were diminished while the level of serum copper, iron and organic phosphorous were increased. These changes were significantly evident in severe psoriasis compared to control and mild psoriasis (P<0.05. Conclusions: There may be a role for trace elements in the etiopathogenesis of psoriasis.

  10. A dramatic response to a single dose of infliximab in a patient with prolonged pustular psoriasis derived from inverse psoriasis.

    Science.gov (United States)

    Li, Mengmeng; Dai, Weiwei; Yan, Wei; Liu, Yuanzhen; Wang, Lian; Li, Wei

    2017-07-01

    We report a case of a 25-year-old Chinese man with an exceptionally prolonged history of pustular psoriasis derived from inverse psoriasis who was unsatisfied with conventional treatment and was successfully treated with a single dose of infliximab without noticeable adverse effects. No recurrence or flaring was observed after 3 months of follow-up. This case illustrates that infliximab may be an effective and safe therapeutic option for patients with refractory pustular psoriasis derived from inverse psoriasis. © 2017 Wiley Periodicals, Inc.

  11. Hypereosinophilia in erythrodermic psoriasis: superimposed scabies.

    Science.gov (United States)

    Harman, Mehmet; Uçmak, Derya; Akkurt, Zeynep M; Türkçü, Gül

    2014-09-01

    Scabies is a common ectoparasitic disease that can be diagnosed based on the presence of pruritus and typical clinical signs including burrows, vesicles, and erythematous papules. If a desquamative disease such as psoriasis precedes scabies, then the disease course may be altered. Pruritus may be absent and typical scabies lesions may be concealed due to the preexisting disease, resulting in delayed diagnosis. We present 2 cases of scabies in a brother and sister with erythrodermic psoriasis. In both cases peripheral hypereosinophilia suggested scabies. In patients with erythematous scaly inflammatory skin diseases who are treated with immunosuppressive agents, peripheral eosinophilia also could suggest scabies; therefore, a search for sarcoptic mites in skin scrapings should be undertaken.

  12. Are biologics useful for nail psoriasis?

    Directory of Open Access Journals (Sweden)

    Andrea Antúnez-Lay

    2016-03-01

    Full Text Available Además de comprometer la piel, la psoriasis puede comprometer las uñas y las estructuras adyacentes. Si bien se dispone de diversas alternativas de terapia existe gran interés por la terapia biológica, aunque no existe consenso sobre su rol. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos dos revisiones sistemáticas que en conjunto incluyen tres estudios aleatorizados. Extrajimos los datos relevantes y realizamos tablas de resumen de los resultados utilizando el método GRADE. Concluimos que no está claro si la terapia biológica es superior al placebo en el tratamiento de psoriasis ungueal porque la certeza de la evidencia existente es muy baja.

  13. Selected aspects of apoptosis in psoriasis

    Directory of Open Access Journals (Sweden)

    Hanna Myśliwiec

    2017-03-01

    Full Text Available Apoptosis is a physiological mechanism of programmed cell death, in contrast to necrosis, without eliciting an inflammatory response. It plays the key role in the functioning of different tissues and organs. The balance between proliferation and apoptosis of keratinocytes is important for epidermal maintenance of homeostasis. Dysfunctional apoptosis plays an important role in the development of several skin disorders. Diseases with an increase of apoptosis are usually acute, while those with inhibited apoptosis tend to be chronic. Psoriasis is an immune-mediated chronic inflammatory skin disease. It is characterized by keratinocyte hyperproliferation and abnormal differentiation. Psoriatic keratinocytes are resistant to apoptosis and this phenomenon can be the key event in psoriatic hyperplasia. Apoptosis disturbances can also affect immune cells involved in the pathogenesis of psoriasis. In this review, we describe the basic concept of apoptosis and its relevance in psoriatic pathogenesis.

  14. Is psoriasis a T-cell disease?

    Science.gov (United States)

    Nickoloff, B J; Schröder, J M; von den Driesch, P; Raychaudhuri, S P; Farber, E M; Boehncke, W H; Morhenn, V B; Rosenberg, E W; Schön, M P; Holick, M F

    2000-10-01

    The etiology and pathogenesis of psoriasis--one of the most common chronic, inflammatory, hyperproliferative skin disorders of man--have long fascinated dermatologists, pathologists and biologists alike. Here, we have a model disease that offers to study neuroectodermal-mesenchymal interactions in the widest sense possible. Epithelial, endothelial, and hematopoietic cells as well as neurons projecting into the skin apparently all interact with each other to generate the characteristic psoriatic lesion. For decades, the ongoing controversy on the molecular nature, choreography and hierarchy of these complex interactions e.g. between epidermal keratinocytes, T cells, neurotrophils, endothelial cells and sensory nerves has served as a driving force propelling investigative dermatology to ever new horizons. This debate has not only been at the heart of our quest to develop more effective forms of therapy for this socially crippling disease, but it also has profoundly influenced how we view the skin as a whole: the numerous competing theories on the pathogenesis of psoriasis published so far also are reflections on the evolution of mainstream thought in skin biology over the last decades. These days, conventional wisdom infatuated with a T-cell-centered approach to inflammatory skin diseases-- portrays psoriasis as an autoimmune disease, where misguided T lymphocyte activities cause secondary epithelial abnormalities. And yet, as this CONTROVERSIES feature reminds us, some authoritative "pockets of academic resistance" are still quite alive, and interpret psoriasis e.g. as a genetically determined, abnormal epithelial response pattern to infectious and/or physicochemical skin insults. Weighing the corresponding lines of argumentation is not only an intriguing, clinically relevant intellectual exercise, but also serves as a wonderful instrument for questioning our own views of the skin universe and its patterns of deviation from a state of homeostasis.

  15. Is the diet important for psoriasis?

    Directory of Open Access Journals (Sweden)

    Agnieszka Owczarczyk-Saczonek

    2014-09-01

    Full Text Available Psoriasis is a systemic disease, associated with the occurrence of metabolic disorders (obesity, diabetes, hyperuricemia, lipid disorders and rapid development of atherosclerosis; therefore diet can be an important adjuvant therapy. A low-calorie diet is an important complement treatment of patients with psoriasis, particularly those with concomitant obesity. There are a lot of studies indicating that obesity is a risk factor for psoriasis and vice versa. Visceral adipose tissue produces numerous proinflammatory cytokines (TNF-α, IL-6, Il-8, Il-17, Il-18, the same ones that participate in development of psoriatic lesions. Important factors in the diet are the essential polyunsaturated omega-3 fatty acids. They have an anti-inflammatory effect because they inhibit the production of proinflammatory cytokines (I-1b, IL-6, IL-8, TNF-α and adhesion molecules (ICAM-1, VCAM-1. In addition, supplementation of omega-3 and natural antioxidants in the diet may help to reduce "oxidative stress" and systemic inflammation. The use of a gluten-free diet is controversial, but in patients with positive anti gliadin antibodies it seems justified. An essential element of the procedure is to avoid alcohol and all its forms and stimulants that have pro-inflammatory effects. We should advise our patients to avoid grapefruit juice during treatment with cyclosporine and limit the supply of simple sugars, animal fats and alcohol during treatment with retinoids. Dietary recommendations for patients with psoriasis are an important part of a holistic approach to patients who expect comprehensive care, not just the prescription.

  16. General measures and quality of life issues in psoriasis

    Directory of Open Access Journals (Sweden)

    Rashmi Sarkar

    2016-01-01

    Full Text Available Psoriasis generally does not affect survival but has significant detrimental effect on quality of life (QOL, which may be comparable to that of ischemic heart disease, diabetes, depression, and cancer. The foremost important thing in the management of psoriasis is counseling of the patient. The clinician needs to be empathetic and spend adequate time with the patient and educating the patient about psoriasis. Clinicians should make it clear to the patient that the primary goal of treatment is control of the disease rather than cure. Eating a balanced and low glycemic diet could be an important adjuvant factor in the prevention and treatment of moderate nonpustular psoriasis. Obese people are more likely to have severe psoriasis and psoriatic arthritis than people with an average body mass index. Dietary supplementation with oily fish, rich in n-3 fatty acids, in psoriasis had shown mixed results in trials. Promising results have been documented for parenteral application of n-3 fatty acid, but not with oral supplementation. Increased smoking or alcohol abuse increases the risk of developing psoriasis and may influence disease severity, and hence must be avoided. Soaking in warm water with bath oil can be done in extensive psoriasis for hydration and emollient effect, and bland soaps or soap substitutes should be used; antiseptics should be avoided as they may irritate the skin. Relatively small, localized patches of psoriasis may improve with occlusion, i.e., waterproof adhesive dressings. The use of emollients is an internationally accepted standard adjunctive to the treatment of psoriasis. Dermatology Life Quality Index is a psychometrically sound and responsive measure of psoriasis-specific outcomes and most comprehensively captures the impact of clinical signs and symptoms on patient's well-being.

  17. Psoriasis and cardiometabolic traits: modest association but distinct genetic architectures

    Science.gov (United States)

    Koch, Manja; Baurecht, Hansjörg; Ried, Janina S.; Rodriguez, Elke; Schlesinger, Sabrina; Volks, Natalie; Gieger, Christian; Rückert, Ina-Maria; Heinrich, Luise; Willenborg, Christina; Smith, Catherine; Peters, Annette; Thorand, Barbara; Koenig, Wolfgang; Lamina, Claudia; Jansen, Henning; Kronenberg, Florian; Seissler, Jochen; Thiery, Joachim; Rathmann, Wolfgang; Schunkert, Heribert; Erdmann, Jeanette; Barker, Jonathan; Nair, Rajan P; Tsoi, Lam C; Elder, James T; Mrowietz, Ulrich; Weichenthal, Michael; Mucha, Sören; Schreiber, Stefan; Franke, Andre; Schmitt, Jochen; Lieb, Wolfgang; Weidinger, Stephan

    2015-01-01

    Psoriasis has been linked to cardiometabolic diseases, but epidemiological findings are inconsistent. We investigated the association between psoriasis and cardiometabolic outcomes in a German cross-sectional study (n=4.185) and a prospective cohort of German Health Insurance beneficiaries (n=1.811.098). A potential genetic overlap was explored using genome-wide data from >22.000 coronary artery disease (CAD) and >4.000 psoriasis cases, and with a dense genotyping study of cardiometabolic risk loci on 927 psoriasis cases and 3.717 controls. Controlling for major confounders, in the cross-sectional analysis psoriasis was significantly associated with type 2 diabetes (T2D, adjusted odd’s ratio OR=2.36; 95% confidence interval CI=1.26–4.41) and myocardial infarction (MI, OR=2.26, 95% CI=1.03–4.96). In the longitudinal study, psoriasis slightly increased the risk for incident T2D (adjusted relative risk RR=1.11; 95%CI=1.08–1.14) and MI (RR=1.14; 95%CI=1.06–1.22), with highest risk increments in systemically treated psoriasis, which accounted for 11 and 17 excess cases of T2D and MI per 10,000 person-years. Except for weak signals from within the MHC, there was no evidence for genetic risk loci shared between psoriasis and cardiometabolic traits. Our findings suggest that psoriasis, in particular severe psoriasis, increases risk for T2D and MI, and that the genetic architecture of psoriasis and cardiometabolic traits is largely distinct. PMID:25599394

  18. Causes of mortality in patients with psoriasis in Malaysia - Evidence from the Malaysian Psoriasis Registry.

    Science.gov (United States)

    Kwan, Z; Yeoh, C A; Mohd Affandi, A; Alias, F A; Hamid, M; Baharum, N; Yong, A S W; Baba, R

    2015-10-01

    Patients with severe psoriasis, namely those requiring phototherapy or systemic treatment, have an increased risk of death. The aim of this study was to determine the prevalence, aetiology and risk factors for mortality among adult patients aged 18 years and above with psoriasis in Malaysia. This was a retrospective study involving adult patients notified by dermatologists to the Malaysian Psoriasis Registry between July 2007 and December 2013. Data were cross-checked against the National Death Registry. Patients certified dead were identified and the cause of death was analysed. Multivariate analysis using multiple logistic regression were conducted on potential factors associated with higher risk of mortality. A total of 419 deaths were identified among the 9775 patients notified. There were four significant risk factors for higher mortality: age>40 years (age 41-60 years old, Odds Ratio (OR) 2.70, 95%CI 1.75, 4.18; age>60 years OR 7.46, 95%CI 4.62, 12.02), male gender (OR 1.72, 95%CI 1.33,2.22), severe psoriasis with body surface area (BSA) >10% (OR 1.52, 95%CI 1.19, 1.96) and presence of at least one cardiovascular co-morbidity (OR 1.67, 95% CI 1.30, 2.14). Among the 301 patients with verifiable causes of death, the leading causes were infection (33.9%), cardiovascular disease (33.6%) and malignancy (15.9%). Infection was the leading cause of death among psoriasis patients in Malaysia. Although cardiovascular diseases are well-known to cause significant morbidity and mortality among psoriasis patients, the role of infections and malignancy should not be overlooked.

  19. Anti-insulin antibody test

    Science.gov (United States)

    Insulin antibodies - serum; Insulin Ab test; Insulin resistance - insulin antibodies; Diabetes - insulin antibodies ... You appear to have an allergic response to insulin Insulin no longer seems to control your diabetes

  20. Current developments in phototherapy for psoriasis.

    Science.gov (United States)

    Morita, Akimichi

    2018-03-01

    Phototherapy utilizes the beneficial effects of ultraviolet (UV) wavelengths to affect immunoregulatory functions. UV light phototherapy using narrowband UV-B (NB-UVB) and bath-psoralen UV-A (bath-PUVA) therapy are well-established treatments for psoriasis. Dual-action mechanisms of UV phototherapy have been identified: apoptosis and immune suppression. NB-UVB depletes pathogenic T cells by inducing apoptosis and regulatory T cells. Other wavelengths are also utilized for phototherapy, namely 308-nm excimer light and 312-nm flat-typed NB-UVB. Excimer light (308-nm) therapy effectively targets the affected skin without unduly exposing other areas and increases the levels of regulatory T cells. Phototherapy improves impaired resting regulatory T cells and increases activated regulatory T cells in patients with psoriasis. Intensive studies of phototherapy effects have led to several improvements in the design, protocols, and light sources, such as UV light-emitting diodes, thereby providing several options for patients with refractory skin disease, such as psoriasis. © 2018 Japanese Dermatological Association.

  1. 21 CFR 358.710 - Active ingredients for the control of dandruff, seborrheic dermatitis, or psoriasis.

    Science.gov (United States)

    2010-04-01

    ..., seborrheic dermatitis, or psoriasis. 358.710 Section 358.710 Food and Drugs FOOD AND DRUG ADMINISTRATION... Psoriasis § 358.710 Active ingredients for the control of dandruff, seborrheic dermatitis, or psoriasis. The... psoriasis. (1) Coal tar, 0.5 to 5 percent. When a coal tar solution, derivative, or fraction is used as the...

  2. Low-dose ciclosporin therapy of erythrodermic psoriasis

    Directory of Open Access Journals (Sweden)

    Ryszard Galus

    2014-07-01

    Full Text Available Psoriasis is a chronic, recurrent inflammatory skin disease which affects around 2% of the population and is characterized by erythematous and scaly macules and papules of greatly varying degree of involvement. Ciclosporin (Cs is a therapeutic agent rarely used in the treatment of erythrodermic psoriasis as a monotherapy [1].

  3. Cellular sources of IL-17 in psoriasis: a paradigm shift?

    NARCIS (Netherlands)

    Keijsers, R.R.M.C.; Joosten, I.; Erp, P.E.J. van; Koenen, H.J.P.M.; Kerkhof, P.C.M. van de

    2014-01-01

    Psoriasis is a common chronic inflammatory skin disease that results from interplay between the immune system and the epithelium. In the light of very successful anticytokine therapies for psoriasis, the focus has been directed towards the adaptive immune system. Expression studies, genetic studies

  4. Pustular psoriasis of pregnancy (impetigo herpetiformis)--case report.

    Science.gov (United States)

    Kondo, Rogerio Nabor; Araújo, Fernanda Mendes; Pereira, Allamanda Moura; Lopes, Vivian Cristina Holanda; Martins, Ligia Márcia Mario

    2013-01-01

    Impetigo herpetiformis is a rare dermatosis of pregnancy with typical onset during the last trimester of pregnancy and rapid resolution in the postpartum period. Clinically and histologically, it is consistent with pustular psoriasis. This similarity has led some authors to name the disease "the pustular psoriasis of pregnancy". We report the case of a patient who developed impetigo herpetiformis in two successive pregnancies.

  5. Increased expression of Th17 cytokines in patients with psoriasis

    African Journals Online (AJOL)

    AJL

    2012-02-16

    Feb 16, 2012 ... Psoriasis is a chronic inflammatory skin disease that is thought to be mediated by a new distinct type of T helper cell, called Th17 cells that play an essential pathogenic role in psoriasis. In this study, we measured serum levels of IL-17A and IL-23P19 in 43 psoriatic patients and 30 healthy control using.

  6. Isoforms of transferrin in psoriasis patients abusing alcohol

    NARCIS (Netherlands)

    P. Hoefkens (Peter); E.M. Higgins; R.J. Ward (Roberta); H.G. van Eijk (Henk)

    1997-01-01

    textabstractThe different isoforms of transferrin have been quantified by isoelectric focusing in the sera of psoriasis patients with and without a history of abusing alcohol. In both male and female psoriasis subjects abusing alcohol, there were significant increases in the

  7. Diprosone ointment in psoriasis | Ross | South African Medical Journal

    African Journals Online (AJOL)

    A double-blind trial which compared the effects of two topical steroids on 58 successive cases of psoriasis is reported. The investigations compared the efficacy and cosmetic acceptability ... of improvement in scaling observed by the investigator (P<0,080). The phenomenon of sweating in patches of psoriasis is discussed.

  8. Epidemiology and treatment of psoriasis: a Brazilian perspective.

    Science.gov (United States)

    Duarte, Gleison V; Porto-Silva, Larissa; de Oliveira, Maria de Fátima Paim

    2015-01-01

    Psoriasis is a chronic immune-mediated systemic disease that is influenced by genetic and environmental factors, is associated with comorbidities, and has a negative impact on the quality of life of affected individuals. The prevalence of psoriasis varies among different ethnic groups, but this topic has not been studied in Brazil to date. In this review, we evaluate the epidemiology and treatment of psoriasis from a Brazilian perspective. We focused on studies that involved Brazilian subjects. The prevalence of psoriasis in Brazil is estimated to be 2.5%, but no population study has been performed previously. Environmental factors, such as tropical climate, in association with genetic factors, such as miscegenation, may exert a beneficial impact on the course and frequency of psoriasis in Brazil. A number of studies have advanced our understanding of the cardiovascular, ophthalmic, and oral comorbidities that are associated with psoriasis. Concerns about biological therapy, such as endemic leprosy, human T-cell lymphotropic virus (HTLV), and tuberculosis infections, are discussed. The nonavailability of treatment options for psoriasis in the public health system contradicts the Brazilian Society of Dermatology guidelines, stimulating the judicialization of access to medicines in psoriasis care.

  9. Psoriasis and staphylococcus aureus skin colonization in Moroccan ...

    African Journals Online (AJOL)

    Psoriatic lesions are rarely complicated by recurrent infections. The aim of our study is to determine skin colonisation and nasal carriage of Staphylococcus aureus in patients with psoriasis and in healthy persons. Patients and methods: a comparative study that include 33 patients with psoriasis and 33 healthy persons.

  10. Increased expression of Th17 cytokines in patients with psoriasis ...

    African Journals Online (AJOL)

    Psoriasis is a chronic inflammatory skin disease that is thought to be mediated by a new distinct type of T helper cell, called Th17 cells that play an essential pathogenic role in psoriasis. In this study, we measured serum levels of IL-17A and IL-23P19 in 43 psoriatic patients and 30 healthy control using nested real time ...

  11. Self-management in daily life with psoriasis

    DEFF Research Database (Denmark)

    Rasmussen, Gitte Susanne; Maindal, Helle Terkildsen; Lomborg, Kirsten

    2012-01-01

    The aim of this integrative review is to identify and discuss patient needs for education to support self-management in daily life with psoriasis. As psoriasis increasingly gains recognition as a serious chronic autoimmune skin disease with long-term impairment on the life course, and not mainly...

  12. Analysis of time-varying psoriasis lesion image patterns

    DEFF Research Database (Denmark)

    Maletti, Gabriela Mariel; Ersbøll, Bjarne Kjær; Nielsen, Allan Aasbjerg

    2004-01-01

    The multivariate alteration detection transform is applied to pairs of within and between time varying registered psoriasis image patterns. Color band contribution to the variates explaining maximal change is analyzed.......The multivariate alteration detection transform is applied to pairs of within and between time varying registered psoriasis image patterns. Color band contribution to the variates explaining maximal change is analyzed....

  13. Psoriasis: A review of the role of serotonergic system

    African Journals Online (AJOL)

    STORAGESEVER

    2010-03-15

    Mar 15, 2010 ... sensitivity to gluten, a food allergen. Thus, treatment using gluten-free diet is considered one of the alternative thera- peutic approaches for patients with psoriasis (Wolters,. 2005). Psoriasis can also be provoked or exacerbated by a variety of diverse environmental factors, particularly infec- tions and drugs.

  14. High Body Mass Index in Adolescent Girls Precedes Psoriasis Hospitalization

    DEFF Research Database (Denmark)

    Bryld, L.E.; Sørensen, T.I.A.; Andersen, Klaus Kaae

    2010-01-01

    identified as having psoriasis, with at least one hospital admission. Multivariate analysis demonstrated an association between excess increase in body mass index and psoriasis in females only. Being overweight in adolescence was the main factor behind this observation. The female group showed a significant...

  15. Infliximab-induced intertriginous psoriasis in patient with Crohn's desease

    Directory of Open Access Journals (Sweden)

    Federica Mola

    2011-10-01

    Full Text Available Tumor necrosis factor-α (TNFα inhibition is an effective treatment of moderate-to-severe psoriasis and other diseases (rheumatoid arthritis, ankylosing spondylitis, psoriasis or Crohn’s disease. We report a case of a 32- years-old patient affected by Crohn’s disease since the age of 25 who started infliximab infusion after four years of treatment with prednisone and azathioprine per os without improvement. After the fifth infusion of infliximab, he developed a form of intertriginous psoriasis which was approached with topical steroid cream. The patient never presented psoriasis in the past. New onset of psoriasis in patients without history for skin diseases (as in our case is a quite uncommon complication of TNFα inhibitor therapy. The increased production of IFNα during TNFα inhibitor therapy is a possible pathophysiologic explanation for this paradoxical effect of the anti-TNFα.

  16. Paradoxical, Cupping-Induced Localized Psoriasis: A Koebner Phenomenon.

    Science.gov (United States)

    Vender, Reid; Vender, Ronald

    2015-01-01

    Cupping therapy is a traditional Chinese medicine used to heal psoriasis. The Koebner phenomenon is the occurrence of psoriatic lesions at the site of cutaneous injury. To describe the first case of biopsy-proven cupping-induced localized psoriasis, an example of the Koebner phenomenon. The histopathology of the lesions is described. A brief review of the literature regarding cupping therapy and its efficacy are discussed. A 45-year-old Asian male presented himself to the dermatology clinic for further treatment of his psoriasis. Four unusually circular plaques on the lower back were discovered. Pathologic diagnosis revealed an early lesion of psoriasis. on further inquiry, the patient admitted to undergoing a recent "cupping" procedure in an attempt to cure his condition. The efficacy of cupping therapy is controversial, and psoriatic patients may develop localized psoriasis through koebnerization as a result of cupping therapy rather than achieve desirable therapeutic benefits. © 2014 Canadian Dermatology Association.

  17. [The psychological and social support in patients with psoriasis].

    Science.gov (United States)

    Makara-Studzińska, Marta; Ziemecki, Piotr; Ziemecka, Anna; Partyka, Iwona

    2013-09-01

    The meaning of non medical forms of support in the treatment of psoriasis is discussed in the paper. Related with psoriasis negative self image and feeling of stigmatization cause various mental disorders. Stress, depression, mental condition affect the appearance of psoriasis. Because of numerous studies and identify the factors and relationships important for psoriasis, patients can take the appropriate psychological and social support. Relaxation techniques, cognitive-behavioral therapy and support groups have a positive effect on the treatment of psoriasis. They reduce the level of stress in the patient, learn emotional control, adequate self-esteem, which leads to the acceptance of the disease and improve the quality of life of the patient.

  18. Clinical improvement in psoriasis with specific targeting of interleukin-23

    DEFF Research Database (Denmark)

    Kopp, Tamara; Riedl, Elisabeth; Bangert, Christine

    2015-01-01

    Psoriasis is a chronic inflammatory skin disorder that affects approximately 2-3% of the population worldwide and has severe effects on patients' physical and psychological well-being. The discovery that psoriasis is an immune-mediated disease has led to more targeted, effective therapies; recent...... advances have focused on the interleukin (IL)-12/23p40 subunit shared by IL-12 and IL-23. Evidence suggests that specific inhibition of IL-23 would result in improvement in psoriasis. Here we evaluate tildrakizumab, a monoclonal antibody that targets the IL-23p19 subunit, in a three-part, randomized......, placebo-controlled, sequential, rising multiple-dose phase I study in patients with moderate-to-severe psoriasis to provide clinical proof that specific targeting of IL-23p19 results in symptomatic improvement of disease severity in human subjects. A 75% reduction in the psoriasis area and severity index...

  19. Frequency of electrocardiographic abnormalities in patients with psoriasis

    DEFF Research Database (Denmark)

    Hansen, Peter Riis; Juhl, Christian Rimer; Isaksen, Jonas Lynggaard

    2018-01-01

    Psoriasis is a chronic inflammatory disease associated with cardiovascular disease, for example, myocardial infarction, stroke, cardiovascular death, and arrhythmias. The resting electrocardiogram may carry prognostic information, but limited evidence is available of electrocardiographic findings...... in subjects with psoriasis. The electrocardiographic results were compared between 1,131 subjects with self-reported psoriasis and 18,397 controls participating in the Danish General Suburban Population Study (GESUS). The mean heart rate was marginally increased in patients with psoriasis (66 ± 11 vs 65 ± 11...... elevation in lead V1, electrocardiographic criteria for left ventricular hypertrophy, electrocardiographic signs of previous myocardial infarction, and premature ventricular or supraventricular complexes, respectively, were comparable between the 2 groups. In conclusion, psoriasis was associated...

  20. Gallstone Risk in Adult Patients with Atopic Dermatitis and Psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Andersen, Yuki M.F.; Gislason, Gunnar H.

    2017-01-01

    Adult atopic dermatitis (AD) is associated with overweight, obesity and cardiovascular diseases (CVD) in Americans, similarly to psoriasis, but no increased risk of CVD has been shown in European patients with AD. This study investigated the prevalence and risk of gallstones in adults with AD...... and in those with psoriasis as a proxy for obesity using nationwide data for all Danish citizens ≥ 30 years of age. Outcome was a diagnosis of gallstones. Odds ratios (ORs) were calculated by logistic regression (cross-sectional study) and hazard ratios (HRs) were estimated by Cox regression (cohort study.......14–1.23) for psoriasis. During follow-up, adjusted HRs were 0.72 (0.56–0.90) for AD and 1.10 (1.02–1.18) for psoriasis. The findings highlight important differences in obesity and lifestyle factors among patients with AD and those with psoriasis....

  1. Reactive Astrocytes in Brain Metastasis

    Directory of Open Access Journals (Sweden)

    David Wasilewski

    2017-12-01

    Full Text Available Brain metastasis, the secondary growth of malignant cells within the central nervous system (CNS, exceeds the incidence of primary brain tumors (i.e., gliomas by tenfold and are seemingly on the rise owing to the emergence of novel targeted therapies that are more effective in controlling extracranial disease relatively to intracranial lesions. Despite the fact that metastasis to the brain poses a unmet clinical problem, with afflicted patients carrying significant morbidity and a fatal prognosis, our knowledge as to how metastatic cells manage to adapt to the tissue environment of the CNS remains limited. Answering this question could pave the way for novel and more specific therapeutic modalities in brain metastasis by targeting the specific makeup of the brain metastatic niche. In regard to this, astrocytes have emerged as the major host cell type that cancer cells encounter and interact with during brain metastasis formation. Similarly to other CNS disorders, astrocytes become reactive and respond to the presence of cancer cells by changing their phenotype and significantly influencing the outcome of disseminated cancer cells within the CNS. Here, we summarize the current knowledge on the contribution of reactive astrocytes in brain metastasis by focusing on the signaling pathways and types of interactions that play a crucial part in the communication with cancer cells and how these could be translated into innovative therapies.

  2. Diabetes and Insulin

    Science.gov (United States)

    ... in the abdomen just behind the stomach, produces insulin. Insulin is a hormone that takes glucose from the ... occurs when the pancreas does not produce enough insulin or when the body doesn’t use insulin ...

  3. Insulin Resistance and Prediabetes

    Science.gov (United States)

    ... in the normal range. What happens with insulin resistance? In insulin resistance, muscle, fat, and liver cells do not ... they do not usually test specifically for insulin resistance. Insulin resistance can be assessed by measuring the level ...

  4. Association of Trabecular Bone Score with Inflammation and Adiposity in Patients with Psoriasis: Effect of Adalimumab Therapy

    Directory of Open Access Journals (Sweden)

    José L. Hernández

    2016-01-01

    Full Text Available Studies on trabecular bone score (TBS in psoriasis are lacking. We aim to assess the association between TBS and inflammation, metabolic syndrome features, and serum adipokines in 29 nondiabetic patients with psoriasis without arthritis, before and after 6-month adalimumab therapy. For that purpose, adjusted partial correlations and stepwise multivariable linear regression analysis were performed. No correlation was found between TBS and disease severity. TBS was negatively associated with weight, BMI, waist perimeter, fat percentage, and systolic and diastolic blood pressure before and after adalimumab. After 6 months of therapy, a negative correlation between TBS and insulin resistance (p=0.02 and leptin (p=0.01 and a positive correlation with adiponectin were found (p=0.01. The best set of predictors for TBS values at baseline were female sex (p=0.015, age (p=0.05, and BMI (p=0.001. The best set of predictors for TBS following 6 months of biologic therapy were age (p=0.001, BMI (p<0.0001, and serum adiponectin levels (p=0.027. In conclusion, in nondiabetic patients with moderate-to-severe psoriasis, TBS correlates with metabolic syndrome features and inflammation. This association is still present after 6 months of adalimumab therapy. Moreover, serum adiponectin levels seem to be an independent variable related to TBS values, after adalimumab therapy.

  5. Correlation Between Dermatology Life Quality Index and Psoriasis Area and Severity Index in Patients with Psoriasis Treated with Ustekinumab

    DEFF Research Database (Denmark)

    Hesselvig, Jeanette Halskou; Egeberg, Alexander; Loft, Nikolai Dyrberg

    2018-01-01

    Monitoring of biological treatment efficacy for psoriasis is based on clinical evaluation and patient's quality of life. However, long-term correlation between Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) in real life has not been studied in patients treated...

  6. Smoking as a permissive factor of periodontal disease in psoriasis.

    Science.gov (United States)

    Antal, Márk; Braunitzer, Gábor; Mattheos, Nikos; Gyulai, Rolland; Nagy, Katalin

    2014-01-01

    Population-based studies have identified smoking as a pathogenetic factor in chronic periodontitis. At the same time, chronic periodontal disease has also been found to occur more often in persons suffering from psoriasis than in controls with no psoriasis. It is known that smoking aggravates both periodontal disease and psoriasis, but so far it has not been investigated how smoking influences the occurrence and severity of periodontal disease in psoriasis. A hospital-based study was conducted to investigate this question. The study population consisted of 82 psoriasis patients and 89 controls. All patients received a full-mouth periodontal examination, and a published classification based on bleeding on probing, clinical attachment level and probing depth was utilized for staging. Both patients and controls were divided into smoker and non-smoker groups, and the resulting groups were compared in terms of periodontal status. Beyond the descriptive statistics, odds ratios were computed. Psoriasis in itself increased the likelihood of severe periodontal disease to 4.373 (OR, as compared to non-smoker controls, psmoking increased it to 24.278 (OR, as compared to non-smoker controls, pperiodontal disease in psoriasis turned out to be six times higher in smokers than in non-smokers. The results of this study corroborate those of other studies regarding the link between psoriasis and periodontal disease, but they also seem to reveal a powerful detrimental effect of smoking on the periodontal health of psoriasis patients, whereby the authors propose that smoking may have a permissive effect on the development of severe periodontal disease in psoriasis.

  7. Generalized Pustular Psoriasis in Association with Squamous Cell Carcinoma of the Hypopharynx

    Directory of Open Access Journals (Sweden)

    Milicic Vesna

    2017-12-01

    Full Text Available Pustular psoriasis is an uncommon form of psoriasis consisting of widespread pustules on an erythematous background. Very rarely pustular psoriasis represent a paraneoplastic dermatosis. In this report we describe a case of generalized pustular psoriasis (GPP associated with advanced, inoperable, metastatic squamous cell carcinoma of the hypopharynx. We suggest that physicians should be alert for the worsening of existing psoriasis or formation of novel psoriasiform eruptions and should undertake clinical evaluation of possible neoplastic disease.

  8. Insulin Resistance

    DEFF Research Database (Denmark)

    Jensen, Benjamin Anderschou Holbech

    Insulin resistance (IR) is escalating with alarming pace and is no longer restricted to westernized countries. As a forerunner for some of the most serious threats to human health including metabolic syndrome, cardiovascular diseases, and type 2-diabetes, the need for new treatment modalities...... interventions. We further show that improving the inflammatory toning, using fish oil as fat source, protects mice against diet induced obesity and -inflammation while preserving insulin sensitivity, even in the absence of free fatty acid receptor 4. Conversely, HFD-induced intestinal dysbiosis is associated...

  9. Nodal metastasis in thyroid cancer

    International Nuclear Information System (INIS)

    Samuel, A.M.

    1999-01-01

    The biological behavior and hence the prognosis of thyroid cancer (TC) depends among other factors on the extent of spread of the disease outside the thyroid bed. This effect is controversial, especially for nodal metastasis of well differentiated thyroid carcinoma (WDC). Nodal metastasis at the time of initial diagnosis behaves differently depending on the histology, age of the patient, presence of extrathyroidal extension, and the sex of the individual. The type of the surgery, administration of 131 I and thyroxin suppression also to some extent influence the rate of recurrence and mortality. Experience has shown that it is not as innocuous as a small intrathyroidal tumor without any invasion outside the thyroid bed and due consideration should be accorded to the management strategies for handling patients with nodal metastasis

  10. Psoriasis and risk of diabetes-associated microvascular and macrovascular complications.

    Science.gov (United States)

    Armstrong, April W; Guérin, Annie; Sundaram, Murali; Wu, Eric Qiong; Faust, Elizabeth Sara; Ionescu-Ittu, Raluca; Mulani, Parvez

    2015-06-01

    Psoriasis's effect on diabetes onset is well documented, but its effect on course of diabetes is poorly understood. We sought to compare risks of developing microvascular and macrovascular complications between diabetic patients with and without psoriasis. Adults with 2 or more diabetes diagnoses selected from MarketScan databases (Truven Health Analytics Inc, Ann Arbor, MI) (2000-2006) were classified into 2 cohorts: 2 or more psoriasis diagnoses and without psoriasis diagnosis. Patients with psoriasis were matched using propensity score, and exactly matched using age, sex, and diabetes characteristics with patients without psoriasis. Outcomes were compared between cohorts using Cox regression models. In all, 6164 diabetic patients with psoriasis (27% moderate to severe) were matched to 6164 diabetic patients without psoriasis. Patients with psoriasis were significantly more likely to develop microvascular events than patients without psoriasis overall (hazard ratio [HR] 1.14, P HR 1.13, P = .004; moderate to severe: HR 1.16, P = .038). Risk of macrovascular events was higher for patients without psoriasis overall (HR 1.13, P = .001) and those with mild psoriasis (HR 1.15, P = .003), but not for moderate to severe cases (HR 1.10, P = .210). Psoriasis to diabetes association may be underestimated. Among diabetic patients, psoriasis is generally associated with higher rates of microvascular and macrovascular complications. Greater psoriasis severity did not increase risk of diabetic complications. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  11. Psoriasis and the risk of pneumonia: a population-based study.

    Directory of Open Access Journals (Sweden)

    Li-Ting Kao

    Full Text Available Psoriasis is a prevalent autoimmune disorder. Various studies have reported on the relationship between psoriasis and chronic diseases but very few have explored the association between psoriasis and subsequent acute infection. This retrospective cohort study aimed to compare the risk of pneumonia between subjects with and those without psoriasis.The medical records of 14,022 patients with psoriasis and 14,022 without psoriasis were obtained from the Taiwan Longitudinal Health Insurance Database 2000. Each patient was followed-up for a three-year period. Cox proportional hazard regressions were performed to compare difference of subsequent pneumonia incidence between subjects with and those without psoriasis.There were 206 (1.47% subjects with psoriasis and 138 (0.98% without psoriasis hospitalized for pneumonia. By Cox proportional hazard regressions analysis, the HR (hazard ratio of pneumonia requiring hospitalization for patients with psoriasis was 1.50 (95% confidence interval [CI]: 1.21-1.86 compared to patients without psoriasis. The adjusted HR was 1.40 (95% CI: 1.12-1.73. The adjusted HR of pneumonia hospitalization for subjects with mild and severe psoriasis was 1.36 (95% CI: 1.09-1.70 and 1.68 (95% CI: 1.12-2.52, respectively, compared to those without psoriasis.Patients with psoriasis have significantly higher incidence of pneumonia compared to those without psoriasis.

  12. Risk of malignancy with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment Registry.

    Science.gov (United States)

    Fiorentino, David; Ho, Vincent; Lebwohl, Mark G; Leite, Luiz; Hopkins, Lori; Galindo, Claudia; Goyal, Kavitha; Langholff, Wayne; Fakharzadeh, Steven; Srivastava, Bhaskar; Langley, Richard G

    2017-11-01

    The effect of systemic therapy on malignancy risk among patients with psoriasis is not fully understood. Evaluate the impact of systemic treatment on malignancy risk among patients with psoriasis in the Psoriasis Longitudinal Assessment and Registry (PSOLAR). Nested case-control analyses were performed among patients with no history of malignancy. Cases were defined as first malignancy (other than nonmelanoma skin cancer) in the Psoriasis Longitudinal Assessment and Registry, and controls were matched by age, sex, geographic region, and time on registry. Study therapies included methotrexate, ustekinumab, and tumor necrosis factor-α (TNF-α) inhibitors. Exposure was defined as 1 or more doses of study therapy within 12 months of malignancy onset and further stratified by duration of therapy. Multivariate conditional logistic regression, adjusted for potential confounders, was used to estimate odds ratios of malignancies associated with therapy. Among 12,090 patients, 252 malignancy cases were identified and 1008 controls were matched. Treatment with methotrexate or ustekinumab for more than 0 months to less than 3 months, 3 months to less than 12 months, or 12 months or longer was not associated with increased malignancy risk versus no exposure. Longer-term (≥12 months) (odds ratio, 1.54; 95% confidence interval, 1.10-2.15; P = .01), but not shorter-term treatment, with a TNF-α inhibitor was associated with increased malignancy risk. Cases and controls could belong to 1 or more therapy categories. Long-term (≥12 months) treatment with a TNF-α inhibitor, but not methotrexate and ustekinumab, may increase risk for malignancy in patients with psoriasis. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Estilos de personalidad en pacientes con psoriasis

    OpenAIRE

    Martín Brufau, Ramón; Corbalán Berná, Francisco Javier; Brufau Redondo, Carmen; Ramirez Andreo, Antonio; Limiñana Gras, Rosa María

    2010-01-01

    La relación entre las enfermedades de la piel y los factores psicológicos ha sido ampliamente documentada en la literatura científica. Dentro de las enfermedades de la piel con claro componente psicológico se encuentra la psoriasis. La correlación entre el agravamiento de las lesiones cutáneas y un aumento de los niveles de psicopatología en respuesta a eventos estresantes ha sido descrita anteriormente en esta enfermedad. Sin embargo, los estudios que comparan pe...

  14. Investigation of Relationship Between Parvovirus B19 Infection and Psoriasis

    Directory of Open Access Journals (Sweden)

    Mehmet Yıldırım

    2010-12-01

    Full Text Available Background and Design: Psoriasis is a common, chronic, relapsing skin disease, characterized by the formation of typical scaly papules or plaques. The three factors well-recognized as triggering the onset, causing new lesions or inducing a flare in the disease are: stress, skin injury and infection. Various microorganisms are associated with provocation and/or exacerbation of psoriasis. The aim of this study was to investigate the relationship between parvovirus B19 (PVB19 and psoriasis/psoriasis area severity index (PASI. Material and Method: Sixty patients with psoriasis (36 men, 24 women and 40 healthy volunteers (22 men, 18 women were included in our study. PVB19 DNA was quantified by real-time polymerase chain reaction. Results: PVB19 DNA was detected in 27 of 60 subjects in the patient group (45% and in 9 of 40 controls (22.5% (p0.05. The relationship between the viral load and the subtypes of psoriasis was not statistically significant (p>0.05.Conclusion: According to the results of this study, it was concluded that a relationship may be present between psoriasis and PVB 19 infection.

  15. Risk of psoriasis in patients with childhood asthma

    DEFF Research Database (Denmark)

    Egeberg, A; Khalid, U; Gislason, G H

    2015-01-01

    BACKGROUND: Psoriasis and asthma are disorders driven by inflammation. Psoriasis may carry an increased risk of asthma, but the reverse relationship has not been investigated. OBJECTIVES: To investigate the risk of psoriasis in subjects with childhood asthma in a nationwide Danish cohort. METHODS......, concomitant medication and comorbidity were estimated by Poisson regression models. RESULTS: There were 21,725 cases of childhood asthma and 6586 incident cases of psoriasis. There were 5697 and 889 incident cases of mild and severe psoriasis, respectively. The incidence rates of overall, mild and severe...... psoriasis were 4.49, 3.88 and 0.61 for the reference population, and 5.95, 5.18 and 0.83 for subjects with childhood asthma, respectively. The IRRs for overall, mild and severe psoriasis were 3.94 [95% confidence interval (CI) 2.16-7.17], 5.03 (95% CI 2.48-10.21) and 2.27 (95% CI 0.61-8.42) for patients...

  16. Abnormal epidermal barrier in the pathogenesis of psoriasis.

    Science.gov (United States)

    Wolf, Ronni; Orion, Edith; Ruocco, Eleonora; Ruocco, Vincenzo

    2012-01-01

    Almost 2 decades ago, Williams and Elias suggested a unifying concept for the pathogenesis of disorders of cornification, according to which the integrity of the epidermal barrier and its effective function is an important factor in the regulation of epidermal DNA synthesis. Interference with the barrier integrity or function will result in epidermal hyperplasia and may be the primary event leading to hyperproliferative skin diseases, such as psoriasis. We have analyzed alterations to several structures of the epidermal barrier that might be responsible for barrier dysfunction and thus lead to hyperproliferation of the epidermis in an attempt to repair the barrier and, as a result, might be inducers of psoriasis. There are several convincing reports indicating that inhibiting of epidermal transglutaminase may lead to epidermal hyperproliferation and that this stimulus might trigger psoriasis among genetically predisposed patients. Disturbance of epidermal barrier function caused by derangement of lipid or cholesterol or ceramide synthesis leads to increased DNA synthesis and epidermal hyperplasia and as a result might be an inducer of psoriasis. We could find little evidence to show that defective defense of the epidermis or an abnormal response of it to bacteria plays a role in the pathogenesis of psoriasis. Accumulating data indicate that there is an association of psoriasis and mutations of genes within the epidermal differentiation complex, which are crucial for the development, maturation, cornification, cross-linking, and terminal differentiation of the epidermis, called psoriasis susceptibility locus 4. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. An overview of acupuncture for psoriasis vulgaris, 2009-2014.

    Science.gov (United States)

    Xiang, Yu; Wu, Xing; Lu, Chuanjian; Wang, Kaiyi

    2017-05-01

    Psoriasis is a chronic, proliferative, and inflammatory skin disease which affects around 2-3% of the global population. Current pharmacotherapy is effective, however medication with safe and long-lasting therapeutic effects is needed. Acupuncture for psoriasis is widely used in China as well as other Asian countries, and is gradually becoming accepted globally. To determine the characteristics and advantages of acupuncture treatment for psoriasis, and to improve the clinical outcomes of this disease in the future, this review summarizes literature on acupuncture treatment for psoriasis published between 2009 and 2014. Databases search was conducted with the China National Knowledge Infrastructure (CNKI), MEDLINE, and PubMed databases over a time period ranging from January 2009 to December 2014. The condition term was "psoriasis" and the key intervention terms were "needling", "moxibustion", "auriculotherapy", "cupping and bloodletting therapy", "catgut embedding therapy", "point-injection therapy", "traditional Chinese medicine fumigation therapy", "fire needling therapy", and "vesiculation moxibustion". Languages were limited to English and Chinese. Therapeutic mechanisms, therapy, therapeutic characteristics, advantages and limits of acupuncture for psoriasis are discussed. The conclusion is that acupuncture therapies for psoriasis are simple, convenient, and effective, with long-lasting therapeutic effects as well as minimal side effects and toxicity.

  18. Psoriasis in childhood: effective strategies to improve treatment adherence.

    Science.gov (United States)

    Shah, Kara N; Cortina, Sandra; Ernst, Michelle M; Kichler, Jessica C

    2015-01-01

    Psoriasis is a relatively common chronic inflammatory skin disease in children for which there is no cure. Most children have mild disease that can be managed with topical therapy as opposed to phototherapy or systemic therapy. Despite the mild presentation of psoriasis in most children, the disease can have a significant impact on quality of life due to the need for ongoing treatment, the frequently visible nature of the cutaneous manifestations, and the social stigma that is associated with psoriasis. Adherence to treatment, in particular topical therapy, is often poor in adults and compromises response to therapy and medical provider management strategies. Multiple factors that may contribute to nonadherence in adults with psoriasis have been identified, including lack of education on the disease and expectations for management, issues related to ease of use and acceptability of topical medications, and anxiety regarding possible medication side effects. There is currently no published data on adherence in the pediatric psoriasis population; however, poor adherence is often suspected when patients fail to respond to appropriate therapy. General strategies used to assess adherence in other pediatric disease populations can be applied to children with psoriasis, and interventions that reflect experience in other chronic dermatologic disorders such as atopic dermatitis may also be helpful for medical providers caring for children with psoriasis.

  19. Gut metastasis from breast carcinoma

    International Nuclear Information System (INIS)

    Al-Qahtani, Mohammad S.

    2007-01-01

    Breast cancer is the second most common malignancy in women. Common sites of metastases include the liver, lung, bone and the brain. Metastases to the gastrointestinal tract are with patients presenting with small-bowel perforation, intestinal obstruction and gastrointestinal bleeding. Here we report a case of Saudi female presenting with invasive lobular carcinoma and i leo-junction metastasis. (author)

  20. Nitric oxide in cancer metastasis.

    Science.gov (United States)

    Cheng, Huiwen; Wang, Lei; Mollica, Molly; Re, Anthony T; Wu, Shiyong; Zuo, Li

    2014-10-10

    Cancer metastasis is the spread and growth of tumor cells from the original neoplasm to further organs. This review analyzes the role of nitric oxide (NO), a signaling molecule, in the regulation of cancer formation, progression, and metastasis. The action of NO on cancer relies on multiple factors including cell type, metastasis stage, and organs involved. Various chemotherapy drugs cause cells to release NO, which in turn induces cytotoxic death of breast, liver, and skin tumors. However, NO has also been clinically connected to a poor cancer prognosis because of its role in angiogenesis and intravasation. This supports the claim that NO can be characterized as both pro-metastatic and anti-metastatic, depending on specific factors. The inhibition of cell proliferation and anti-apoptosis pathways by NO donors has been proposed as a novel therapy to various cancers. Studies suggest that NO-releasing non-steroidal anti-inflammatory drugs act on cancer cells in several ways that may make them ideal for cancer therapy. This review summarizes the biological significance of NO in each step of cancer metastasis, its controversial effects for cancer progression, and its therapeutic potential. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Maxillofacial metastasis from breast cancer

    Science.gov (United States)

    Namad, Tariq; Benbrahim, Zineb; Najib, Rajae; Mohammed, Afif; Baggar, Soufiane; Bouyahia, Nezar; Arifi, Samia; Mellas, Nawfel

    2014-01-01

    Metastatic tumors to paranasal sinuses are exclusively rare. In this paper, we report acase of breast carcinoma metastasizing to the right maxilla. The metastasis occurred 5 years after radical mastectomy and presented as a primary sinonasalmass. The diagnosis was confirmed with histopathologic andimmunohistochemical examination however the patient died before starting any specific treatment because of tumor bleeding. PMID:25767674

  2. Pulmonary Metastasis from Pseudomyxoma Peritonei

    Directory of Open Access Journals (Sweden)

    Toshiyuki Kitai

    2012-01-01

    Full Text Available Pseudomyxoma peritonei (PMP is a rare clinical condition, where copious mucinous ascites accumulate in the peritoneal cavity due to dissemination of mucin-producing tumor. Because of this disseminating, yet nonmetastasizing, behavior, PMP attracts much interest from surgical oncologists in that aggressive locoregional therapy can give the opportunity of long survival and even cure. Although extra-abdominal metastasis is exceptionally rare, the lung is the most likely site in such a case. In this paper, the clinical findings and treatment of eleven cases with pulmonary metastasis from PMP were reviewed, including ten cases in the literature and one case which we experienced. The clinical features of PMP cases with pulmonary metastasis were similar to cases without pulmonary metastasis. The histological type was low-grade mucinous neoplasm in most cases. Pulmonary lesions were resected in seven cases in which abdominal lesions were controlled by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy or another therapeutic modality. Disease-free state was maintained in five cases at the end of the follow-up period. However, it should be noted that rapid progression after resection was seen in two cases, suggesting that biological features may have changed by surgical intervention.

  3. Metastasis genetics, epigenetics, and the tumor microenvironment

    Science.gov (United States)

    KISS1 is a member of a family of genes known as metastasis suppressors, defined by their ability to block metastasis without blocking primary tumor development and growth. KISS1 re-expression in multiple metastatic cell lines of diverse cellular origin suppresses metastasis; yet, still allows comple...

  4. Addiction: an underestimated problem in psoriasis health care.

    Science.gov (United States)

    Zink, A; Herrmann, M; Fischer, T; Lauffer, F; Garzorz-Stark, N; Böhner, A; Spinner, C D; Biedermann, T; Eyerich, K

    2017-08-01

    Psoriasis is a disease of enormous socio-economic impact. Despite approval of numerous highly efficient and costly therapies, a minor proportion of severely affected patients actually receives sufficient treatment. To investigate whether addictions are associated with psoriasis and to develop evidence-based recommendations for dermatologists in their daily clinical practice in order to improve medical assessment of psoriasis and patients' quality of life. Psoriasis patients at the University Department of Dermatology were asked to fill out a paper-based self-reported anonymous questionnaire with 92 questions of validated screening tests for the six most common addictions in Germany (alcohol, nicotine, drugs and illegal drugs, gambling, food). Body weight and height as well as current Psoriasis Area and Severity Index (PASI) were documented as well. Between October 2015 and February 2016, 102 patients (65 males, 37 females; mean age 49.7 years (SD 13.4), range 18-83 years) participated in the study. Fifty-seven of the 102 patients showed addictive behaviour. Of these, 23.8% were high-risk drinkers, 41% regular smokers, 11% at risk of drug abuse, 4.1% at risk of food dependency and 19% compulsive gamblers. Compared with the general population, these results are significantly higher for alcohol abuse (P < 0.005), nicotine (P < 0.001) and gambling (P < 0.001). Body mass index was significantly higher in the study population (P < 0.001). Addictions and gambling are more prevalent in patients with psoriasis compared with the general population. Respective screening measures are recommended in daily practice for doctors treating psoriasis patients, and PeakPASI is suggested as a score to document patients' lifetime highest PASI. Parallel to new drug approvals and even more detailed insights into the pathomechanism of psoriasis, public health strategies and interdisciplinary approaches are essential for a general sustained psoriasis treatment. © 2017 European Academy of

  5. [Psoriasis and AIDS: a report of 2 cases].

    Science.gov (United States)

    Blanco González, O A; Larrondo Muguercia, R J; Blanco González, B L; Rodríguez Barreras, M E

    2000-01-01

    Even when there is not direct relation between psoriasis and AIDS, there have been reported impressive manifestations of psoriasis in AIDS diagnosis, difficulties in response to therapy, increase of serious forms of the disease, and clearing of lesions in terminal phase of AIDS. Two cases in which the two diseases are associated were presented. Both cases had outbreaking psoriasis guttata, one of them after being diagnosed with AIDS, in addition to have other dermatosis such as leukoplasia and ungual candidiasis; and the two patients also had scabies. Additionally, presentation of generalized lesions resistant to prescribed therapies was observed.

  6. Coincident systemic lupus erythematosus and psoriasis vulgaris: a case report.

    Science.gov (United States)

    Wang, Y; Da, G; Yu, Y; Han, J; Li, H

    2015-12-01

    Psoriasis vulgaris is an autoimmune chronic inflammatory skin disease, but its association with other typical autoimmune disease such as systemic lupus erythematosus has only occasionally been reported. We presented a 25-year-old female who developed systemic lupus erythematosus associated with psoriasis vulgaris. Her conditions were in good control after she got administration of prednisolone (5 mg/day) and Tripterygium Wilfordii Hook (20 mg/day). It is necessary to integrate past history and physical examination to diagnose coincident SLE and psoriasis, and combined treatment with prednisolone and Tripterygium Wilfordii Hook proves effective.

  7. Generalized pustular psoriasis of pregnancy successfully treated with cyclosporine.

    Science.gov (United States)

    Hazarika, Debeeka

    2009-01-01

    Two multigravidae aged 27 and 29 years, with previous uneventful pregnancies, second being psoriatic, reported at 24 and 28 weeks of pregnancies, with generalized pustular lesions. Laboratory findings, including serum calcium were normal. Ultrasonography showed normal fetal growth. Histopathology confirmed pustular psoriasis. Patients were put on cyclosporine 3 mg/ kg weight/ day after failure of an initial systemic steroid. Blood pressure, pulse, and fetal heart sounds were recorded every 12 hours, and ultrasonography and blood parameters, biweekly. Cyclosporine was tapered and stopped after delivery of two healthy babies at 38 weeks. We conclude that cyclosporine can be an option in the management of pustular psoriasis of pregnancy or psoriasis with pustulation in pregnancy.

  8. Scintigraphic investigation of clavicular bone area in patients with psoriasis

    International Nuclear Information System (INIS)

    Aso, Kazuo; Amano, Michiko; Sekiya, Sakae; Komatani, Akio

    1984-01-01

    Bone scintigraphy with sup(99m)Tc-methylene diphosphonate (MDP) was performed in 38 patients with psoriasis, 5 patients with palmoplantar pustulosis, and 56 control subjects. Abnormal uptake was seen primarily in the sternoclavicular junction and the cartilage of the first rib in 24 of the patients with psoriasis (63%) and in 3 of the patients with palmoplantar pustulosis (60%), and in the sternoclavicular junction in 21 of the control subjects (38%). The incidence of uptake in the sternoclavicular junction area in the psoriasis patients clearly exceeded that in the control subjects. (Namekawa, K.)

  9. Coste efectividad de diferentes tratamientos para la psoriasis

    OpenAIRE

    Alfageme Roldán, Fernando; Bermejo Hernando, Almudena; Calvo González, José Luís; Marqués Sánchez, Pilar

    2016-01-01

    Fundamentos: Los nuevos tratamientos biológicos, si bien mejoran la calidad de vida del paciente, incrementan los costes exponencialmente en relación al resto de tratamientos. El objetivo fue calcular el tratamiento más coste efectivo de los existentes para la psoriasis. Métodos: Se desarrolló un modelo de evaluación económica en psoriasis recogiendo todos los costes directos e indirectos de cada tratamiento. El indicador de efectividad que se utilizó fue Psoriasis Area Severity Index (PAS...

  10. TNF blockade induces a dysregulated type I interferon response without autoimmunity in paradoxical psoriasis.

    Science.gov (United States)

    Conrad, Curdin; Di Domizio, Jeremy; Mylonas, Alessio; Belkhodja, Cyrine; Demaria, Olivier; Navarini, Alexander A; Lapointe, Anne-Karine; French, Lars E; Vernez, Maxime; Gilliet, Michel

    2018-01-02

    Although anti-tumor necrosis factor (TNF) agents are highly effective in the treatment of psoriasis, 2-5% of treated patients develop psoriasis-like skin lesions called paradoxical psoriasis. The pathogenesis of this side effect and its distinction from classical psoriasis remain unknown. Here we show that skin lesions from patients with paradoxical psoriasis are characterized by a selective overexpression of type I interferons, dermal accumulation of plasmacytoid dendritic cells (pDC), and reduced T-cell numbers, when compared to classical psoriasis. Anti-TNF treatment prolongs type I interferon production by pDCs through inhibition of their maturation. The resulting type I interferon overexpression is responsible for the skin phenotype of paradoxical psoriasis, which, unlike classical psoriasis, is independent of T cells. These findings indicate that paradoxical psoriasis represents an ongoing overactive innate inflammatory process, driven by pDC-derived type I interferon that does not lead to T-cell autoimmunity.

  11. The risk of melanoma and hematologic cancers in patients with psoriasis.

    Science.gov (United States)

    Reddy, Shivani P; Martires, Kathryn; Wu, Jashin J

    2017-04-01

    The risk of melanoma and hematologic cancers in patients with psoriasis is controversial. We sought to assess the risk of melanoma and hematologic cancers in patients with psoriasis, and the association with different treatments. We used case-control and retrospective cohort designs to determine melanoma or hematologic cancer risk in patients with psoriasis. Risk with treatment type was assessed using Fisher exact test. Patients with psoriasis had 1.53 times greater risk of developing a malignancy compared with patients without psoriasis (P psoriasis and malignancy did not have significantly worse survival than patients without psoriasis. It is possible that patients developed malignancy subsequent to the follow-up time included in the study. Patients with psoriasis may experience an elevated risk of melanoma and hematologic cancers, compared with the general population. The risk is not increased by systemic or biologic psoriasis therapies. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Patient perspectives in the management of psoriasis: results from the population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey

    NARCIS (Netherlands)

    Lebwohl, M.G.; Bachelez, H.; Barker, J.; Girolomoni, G.; Kavanaugh, A.; Langley, R.G.; Paul, C.F.; Puig, L.; Reich, K.; Kerkhof, P.C.M. van de

    2014-01-01

    BACKGROUND: Available psoriasis surveys offer valuable information about psoriasis and psoriatic arthritis (PsA), but are limited by methodology or enrollment requirements. OBJECTIVE: To further the understanding of the unmet needs of psoriasis and PsA patients. METHODS: This was a large,

  13. Personalized medicine in psoriasis: concept and applications.

    Science.gov (United States)

    Al-Hoqail, Ibrahim A

    2010-05-01

    Personalized medicine is a new treatment modality where patients are the center of interest. Thus, one drug does not fit all; rather we look for a drug which fits the individual patients' disease. Treatment is moving towards molecular medicine driven by the growing knowledge and understanding of pharmacogenetics. Psoriasis is a common dermatological disease characterized by genetic polymorphism. The association of biomarkers and psoriasis is helpful to evaluate susceptibility to the disease, its severity and its progression. Additionally, the response to treatment will be anticipated. The growing expenses of health care systems worldwide are primarily due to increasing costs of chronic disease management. Hence, activation of preventive medicine will minimize treatment costs. A revolution in treatment modalities is expected to start at the level of pharmaceutical companies, as personalization of medicine will decrease the cost of clinical trials by minimizing the number of subjects required. In turn, this will decrease the cost of developing new medications. My vision for the future is that personalized medicine will mandate special physicians capable of understanding molecular medicine and using genetics and biomarkers for diagnosis, evaluation of the effect of drugs and overall prognosis. This new therapeutic modality will need special training.

  14. In vitro psoriasis models with focus on reconstructed skin models as promising tools in psoriasis research.

    Science.gov (United States)

    Desmet, Eline; Ramadhas, Anesh; Lambert, Jo; Van Gele, Mireille

    2017-06-01

    Psoriasis is a complex chronic immune-mediated inflammatory cutaneous disease associated with the development of inflammatory plaques on the skin. Studies proved that the disease results from a deregulated interplay between skin keratinocytes, immune cells and the environment leading to a persisting inflammatory process modulated by pro-inflammatory cytokines and activation of T cells. However, a major hindrance to study the pathogenesis of psoriasis more in depth and subsequent development of novel therapies is the lack of suitable pre-clinical models mimicking the complex phenotype of this skin disorder. Recent advances in and optimization of three-dimensional skin equivalent models have made them attractive and promising alternatives to the simplistic monolayer cultures, immunological different in vivo models and scarce ex vivo skin explants. Moreover, human skin equivalents are increasing in complexity level to match human biology as closely as possible. Here, we critically review the different types of three-dimensional skin models of psoriasis with relevance to their application potential and advantages over other models. This will guide researchers in choosing the most suitable psoriasis skin model for therapeutic drug testing (including gene therapy via siRNA molecules), or to examine biological features contributing to the pathology of psoriasis. However, the addition of T cells (as recently applied to a de-epidermized dermis-based psoriatic skin model) or other immune cells would make them even more attractive models and broaden their application potential. Eventually, the ultimate goal would be to substitute animal models by three-dimensional psoriatic skin models in the pre-clinical phases of anti-psoriasis candidate drugs. Impact statement The continuous development of novel in vitro models mimicking the psoriasis phenotype is important in the field of psoriasis research, as currently no model exists that completely matches the in vivo psoriasis

  15. The Coexistence of Coeliac Disease, Psoriasis and Vitiligo

    Directory of Open Access Journals (Sweden)

    Sevgi Akarsu

    2010-06-01

    Full Text Available It has been defined that coeliac disease is associated with most of the autoimmune diseases including psoriasis and vitiligo. Here, a 26-year-old woman who was diagnosed palmoplantar pustular psoriasis and already had coeliac disease and vitiligo is reported. According to our opinions, this is the first report describing the development of these three disorders in one patient, even though vitiligo, psoriasis and coeliac disease are common disorders, and the coexistence of the two of them has been previously reported in the literature. This case has been presented to emphasize the importance of considering and inquiring the possible coeliac disease in chronic and autoimmune dermatoses, although psoriasis and vitiligo may have coincidental associations with coeliac disease.

  16. Palmoplantar Psoriasis and Palmoplantar Pustulosis: Current Treatment and Future Prospects.

    Science.gov (United States)

    Raposo, Inês; Torres, Tiago

    2016-08-01

    Palmoplantar psoriasis and palmoplantar pustulosis are chronic skin diseases with a large impact on patient quality of life. They are frequently refractory to treatment, being generally described as a therapeutic challenge. This article aims to review the definitions of palmoplantar psoriasis and palmoplantar pustulosis, highlighting the similarities and differences in terms of epidemiology, clinical presentation, genetics, histopathology, and pathogenesis, as well as treatment options for both entities. Classical management of mild to moderate palmoplantar pustulosis and palmoplantar psoriasis relies on use of potent topical corticosteroids, phototherapy, and/or acitretin. Nevertheless, these drugs have proven to be insufficient in long-term control of extensive disease. Biologic therapy-namely, anti-interleukin-17 agents and phosphodiesterase type 4 inhibitors-has recently shown promising results in the treatment of palmoplantar psoriasis. Knowledge of the pathophysiologic pathways of both entities is of utmost importance and may, in the future, allow development of molecularly targeted therapeutics.

  17. Diagnostic difficulties in a patient with generalized pustular psoriasis

    Directory of Open Access Journals (Sweden)

    Katarzyna Juczyńska

    2014-11-01

    Full Text Available Introduction . Generalized pustular psoriasis is an uncommon, severe form of psoriasis. It may have a chronic, recurrent clinical course after rapid onset. Objective . To present diagnostic problems in a patient with a medical history of rheumatoid arthritis and sudden onset of generalized pustular eruption. Case report . A 66-year-old patient with rheumatoid arthritis, treated with immunosuppressants, was admitted to our department with acute, generalized pustular eruption. Histopathological findings in skin biopsy were equivocal; however, clinical diagnosis of pustular psoriasis was established. The diagnosis was sustained in longer perspective as slow regression of pustular eruptions and chronic, recurrent nature of skin lesions were observed. Conclusions . The presented case report along with data from the literature indicate that clinical and histopathological diagnosis of pustular psoriasis can be difficult. It is suggested that immunosuppressive therapy can affect both histopathological findings and therapy outcome.

  18. Management of cardiovascular disease in patients with psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Skov, Lone

    2016-01-01

    lifestyle factors such as smoking and alcohol abuse. AREAS COVERED: In this manuscript we describe the evidence associating psoriasis with CV disease, as well as the pharmacological and non-pharmacological treatment of CV risk factors including the CV effects of anti-psoriatic therapy and vice versa. EXPERT...... OPINION: Current guidelines recommend that patients with psoriasis are screened for CV risk factors, and recommend smoking cessation, reduced alcohol consumption, altering of lifestyle to move to a normal-weight body-mass index, exercising 3 times a week for 30 minutes, and monitoring and modifying...... cholesterol levels, respectively. While the current sum of evidence is not sufficient to recommend specific therapies for psoriasis solely based on their potential CV impact, some guidelines have suggested a 1.5 multiplication factor, in patients with severe psoriasis, to the Framingham risk score. Indeed...

  19. Economical effectiveness of therapy in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Nel'ubova 0.I.

    2014-09-01

    Full Text Available The review of regulatory acts and publications of domestic and foreign authors on the methods of economic evaluation of treatment effectiveness and quality of medical care to patients with psoriasis was presented

  20. MicroRNAs as regulatory elements in psoriasis

    Directory of Open Access Journals (Sweden)

    Liu Yuan

    2016-01-01

    Full Text Available Psoriasis is a chronic, autoimmune, and complex genetic disorder that affects 23% of the European population. The symptoms of Psoriatic skin are inflammation, raised and scaly lesions. microRNA, which is short, nonprotein-coding, regulatory RNAs, plays critical roles in psoriasis. microRNA participates in nearly all biological processes, such as cell differentiation, development and metabolism. Recent researches reveal that multitudinous novel microRNAs have been identified in skin. Some of these substantial novel microRNAs play as a class of posttranscriptional gene regulator in skin disease, such as psoriasis. In order to insight into microRNAs biological functions and verify microRNAs biomarker, we review diverse references about characterization, profiling and subtype of microRNAs. Here we will share our opinions about how and which microRNAs are as regulatory in psoriasis.

  1. Adenosine-deaminase (ADA activity in Psoriasis (A Preliminary Study

    Directory of Open Access Journals (Sweden)

    S D Chaudhry

    1988-01-01

    Full Text Available Study of adenosine-deaminase activity ′in 23 patients hav-mg psoriasis compared with an equal number of healthy controls revealed significantly high ADA-activity in the psotiatic patients.

  2. Evaluation of potent phytomedicine for treatment of psoriasis using UV radiation induced psoriasis in rats.

    Science.gov (United States)

    Nagar, Hemant K; Srivastava, Amit K; Srivastava, Rajnish; Ranawat, Mahendra S

    2016-12-01

    The aim of present study was to determine the effect of newly formulated gels and suspensions of extractive Phytoconstituents of Woodfordia fructicosa flowers and Gardenia gummifera leaves by using UV Radiation induced psoriasis in rats. Both plants are traditionally claimed to be useful in treatment of number of skin diseases. However, there are no established scientific reports for their potential in psoriasis. Formulated Gels and Suspensions of ethanolic extract of both plants were tested for acute dermal and oral toxicity study respectively. The results of acute dermal toxicity at concentration 1% w/w and oral toxicity at dose 1000mg/kg showed that the gels and suspensions were safe. Psoriasis was induced in Wistar rats by espousing 10% area of total body by UV radiations. Anti-psoriatic activity was performed by applying 0.1% gel and orally at a dose 100mg/kg body weight in rats. Severity Index, histological study and biochemical estimation were analyzed. The results of our studies showed that the test formulations (Gels and Suspensions) of both plant extracts exhibited potential effect in anti-psoriatic activity. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Infliximab-induced intertriginous psoriasis in patient with Crohn's disease

    OpenAIRE

    Mola, Federica; Motolese, Alberico

    2011-01-01

    Tumor necrosis factor-α (TNFα) inhibition is an effective treatment of moderate-to-severe psoriasis and other diseases (rheumatoid arthritis, ankylosing spondylitis, psoriasis or Crohn’s disease). We report a case of a 32- years-old patient affected by Crohn’s disease since the age of 25 who started infliximab infusion after four years of treatment with prednisone and azathioprine per os without improvement. After the fifth infusion of infliximab, he developed a form of intertriginous psorias...

  4. Juvenile psoriasis in European and Asian children: similarities and differences.

    Science.gov (United States)

    Chiam, L Y T; de Jager, M E A; Giam, Y C; de Jong, E M G J; van de Kerkhof, P C M; Seyger, M M B

    2011-05-01

    The first manifestations of psoriasis begin in childhood in more than one-third of patients. However, epidemiological data of juvenile psoriasis are lacking. To compare Dutch (NL group) and Singaporean (SG group) children with psoriasis with the aim of studying the characteristics of juvenile psoriasis and to highlight similarities and differences between these different ethnic groups. Data were collected from 207 patients younger than 18 years diagnosed with psoriasis from Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands and the National Skin Centre, Singapore. A striking difference in familial distribution was found, with more Dutch children having an affected family member (73·3% vs. 13·6%). Presence of itch and triggering factors were more common among Dutch children (80% vs. 14·2% and 33·3% vs. 7·4%, respectively). However, both groups shared similar triggering factors like stress and infections. Other similarities included mean age at presentation (NL group 11·3 years; SG group 14·1 years) and gender ratio (NL group, M/F 1 : 1·1; SG group, M/F 1 : 1·4). Plaque psoriasis was the most common type in both cohorts while guttate and pustular psoriasis were rare. In both groups, the head, followed by the limbs, was the most common site involved. Similar proportions of children in both countries had nail involvement and psoriatic arthritis was rare. The disparity in familial distribution may point to genetic differences between the two groups. Further studies to evaluate this difference in familial distribution may contribute to the understanding of the pathogenesis of psoriasis. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

  5. Fumaric acid esters in the management of psoriasis

    Directory of Open Access Journals (Sweden)

    Balak DMW

    2015-01-01

    Full Text Available Deepak MW Balak Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands Abstract: Fumaric acid esters (FAE are small molecules with immunomodulating, anti-inflammatory, and anti-oxidative effects. FAE were introduced as a systemic psoriasis treatment in 1959 and empirically developed further between 1970 and 1990 in Germany, Switzerland, and the Netherlands. The development of FAE as psoriasis treatment did not follow the traditional drug development phases. Nonetheless, in 1994 FAE were approved in Germany for the treatment of severe plaque psoriasis. FAE are currently one of the most commonly used treatments in Germany, and FAE are increasingly being used as an unlicensed treatment in several other European countries. To date, six randomized controlled trials and 29 observational studies have evaluated FAE in a combined total of 3,439 patients. The efficacy and safety profile of FAE is favorable. About 50%–70% of patients achieve at least 75% improvement in psoriasis severity after 16 weeks of treatment. Common adverse events of FAE include gastrointestinal complaints and flushing symptoms, which lead to treatment discontinuation in up to 40% of patients. Lymphocytopenia, eosinophilia, and proteinuria are commonly observed during FAE treatment, but rarely require treatment discontinuation. The long-term safety profile of continuous FAE treatment is favorable without an increased risk for infections, malignancies, or other serious adverse events. There are no known drug-interactions for FAE. The 2009 European evidence-based S3-guidelines on psoriasis treatment recommend FAE and suggest it as a first-line systemic treatment for moderate-to-severe plaque psoriasis. This review is aimed to give an overview of FAE treatment in the management of psoriasis. Keywords: fumaric acid esters, fumarates, dimethyl fumarate, Fumaderm, psoriasis, systemic treatment

  6. Fumaric acid esters in the management of psoriasis

    OpenAIRE

    Balak, Deepak MW

    2015-01-01

    Deepak MW Balak Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands Abstract: Fumaric acid esters (FAE) are small molecules with immunomodulating, anti-inflammatory, and anti-oxidative effects. FAE were introduced as a systemic psoriasis treatment in 1959 and empirically developed further between 1970 and 1990 in Germany, Switzerland, and the Netherlands. The development of FAE as psoriasis treatment did not follow the traditional drug development phases. Nonetheles...

  7. Evaluations of Audiovestibular Manifestations in Patients with Psoriasis

    Directory of Open Access Journals (Sweden)

    İsmail Cem Temel

    2017-12-01

    Full Text Available Objective: Sensorineural hearing loss can occur as a complication of autoimmune and inflammatory diseases. Although psoriasis is also a chronic inflammatory skin disease characterized by T-cell mediated hyper proliferation of the keratinocytes, the information about the relationship between audiological disorders is limited in the literature and the relationship with vestibular disorders has not been investigated before. In this study, we aimed to investigate the presence of audiovestibular disorders and their relationship with disease parameters. Methods: Sixty-one patients with psoriasis and 61 healthy individuals were included in this prospective cross-sectional study. Those with possible etiologic factors that may lead to hearing and balance disorders were not included in the study. All participants were first performed a full ear, nose and throat examination. Subsequently, full audiological examination (pure audiometry, autoacoustic emission, stapes reflex, detection threshold of speech and discrimination and electronystagmography tests were performed in the audiology laboratory where sound isolation was provided. Psoriasis severity was assessed by psoriasis area and severity index, body surface area and general evaluation of researcher. Results: There were significant differences between patients and controls in terms of audiovestibular symptoms. According to audiograms, predominant bilateral sensorineural hearing loss was detected in high frequency in psoriasis patients. The vestibular abnormalities in patients with psoriasis were found to be more frequent than those in controls, only saccadic test values were observed as statistically significant. Conclusion: Our study demonstrates that audiovestibular abnormalities are significantly associated with psoriasis. Therefore, patients with psoriasis should be evaluated for the co-occurrence of hearing loss or vestibular problems which might affect patients’ quality of life.

  8. Psoriasis and Hashimoto's thyroiditis in a child with down syndrome

    Directory of Open Access Journals (Sweden)

    Hilal Gokalp

    2016-01-01

    Full Text Available Down syndrome (DS, or trisomy 21, is the most common chromosomal disorder. DS has been associated with autoimmune diseases including autoimmune thyroiditis, Type 1 diabetes mellitus, celiac disease, autoimmune chronic active hepatitis, alopecia, vitiligo, hypoparathyroidism, psoriasis, and psoriatic arthritis. To our knowledge, we herein report the first concurrence of psoriasis and Hashimoto's thyroiditis in an individual with DS, emphasizing the predisposition of DS individuals to autoimmune diseases.

  9. Pustular psoriasis of pregnancy (Impetigo herpetiformis) - Case report*

    Science.gov (United States)

    Kondo, Rogerio Nabor; Araújo, Fernanda Mendes; Pereira, Allamanda Moura; Lopes, Vivian Cristina Holanda; Martins, Ligia Márcia Mario

    2013-01-01

    Impetigo herpetiformis is a rare dermatosis of pregnancy with typical onset during the last trimester of pregnancy and rapid resolution in the postpartum period. Clinically and histologically, it is consistent with pustular psoriasis. This similarity has led some authors to name the disease "the pustular psoriasis of pregnancy". We report the case of a patient who developed impetigo herpetiformis in two sucessive pregnancies. PMID:24346915

  10. Cellular sources of IL-17 in psoriasis: a paradigm shift?

    Science.gov (United States)

    Keijsers, Romy R M C; Joosten, Irma; van Erp, Piet E J; Koenen, Hans J P M; van de Kerkhof, Peter C M

    2014-11-01

    Psoriasis is a common chronic inflammatory skin disease that results from interplay between the immune system and the epithelium. In the light of very successful anticytokine therapies for psoriasis, the focus has been directed towards the adaptive immune system. Expression studies, genetic studies and treatments specifically targeting players of the IL-23/IL-17 pathway, point at an important role for IL-17 in the pathogenesis of psoriasis. IL-17 stimulates the keratinocytes to produce psoriasis-associated molecules, eventually leading to chronic skin inflammation. The current opinion is that IL-17 is mainly produced by T cells, so-called T-helper 17 (Th17) cells, in psoriasis. However, evidence is accumulating that cells of the innate immune system, like neutrophils, mast cells, γδ T cells and innate lymphoid cells are the main source of IL-17 in psoriasis, rather than T cells. The paradigm in this field of research is shifting. With this viewpoint article, we will address this novel concept by critically summarizing the current literature on this subject. In psoriatic arthritis and atherosclerosis, important conditions related to psoriasis, it was also found that the majority of IL-17 is associated with cells of the innate immune system. This new concept changes our view of IL-17. Blocking IL-17 with targeted treatments might be more far-reaching than previously thought; not only IL-17 production by T cells but also by innate immune cells is blocked. Furthermore, therapies specifically targeting IL-17 may not only improve psoriasis, but also comorbidity that is associated with the IL-17 pathway, hereby preventing serious complications on the long term. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Comorbidity profiles of psoriasis in Taiwan: A latent class analysis.

    Science.gov (United States)

    Wu, Chen-Yi; Hu, Hsiao-Yun; Li, Chung-Pin; Chou, Yiing-Jeng; Chang, Yun-Ting

    2018-01-01

    Psoriasis is associated with many comorbidities. An understanding of these comorbidity patterns can help foster better care of patients with psoriasis. To identify the heterogeneity of psoriasis comorbidities using latent class analysis (LCA). LCA was used to empirically identify psoriasis comorbidity patterns in a nationwide sample of 110,729 incident cases of psoriasis (2002-2012) from the National Health Insurance database in Taiwan. The mean age of incident psoriasis was 46.1 years. Hypertension (28.8%), dyslipidemia (18.9%), and chronic liver disease/cirrhosis/hepatitis (18.1%) were the top three comorbidities in patients with psoriasis. LCA identified four distinct comorbidity classes among these patients, including 9.9% of patients in the "multi-comorbidity" class, 17.9% in the "metabolic syndrome" class, 11.3% in the "hypertension and chronic obstructive pulmonary disease (COPD)" class, and 60.9% in the "relatively healthy" class. Psoriatic arthritis was evenly distributed among each class. Relative to membership in the "relative healthy" class, an increase of one year of age had a higher probability of membership in the "multi-comorbidity" (odds ratio [OR], 1.25), "metabolic syndrome" (OR, 1.11), or "hypertension and COPD" (OR, 1.34) classes. Relative to membership in the "relative healthy" class, compared to women, men had a higher probability of membership in the "multi-comorbidity" (OR, 1.39), "metabolic syndrome" (OR, 1.77), or "hypertension and COPD" (OR, 1.22) classes. We observed four distinct classes of psoriasis comorbidities, including the "multi-comorbidity", "metabolic syndrome", "hypertension and COPD", and "relatively healthy" classes, as well as the clustering of liver diseases with metabolic syndrome and clustering of COPD with hypertension.

  12. Comparative clinical, roentgenological, scintigraphic and thermographic investigations in psoriasis arthropathica

    International Nuclear Information System (INIS)

    Loreck, D.; Lips, H.; Schulze, P.

    1988-01-01

    20 patients with psoriasis arthropatica and different duration of the articular symptoms were examined. Besides clinical investigation radiographs of both hands and feet (central and phalanges), scintigraphy of hands, feet and the sacroiliac joints as well as liquid crystal thermograhy of both hands were performed and the results are compared. The conclusions drawn characterize the diagnostic value of the methods. Scintigraphy as well as thermography are very good means for the early detection of psoriasis arthropathica. (author)

  13. Psoriasis in childhood: effective strategies to improve treatment adherence

    Directory of Open Access Journals (Sweden)

    Shah KN

    2015-03-01

    Full Text Available Kara N Shah,1 Sandra Cortina,2,3 Michelle M Ernst,2 Jessica C Kichler2 1Division of Pediatric Dermatology, 2Division of Behavioral Medicine and Clinical Psychology, 3Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA Abstract: Psoriasis is a relatively common chronic inflammatory skin disease in children for which there is no cure. Most children have mild disease that can be managed with topical therapy as opposed to phototherapy or systemic therapy. Despite the mild presentation of psoriasis in most children, the disease can have a significant impact on quality of life due to the need for ongoing treatment, the frequently visible nature of the cutaneous manifestations, and the social stigma that is associated with psoriasis. Adherence to treatment, in particular topical therapy, is often poor in adults and compromises response to therapy and medical provider management strategies. Multiple factors that may contribute to nonadherence in adults with psoriasis have been identified, including lack of education on the disease and expectations for management, issues related to ease of use and acceptability of topical medications, and anxiety regarding possible medication side effects. There is currently no published data on adherence in the pediatric psoriasis population; however, poor adherence is often suspected when patients fail to respond to appropriate therapy. General strategies used to assess adherence in other pediatric disease populations can be applied to children with psoriasis, and interventions that reflect experience in other chronic dermatologic disorders such as atopic dermatitis may also be helpful for medical providers caring for children with psoriasis. Keywords: adherence, psoriasis, children

  14. Vasculogenic mimicry and tumor metastasis.

    Science.gov (United States)

    Zhang, Jingxin; Qiao, Lili; Liang, Ning; Xie, Jian; Luo, Hui; Deng, Guodong; Zhang, Jiandong

    2016-01-01

    Vasculogenic mimicry (VM), a microvascular channel made up of nonendothelial cells, has been accepted as a new model of neovascularization in aggressive tumors, owning to the specific capacity of malignant cells to form vessel-like networks which provide sufficient blood supply for tumor growth. Multiple molecular mechanisms, especially vascular endothelial (VE)-cadherin, erythropoietin-producing hepatocellular receptor A2 (EphA2), phosphatidyl inositol 3-kinase (PI3K), matrix metalloproteinases (MMPs), vascular endothelial growth factor receptor (VEGFR1), and hypoxia inducible factor (HIF)-1a, have been reported to participate in VM formation which is associated with tumor migration and invasion. In addition, hypoxia, cancer stem cells (CSCs) and epithelial-mesenehymal transition (EMT) are regarded as significant factors in VM formation and tumor metastasis. Due to the important effects of VM on tumor progression, a review was carried out in the present study, to synthetically analyze the relationship between VM and tumor metastasis.

  15. Pericytes limit tumor cell metastasis

    DEFF Research Database (Denmark)

    Xian, Xiaojie; Håkansson, Joakim; Ståhlberg, Anders

    2006-01-01

    Previously we observed that neural cell adhesion molecule (NCAM) deficiency in beta tumor cells facilitates metastasis into distant organs and local lymph nodes. Here, we show that NCAM-deficient beta cell tumors grew leaky blood vessels with perturbed pericyte-endothelial cell-cell interactions...... and deficient perivascular deposition of ECM components. Conversely, tumor cell expression of NCAM in a fibrosarcoma model (T241) improved pericyte recruitment and increased perivascular deposition of ECM molecules. Together, these findings suggest that NCAM may limit tumor cell metastasis by stabilizing...... the microvessel wall. To directly address whether pericyte dysfunction increases the metastatic potential of solid tumors, we studied beta cell tumorigenesis in primary pericyte-deficient Pdgfb(ret/ret) mice. This resulted in beta tumor cell metastases in distant organs and local lymph nodes, demonstrating a role...

  16. Raman spectroscopy of bone metastasis

    Science.gov (United States)

    Esmonde-White, Karen A.; Sottnik, Joseph; Morris, Michael; Keller, Evan

    2012-02-01

    Raman spectroscopy of bone has been used to characterize chemical changes occurring in diseases such as osteoporosis, osteoarthritis and osteomyelitis. Metastasis of cancer into bone causes changes to bone quality that are similar to those observed in osteoporosis, such as decreased bone strength, but with an accelerated timeframe. In particular, osteolytic (bone degrading) lesions in bone metastasis have a marked effect on patient quality of life because of increased risk of fractures, pain, and hypercalcemia. We use Raman spectroscopy to examine bone from two different mouse models of osteolytic bone metastasis. Raman spectroscopy measures physicochemical information which cannot be obtained through standard biochemical and histological measurements. This study was reviewed and approved by the University of Michigan University Committee on the Care and Use of Animals. Two mouse models of prostate cancer bone metastasis, RM1 (n=3) and PC3-luc (n=4) were examined. Tibiae were injected with RM1 or PC3-luc cancer cells, while the contralateral tibiae received a placebo injection for use as controls. After 2 weeks of incubation, the mice were sacrificed and the tibiae were examined by Raman microspectroscopy (λ=785 nm). Spectroscopic markers corresponding to mineral stoichiometry, bone mineralization, and mineral crystallinity were compared in spectra from the cancerous and control tibiae. X-ray imaging of the tibia confirmed extensive osteolysis in the RM1 mice, with tumor invasion into adjoining soft tissue and moderate osteolysis in the PC3-luc mice. Raman spectroscopic markers indicate that osteolytic lesions are less mineralized than normal bone tissue, with an altered mineral stoichiometry and crystallinity.

  17. Endocannabinoids as Guardians of Metastasis.

    Science.gov (United States)

    Tegeder, Irmgard

    2016-02-10

    Endocannabinoids including anandamide and 2-arachidonoylglycerol are involved in cancer pathophysiology in several ways, including tumor growth and progression, peritumoral inflammation, nausea and cancer pain. Recently we showed that the endocannabinoid profiles are deranged during cancer to an extent that this manifests in alterations of plasma endocannabinoids in cancer patients, which was mimicked by similar changes in rodent models of local and metastatic cancer. The present topical review summarizes the complexity of endocannabinoid signaling in the context of tumor growth and metastasis.

  18. Geographic Tongue and Fissured Tongue in 348 Patients with Psoriasis: Correlation with Disease Severity

    Directory of Open Access Journals (Sweden)

    Bruna L. S. Picciani

    2015-01-01

    Full Text Available Geographic tongue (GT and fissured tongue (FT are the more frequent oral lesions in patients with psoriasis. The aims of this study were to compare the prevalence of GT/FT between psoriasis group (PG and healthy controls (HC and investigate the correlation between GT/FT and psoriasis severity using the PASI and age of psoriasis onset. Three hundred and forty-eight PG and 348 HC were selected. According to the age of psoriasis onset, the individuals were classified as having early psoriasis and late psoriasis. The severity of vulgaris psoriasis was determined according to PASI. A follow-up was conducted in patients with psoriasis vulgaris (PV with GT to evaluate the progression of oral and cutaneous lesions. The FT and GT were more frequent in PG than in HC. The incidence of GT was higher in patients with early psoriasis and that of FT in late-psoriasis. There is association between psoriasis intensity and GT; and a higher monthly decrease of PASI score in patients without GT. The presence of GT and FT is higher in PG than in the HC. GT is associated with disease severity and may be a marker of the psoriasis severity.

  19. Geographic Tongue and Fissured Tongue in 348 Patients with Psoriasis: Correlation with Disease Severity

    Science.gov (United States)

    Picciani, Bruna L. S.; Souza, Thays T.; Santos, Vanessa de Carla B.; Domingos, Tábata A.; Carneiro, Sueli; Avelleira, João Carlos; Azulay, David R.; Pinto, Jane M. N.; Dias, Eliane P.

    2015-01-01

    Geographic tongue (GT) and fissured tongue (FT) are the more frequent oral lesions in patients with psoriasis. The aims of this study were to compare the prevalence of GT/FT between psoriasis group (PG) and healthy controls (HC) and investigate the correlation between GT/FT and psoriasis severity using the PASI and age of psoriasis onset. Three hundred and forty-eight PG and 348 HC were selected. According to the age of psoriasis onset, the individuals were classified as having early psoriasis and late psoriasis. The severity of vulgaris psoriasis was determined according to PASI. A follow-up was conducted in patients with psoriasis vulgaris (PV) with GT to evaluate the progression of oral and cutaneous lesions. The FT and GT were more frequent in PG than in HC. The incidence of GT was higher in patients with early psoriasis and that of FT in late-psoriasis. There is association between psoriasis intensity and GT; and a higher monthly decrease of PASI score in patients without GT. The presence of GT and FT is higher in PG than in the HC. GT is associated with disease severity and may be a marker of the psoriasis severity. PMID:25685842

  20. Multiplicity of comorbidities in patients with severe psoriasis

    Directory of Open Access Journals (Sweden)

    N. V. Batkaeva

    2018-01-01

    Full Text Available Rationale: Severe treatment-resistant psoriasis and comorbidities are on the rise.Aim: To evaluate the prevalence of comorbidities in a  hospital-based cohort of patients with severe psoriases.Materials and methods: We performed a  retrospective analysis of medical files of 890  patients with moderate-to-severe plaque psoriasis (PASI > 10 treated in a  hospital from 2010 to 2015 (men, 516 [58%], women, 374 [42%]; mean age 51.9 ± 11.6 years; mean PASI, 44.3 ± 7.8  scores.Results: Comorbidities were found in 61% (543 / 890 of the patients with severe psoriasis, with cardiovascular disorders ranking first (59%, or 516 / 890 and gastrointestinal and hepatobiliary disorders ranking second (46,4%, or 413 / 890. Psoriatic arthritis was diagnosed in 34% (303 / 890 of the patients and other disorders of the musculoskeletal system unrelated to psoriasis in 19.8% (176 / 890. The proportion of diabetes was 15.4% (137 / 890.Conclusion: Psoriasis has a high rate of comorbidities, in particular of cardiovascular disorders. It significantly deteriorates the course of psoriasis and its response to therapy, and in some cases may reduce the possibility of adequate anti-psoriatic treatment due to contraindications.

  1. [The role of alexithymia as a psychosomatic factor in psoriasis].

    Science.gov (United States)

    Torres-Hernández, Marcela; López-García, Sonia; Pedroza-Escobar, David; Escamilla-Tilch, Mónica

    2015-01-01

    Alexithymia is the lack of mental representations of emotions leading to limited ability to understand and regulate these and can contribute to the development or maintenance of a psychosomatic illness. The aim of the study was to demonstrate that alexithymia is a feature that occurs more frequently in patients with psoriasis and that the coexistence of alexitimia-psoriasis is associated with high levels of trait anxiety. We applied the Toronto Alexithymia Scale -20 (TAS-20), Inventory of state-trait anxiety (STAI) to 16 outpatients with psoriasis of Dermatology Service of Hospital de Especialidades (Centro Médico Nacional Siglo XXI) and the results were compared with 25 control subjects. 25 % of patients with psoriasis presented alexitimia, while in the control group was 8 % (p = 0.002). Correlation between the scores of the TSA-20 and STAI-trait (r = 0.6957, p alexitimia occurs more frequently in individuals with psoriasis than in the general population, and levels of trait anxiety in individuals with psoriasis are similar regardless of the presence of alexithymia.

  2. Prokineticin 2 Plays a Pivotal Role in Psoriasis

    Directory of Open Access Journals (Sweden)

    Xiaoqin He

    2016-11-01

    Full Text Available Psoriasis is histologically characterized by keratinocytes (KC hyperproliferation, inflammation, and increased angiogenesis, but the pathological factor responsible for these symptoms is unknown. Here, a neuroendocrine peptide (prokineticin 2, PK2, is highly expressed in human and mouse psoriatic skins but no significant change in other autoimmune diseases, suggesting that PK2 is a psoriasis-specific factor. Bacterial products significantly up-regulated PK2, implying that infection induces PK2 over-expression. PK2 promoted KC and macrophage to produce interleukin-1 (IL-1, the central player of inflammation and psoriasis, which acts on adjacent fibroblast to induce inflammatory cascades and KC hyperproliferation. IL-1 feeds back on macrophages to induce PK2 production to perpetuate PK2-IL-1 positive feedback loop. PK2 also promoted angiogenesis, another psoriatic symptom. In mouse models, PK2 over-expression aggravated psoriasis while its knock-down inhibited pathological development. The results indicate that PK2 over-production perpetuates psoriatic symptoms by creating PK-2-IL-1 vicious loop. PK2 is a central player in psoriasis and a promising psoriasis-specific target.

  3. Psoriasis comorbidities: complications and benefits of immunobiological treatment.

    Science.gov (United States)

    Carvalho, André Vicente Esteves de; Romiti, Ricardo; Souza, Cacilda da Silva; Paschoal, Renato Soriani; Milman, Laura de Mattos; Meneghello, Luana Pizarro

    2016-01-01

    During the last decade, different studies have converged to evidence the high prevalence of comorbidities in subjects with psoriasis. Although a causal relation has not been fully elucidated, genetic relation, inflammatory pathways and/or common environmental factors appear to be underlying the development of psoriasis and the metabolic comorbidities. The concept of psoriasis as a systemic disease directed the attention of the scientific community in order to investigate the extent to which therapeutic interventions influence the onset and evolution of the most prevalent comorbidities in patients with psoriasis. This study presents scientific evidence of the influence of immunobiological treatments for psoriasis available in Brazil (infliximab, adalimumab, etanercept and ustekinumab) on the main comorbidities related to psoriasis. It highlights the importance of the inflammatory burden on the clinical outcome of patients, not only on disease activity, but also on the comorbidities. In this sense, systemic treatments, whether immunobiologicals or classic, can play a critical role to effectively control the inflammatory burden in psoriatic patients.

  4. Guidelines on the Use of Methotrexate in Psoriasis.

    Science.gov (United States)

    Carretero, G; Puig, L; Dehesa, L; Carrascosa, J M; Ribera, M; Sánchez-Regaña, M; Daudén, E; Vidal, D; Alsina, M; Muñoz-Santos, C; López-Estebaranz, J L; Notario, J; Ferrandiz, C; Vanaclocha, F; García-Bustinduy, M; Taberner, R; Belinchón, I; Sánchez-Carazo, J; Moreno, J C

    2010-09-01

    Psoriasis, a chronic multifactorial inflammatory disease that develops in genetically predisposed individuals, affects approximately 1.5% of the Spanish population. This disease has a negative impact on patients' quality of life, and long-term therapy is often required to control the symptoms. In addition to the classical systemic treatments (methotrexate, acitretin, cyclosporine, and ultraviolet light), the group of drugs known as biologics (etanercept, infliximab, adalimumab, and ustekinumab) provides the dermatologist with an expanded therapeutic armamentarium, thereby improving the likelihood of controlling psoriasis in patients with severe and/or extensive disease. Methotrexate, a classic antipsoriatic drug, is still very useful either as single-drug therapy or in combination with other systemic drugs, particularly as a rescue therapy or combined with biologics. This article aims to establish the role of methotrexate in the treatment of psoriasis. We considered it of interest to develop guidelines for using methotrexate in the management of psoriasis with a view to ensuring the safe and proper use of this drug in the management of psoriasis. This document was developed by consensus among members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology. Copyright © 2010 Elsevier España, S.L. y AEDV. All rights reserved.

  5. [Guidelines on the use of methotrexate in psoriasis].

    Science.gov (United States)

    Carretero, G; Puig, L; Dehesa, L; Carrascosa, J M; Ribera, M; Sánchez-Regaña, M; Daudén, E; Vidal, D; Alsina, M; Muñoz-Santos, C; López-Estebaranz, J L; Notario, J; Ferrandiz, C; Vanaclocha, F; García-Bustinduy, M; Taberner, R; Belinchón, I; Sánchez-Carazo, J; Moreno, J C

    2010-09-01

    Psoriasis, a chronic multifactorial inflammatory disease that develops in genetically predisposed individuals, affects approximately 1.5% of the Spanish population. This disease has a negative impact on patients' quality of life, and long-term therapy is often required to control the symptoms. In addition to the classical systemic treatments (methotrexate, acitretin, cyclosporine, and ultraviolet light), the group of drugs known as biologics (etanercept, infliximab, adalimumab, and ustekinumab) provides the dermatologist with an expanded therapeutic armamentarium, thereby improving the likelihood of controlling psoriasis in patients with severe and/or extensive disease. Methotrexate, a classic antipsoriatic drug, is still very useful either as single-drug therapy or in combination with other systemic drugs, particularly as a rescue therapy or combined with biologics. This article aims to establish the role of methotrexate in the treatment of psoriasis. We considered it of interest to develop guidelines for using methotrexate in the management of psoriasis with a view to ensuring the safe and proper use of this drug in the management of psoriasis. This document was developed by consensus among members of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology.

  6. Investigating the potential of Oxymatrine as a psoriasis therapy.

    Science.gov (United States)

    Chen, Qian; Zhou, Hui; Yang, Yinxue; Chi, Mingwei; Xie, Nan; Zhang, Hong; Deng, Xingwang; Leavesley, David; Shi, Huijuan; Xie, Yan

    2017-06-01

    Psoriasis vulgaris is a chronic inflammatory skin disease, stubbornly intractable, with substantial consequences for patient physical and mental welfare. Approaches currently available to treat psoriasis are not satisfactory due to undesirable side-effects or expense. Psoriasis is characterized by hyperproliferation and inflammation. Oxymatrine, an active component extracted from Sophora flavescens, has been demonstrated to possess anti-proliferation, anti-inflammatory, anti-tumorigenic, immune regulation and pro-apoptotic properties. This investigation presents a detailed retrospective review examining the effect of Oxymatrine on psoriasis and investigates the mechanisms underlying patient responses to Oxymatrine. We confirm that Oxymatrine administration significantly reduced the Psoriasis Area Severity Index score, with high efficacy compared to the control group. In addition, we have found that Oxymatrine significantly inhibits the viability, proliferation and differentiation of human keratinocyte in vitro. Immunohistochemical analysis indicates Oxymatrine significantly suppresses the expression of Pan-Cytokeratin, p63 and keratin 10. The results indicate that the suppression of p63 expression may lead to the anti-proliferation effect of Oxymatrine on human skin keratinocytes. Oxymatrine does not affect the formation of basement membrane, which is very important to maintain the normal function of human skin keratinocytes. In summary, Oxymatrine offers an effective, economical, and safe treatment for patients presenting with intractable psoriasis vulgaris. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Eosinophils are rare in biopsy specimens of psoriasis vulgaris.

    Science.gov (United States)

    Rosa, Gabriela; Fernandez, Anthony P; Schneider, Sarah; Billings, Steven D

    2017-12-01

    Histological features of lesional biopsies can be helpful in distinguishing psoriasis subtypes from disease mimickers. However, occasionally, classic histological features are not sufficient for distinction, and additional clues would be useful. There is a common belief that the presence of eosinophils in skin biopsies argues against psoriasis, but actual literature is scant. Skin biopsies with a diagnosis of psoriasis from 2013 to 2016 were reviewed. For inclusion, both histological and clinical features were required to be consistent with psoriasis. For biopsies meeting inclusion criteria, a detailed evaluation for typical histological parameters of psoriasis, as well as presence of dermal eosinophils, was performed. Of 85 cases meeting inclusion criteria, all had either individual or grouped intracorneal neutrophils and dilated papillary blood vessels. Diminished or complete loss of the granular cell layer was seen in 83 cases (98%), and parakeratosis was seen in 84 cases (99%). Alternatively, dermal eosinophils were seen in only 15 cases (18%). Of cases with eosinophils, none had more than 3 eosinophils upon examination of the entire dermis. Active treatment did not appear to impact presence/absence or numbers of eosinophils. Eosinophils are uncommon in psoriasis biopsies, and when present, they are found in small numbers. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Safety of Systemic Agents for the Treatment of Pediatric Psoriasis.

    Science.gov (United States)

    Bronckers, Inge M G J; Seyger, Marieke M B; West, Dennis P; Lara-Corrales, Irene; Tollefson, Megha; Tom, Wynnis L; Hogeling, Marcia; Belazarian, Leah; Zachariae, Claus; Mahé, Emmanuel; Siegfried, Elaine; Philipp, Sandra; Szalai, Zsuzsanna; Vleugels, Ruth Ann; Holland, Kristen; Murphy, Ruth; Baselga, Eulalia; Cordoro, Kelly; Lambert, Jo; Alexopoulos, Alex; Mrowietz, Ulrich; Kievit, Wietske; Paller, Amy S

    2017-11-01

    Use of systemic therapies for moderate to severe psoriasis in children is increasing, but comparative data on their use and toxicities are limited. To assess patterns of use and relative risks of systemic agents for moderate to severe psoriasis in children. A retrospective review was conducted at 20 centers in North America and Europe, and included all consecutive children with moderate to severe psoriasis who used systemic medications or phototherapy for at least 3 months from December 1, 1990, to September 16, 2014. The minimal core data set included age, sex, severity of psoriasis, systemic interventions, monitoring, adverse events (AEs), and reason for discontinuation. For 390 children (203 girls and 187 boys; mean [SD] age at diagnosis, 8.4 [3.7] years) with psoriasis who used 1 or more systemic medications, the mean interval between diagnosis and starting systemic therapy was 3.0 years. Methotrexate was used by 270 patients (69.2%), biologic agents (primarily etanercept) by 106 (27.2%), acitretin by 57 (14.6%), cyclosporine by 30 (7.7%), fumaric acid esters by 19 (4.9%), and more than 1 medication was used by 73 (18.7%). Of 270 children taking methotrexate, 130 (48.1%) reported 1 or more AEs associated with methotrexate, primarily gastrointestinal (67 [24.8%]). Folic acid 6 days per week (odds ratio, 0.16; 95% CI, 0.06-0.41; P psoriasis.

  9. Adalimumab for treating childhood plaque psoriasis: a clinical trial evaluation.

    Science.gov (United States)

    Di Lernia, Vito

    2017-12-01

    Most systemic therapies have not been systematically investigated in moderate to severe childhood plaque psoriasis. Evidence on the efficacy and safety of systemic treatments is limited and therapeutic guidelines are lacking. Recently adalimumab, a fully human monoclonal antibody that binds tumor necrosis factor (TNF)- alpha, was investigated in childhood psoriasis. Adalimumab is licensed for many inflammatory conditions including chronic plaque psoriasis in adults. Areas covered: A randomized phase III study published provided favourable efficacy and safety data of adalimumab in childhood psoriasis. The active comparator was methotrexate. After 16 weeks of treatment, a PASI 75 score was achieved in 58% of patients within the adalimumab 0.8 mg/kg group compared with 32% of patients within the methotrexate group. Safety data gave no evidence of drug-related serious adverse events and no organ toxicity. This is the first randomised controlled study of either adalimumab or methotrexate in children and adolescents with psoriasis. Expert opinion: The aforementioned trial was the first to provide clinical data on adalimumab's efficacy and safety in the short term when treating children and adolescents with psoriasis. Through the use of an active comparator, this study has opened the way for the future assessment of systemic therapies in children and adolescent with this condition.

  10. Psoriasis prediction from genome-wide SNP profiles

    Directory of Open Access Journals (Sweden)

    Fang Xiangzhong

    2011-01-01

    Full Text Available Abstract Background With the availability of large-scale genome-wide association study (GWAS data, choosing an optimal set of SNPs for disease susceptibility prediction is a challenging task. This study aimed to use single nucleotide polymorphisms (SNPs to predict psoriasis from searching GWAS data. Methods Totally we had 2,798 samples and 451,724 SNPs. Process for searching a set of SNPs to predict susceptibility for psoriasis consisted of two steps. The first one was to search top 1,000 SNPs with high accuracy for prediction of psoriasis from GWAS dataset. The second one was to search for an optimal SNP subset for predicting psoriasis. The sequential information bottleneck (sIB method was compared with classical linear discriminant analysis(LDA for classification performance. Results The best test harmonic mean of sensitivity and specificity for predicting psoriasis by sIB was 0.674(95% CI: 0.650-0.698, while only 0.520(95% CI: 0.472-0.524 was reported for predicting disease by LDA. Our results indicate that the new classifier sIB performs better than LDA in the study. Conclusions The fact that a small set of SNPs can predict disease status with average accuracy of 68% makes it possible to use SNP data for psoriasis prediction.

  11. Genetics of Psoriasis and Pharmacogenetics of Biological Drugs

    Directory of Open Access Journals (Sweden)

    Rocío Prieto-Pérez

    2013-01-01

    Full Text Available Psoriasis is a chronic inflammatory disease of the skin. The causes of psoriasis are unknown, although family and twin studies have shown genetic factors to play a key role in its development. The many genes associated with psoriasis and the immune response include TNFα, IL23, and IL12. Advances in knowledge of the pathogenesis of psoriasis have enabled the development of new drugs that target cytokines (e.g., etanercept, adalimumab, and infliximab, which target TNFα, and ustekinumab, which targets the p40 subunit of IL23 and IL12. These drugs have improved the safety and efficacy of treatment in comparison with previous therapies. However, not all patients respond equally to treatment, possibly owing to interindividual genetic variability. In this review, we describe the genes associated with psoriasis and the immune response, the biological drugs used to treat chronic severe plaque psoriasis, new drugs in phase II and III trials, and current knowledge on the implications of pharmacogenomics in predicting response to these treatments.

  12. Insulin Human Inhalation

    Science.gov (United States)

    Insulin inhalation is used in combination with a long-acting insulin to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar ...

  13. Research prevalence of psoriasis in countries and Ukraine

    Directory of Open Access Journals (Sweden)

    А. А. Kotvitska

    2013-06-01

    Full Text Available Introduction. In recent years there was a negative trend growth of dermatological diseases. One of the first places in the practice of dermatology has psoriasis, which today, unfortunately, is not a “disease” but lifelong condition. Human health is the highest value, and arrangement of conditions for the protection of public health should be a priority of any country. The study of medical-demographic characteristics, tendencies of morbidity and prevalence of diseases, including dermatological profile, patterns of changes above parameters and comparing the finding with the world data is an important part of strategic planning line of development of the public health and pharmaceutical sector of the country. The aim of this study was an investigation of the prevalence of psoriasis in the world and in Ukraine, it’s analysis taking into account geographical, racial, gender and age characteristics of patients. Analyses. Content analysis, analytical and statistical methods (analysis of statistical data of the prevalence of psoriasis, analysis of scientific information. Research results. We have analyzed the prevalence of psoriasis in 18 countries and determined that the average rate of the disease is 2.8%. The study found that the highest prevalence of psoriasis observed in countries such as Germany (up 6.5%, the Netherlands (5%, Norway (up 4.8%, France (up 4.7%, Denmark (up 4.2%. Statistical data on the prevalence of psoriasis in Ukraine differ significantly from the average for Europe and countries of the world. According to official statistics from the Ministry of Health of Ukraine prevalence of psoriasis in absolute terms in 2009 was 98,544 patients (0.21% of the population and morbidity – 13,529 persons (0.03% of the population. It should be noted that according to many experts the actual rate of this disease is much higher. According to unofficial sources in Ukraine with psoriasis suffer about 1.5 million of people (> 3% of the

  14. Concentrated insulins: the new basal insulins

    Directory of Open Access Journals (Sweden)

    Lamos EM

    2016-03-01

    Full Text Available Elizabeth M Lamos,1 Lisa M Younk,2 Stephen N Davis3 1Division of Endocrinology, Diabetes and Nutrition, 2Department of Medicine, University of Maryland School of Medicine, 3Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA Introduction: Insulin therapy plays a critical role in the treatment of type 1 and type 2 diabetes mellitus. However, there is still a need to find basal insulins with 24-hour coverage and reduced risk of hypoglycemia. Additionally, with increasing obesity and insulin resistance, the ability to provide clinically necessary high doses of insulin at low volume is also needed. Areas covered: This review highlights the published reports of the pharmacokinetic (PK and glucodynamic properties of concentrated insulins: Humulin-R U500, insulin degludec U200, and insulin glargine U300, describes the clinical efficacy, risk of hypoglycemic, and metabolic changes observed, and finally, discusses observations about the complexity of introducing a new generation of concentrated insulins to the therapeutic market. Conclusion: Humulin-R U500 has a similar onset but longer duration of action compared with U100 regular insulin. Insulin glargine U300 has differential PK/pharmacodynamic effects when compared with insulin glargine U100. In noninferiority studies, glycemic control with degludec U200 and glargine U300 is similar to insulin glargine U100 and nocturnal hypoglycemia is reduced. Concentrated formulations appear to behave as separate molecular entities when compared with earlier U100 insulin analog compounds. In the review of available published data, newer concentrated basal insulins may offer an advantage in terms of reduced intraindividual variability as well as reducing the injection burden in individuals requiring high-dose and large volume insulin therapy. Understanding the PK and pharmacodynamic properties of this new generation of insulins is critical to safe dosing, dispensing, and administration

  15. Clinical utility of insulin and insulin analogs

    Science.gov (United States)

    Sanlioglu, Ahter D.; Altunbas, Hasan Ali; Balci, Mustafa Kemal; Griffith, Thomas S.; Sanlioglu, Salih

    2013-01-01

    Diabetes is a pandemic disease characterized by autoimmune, genetic and metabolic abnormalities. While insulin deficiency manifested as hyperglycemia is a common sequel of both Type-1 and Type-2 diabetes (T1DM and T2DM), it does not result from a single genetic defect—rather insulin deficiency results from the functional loss of pancreatic β cells due to multifactorial mechanisms. Since pancreatic β cells of patients with T1DM are destroyed by autoimmune reaction, these patients require daily insulin injections. Insulin resistance followed by β cell dysfunction and β cell loss is the characteristics of T2DM. Therefore, most patients with T2DM will require insulin treatment due to eventual loss of insulin secretion. Despite the evidence of early insulin treatment lowering macrovascular (coronary artery disease, peripheral arterial disease and stroke) and microvascular (diabetic nephropathy, neuropathy and retinopathy) complications of T2DM, controversy exists among physicians on how to initiate and intensify insulin therapy. The slow acting nature of regular human insulin makes its use ineffective in counteracting postprandial hyperglycemia. Instead, recombinant insulin analogs have been generated with a variable degree of specificity and action. Due to the metabolic variability among individuals, optimum blood glucose management is a formidable task to accomplish despite the presence of novel insulin analogs. In this article, we present a recent update on insulin analog structure and function with an overview of the evidence on the various insulin regimens clinically used to treat diabetes. PMID:23584214

  16. The reliability of three psoriasis assessment tools: Psoriasis area and severity index, body surface area and physician global assessment.

    Science.gov (United States)

    Bożek, Agnieszka; Reich, Adam

    2017-08-01

    A wide variety of psoriasis assessment tools have been proposed to evaluate the severity of psoriasis in clinical trials and daily practice. The most frequently used clinical instrument is the psoriasis area and severity index (PASI); however, none of the currently published severity scores used for psoriasis meets all the validation criteria required for an ideal score. The aim of this study was to compare and assess the reliability of 3 commonly used assessment instruments for psoriasis severity: the psoriasis area and severity index (PASI), body surface area (BSA) and physician global assessment (PGA). On the scoring day, 10 trained dermatologists evaluated 9 adult patients with plaque-type psoriasis using the PASI, BSA and PGA. All the subjects were assessed twice by each physician. Correlations between the assessments were analyzed using the Pearson correlation coefficient. Intra-class correlation coefficient (ICC) was calculated to analyze intra-rater reliability, and the coefficient of variation (CV) was used to assess inter-rater variability. Significant correlations were observed among the 3 scales in both assessments. In all 3 scales the ICCs were > 0.75, indicating high intra-rater reliability. The highest ICC was for the BSA (0.96) and the lowest one for the PGA (0.87). The CV for the PGA and PASI were 29.3 and 36.9, respectively, indicating moderate inter-rater variability. The CV for the BSA was 57.1, indicating high inter-rater variability. Comparing the PASI, PGA and BSA, it was shown that the PGA had the highest inter-rater reliability, whereas the BSA had the highest intra-rater reliability. The PASI showed intermediate values in terms of interand intra-rater reliability. None of the 3 assessment instruments showed a significant advantage over the other. A reliable assessment of psoriasis severity requires the use of several independent evaluations simultaneously.

  17. Systemic combination treatment for psoriasis: a review

    DEFF Research Database (Denmark)

    Jensen, Peter; Skov, Lone; Zachariae, Claus

    2010-01-01

    Psoriasis is a chronic inflammatory skin disease, which affects approximately 2.6% of the population in Northern Europe and Scandinavia. In order to achieve disease control, combinations of systemic treatments are sometimes needed for variable time periods. However, no evidence-based guidelines...... exist for the use of systemic combination therapy. Therefore, our aim was to review the current literature on systemic anti-psoriatic combination regimens. We searched PubMed and identified 98 papers describing 116 studies (23 randomized) reporting on the effect of various systemic combination...... treatments. The most thoroughly investigated combination was retinoid and phototherapy. Further controlled research is needed to define the safest and most effective combination regimens....

  18. The impact of obesity on psoriasis

    Directory of Open Access Journals (Sweden)

    Dorota Krasowska

    2016-09-01

    Full Text Available Many psoriatic patients, especially those suffering from severe forms of the disease, are obese and present other features of metabolic syndrome. It is likely due to proinflammatory activity of hormones and cytokines, called adipokines, which are produced by excess of fat tissue. Obese psoriatic patients usually have more severe skin lesions. They also respond poorly to systemic antipsoriatic therapies. Furthermore, this group of patients has a higher frequency of cardiovascular events and metabolic complications as well as psychological disturbances, such as depression, low self-esteem and anxiety disorders. Dietary counseling and lifestyle modification aimed at weight loss should be an integral part of therapeutic management in obese patients with psoriasis.

  19. Therapy of psoriasis with retinoid plus PUVA

    International Nuclear Information System (INIS)

    Heidbreder, G.; Christophers, E.

    1979-01-01

    In a group of 40 patients suffering from wide-spread psoriasis oral administration of a retinoid (Ro 10-9359) was followed by PUVA therapy. The clearance rate was increased by 30% as compared to PUVA alone. Except for cheilitis no side effects were seen. Histological analysis in 20 patients before, during and after therapy revealed an intensification of psoriatic tissue changes after retinoid treatment. Loss of corneal layers, massive exoserosis, and neutrophil migration were prominent features. Mitotic counts were not increased by the pretreatment. The increased susceptibility of diseased skin to PUVA as produced by this drug appears to be based on several factors related to the tissue changes revealed by histology. (orig.) [de

  20. On arthropathic psoriasis: X-ray peculiarities.

    Science.gov (United States)

    Lomuto, M; Cammisa, M; Ditano, G

    1984-01-01

    A radiographic study of the hands, using the method of optical enlargement or 'microradioscopy', was carried out on a group of 58 psoriatic patients suffering from different clinical forms of the disease, but without clinical symptoms of arthropathy. A significant statistical incidence for the following lesions was revealed: (a) focal discontinuity and irregularity of the tuft cortical, similar to a nail-stroke; (b) focal lamellar thickening of the periosteum; (c) small intraspongous geodes; (d) increase of the intracortical striae; (e) small juxta-articular erosions. The radiological aspect of the hands, characterized by monolateral and variously combined lesions (with the almost constant presence of the erosions of the tuft cortical) is characteristic, enough to be recognized as a marker of the disease. The authors assume that psoriasis is a systemic disease characterized by accelerated turnover, and that cutaneous and bone lesions represent a different clinical expression of this same biological process.

  1. Relationship between psoriasis severity degree and TNF-α levels in patients with psoriasis in combination with arterial hypertension

    Directory of Open Access Journals (Sweden)

    V. P. Fedotov

    2015-06-01

    Full Text Available The urgency of the problem is determined by the frequency of comorbidity of psoriasis by essential hypertension. Aim. In order to study the level of TNF-α in patients with psoriasis in combination with essential hypertension 102 patients were examined. Methods and results. The main group (I group consisted of 27 patients with psoriasis in combination with essential hypertension. There were two groups of comparisons: 26 patients with psoriasis (II group and 49 patients with essential hypertension (III group. Severity of the disease was assessed with Psoriasis Area and Severity Index (PASI. Patients completed questionnaire The Dermatology Life Quality Index (DLQI to study the quality of life. Determination of TNF-α in the serum were provided by indirect ELISA. It was found that patients from the 1st group more frequently had widespread forms of dermatosis, with frequent relapses, psoriatic arthropathy. Conclusion. Cytokine activation correlated with worsening of the life quality. Regressive analysis revealed association between psoriasis severity and TNF-α serum level in patients from the main group.

  2. Measurement Properties of the Psoriasis Symptom Inventory Electronic Daily Diary in Patients with Moderate to Severe Plaque Psoriasis.

    Science.gov (United States)

    Viswanathan, Hema N; Mutebi, Alex; Milmont, Cassandra E; Gordon, Kenneth; Wilson, Hilary; Zhang, Hao; Klekotka, Paul A; Revicki, Dennis A; Augustin, Matthias; Kricorian, Gregory; Nirula, Ajay; Strober, Bruce

    2017-09-01

    The Psoriasis Symptom Inventory (PSI) is a patient-reported outcome instrument that measures the severity of psoriasis signs and symptoms. This study evaluated measurement properties of the PSI in patients with moderate to severe plaque psoriasis. This secondary analysis used pooled data from a phase 3 brodalumab clinical trial (AMAGINE-1). Outcome measures included the PSI, Psoriasis Area and Severity Index (PASI), static Physician's Global Assessment (sPGA), psoriasis-affected body surface area, 36-item Short-Form Health Survey version 2, and the Dermatology Life Quality Index (DLQI). The PSI was evaluated for dimensionality, item performance, reliability (internal consistency and test-retest), construct validity, ability to detect change, and agreement between PSI response and response measures based on the PASI, sPGA, and DLQI. Results supported unidimensionality, good item fit, ordered responses, and PSI scoring. The PSI demonstrated reliability: baseline Cronbach's alpha ≥ 0.92 and intraclass correlation coefficients ≥ 0.95. Correlations between PSI total score and DLQI item 1 (r = 0.86), DLQI symptoms and feelings (r = 0.87), and 36-item Short-Form Health Survey version 2 bodily pain (r = -0.61) supported convergent validity. PSI scores differed significantly (P 10%), and DLQI (≤ 5/> 5) at weeks 8 and 12. At week 12, the PSI detected significant changes in severity based on PASI responses (psoriasis signs and symptoms. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. SEZARY SYNDROME MIMICKING GENERALIZED PSORIASIS VULGARIS

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    Eko Rianova Lynoora

    2016-09-01

    Full Text Available Sezary syndrome is the leukemic variant of cutaneous T cell lymphoma. This disease is characterized by some reddish patches or plaques all over the skin which extends to the whole body into erythroderma, lymphadenopathy. It is also indicated by the presence of atypical lymphocytes called Sezary cells. This case report is aimed to know clinical manifestation, examination and management of Sezary syndrome which clinically resembles generalized psoriasis. A 60 years old man came with scaly reddish brown plaques almost all over his body. It was accompanied by lymphadenopathy on the supraclavicular lymph node right and left as well as intense itchy. Other clinical features were alopecia, palmoplantar hyperkeratosis, onychodysthropy, facies leonine without anesthesia on the lesion and enlargement of peripheral nerve. From a laboratory test, an increase in the number of leukocytes and, Sezary cells were found in peripheral blood smear examination; while the histopathology showed focal athrophy and acanthosis of the epidermis and dense infiltration of lymphocytes in the dermo-epidermal junction and superficial dermis. Patient received 3 x 5 mg (1 cycle of methotrexate (MTX with 0,1% cream mometasone furoate and 3x1 tablet of CTM for adjunctive therapy. Methotrexate was discontinued because there was a disturbance in liver function and deterioration of patient’s condition. After 25 days of treatment, the patient got sepsis and then passed away. Early onset of Sezary syndrome in this case is difficult to know because the clinical manifestation is similar with psoriasis vulgaris. Supporting examination such as laboratory test, blood smears and histopathology examination could help the diagnosis. The presence of lymphadenopathy, and atypical lymphocytes in the peripheral blood and the extensive skin involvement reflect the poor prognosis. The most common cause of death was sepsis.

  4. The combination of psoriasis and secondary syphilis. Role of dermatoscopy in differential diagnostics

    Directory of Open Access Journals (Sweden)

    Sherstobitova K.Yu.

    2015-09-01

    Full Text Available A clinical case of the combination of psoriasis and secondary syphilis is presented. The problem of differential diagnostics of the clinical manifestations of syphilis and psoriasis, including the dermatoscopy usage are considered.

  5. Emotion Regulation in Patients with Psoriasis: Correlates of Disability, Clinical Dimensions, and Psychopathology Symptoms.

    Science.gov (United States)

    Almeida, Vera; Taveira, Sofia; Teixeira, Maribel; Almeida, Isabel; Rocha, José; Teixeira, Ana

    2017-08-01

    There are known connections between emotions and psoriasis; however, we have not established a clear pathway for this association. This study aimed to explore correlates of difficulties in emotional regulation in patients with psoriasis and predict the influence of emotional regulation in psoriasis disability. Two hundred and twenty eight participants completed the Difficulties in Emotion Regulation Scale, Self-administered Psoriasis Area and Severity Index, Psoriasis Disability Index, and Brief Symptom Inventory. Spearman's correlation and a hierarchical stepwise multiple regression were carried out to analyse associations. Results indicated that patients with the most recent diagnoses experienced greater difficulty in acting in accordance with goals (r = .16, p psoriasis severity (r = .15, p psoriasis disability (β = .34). The results highlighted the relationship between emotional regulation difficulty, disease characteristics, and psychological variables in psoriasis disability emphasizing the importance of including a broader approach in clinical management of psoriatic patients.

  6. Degludec insulin: A novel basal insulin

    OpenAIRE

    Kalra, Sanjay; Unnikrishnan, Ambika Gopalakrishnan; Baruah, Manash; Kalra, Bharti

    2011-01-01

    This paper reviews a novel insulin analogue, degludec, which has the potential to emerge as an ideal basal insulin. It reviews the limitations of existing basal insulin and analogues, and highlights the need for a newer molecule. The paper discusses the potential advantages of degludec, while reviewing its pharmacologic and clinical studies done so far. The paper assesses the potential role of insulin degludec and degludec plus in clinical diabetes practice.

  7. Body image, self-esteem, and quality of life in patients with psoriasis

    OpenAIRE

    Hulya Nazik; Selcuk Nazik; Feride C Gul

    2017-01-01

    Background: Psoriasis is a chronic inflammatory disease of the skin that may affect the visible areas of body. Hence, the quality of life, self-esteem, and body image can be affected in psoriasis patients. Objectives: We aimed in the present study to assess the effects of psoriasis on the quality of life, self-esteem, and body image. Materials and Methods: The study included 92 patients with psoriasis, along with 98 control participants. The sociodemographic characteristics of the patient...

  8. The global state of psoriasis disease epidemiology:A workshop report

    OpenAIRE

    Griffiths, Christopher; Van der Walt, J. M.; Ashcroft, D M; Flohr, Carsten; Naldi, L.; Nijsten, T.; Augustin, M

    2017-01-01

    Summary The International Psoriasis Council, a global nonprofit organization dedicated to innovation across the full spectrum of psoriasis, led a symposium to discuss the current state of psoriasis epidemiology and to introduce the vision and development of a Global Psoriasis Atlas. The symposium was held on 9 September 2015 at the 45th annual meeting of the European Society for Dermatological Research, Rotterdam, the Netherlands. Collectively, these presentations highlighted challenges assoc...

  9. Köebner phenomenon induced by cupping therapy in a psoriasis patient.

    Science.gov (United States)

    Yu, Rui-Xing; Hui, Yun; Li, Cheng-Rang

    2013-06-15

    Psoriasis is a chronic, immune-mediated inflammatory and refractory disease. The koebner phenomenon, which can be induced by trauma, is common in psoriasis patients. Herein, we report a patient with psoriasis who was treated by cupping therapy and subsequently developed the koebner phenomenon (KP) at the cupped sites. To our knowledge, it is the first report about cupping therapy leading to KP in a psoriasis patient.

  10. Histamine and histamine type-2 receptor antagonists in psoriasis. Mechanisms and speculations

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen

    1991-01-01

    antagonists, previously reported to have a clinical effect on psoriasis. But randomised short-term studies have disclosed that these drugs have no beneficial or even an aggravating effect on the disease. This article reports on recent findings of improvement in psoriasis using high doses of the histamine-2...... receptor antagonist ranitidine in long-term studies. Also presented are a hypothetical action of histamine in development of psoriasis and a rationale for ranitidine as a potential agent in the therapy of psoriasis....

  11. The concept of psoriatic disease: can cutaneous psoriasis any longer be separated by the systemic comorbidities?

    Science.gov (United States)

    Lotti, Torello; Hercogova, Jana; Prignano, Francesca

    2010-01-01

    Psoriasis is a general inflammatory status in which the skin is usually visibly involved. Recent papers show that several comorbidities, including psoriatic arthritis, metabolic syndrome, cancer, osteoporosis, cardiovascular disease, chronic inflammatory bowel disease etc., are significantly associated with psoriasis. Detecting association between psoriasis and comorbidities, properly evaluate confounders and make a correct distinction among absolute risk, relative risk and clinical relevance is mandatory, before embracing the fact the psoriasis is, in fact, a complex and common international disease.

  12. Translation into Brazilian portuguese and validation of the psoriasis family index

    OpenAIRE

    Boza, Juliana Catucci; Basra, Mohammad K. A.; Vanin, Rafaela Caminha; Carvalho, Renata Rosa; Weber, Magda Blessmann; Cestari, Tania Ferreira

    2013-01-01

    Psoriasis Family Index is a quality of life instrument for family members of patients with psoriasis developed in English. The aims of this study were to translate the Psoriasis Family Index into Brazilian Portuguese, culturally adapt it and verify its reliability and validity. The study followed these two steps: 1) Translation, linguistic and cultural adaptation, 2) Validation. The translated Psoriasis Family Index showed high internal consistency and high test-retest reliability, confirming...

  13. Fumaric acid esters in the management of psoriasis

    Science.gov (United States)

    Balak, Deepak MW

    2015-01-01

    Fumaric acid esters (FAE) are small molecules with immunomodulating, anti-inflammatory, and anti-oxidative effects. FAE were introduced as a systemic psoriasis treatment in 1959 and empirically developed further between 1970 and 1990 in Germany, Switzerland, and the Netherlands. The development of FAE as psoriasis treatment did not follow the traditional drug development phases. Nonetheless, in 1994 FAE were approved in Germany for the treatment of severe plaque psoriasis. FAE are currently one of the most commonly used treatments in Germany, and FAE are increasingly being used as an unlicensed treatment in several other European countries. To date, six randomized controlled trials and 29 observational studies have evaluated FAE in a combined total of 3,439 patients. The efficacy and safety profile of FAE is favorable. About 50%–70% of patients achieve at least 75% improvement in psoriasis severity after 16 weeks of treatment. Common adverse events of FAE include gastrointestinal complaints and flushing symptoms, which lead to treatment discontinuation in up to 40% of patients. Lymphocytopenia, eosinophilia, and proteinuria are commonly observed during FAE treatment, but rarely require treatment discontinuation. The long-term safety profile of continuous FAE treatment is favorable without an increased risk for infections, malignancies, or other serious adverse events. There are no known drug-interactions for FAE. The 2009 European evidence-based S3-guidelines on psoriasis treatment recommend FAE and suggest it as a first-line systemic treatment for moderate-to-severe plaque psoriasis. This review is aimed to give an overview of FAE treatment in the management of psoriasis. PMID:29387578

  14. Mortality in patients with psoriasis. A retrospective cohort study.

    Science.gov (United States)

    Masson, Walter; Rossi, Emiliano; Galimberti, María Laura; Krauss, Juan; Navarro Estrada, José; Galimberti, Ricardo; Cagide, Arturo

    2017-06-07

    The immune and inflammatory pathways involved in psoriasis could favor the development of atherosclerosis, consequently increasing mortality. The objectives of this study were: 1) to assess the mortality of a population with psoriasis compared to a control group, and 2) to assess the prevalence of cardiovascular risk factors. A retrospective cohort was analyzed from a secondary database (electronic medical record). All patients with a diagnosis of psoriasis at 1-01-2010 were included in the study and compared to a control group of the same health system, selected randomly (1:1). Subjects with a history of cardiovascular disease were excluded from the study. A survival analysis was performed considering death from any cause as an event. Follow-up was extended until 30-06-2015. We included 1,481 subjects with psoriasis and 1,500 controls. Prevalence of cardiovascular risk factors was higher in the group with psoriasis. The average follow-up time was 4.6±1.7 years. Mortality was higher in psoriasis patients compared to controls (15.1 vs. 9.6 events per 1,000 person-year, PPsoriasis was seen to be significantly associated with increased mortality rates compared to the control group in the univariate analysis (HR 1.58, 95% CI 1.16-2.15, P=.004) and after adjusting for cardiovascular risk factors (HR 1.48, 95% CI 1.08-2.3, P=.014). In this population, patients with psoriasis showed a higher prevalence for the onset of cardiovascular risk factors as well as higher mortality rates during follow-up. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  15. Evaluation of sleep quality in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Fatma Biçici

    2015-09-01

    Full Text Available Background and Design: Psoriasis causes impairments in many daily activities, such as sleeping and occupational performance. One of the most important factors determining the quality of life of a person is sleeping. Studies about sleep quality in psoriasis are quite limited. In this study, we aimed to assess the quality of sleep and to examine the factors affecting the quality of sleep in patients with psoriasis. Materials and Methods: Seventy-three patients with psoriasis and 73 healthy subjects were included in the study. A sociodemographic data form was completed by all the participants and the Pittsburgh Sleep Quality Index (PSQI, 36-item Short-form Health Survey (SF-36, Hamilton Depression Rating Scale (HAM-D and the Hamilton Anxiety Rating Scale (HAM-A were administered to the patients and controls. Body Mass Index (BMI was calculated in patient and control groups. The Psoriasis Area Severity Index (PASI and Dermatology Life Quality Index (DLQI were administered and pruritus was assessed in patient group. Results: PSQI global scores in patient group were found to be higher than in control group. Quality of sleep was worse in patient group. Severity of disease and sociodemographic features were found to be factors not affecting the quality of sleep. In patient group, the patients with higher sleep disturbances had higher rates of depression and anxiety scores. In patient group, the patients with severe pruritus had worse sleep quality. Conclusion: Psoriasis and psoriatic symptoms including pruritus impair sleep quality. Assessment of sleep quality and new strategies to improve sleep quality in patients with psoriasis may help improve quality of life.

  16. Oral gingival metastasis: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Nalini Aswath

    2017-01-01

    Full Text Available Oral cavity is a rare target for metastasis with an incidence of 1% among all oral cancers. In 24% of such cases, oral metastasis is the first indication of an undiagnosed primary. Metastatic oral malignancies have been reported in the mandible, tongue, and gingiva. Although gingival metastasis has been reported from lung, prostate, rectal carcinoma in men and carcinoma of breast, adrenal glands, and genitalia in females, gingival metastasis from carcinoma of the penis has not been reported. Herein, a case of metastatic gingival carcinoma that developed after extraction of teeth from primary carcinoma of the penis is presented. An extensive literature search revealed no such similar case reports.

  17. Dural Metastasis Mimicking Meningioma: An Interesting Case

    Directory of Open Access Journals (Sweden)

    Hamzaini Abdul Hamid

    2009-01-01

    Full Text Available Dural metastasis is a rare entity in clinical practice. We report a case of dural metastasis secondary to thyroid carcinoma, which on both preoperative CT and MRI and at surgery had the typical appearance of a meningioma. Histopathological findings confirmed metastatic follicular thyroid carcinoma as a primary site. Although rare, dural metastases can mimic a meningioma. Our experience in this case has led us to consider metastasis as a differential diagnosis even when a meningioma is suspected. We believe that reporting of the case of dural metastasis mimicking a meningioma may help clinicians in future.

  18. Psoriasis sparing the polio-affected limb: Is it merely the koebner phenomenon?

    Directory of Open Access Journals (Sweden)

    B C Ravikumar

    2014-01-01

    Full Text Available Psoriasis being a common skin condition, atypical forms and unusual localizations of this disease are quite frequently seen. However, psoriasis sparing a polio-affected limb is extremely rare. We report a case of an adult male, who presented with psoriasis distributed all over the body but with almost complete sparing of the polio-affected left lower limb.

  19. Conditional analysis identifies three novel major histocompatibility complex loci associated with psoriasis

    NARCIS (Netherlands)

    Knight, J.; Spain, S.L.; Capon, F.; Hayday, A.; Nestle, F.O.; Clop, A.; Barker, J.N.; Weale, M.E.; Trembath, R.C.; Donnelly, P.; Bergboer, J.G.M.; et al.,

    2012-01-01

    Psoriasis is a common, chronic, inflammatory skin disorder. A number of genetic loci have been shown to confer risk for psoriasis. Collectively, these offer an integrated model for the inherited basis for susceptibility to psoriasis that combines altered skin barrier function together with the

  20. An intrapatient comparison of quality of life in psoriasis in childhood and adulthood

    NARCIS (Netherlands)

    Jager, M.E.A. de; Jong, E.M.G.J. de; Kerkhof, P.C.M. van de; Evers, A.W.M.; Seijger, M.M.B.

    2011-01-01

    BACKGROUND: Chronic diseases can have a great influence on health-related quality of life. Nevertheless, only little research has been carried out on childhood psoriasis. The perception of quality of life by adults with psoriasis of their childhood psoriasis has never been investigated. OBJECTIVES:

  1. Pancreatic Metastasis from Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Julian Jacob

    2010-01-01

    Full Text Available The pancreas is an unusual location for metastases from other primary cancers. Rarely, pancreatic metastases from kidney or colorectal cancers have been reported. However, a variety of other cancers may also spread to the pancreas. We report an exceptional case of pancreatic metastasis from prostate cancer. Differences in management between primary and secondary pancreatic tumors make recognition of metastases to the pancreas an objective of first importance. Knowledge of unusual locations for metastatic spread will reduce diagnostic delay and lead to a timely delivery of an appropriate treatment.

  2. Pulmonary metastasis in thyroid cancer

    International Nuclear Information System (INIS)

    Samuel, A.M.; Rajashekharrao, B.; Shah, D.H.

    1999-01-01

    Although thyroid cancer (TC) in its differentiated form is generally associated with a good prognosis and a near normal life expectancy, a subset of patients especially with distant metastatic disease may run an aggressive course leading to poor survival and early death. The clinical presentation and the manner in which the disease progresses differs with the site and type of the metastatic disease. The behaviour and course of skeletal metastasis has been described elsewhere. The biological behaviour and treatment of pulmonary metastatic disease is focussed on

  3. The Australasian Psoriasis Collaboration view on methotrexate for psoriasis in the Australasian setting.

    Science.gov (United States)

    Rademaker, Marius; Gupta, Monisha; Andrews, Megan; Armour, Katherine; Baker, Chris; Foley, Peter; Gebauer, Kurt; George, Jacob; Rubel, Diana; Sullivan, John

    2017-08-01

    The Australasian Psoriasis Collaboration reviewed methotrexate (MTX) in the management of psoriasis in the Australian and New Zealand setting. The following comments are based on expert opinion and a literature review. Low-dose MTX (< 0.4 mg/kg per week) has a slow onset of action and has moderate to good efficacy, together with an acceptable safety profile. The mechanism of action is anti-inflammatory, rather than immunosuppressive. For pretreatment, consider testing full blood count (FBC), liver and renal function, non-fasting lipids, hepatitis serology, HbA1c and glucose. Body mass index and abdominal circumference should also be measured. Optional investigations in at-risk groups include an HIV test, a QuantiFERON-TB Gold test and a chest X-ray. In patients without complications, repeat the FBC at 2-4 weeks, then every 3-6 months and the liver/renal function test at 3 months and then every 6 months. There is little evidence that a MTX test dose is of value. Low-dose MTX rarely causes clinically significant hepatotoxicity in psoriasis. Most treatment-emergent liver toxicity is related to underlying metabolic syndrome and non-alcoholic fatty liver disease or non-alcoholic steatohepatitis. Alcohol itself is not contraindicated, but should be limited to < 20 gm/day. [Correction added on 6 January 2017, after first online publication: '20 mg/day' has been corrected to '20 gm/day'.] Although MTX is a potential teratogen post-conception, there is little evidence for this pre-conception. MTX does not affect the quality of sperm. There is no evidence that MTX reduces healing, so there is no specific need to stop MTX peri-surgery. MTX may be used in combination with cyclosporine, acitretin, prednisone and anti-tumour necrosis factor biologics. © 2016 The Australasian College of Dermatologists.

  4. Metastasis

    Science.gov (United States)

    ... and Care Surgical Treatment Laparoscopic Surgery Vaccine Radiation Therapy Chemotherapy Clinical Trials Pain Management Nutrition and Exercise Holistic Care Pathology Intraductal Papillary Mucinous Neoplasms Islet Cell ...

  5. Efficacy and safety of ixekizumab treatment for Japanese patients with moderate to severe plaque psoriasis, erythrodermic psoriasis and generalized pustular psoriasis: Results from a 52-week, open-label, phase 3 study (UNCOVER-J).

    Science.gov (United States)

    Saeki, Hidehisa; Nakagawa, Hidemi; Nakajo, Ko; Ishii, Taeko; Morisaki, Yoji; Aoki, Takehiro; Cameron, Gregory S; Osuntokun, Olawale O

    2017-04-01

    Psoriasis, a chronic, immune-mediated skin disease characterized by red, scaly plaques, affects approximately 0.3% of the population in Japan. The aim of this open-label study was to evaluate the long-term efficacy and safety of ixekizumab, a humanized, anti-interleukin-17A monoclonal antibody, in Japanese patients with plaque psoriasis (n = 78, including 11 psoriatic arthritis), erythrodermic psoriasis (n = 8) and generalized pustular psoriasis (n = 5). Ixekizumab was administrated s.c. at baseline (week 0, 160 mg), from weeks 2 to 12 (80 mg every 2 weeks), and from weeks 16 to 52 (80 mg every 4 weeks). At week 52, 92.3% of patients with plaque psoriasis achieved Psoriasis Area and Severity Index (PASI) 75, 80.8% achieved PASI 90, 48.7% achieved PASI 100, and 52.6% had remission of plaques (by static Physician Global Assessment, sPGA [0]). Difficult to treat areas of psoriasis (nail or scalp) also responded to ixekizumab. All patients with psoriatic arthritis who were assessed (5/5) achieved an American College of Rheumatology 20 response. Most patients with erythrodermic psoriasis or generalized pustular psoriasis responded to ixekizumab and the clinical outcome was maintained over 52 weeks (75% and 60% of patients achieved sPGA [0, 1] at week 52, respectively). Mostly mild or moderate treatment-emergent adverse events were reported by 79 of 91 patients; the most common were nasopharyngitis, eczema, seborrheic dermatitis, urticaria and injection site reactions. In conclusion, 52-week ixekizumab treatment was efficacious and well tolerated in Japanese patients with plaque psoriasis. Efficacy was also observed in patients with erythrodermic psoriasis, generalized pustular psoriasis and psoriatic arthritis. © 2016 Eli Lilly Japan K.K. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.

  6. [Adverse reactions to insulin].

    Science.gov (United States)

    Liñana, J J; Montoro, F J; Hernández, M D; Basomba, A

    1997-07-01

    The prevalence of allergic reactions to insuline has decreased during the last few years. Probably this is due to the use of the newly-developed recombinant human insuline. At present, adverse reactions to insuline occur in 5-10% of patients on therapy with insuline. Adverse reactions may be local (more frequent) or systemic (rare). Insuline resistance consists in a different type of immunological reaction. Diagnosis of allergy to insuline is based on clinical history and cutaneous and serological tests. Treatment depends upon the severity of the reaction. When insuline is indispensable despite a previous allergic reaction, a desensitization protocol may be implemented.

  7. Expert Recommendations on Treating Psoriasis in Special Circumstances (Part II).

    Science.gov (United States)

    Carrascosa, J M; Galán, M; de Lucas, R; Pérez-Ferriols, A; Ribera, M; Yanguas, I

    2016-11-01

    There is insufficient information on how best to treat moderate to severe psoriasis in difficult clinical circumstances. We considered 5 areas where there is conflicting or insufficient evidence: pediatric psoriasis, risk of infection in patients being treated with biologics, psoriasis in difficult locations, biologic drug survival, and impact of disease on quality of life. Following discussion of the issues by an expert panel of dermatologists specialized in the management of psoriasis, participants answered a questionnaire survey according to the Delphi method. Consensus was reached on 66 (70.9%) of the 93 items analyzed; the experts agreed with 49 statements and disagreed with 17. It was agreed that body mass index, metabolic comorbidities, and quality of life should be monitored in children with psoriasis. The experts also agreed that the most appropriate systemic treatment for this age group was methotrexate, while the most appropriate biologic treatment was etanercept. Although it was recognized that the available evidence was inconsistent and difficult to extrapolate, the panel agreed that biologic drug survival could be increased by flexible, individualized dosing regimens, continuous treatment, and combination therapies. Finally, consensus was reached on using the Dermatology Quality of Life Index to assess treatment effectiveness and aid decision-making in clinical practice. The structured opinion of experts guides decision-making regarding aspects of clinical practice for which there is incomplete or conflicting information. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Psoriasis--new insights into pathogenesis and treatment.

    Science.gov (United States)

    Mrowietz, Ulrich; Reich, Kristian

    2009-01-01

    Psoriasis is one of the most prevalent chronic inflammatory diseases, affecting approximately 2 million people in Germany. Selective literature review taking into account the German S1 and S3 guidelines for the treatment of this condition. Psoriasis is a very troublesome disease with a high economic impact. The disease often persists for life, and the patient has an increased risk of cardiovascular diseases and their complications. One out of five patients develops psoriatic arthritis. The clinical picture of psoriasis is highly variable with regard to lesional characteristics and the severity of disease. To improve the management of psoriasis the guidelines must be followed and all appropriate topical and systemic treatment options must be tried, with clearly defined treatment goals. The spectrum of established systemic treatments for psoriasis has been extended by the biologics. These can be used to achieve a good skin status and a clear-cut improvement in quality of life even in patients who do not--or no longer--respond adequately to conventional therapies.

  9. Serum peptides as putative modulators of inflammation in psoriasis.

    Science.gov (United States)

    Matsuura, Tetsuhiko; Sato, Masaaki; Nagai, Kouhei; Sato, Toshiyuki; Arito, Mitsumi; Omoteyama, Kazuki; Suematsu, Naoya; Okamoto, Kazuki; Kato, Tomohiro; Soma, Yoshinao; Kurokawa, Manae S

    2017-07-01

    Psoriasis is a refractory inflammatory disease, however, its pathophysiology is still not fully understood. We tried to identify novel serum peptides associated with the pathophysiology of psoriasis. Serum peptides from 24 patients with psoriasis vulgaris (PV), 10 patients with psoriatic arthritis (PsA), 14 patients with atopic dermatitis (AD), and 23 healthy control (HC) subjects were analyzed by mass spectrometry. The effects of some peptides on the secretion of humoral factors from dermal cells were investigated by cytokine arrays and ELISAs. A total of 93 peptides were detected. 24, 20, 23, and 2 peptides showed at least 1.2-fold difference in ion intensity between the psoriasis (PV+PsA) and HC groups, between the PV+PsA and AD groups, between the PV and PsA groups, and between patients with severe-to-moderate PV (n=6) and those with mild PV (n=18), respectively (ppsoriasis, regulating the secretion of inflammatory chemokines and an antimicrobial protein. The modulation of serum peptides may be a potential therapeutic strategy for psoriasis. Copyright © 2017 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

  10. Psoriasis pathogenesis and the development of novel targeted immune therapies.

    Science.gov (United States)

    Hawkes, Jason E; Chan, Tom C; Krueger, James G

    2017-09-01

    Psoriasis is caused by a complex interplay between the immune system, psoriasis-associated susceptibility loci, autoantigens, and multiple environmental factors. Over the last 2 decades, research has unequivocally shown that psoriasis represents a bona fide T cell-mediated disease primarily driven by pathogenic T cells that produce high levels of IL-17 in response to IL-23. The discovery of the central role for the IL-23/type 17 T-cell axis in the development of psoriasis has led to a major paradigm shift in the pathogenic model for this condition. The activation and upregulation of IL-17 in prepsoriatic skin produces a "feed forward" inflammatory response in keratinocytes that is self-amplifying and drives the development of mature psoriatic plaques by inducing epidermal hyperplasia, epidermal cell proliferation, and recruitment of leukocyte subsets into the skin. Clinical trial data for mAbs against IL-17 signaling (secukinumab, ixekizumab, and brodalumab) and newer IL-23p19 antagonists (tildrakizumab, guselkumab, and risankizumab) underscore the central role of these cytokines as predominant drivers of psoriatic disease. Currently, we are witnessing a translational revolution in the treatment and management of psoriasis. Emerging bispecific antibodies offer the potential for even better disease control, whereas small-molecule drugs offer future alternatives to the use of biologics and less costly long-term disease management. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. The prevalence of fibromyalgia among patients with psoriasis.

    Science.gov (United States)

    Thune, Per O

    2005-01-01

    The aim of the present study was to investigate the prevalence of fibromyalgia and allied symptoms in patients with psoriasis. During a 3-year period from 1997 until 2000, 1269 patients were consecutively diagnosed with psoriasis. All patients were questioned about musculoskeletal symptoms and those with such symptoms were further examined according to a standardized protocol. In total 335 of 1269 patients had musculoskeletal symptoms. More women than men had such complaints, 33% versus 18.5%, respectively. As many as 13% of the women fulfilled the American College of Rheumatology 1990 (ACR-90) criteria for fibromyalgia, while 14.1% had symptoms compatible with chronic widespread pain without meeting the fibromyalgia criteria. In total, 8.3% suffered from fibromyalgia and 9% from chronic widespread pain. The results indicate that fibromyalgia and allied symptoms are frequent in female patients with psoriasis and constitute important problems with regard to disability and health-related quality of life. Only 35 of 105 patients with fibromyalgia had previously been diagnosed with psoriasis and the diagnostic label of fibromyalgia was new to 51 of them. Female patients with symptoms of psoriasis and pain seem to constitute a subgroup which deserves further studies.

  12. Insulin causes insulin-receptor internalization in human erythrocyte ghosts.

    OpenAIRE

    Kelleher, R S; Murray, E F; Peterson, S W

    1987-01-01

    The effect of incubation with insulin on insulin-receptor internalization by erythrocyte ghosts was investigated. The number of surface insulin receptors decreased by 30-40% after incubation of ghosts with insulin. Total insulin-receptor binding to solubilized ghosts was the same in insulin-incubated and control ghosts, whereas insulin binding to an internal vesicular fraction was substantially increased in insulin-incubated ghosts. Our findings suggest that erythrocyte-ghost insulin receptor...

  13. Pseudo ?insulin allergy?

    OpenAIRE

    Chettiar, Pradeep Raman; Sanalkumar, Nishanth; John, Mathew

    2008-01-01

    Allergy to human insulin is relatively rare in clinical practice. This report describes a patient referred for suspected ?insulin allergy? due to lesions appearing at all sites of insulin injection. Careful evaluation confirmed contamination of the insulin syringes due to faulty techniques used by the patient. The report discusses the various types of insulin allergies and the need for proper diabetic education to avoid such infections.

  14. Insulin and the Brain

    Directory of Open Access Journals (Sweden)

    Grosu Cristina

    2017-12-01

    Full Text Available The brain represents an important site for the action of insulin. Besides the traditionally known importance in glucoregulation, insulin has significant neurotrophic properties and influences the brain activity: insulin influences eating behavior, regulates the storage of energy and several aspects concerning memory and knowledge. Insulin resistance and hyperinsulinism could be associated with brain aging, vascular and metabolic pathologies. Elucidating the pathways and metabolism of brain insulin could have a major impact on future targeted therapies.

  15. Hypothyroidism in Patients with Psoriasis or Rosacea: A Large Population Study.

    Science.gov (United States)

    James, Sara M; Hill, Dane E; Feldman, Steven R

    2016-10-15

    Hypothyroidism is a common disease, and there may be a link between hypothyroidism and inflammatory skin disease. The purpose of this study is to assess whether hypothyroidism is more prevalent in psoriasis or rosacea patients. We utilized a large claims-based database to analyze rates of hypothyroidism in patients with psoriasis and rosacea compared to other patients with skin diseases. Participants were patients between 20-64 years of age with ICD-9 diagnosis codes for psoriasis, rosacea, and hypothyroidism. We found that rates of hypothyroidism in rosacea and psoriasis patients were similar to rates of hypothyroidism in those without rosacea or psoriasis.

  16. Introducing Stereology as a Tool to Assess the Severity of Psoriasis

    DEFF Research Database (Denmark)

    Kamp, Søren; Stenderup, Karin; Rosada, Cecilia

    2008-01-01

    to histological specimens in order to obtain three-dimensional properties from two-dimensional tissue samples. The psoriasis xenograft model used in this trial is accepted as a leading animal model for psoriasis. Psoriatic skin from psoriatic patients was grafted onto severe combined immunodeficient (SCID) mice......  The purpose of this study was to introduce stereology as a novel tool in assessing the severity of psoriasis. Psoriasis is a well described chronic inflammatory skin disease affecting approximately 2% of the Caucasian population.   The severity of psoriasis has been assessed by a multitude...

  17. Isolated Pancreatic Metastasis from Malignant Melanoma: Is ...

    African Journals Online (AJOL)

    Thus, pre-operative exhaustive staging is needed to confirm both the absence of local invasion of major vasculature and the absence of distant metastasis. Positron emission tomography scanning seems to have a higher sensitivity and specificity than conventional imaging for detecting metastasis from malignant melanoma.

  18. Hepatic Metastasis of Thymoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jung Hun; Kim, Jang Ho; Shin, Hyun Woong; Lee, Il Ki; Sohn, Kyung Rak [Fatima Hospital, Daegu (Korea, Republic of)

    2005-03-15

    Thymoma is the most common neoplasm in the anterior mediastinum, and extrathoracic involvement is rare. Moreover, cystic liver metastasis is extremely rare; few cases have been reported in the literature to date. We report here on a case of cystic liver metastasis of thymoma treated with surgical resection, describing the ultrasonography, CT and MRI findings

  19. Metastasis within a metastasis to the thyroid: A rare phenomenon

    Directory of Open Access Journals (Sweden)

    Yin Ping Wong

    2017-01-01

    Full Text Available Metastatic disease involving the thyroid gland is uncommon. Solitary thyroid metastases from various primary sites particularly kidney, lung, and breast had been previously described. To the best of our knowledge, metastases from two topographically separate primary malignancies to the thyroid have never been documented hitherto. This is the first reported case of cancer-to-cancer metastasis involving an invasive breast carcinoma metastasized within a metastatic renal cell carcinoma in the nonneoplastic thyroid in a 58-year-old woman. Distinguishing a secondary thyroid metastases from a primary thyroid malignancy is utmost crucial as treatment differs. The possibility of tumor metastases from two separated primaries should always be considered in a tumor exhibiting malignant cell populations with two distinctive histomorphological appearances. The role of immunohistochemistry stains in equivocal cases cannot be overemphasized.

  20. Guidelines for the use of acitretin in psoriasis. Psoriasis Group of the Spanish Academy of Dermatology and Venereology.

    Science.gov (United States)

    Carretero, G; Ribera, M; Belinchón, I; Carrascosa, J M; Puig, Ll; Ferrandiz, C; Dehesa, L; Vidal, D; Peral, F; Jorquera, E; González-Quesada, A; Muñoz, C; Notario, J; Vanaclocha, F; Moreno, J C

    2013-09-01

    Phototherapy, classic systemic treatments (methotrexate, acitretin, and ciclosporin), and biologic agents (etanercept, infliximab, adalimumab, and ustekinumab) constitute a broad therapeutic arsenal that increases the likelihood of achieving control of severe and extensive disease in patients with psoriasis. Acitretin continues to be a very valuable tool in both monotherapy, in which it is combined with other systemic treatments (classic or biologic), and in sequential therapy. Thanks to its lack of a direct immunosuppressive effect and its ability to achieve a long-term response, acitretin has an important role in the treatment of psoriasis, although this has not always been acknowledged in relevant treatment guidelines. We present consensus guidelines for the use of acitretin in psoriasis drawn up by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology. These guidelines provide a detailed account of acitretin, including pharmacological properties, indications and contraindications, adverse effects, and factors that should be taken into account to enhance the safe use of this drug. They also propose treatment strategies for use in routine clinical practice. The overall aim of these guidelines is to define the criteria for the use and management of acetretin in psoriasis. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

  1. Contiguous spinal metastasis mimicking infectious spondylodiscitis

    International Nuclear Information System (INIS)

    Lee, Chul Min; Lee, Seung Hun; Bae, Ji Yoon

    2015-01-01

    Differential diagnosis between spinal metastasis and infectious spondylodiscitis is one of the occasional challenges in daily clinical practice. We encountered an unusual case of spinal metastasis in a 75-year-old female breast cancer patient that mimicked infectious spondylodiscitis. Magnetic resonance imaging (MRI) showed diffuse bone marrow infiltrations with paraspinal soft tissue infiltrative changes in 5 contiguous cervical vertebrae without significant compression fracture or cortical destruction. These MRI findings made it difficult to differentiate between spinal metastasis and infectious spondylodiscitis. Infectious spondylodiscitis such as tuberculous spondylodiscitis was regarded as the more appropriate diagnosis due to the continuous involvement of > 5 cervical vertebrae. The patient's clinical presentation also supported the presumptive diagnosis of infectious spondylodiscitis rather than spinal metastasis. Intravenous antibiotics were administered, but clinical symptoms worsened despite treatment. After pathologic confirmation by computed tomography-guided biopsy, we were able to confirm a final diagnosis of spinal metastasis

  2. Contiguous spinal metastasis mimicking infectious spondylodiscitis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chul Min; Lee, Seung Hun [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of); Bae, Ji Yoon [Dept. of Pathology, National Police Hospital, Seoul (Korea, Republic of)

    2015-12-15

    Differential diagnosis between spinal metastasis and infectious spondylodiscitis is one of the occasional challenges in daily clinical practice. We encountered an unusual case of spinal metastasis in a 75-year-old female breast cancer patient that mimicked infectious spondylodiscitis. Magnetic resonance imaging (MRI) showed diffuse bone marrow infiltrations with paraspinal soft tissue infiltrative changes in 5 contiguous cervical vertebrae without significant compression fracture or cortical destruction. These MRI findings made it difficult to differentiate between spinal metastasis and infectious spondylodiscitis. Infectious spondylodiscitis such as tuberculous spondylodiscitis was regarded as the more appropriate diagnosis due to the continuous involvement of > 5 cervical vertebrae. The patient's clinical presentation also supported the presumptive diagnosis of infectious spondylodiscitis rather than spinal metastasis. Intravenous antibiotics were administered, but clinical symptoms worsened despite treatment. After pathologic confirmation by computed tomography-guided biopsy, we were able to confirm a final diagnosis of spinal metastasis.

  3. Medical adherence to topical corticosteroid preparations prescribed for psoriasis

    DEFF Research Database (Denmark)

    Svendsen, Mathias Tiedemann; Andersen, Flemming; Hansen, Jakob

    2017-01-01

    OBJECTIVE: Topical corticosteroids and corticosteroid combinations are the principal treatments in psoriasis. The aim of this study was to investigate published literature dealing with medical adherence to topical corticosteroid or corticosteroid combinations in patients with psoriasis. MATERIALS...... health outcome in topical treatment of psoriasis, further studies should be conducted addressing determinants of nonadherence and test interventions to improve adherence. Validated measurements of medical nonadherence, prescription registers, or medication-weight are needed....... interventional study. Observation periods varied and rates of nonadherence ranged from 8% to 88.3%. The rates were reported by patients on eight nonvalidated scales and one validated scale, measured by medication weight in two studies, and in two studies rates of nonadherence were measured using prescription...

  4. Generalized pustular psoriasis of pregnancy successfully treated with cyclosporine

    Directory of Open Access Journals (Sweden)

    Hazarika Debeeka

    2009-01-01

    Full Text Available Two multigravidae aged 27 and 29 years, with previous uneventful pregnancies, second being psoriatic, reported at 24 and 28 weeks of pregnancies, with generalized pustular lesions. Laboratory findings, including serum calcium were normal. Ultrasonography showed normal fetal growth. Histopathology confirmed pustular psoriasis. Patients were put on cyclosporine 3 mg/ kg weight/ day after failure of an initial systemic steroid. Blood pressure, pulse, and fetal heart sounds were recorded every 12 hours, and ultrasonography and blood parameters, biweekly. Cyclosporine was tapered and stopped after delivery of two healthy babies at 38 weeks. We conclude that cyclosporine can be an option in the management of pustular psoriasis of pregnancy or psoriasis with pustulation in pregnancy.

  5. Diagnostic value of dermatoscopy in case of psoriasis

    Directory of Open Access Journals (Sweden)

    Utz S.R.

    2015-09-01

    Full Text Available Aim: to evaluate the picture of dermatoscopy in case of psoriasis at different stages of the disease. Materials and Methods. We observed 30 patients with a diagnosis of disseminated papular — plaque psoriasis at the stage of progression. Dermatoscopic study was conducted by the expert class videodermatoskop MoleMaxHD (company Derma Medical Systems, Austria, with an increase from x30 to x80 to initiation of therapy, on the 7th and 15th days of treatment. Results. Changes of dermatoscopic picture in psoriasis are observed on the first days of treatment, and outperformed the major clinical manifestations of infections detected by the human eye. Conclusion. Dermatoscopy reveals the earliest signs of positive dynamics of the therapy and can be used to select a rational method of treatment.

  6. Facing the dilemma of patient-centred psoriasis care

    DEFF Research Database (Denmark)

    Khoury, L R; Skov, L; Møller, T

    2017-01-01

    BACKGROUND: Caregivers must be aware of patients' current needs by providing care responsive to patients' values and preferences and by identifying what approach improves and encourages patients to participate in their treatment and disease management. Patients with psoriasis healthcare needs...... perhaps change as medical knowledge improves, new drugs emerge and the healthcare system improves its efficiency as a result of constant structural development. OBJECTIVES: To explore the unmet needs and health perceptions of people with psoriasis, regarding interaction with clinicians and the structure...... inherent to consultations in a hospital outpatient dermatological clinic. METHODS: A qualitative investigation with data generated from semi-structured interviews. Transcriptions were subsequently analysed using the template analysis method. RESULTS: Sixteen patients with psoriasis were interviewed...

  7. Treating moderate to severe psoriasis - best use of biologics.

    LENUS (Irish Health Repository)

    Lynch, Maeve

    2014-02-01

    This review focuses on the efficacy, safety and best use of biologic agents in moderate-to-severe psoriasis. Recommendations from two recent guidelines are summarised. The NICE Guidelines 2012 provide recommendations on best practice for prescribing biologics. The German S3 Guidelines are based on a systematic review of published studies and report the efficacy of biologics and guidelines for treatment. Data on the safety of biologics are available for up to 5 years in psoriasis and are on the whole reassuring. Registry data is evolving and will provide data on safety to help inform long-term monitoring of patients with psoriasis on biologics agents. New anti-interleukin-17 (IL17) and anti-IL17RA biologics are in Phase 3 clinical trials and may prove to be more effective than existing biologics.

  8. A Clinician's Guide to the Diagnosis and Treatment of Candidiasis in Patients with Psoriasis.

    Science.gov (United States)

    Armstrong, April W; Bukhalo, Michael; Blauvelt, Andrew

    2016-08-01

    Many of the molecular pathways associated with psoriasis pathogenesis are also involved in host defense mechanisms that protect against common pathogens. Candida can stimulate the production of cytokines that trigger or exacerbate psoriasis, and many systemic psoriasis treatments may put patients at increased risk for developing oral, cutaneous, and genitourinary candidiasis. Therefore, dermatologists should regularly screen patients with psoriasis for signs of Candida infection, and take steps to effectively treat these infections to prevent worsening of psoriasis symptoms. This review provides an overview of candidiasis epidemiology in patients with psoriasis, followed by a primer on the diagnosis and treatment of superficial Candida infections, with specific guidance for patients with psoriasis. Candidiasis in patients with psoriasis typically responds to topical or oral antifungal therapy. While biologic agents used to treat moderate-to-severe psoriasis, such as tumor necrosis factor-α inhibitors and interleukin-17 inhibitors, are known to increase patients' risk of developing localized candidiasis, the overall risk of infection is low, and candidiasis can be effectively managed in most patients while receiving systemic psoriasis therapies. Thus, the development of candidiasis does not usually necessitate changes to psoriasis treatment regimens.

  9. Psoriasis and wound healing outcomes: A retrospective cohort study examining wound complications and antibiotic use.

    Science.gov (United States)

    Young, Paulina M; Parsi, Kory K; Schupp, Clayton W; Armstrong, April W

    2017-11-15

    Little is known about wound healing in psoriasis. We performed a cohort study examining differences in wound healing complications between patients with and without psoriasis. Psoriasis patients with traumatic wounds were matched 1:3 to non-psoriasis patients with traumatic wounds based on age, gender, and body mass index (BMI). We examined theincidence of wound complications including infection, necrosis, and hematoma as well as incident antibiotic use within three months following diagnosis of a traumatic wound. The study included 164 patients with traumatic wounds, comprised of 41 patients with psoriasis matched to 123 patients without psoriasis. No statistically significant differences were detected in the incidence of overall wound complications between wound patients with psoriasis and wound patients without psoriasis (14.6% versus. 13.0%, HR 1.18, CI 0.39-3.56). After adjustment for diabetes, peripheral vascular disease, and smoking, no statistically significant differences were detected in the incidence of overall wound complications between patients with and without psoriasis (HR 1.11, CI 0.34-3.58). Specifically, the adjusted rates of antibiotic use were not significantly different between those with and without psoriasis (HR 0.65, CI 0.29-1.46). The incidence of wound complications following traumatic wounds of the skin was found to be similar between patients with and without psoriasis.

  10. Excessive angiogenesis associated with psoriasis as a cause for cardiovascular ischaemia.

    Science.gov (United States)

    Malecic, Nina; Young, Helen S

    2017-04-01

    Psoriasis, a common disease affecting 2%-3% of the UK population, produces significant impairment of quality of life and is an immense burden on sufferers and their families. Psoriasis is associated with significant cardiovascular comorbidity and the metabolic syndrome. Angiogenesis, a relatively under-researched component of psoriasis, is a key factor in pathogenesis of psoriasis and also contributes to the development of atherosclerosis. Vascular endothelial growth factor (VEGF) is a well-established mediator of pathological angiogenesis which is upregulated in psoriasis. It is possible that, in patients with psoriasis, cutaneous angiogenesis may be both a marker for systemic vascular pathology and a novel therapeutic target. In this viewpoint study, the role of VEGF-mediated angiogenesis as a cause for cardiovascular events in patients with psoriasis is explored. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Psychiatric comorbidities in children and adolescents with psoriasis - a population-based cohort study

    DEFF Research Database (Denmark)

    Todberg, T; Egeberg, A; Jensen, P

    2017-01-01

    Psoriasis is present in 2-3% of the adult European population(1) and 0.7-1.2% in children(1,2) . Adults with psoriasis have increased risk of depression(3) , and US data reported an increased risk of psychiatric diseases in pediatrics with psoriasis(4) , however European data are lacking. Primary...... outcomes were to examine the risk of psychiatric disorders including use of psychopharmacotherapy in children with psoriasis compared to healthy controls in a population-based cohort study. This article is protected by copyright. All rights reserved.......Psoriasis is present in 2-3% of the adult European population(1) and 0.7-1.2% in children(1,2) . Adults with psoriasis have increased risk of depression(3) , and US data reported an increased risk of psychiatric diseases in pediatrics with psoriasis(4) , however European data are lacking. Primary...

  12. Defining Outcome Measures for Psoriasis: The IDEOM Report from the GRAPPA 2016 Annual Meeting.

    Science.gov (United States)

    Callis Duffin, Kristina; Gottlieb, Alice B; Merola, Joseph F; Latella, John; Garg, Amit; Armstrong, April W

    2017-05-01

    The International Dermatology Outcome Measures (IDEOM) psoriasis working group was established to develop core domains and measurements sets for psoriasis clinical trials and ultimately clinical practice. At the 2016 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis, the IDEOM psoriasis group presented an overview of its progress toward developing this psoriasis core domain set. First, it summarized the February 2016 meeting of all involved with the IDEOM, highlighting patient and payer perspectives on outcome measures. Second, the group presented an overview of the consensus process for developing the core domain set for psoriasis, including previous literature reviews, nominal group exercises, and meeting discussions. Future plans include the development of working groups to review candidate measures for at least 2 of the domains, including primary pathophysiologic manifestations and patient-reported outcomes, and Delphi surveys to gain consensus on the final psoriasis core domain set.

  13. Psoriasis: A STAT3-Centric View.

    Science.gov (United States)

    Calautti, Enzo; Avalle, Lidia; Poli, Valeria

    2018-01-06

    Signal Transducer and Activator of Transcription (STAT)3 has recently emerged as a key player in the development and pathogenesis of psoriasis and psoriatic-like inflammatory conditions. Indeed, STAT3 hyperactivation has been reported in virtually every cell type involved in disease initiation and maintenance, and this factor mediates the signal of most cytokines that are involved in disease pathogenesis, including the central Interleukin (IL)-23/IL-17/IL-22 axis. Despite the recent availability of effective biological agents (monoclonal antibodies) against IL-17 and IL-23, which have radically changed the current standard of disease management, the possibility of targeting either STAT3 itself or, even better, the family of upstream activators Janus kinases (JAK1, 2, 3, and TYK2) offers additional therapeutic options. Due to the oral/topical administration modality of these small molecule drugs, their lower cost, and the reduced risk of eliciting adverse immune responses, these compounds are being actively scrutinized in clinical settings. Here, we summarize the main pathological features of psoriatic conditions that provide the rationale for targeting the JAK/STAT3 axis in disease treatment.

  14. Photosensitizing compounds in the treatment of psoriasis.

    Science.gov (United States)

    Hönigsmann, H; Tanew, A; Brücke, J; Ortel, B

    1989-01-01

    Photosensitizers were first used to treat psoriasis 15 years ago when the phototoxic reaction of psoralens and UVA was found to induce remissions of the disease. The effect of this reaction on DNA, particularly the formation of cross-links, was thought to be the decisive event. Strong cross-linking agents such as 8-MOP, TMP and 5-MOP are clinically effective whereas most compounds which produce only monofunctional adducts are virtually ineffective. Orally administered 8-methoxypsoralen (8-MOP) is the most widely used compound. 4,5',8-Trimethylpsoralen (TMP) is poorly absorbed from the intestine but has marked efficacy when applied topically. 5-MOP may be a useful alternative to 8-MOP because it is less erythemogenic and does not cause nausea. These three furocoumarins appear to be similar photochemically and may introduce similar risks. However, the photobiological properties of furocoumarins can be modified by altering one or more parts of the molecule. Such modifications might yield effective analogues with reduced cytogenetic hazards. Several psoralens and angular furocoumarins are being tested for effectiveness combined with fewest long-term side-effects, especially carcinogenesis. Encouraging preliminary results have been obtained with 7-methyl-pyridopsoralen and 4,6,4'-trimethylangelicin. Other important approaches to increasing the safety of photochemotherapy may be the use of different photoactivating wavelengths or the introduction of new classes of photosensitizers.

  15. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2011-06-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  16. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2012-02-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  17. Main level of cytokines in patients with psoriasis

    Directory of Open Access Journals (Sweden)

    A. S. Beltyukova

    2015-01-01

    Full Text Available The aim of the study was to determine the level of cytokines in the serum of patients with psoriatic arthritis (PsA and psoriasis vulgaris (Ps and to identify key immune markers associated with clinical manifestations of psoriasis. Materials and methods. The study involved 52 patients with psoriatic arthritis (PsA and 20 patients with psoriasis vulgaris (PS by multiplex analysis of proteins using Bio-Plex device and commercial test kits 23-Plex and 27-Plex, 8-Plex. Assessment of the severity and prevalence of psoriatic skin lesions in patients was conducted by index PASI (Psoriasis Area and Severity Index. Indicators of acute-phase activity (ESR, CRP, CEC were defined in all patients. the comparison group consisted of patients with a diagnosis of patchy scleroderma (10 patients and patients with atopic dermatitis (10 patients. 13 healthy individuals were examined as a control group. Main results. Significant elevation of cytokines: IL-2, IL-6, GM-CSF, IFN-y and TNF-a was found in the serum of patients with PS compared with the group of apparently healthy individuals, and GM-CSF, IFN-y compared with patients with atopic dermatitis. It was determined that the detected levels of Il-В in serum has a direct correlation with the prevalence and severity of PS. Inverse correlation between ESR and the level of IL-8, GM-CSF and the CEC, IFN-y and the CEC and the direct correlation between the level of TNF-a and CRP in serum were shown. Conclusion. The obtained data indicate shifts in the system of pro-inflammatory and anti-inflammatory cytokines in psoriasis, which can be considered as a manifestation of endogenous homeostatic mechanisms designed to limit the intensity of the inflammatory process. Immune markers associated with clinical manifestations of psoriasis, in particular, the prevalence and severity of PS (index PASI, indicators of acute-phase activity (ESR, CRP, were identified.

  18. Nail psoriasis: clinical features, pathogenesis, differential diagnoses, and management

    Directory of Open Access Journals (Sweden)

    Haneke E

    2017-10-01

    Full Text Available Eckart Haneke1–4 1Department of Dermatology, Inselspital, University of Bern, Bern, Switzerland; 2Dermatology Practice Dermaticum, Freiburg, Germany; 3Centro de Dermatología Epidermis, Instituto CUF, Porto, Portugal; 4Department of Dermatology, University Hospital, Gent, Belgium Abstract: Psoriasis is the skin disease that most frequently affects the nails. Depending on the very nail structure involved, different clinical nail alterations can be observed. Irritation of the apical matrix results in psoriatic pits, mid-matrix involvement may cause leukonychia, whole matrix affection may lead to red lunulae or severe nail dystrophy, nail bed involvement may cause salmon spots, subungual hyperkeratosis, and splinter hemorrhages, and psoriasis of the distal nail bed and hyponychium causes onycholysis whereas that of the proximal nail fold causes psoriatic paronychia. The more extensive the involvement, the more severe is the nail destruction. Pustular psoriasis may be seen as yellow spots under the nail or, in case of acrodermatitis continua suppurativa, as an insidious progressive loss of the nail organ. Nail psoriasis has a severe impact on quality of life and may interfere with professional and other activities. Management includes patient counseling, avoidance of stress and strain to the nail apparatus, and different types of treatment. Topical therapy may be tried but is rarely sufficiently efficient. Perilesional injections with corticosteroids and methotrexate are often beneficial but may be painful and cannot be applied to many nails. All systemic treatments clearing widespread skin lesions usually also clear the nail lesions. Recently, biologicals were introduced into nail psoriasis treatment and found to be very effective. However, their use is restricted to severe cases due to high cost and potential systemic adverse effects. Keywords: nail psoriasis, etiology, pathology, quality of life, impact, treatment

  19. Body image and depressive symptoms in person suffering from psoriasis.

    Science.gov (United States)

    Rosińska, Monika; Rzepa, Teresa; Szramka-Pawlak, Beata; Żaba, Ryszard

    2017-12-30

    The purpose of the research study was specifying the relationship between severity of psoriasis and body image and self-reported depressive symptoms, taking into account the differences between the sexes. The research study involved 54 psoriasis patients, including 30 men and 24 women aged from 19 to 82. The level of depressive symptoms was assessed using the Beck Depression Inventory, and body image - using the Multidimensional Body-Self Relations Questionnaire. The disease severity was objectively assessed using the Psoriasis Area and Severity Index. The female psoriasis patients were more critical of their appearance than the men (p< 0.01), and at the same time they were more appearance-oriented (p< 0.05). The men rated their fitness level (p< 0.01) and care for good physical condition (p< 0.01) higher than the women. The women showed less satisfaction with their body parts than the men (p< 0.01) and more fear of obesity (p< 0.05) and overweight (p< 0.05). No statistically significant differences were found between men and women with regard to general evaluation of body image and self-reported depressive symptoms. Moreover, it was established that in the case of both women and men there was a correlation between lowered mood and psoriasis severity (R = 0.416), as well as body image (R = - 0.282). In relation to individual scales, there was a statistically significant relationship between self-reported depressive symptoms and appearance evaluation (R = - 0.519), health evaluation (R = - 0.585), satisfaction with body parts (R = - 0.462), as well as appearance orientation (R = 0.425). Distortion of body image is correlated with self-reported depressive symptoms in psoriasis patients.

  20. Alteration in insulin action

    DEFF Research Database (Denmark)

    Tanti, J F; Gual, P; Grémeaux, T

    2004-01-01

    Insulin resistance, when combined with impaired insulin secretion, contributes to the development of type 2 diabetes. Insulin resistance is characterised by a decrease in insulin effect on glucose transport in muscle and adipose tIssue. Tyrosine phosphorylation of insulin receptor substrate 1 (IRS......-1) and its binding to phosphatidylinositol 3-kinase (PI 3-kinase) are critical events in the insulin signalling cascade leading to insulin-stimulated glucose transport. Modification of IRS-1 by serine phosphorylation could be one of the mechanisms leading to a decrease in IRS-1 tyrosine...... to phosphorylate these serine residues have been identified. These exciting results suggest that serine phosphorylation of IRS-1 is a possible hallmark of insulin resistance in biologically insulin responsive cells or tIssues. Identifying the pathways by which "diabetogenic" factors activate IRS-1 kinases...

  1. Alteration in insulin action

    DEFF Research Database (Denmark)

    Tanti, J F; Gual, P; Grémeaux, T

    2004-01-01

    Insulin resistance, when combined with impaired insulin secretion, contributes to the development of type 2 diabetes. Insulin resistance is characterised by a decrease in insulin effect on glucose transport in muscle and adipose tIssue. Tyrosine phosphorylation of insulin receptor substrate 1 (IRS...... to phosphorylate these serine residues have been identified. These exciting results suggest that serine phosphorylation of IRS-1 is a possible hallmark of insulin resistance in biologically insulin responsive cells or tIssues. Identifying the pathways by which "diabetogenic" factors activate IRS-1 kinases......-1) and its binding to phosphatidylinositol 3-kinase (PI 3-kinase) are critical events in the insulin signalling cascade leading to insulin-stimulated glucose transport. Modification of IRS-1 by serine phosphorylation could be one of the mechanisms leading to a decrease in IRS-1 tyrosine...

  2. Emerging targeted therapies for plaque psoriasis – impact of ixekizumab

    Directory of Open Access Journals (Sweden)

    Kazemi T

    2017-04-01

    Full Text Available Tiana Kazemi,1 Benjamin Farahnik,2 John Koo,3 Kourosh Beroukhim1 1University of California – Los Angeles, David Geffen School of Medicine, Los Angeles, CA, 2University of Vermont College of Medicine, Burlington, VT, 3University of California – San Francisco, Department of Dermatology, Psoriasis and Skin Treatment Center, San Francisco, CA, USA Background: Recent studies into the pathogenesis of psoriasis have identified the importance of interleukin 17 (IL-17 in disease activity and have thus provided a new target for biologic therapy. Ixekizumab, the most recent US Food and Drug Administration (FDA-approved anti-IL-17 biologic agent, appears to be a promising medication for patients suffering from moderate-to-severe plaque psoriasis. Methods: We reviewed the results of phase III trials for ixekizumab in order to assess the efficacy, safety, and impact on quality of life of this agent in the treatment of plaque psoriasis. Additionally, we compared these results to phase II and phase III trials for other biologic psoriasis medications including the anti-IL-23 agents tildrakizumab and guselkumab, the combined anti-IL-12 and anti-IL-23 agent ustekinumab, and the anti-IL-17 agents brodalumab and secukinumab. Results: Pooled results from individual studies demonstrate that among the most efficacious dosing regimens of these anti-interleukin therapies, ixekizumab achieves higher Psoriasis Area and Severity Index 75 rates and similar or higher static Physician Global Assessment 0-1 rates than the other anti-IL-17 and anti-IL-23 agents. The safety profile of ixekizumab is similar to these agents, with nasopharyngitis, upper respiratory infection, headache, arthralgia, and injection-site erythema as the most commonly reported adverse events. Conclusion: Ixekizumab is a highly efficacious, newly FDA-approved treatment for moderate-to-severe plaque psoriasis that demonstrates a robust clinical response, significant improvement in patient quality of

  3. Klinisk effekt af ranitidin ved psoriasis. Et abent prospektivt studie

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Kristensen, J K; Hansen, Ulla

    1997-01-01

    We report the results of an open, prospective study of 20 patients with moderate to severe psoriasis (median PASI score: 15.7) treated with oral ranitidine 300 mg twice daily for six months. No other medication was allowed during the study period. The median PASI score was reduced to 14.5, 9...... patients continued therapy with ranitidine 300 mg twice daily after the study was completed. None of these patients relapsed during a follow-up period of 12-18 months. The results of the present study suggest that ranitidine may be beneficial in the treatment of some patients with psoriasis....

  4. Risk of Multiple Sclerosis in Patients with Psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Mallbris, Lotus; Gislason, Gunnar Hilmar

    2016-01-01

    Psoriasis and multiple sclerosis (MS) are inflammatory disorders with similarities in genetic risk variants and inflammatory pathways. Limited evidence is available on the relationship between the two diseases. We therefore investigated the risk of incident (new-onset) MS in patients with mild...... and severe psoriasis, respectively. All Danish citizens aged ≥18 years from January 1, 1997 to December 31, 2011 were identified by linkage of nationwide registries at the individual level. We estimated incidence rate ratios (IRRs) adjusted for age, gender, socio-economic status, smoking, medication...

  5. ACRODERMATITIS CONTINUA SUPPURATIVA HALLOPEAU IN COMBINATION WITH LOCALIZED PSORIASIS VULGARIS

    Directory of Open Access Journals (Sweden)

    E. V. Sokolovskiy

    2017-01-01

    Full Text Available А clinical case of a rare form of pustular psoriasis, known as “acrodermatitis continua suppurativa Hallopeau” is described. The involvement of the distal phalanges of the fingers and toes in combination with localized psoriasis vulgaris is observed. Specific features of this case are the presence of two different forms of the disease and comorbidities, that limits treatment options. The article provides current data on the clinical features and management of acrodermamtitis continua suppurativa Hallopeau. An acceptable personalized treatment with systemic retinoids and topical substances containing betamethasone dipropionate and calcipotriol has been proposed.

  6. Position of scintigraphy, radiography and thermography in arthropathic psoriasis

    International Nuclear Information System (INIS)

    Lips, H.; Schulze, P.; Loreck, D.

    1989-01-01

    In 28 patients suffering from an arthropathic psoriasis with a different duration of the articular symptoms besides clinical inspections roentgenologic and scintigraphic examinations of hands and feet as well as the liquid crystal thermography of the hands were accomplished. There was a conformity of clinical and scintigraphic findings in 64 per cent, of clinical and thermographic ones in 57 per cent of the cases. Scintigraphy as well as liquid crystal thermography are very suitable for early diagnosis of arthropathic psoriasis with articular symptoms not yet to be classifyable. X-ray examinations should be always taken into consideration not at least because of the differential diagnostic point of view. (author)

  7. Lymph node metastasis and the physicochemical micro-environment of pancreatic ductal adenocarcinoma xenografts.

    Science.gov (United States)

    Andersen, Lise Mari K; Wegner, Catherine S; Simonsen, Trude G; Huang, Ruixia; Gaustad, Jon-Vidar; Hauge, Anette; Galappathi, Kanthi; Rofstad, Einar K

    2017-07-18

    Pancreatic ductal adenocarcinoma (PDAC) patients develop lymph node metastases early and have a particularly poor prognosis. The poor prognosis has been shown to be associated with the physicochemical microenvironment of the tumor tissue, which is characterized by desmoplasia, abnormal microvasculature, extensive hypoxia, and highly elevated interstitial fluid pressure (IFP). In this study, we searched for associations between lymph node metastasis and features of the physicochemical microenvironment in an attempt to identify mechanisms leading to metastatic dissemination and growth. BxPC-3 and Capan-2 PDAC xenografts were used as preclinical models of human PDAC. In both models, lymph node metastasis was associated with high IFP rather than high fraction of hypoxic tissue or high microvascular density. Seven angiogenesis-related genes associated with high IFP-associated lymph node metastasis were detected by quantitative PCR in each of the models, and these genes were all up-regulated in high IFP/highly metastatic tumors. Three genes were mutual for the BxPC-3 and Capan-2 models: transforming growth factor beta, angiogenin, and insulin-like growth factor 1. Further comprehensive studies are needed to determine whether there is a causal relationship between the up-regulation of these genes and high IFP and/or high propensity for lymph node metastasis in PDAC.

  8. Investigation of dietary supplements prevalence as complementary therapy: Comparison between hospitalized psoriasis patients and non-psoriasis patients, correlation with disease severity and quality of life.

    Science.gov (United States)

    Yousefzadeh, Hadis; Mahmoudi, Mahmoud; Banihashemi, Mahnaz; Rastin, Maryam; Azad, Farahzad Jabbari

    2017-08-01

    Psoriasis patients are often displeased with traditional medical treatments and they may self-prescribe dietary supplements as an alternative or complementary treatments. We aimed to investigate the prevalence of self-medication of dietary supplements among psoriasis and non-psoriasis cases and its impact on disease severity and quality of life. This case-control study evaluated 252 records of psoriasis patients and 245 non-psoriasis cases. Dietary supplementation over last 30days and characteristics, including age, age at onset of disease, co-morbidities, smoking and education were recorded. Psoriasis area and severity index (PASI) and dermatology quality of life index (DLQI) were calculated. P value less than 0.05 was considered as significant level. This study consisted 138 psoriasis (females; 54) and 138 non-psoriasis cases (females; 50), aged between 21 and 91 years. Among psoriasis patients, 72% reported using at least one of dietary supplements, which was different from non-psoriasis cases (25.36%, P=0.01). Multivitamin/mineral supplements (MVM) were the most frequent used dietary supplements (26.81%) and the most common reasons for the consumption of these supplements were to maintain and improve health. The consumption of folic acid (21.73%), omega-3 fatty acids or fish oil (10.14%), herbs (12.31%) and vitamin E (1.44%) had the most frequencies after MVM. No significant differences in PASI and DLQI were found among patients with consumption of different supplements (P>0.05). There was non-significant and negative correlation between education and use of supplements (P=0.21, r=-0.02). Self-medicating of MVM over last 30days was prevalent among studied psoriasis patients. They took dietary supplements in order to improve and maintain their health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared to moderate-to-severe plaque psoriasis

    Science.gov (United States)

    Chung, Jina; Duffin, Kristina Callis; Takeshita, Junko; Shin, Daniel B.; Krueger, Gerald G.; Robertson, Andrew D.; Troxel, Andrea B.; Van Voorhees, Abby S.; Edson-Heredia, Emily; Gelfand, Joel M.

    2014-01-01

    Background The impact of palmoplantar psoriasis on health-related quality of life (QoL) is largely unknown. Objective To compare clinical characteristics and patient-reported outcomes between patients with palmoplantar psoriasis and moderate-to-severe plaque psoriasis. Methods We conducted a cross-sectional study of patients with plaque psoriasis (N=1,153) and palmoplantar psoriasis (N=66) currently receiving systemic or light treatment for psoriasis. Results Patients with palmoplantar psoriasis were more likely to report Dermatology Life Quality Index scores that correspond to at least a moderate impact on QoL (odds ratio [OR] 2.08; 95% confidence interval [CI], 1.20-3.61); problems with mobility (OR 1.98; 95% CI, 1.10-3.58), self-care (OR 3.12; 95% CI, 1.24-7.86), and usual activities (OR 2.47; 95% CI, 1.44-4.22) on the European Quality of Life-5 Dimensions questionnaire; and heavy topical prescription use of at least twice daily in the preceding week (OR 2.81; 95% CI, 1.63-4.85) than those with plaque psoriasis. Limitations Our assessment tools may not account for all dimensions of health-related QoL affected by palmoplantar disease, and these results may not be generalizable to patients with milder forms of psoriasis. Conclusion Patients with palmoplantar psoriasis suffer from greater health-related QoL impairment and are more likely to report heavy use of topical prescriptions than those with moderate-to-severe plaque psoriasis. PMID:24894455

  10. Cutaneous neoplasia following PUVA therapy for psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    McKenna, K.E.; Handley, J.; McGinn, S.; Allen, G. [Belfast City Hospital (United Kingdom). Dept. of Dermatology; Patterson, C.C. [Queen`s Univ., Belfast, Northern Ireland (United Kingdom)

    1996-04-01

    To determine the risk of cutaneous neoplasia following photochemotherapy (PUVA), we reviewed patients with psoriasis treated at out unit between 1979 and 1991. Two hundred and forty-five patients were assessed, with a median duration of follow-up of 9.5 years. Fifty-nine per cent were male, and 41% female. The median number of exposures was 59, and the median total dose was 133J/cm{sup 2} for the group as a whole. Non-melanoma skin cancers (NMSC) occurred in six individuals (2.4%), basal cell carcinoma occurred in all six and one individual also developed four squamous cell carcinomas and Bowen`s disease of the penis. No cases of malignant melanoma were recorded. Patients who developed NMSC received a median number of 225 exposures and a median cumulative dose of 654J/cm{sup 2}. Compared with a control study population in West Glamorgan, Wales, there was a 1.4 (95% confidence limits (CL) 0.5 and 3.1) times increased risk of NMSC. A statistically significant increased incidence of NMSC was found for patients who had received 100 or more exposures, and 250 or more J/cm{sup 2}, with risks of 3.7 (95% CL 1.0 and 9.5), and 4.0 (95% CL 1.1 and 10), respectively. A PUVA dose of < 250 J/cm{sup 2} or < 100 exposures conferred a minimal increase in risk of NMSC in our study population. (author).

  11. Insulin pump (image)

    Science.gov (United States)

    The catheter at the end of the insulin pump is inserted through a needle into the abdominal ... with diabetes. Dosage instructions are entered into the pump's small computer and the appropriate amount of insulin ...

  12. Prevalence of metabolic syndrome in Chinese psoriasis patients: A hospital-based cross-sectional study.

    Science.gov (United States)

    Gui, Xin-Yu; Yu, Xiao-Ling; Jin, Hong-Zhong; Zuo, Ya-Gang; Wu, Chao

    2018-01-01

    Psoriasis, a chronic autoimmune skin disorder, is believed to contribute to cardiovascular diseases and metabolic syndrome. Psoriasis's association with the components of metabolic syndrome has been reported previously. However, large-scale cross-sectional studies about psoriasis and metabolic syndrome are rare in China. We assessed the prevalence of metabolic syndrome in Chinese psoriasis patients and controls. A total of 859 psoriasis patients and 1,718 controls were recruited in an age- and sex-matched cross-sectional study. Metabolic syndrome occurred in 14.3% of the psoriasis patients as opposed to 10.0% of the control participants (P = 0.001). Psoriasis patients had a higher prevalence of overweight/obesity, hyperglycemia and dyslipidemia when compared with controls. Meanwhile, psoriasis patients with metabolic syndrome were older, and had an older age of onset and a longer disease duration when compared with those without metabolic syndrome. The prevalence of metabolic syndrome is higher in the Chinese psoriatic population, which can favor cardiovascular events. The present study strengthens the value of treating psoriasis patients not only dealing with the skin lesions, and we suggest appropriate screening and relevant health education be carried out in the treatment of psoriasis patients. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  13. [Addictions and psoriasis: an example of the dermatologist's implication in preventive medicine ?].

    Science.gov (United States)

    Meyer, N; Viraben, R; Paul, C

    2008-02-01

    Association between psoriasis and addictive disorders has been longtime suspected and several studies are supporting the association of psoriasis and alcohol, and of psoriasis and tobacco. The association of psoriasis and other addictive disorders has not yet been reported. The association of psoriasis and alcohol is not restricted to alcoholism (defined as excessive alcohol consumption with psychic and/or psychic (correction of physic) dependence). It has been suggested that psoriasis is more closely linked to alcohol misuse than it is to alcoholism. The association of psoriasis and alcohol seems not been influenced by the gender, and shows a dose-effect relation. The most striking link between cigarette smoking and psoriasis has been established in palmo-plantar pustulosis. This link also seems to exist for other forms of psoriasis, with a dose-effect relation. Cigarette smoking could be involved in the high prevalence of lung cancer and cardio vascular disorders in psoriatic patients. There are a number of difficulties in the assessment of the correlation between psoriasis, cigarette smoking, and alcohol, and even more so in establishing a causal or etiologic relationship between the three, because of several confusion factors. This must not occult the reality of this association and its impact of psoriatic patients' health and the importance of detecting and preventing them. The detection and the prevention of the complications of these addictions belong to the dermatologists.

  14. Quantifying cardiovascular disease risk factors in patients with psoriasis

    DEFF Research Database (Denmark)

    Miller, I M; Skaaby, T; Ellervik, C

    2013-01-01

    BACKGROUND: In a previous meta-analysis on categorical data we found an association between psoriasis and cardiovascular disease and associated risk factors. OBJECTIVES: To quantify the level of cardiovascular disease risk factors in order to provide additional data for the clinical management...

  15. Safety and therapeutic effectiveness of selected psoralens in psoriasis.

    Science.gov (United States)

    Wolff, K; Hönigsmann, H

    1984-12-01

    This review summarizes the most important facts regarding the clinical effectiveness of oral photochemotherapy for psoriasis with UV radiation at 320-400 nm (UVA) and selected furocoumarins. The most widely used compound is 8-methoxypsoralen (8-MOP); its effectiveness has been documented by many clinical trials. Oral 5-methoxypsoralen (5-MOP) has been evaluated as an alternative drug because it is less erythemogenic and thus reduces the danger of accidental over-exposure. It has been as effective as 8-MOP in clearing psoriasis, but the UVA doses required were considerably higher. Although oral 4,5',8-trimethylpsoralen does not clear psoriasis satisfactorily, excellent treatment results have been recorded when it was applied topically. The 3 drugs produce bifunctional adducts with DNA (cross-links), which may be of particular importance for mutagenesis and tumor formation. In an attempt to reduce possible oncogenic hazards, investigators are currently testing non-crosslinking furocoumarins for their therapeutic effectiveness. At present, these compounds are available for topical use only. 3-Carbethoxypsoralen has been reported to produce excellent treatment results by others but was ineffective in our clinical trials. Similarly disappointing was the application of 4,5'-dimethylangelicin and 5-methylangelicin. Although monofunctional compounds also inhibit cell proliferation in vitro, it appears that cross-linking is a prerequisite for the therapeutic success in psoriasis. The actual important of cross-links, however, remains to be clarified.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Recent advances in understanding psoriasis [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Franziska C. Eberle

    2016-04-01

    Full Text Available T helper (Th cells producing interleukin (IL-17, IL-22, and tumor necrosis factor (TNF form the key T cell population driving psoriasis pathogenesis. They orchestrate the inflammation in the skin that results in the proliferation of keratinocytes and endothelial cells. Besides Th17 cells, other immune cells that are capable of producing IL-17-associated cytokines participate in psoriatic inflammation. Recent advances in psoriasis research improved our understanding of the cellular and molecular players that are involved in Th17 pathology and inflammatory pathways in the skin. The inflammation-driving actions of TNF in psoriasis are already well known and antibodies against TNF are successful in the treatment of Th17-mediated psoriatic skin inflammation. A further key cytokine with potent IL-17-/IL-22-promoting properties is IL-23. Therapeutics directly neutralizing IL-23 or IL-17 itself are now extending the therapeutic spectrum of antipsoriatic agents and further developments are on the way. The enormous progress in psoriasis research allows us to control this Th17-mediated inflammatory skin disease in many patients.

  17. Generalized pustular psoriasis complicated by acute respiratory distress syndrome.

    Science.gov (United States)

    Abou-Samra, T; Constantin, J-M; Amarger, S; Mansard, S; Souteyrand, P; Bazin, J-E; D'Incan, M

    2004-02-01

    Psoriasis has a chronic and relatively benign course. However, severe complications are possible. One rare complication is acute interstitial pneumonitis. This entity should be suspected when a patient presents with dyspnoea and high fever. Knowledge of this pathology is crucial, for although it is essential to rule out aetiologies requiring specific management such as microbial infection or drug-related syndromes, diagnosis should not be delayed as its severe clinical course is improved by corticosteroids. We report two patients with an acute respiratory distress syndrome arising during the course of pustular psoriasis. Repeated bacteriological testing in lungs and blood remained negative. In both cases lung involvement was severe, requiring artificial ventilation. Dramatic clinical resolution was obtained by using corticosteroids. Besides infectious causes and drug hypersensitivity to methotrexate or acitretin, acute respiratory distress syndrome, sometimes due to a pulmonary capillary leak syndrome, is a rare cause of pneumonitis in the course of psoriasis, and may be fatal. Its pathogenesis is unknown. However, animal models suggest a role for T-helper (Th) 1 lymphocytes, known to be activated in psoriasis, and a role for tumour necrosis factor-alpha, a major Th1 cytokine, in alveolar damage.

  18. Gallstone risk in adult patients with atopic dermatitis and psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Andersen, Yuki M.F.; Gislason, Gunnar H.

    2017-01-01

    and in those with psoriasis as a proxy for obesity using nationwide data for all Danish citizens ≥ 30 years of age. Outcome was a diagnosis of gallstones. Odds ratios (ORs) were calculated by logistic regression (cross-sectional study) and hazard ratios (HRs) were estimated by Cox regression (cohort study...

  19. Automatic scoring of the severity of psoriasis scaling

    DEFF Research Database (Denmark)

    Gomez, David Delgado; Ersbøll, Bjarne Kjær; Carstensen, Jens Michael

    2004-01-01

    In this work, a combined statistical and image analysis method to automatically evaluate the severity of scaling in psoriasis lesions is proposed. The method separates the different regions of the disease in the image and scores the degree of scaling based on the properties of these areas. The pr...

  20. Erectile Dysfunction in Male Adults With Atopic Dermatitis and Psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Hansen, Peter R.; Gislason, Gunnar H.

    2017-01-01

    , and risk of ED in men with psoriasis and AD. Methods The sample included all Danish men at least 30 years old. In patients with AD and psoriasis, we determined disease severity based on use of systemic therapy. We performed a cross-sectional study (January 1, 2008) using logistic regression to estimate.......7%, and 12.8% for the general population, patients with AD, and patients with psoriasis, respectively. Adjusted odds ratios (logistic regression) of ED were decreased in patients with AD (0.68; 0.57–0.80) but increased in those with psoriasis (1.15; 1.11–1.20). Adjusted odds ratios for mild and severe AD...... the prevalence and odds ratio of ED. Moreover, in a cohort study design, patients were followed from January 1, 2008 through December 31, 2012, and Cox regression models were used to estimate adjusted hazard ratios of new-onset ED. Models were adjusted for potential confounding factors, including age...

  1. Pustulosis palmoplantaris is a disease distinct from psoriasis

    NARCIS (Netherlands)

    Waal, A.C. de; Kerkhof, P.C.M. van de

    2011-01-01

    Pustulosis palmoplantaris (PPP) is a chronic inflammatory skin disease with a considerable impairment of quality of life and is characterized by sterile pustules and red, scaly skin on the palms and soles. The position of PPP in relation to psoriasis is unclear. Some authors regard PPP as a distinct

  2. Undecylenic acid in the treatment of psoriasis and neurodermatitis.

    Science.gov (United States)

    NELSON, L M

    1951-01-01

    Undecylenic acid in a dosage tolerated by most patients is of doubtful value in the treatment of psoriasis and neurodermatitis.Thirty-one patients were given the drug. Exudative dermatitis developed in one case, generalized pruritus in another. One patient may have had a cardiac accident attributable to the drug.

  3. Psoriasis vulgaris and digestive system disorders: is there a linkage?

    Science.gov (United States)

    Pietrzak, Aldona; Jastrzebska, Iwona; Chodorowska, Grazyna; Maciejewski, Ryszard; Dybiec, Ewa; Juszkiewicz-Borowiec, Maria; Krasowska, Dorota; Schwartz, Robert A

    2009-01-01

    Psoriasis is well-known immune-mediated skin disease often associated with co-morbidities, including dyslipidaemia and obesity. Few reports imply that the disease might be also related to pathology of mucosal surfaces, especially that of the digestive system. The authors present a case of psoriasis and concurrent digestive system abnormalities, and review the literature regarding the topic. A 40-year-old man suffered from an exacerbation of exudative psoriasis for about 6 months. Topical antipsoriatics proved ineffective and the disease gradually progressed to a severe disseminated form. Subsequent detailed examinations revealed persistent gastroduodenitis due to H. pylori infection, pancreatic dysfunction and fatty change of the liver, although the patient denied any gastrointestinal symptoms. As a result appropriate treatment of the diagnosed digestive system disorders was added to topical antipsoriatic therapy. Within 2 weeks of treatment clinical symptoms and laboratory signs showed a marked trend to normalisation. The presented medical history seems to suggest that there may be some kind of interplay between psoriasis and digestive system disorders.

  4. Systemic methotrexate therapy for psoriasis: past, present and future.

    Science.gov (United States)

    Dogra, S; Mahajan, R

    2013-08-01

    Methotrexate (MTX) has remained the backbone of the treatment for moderate to severe psoriasis ever since its first use nearly half a century ago. Over the years, its high efficacy, low cost, relative ease of administration and usefulness in concomitant psoriatic arthritis have contributed in making MTX the drug of choice in managing severe psoriasis. Although the majority of patients achieve remission of disease activity with MTX, a significant proportion may experience mild and transient adverse effects. From time to time, various guidelines on the use of MTX have correctly and adequately stressed the need for strict monitoring of haematological and hepatic adverse events. Over the years, the safe total cumulative dose of MTX (above which the risk of developing liver fibrosis is significantly increased) has been raised. Simultaneously, there has been an increased emphasis on developing noninvasive tests such as scanning and serum biomarker assays for detecting early liver fibrosis, in order to obviate the need for liver biopsy. However, the recent discovery and subsequent proliferating use of biological response modifiers has gradually shifted the focus away from MTX, despite it still being the most commonly prescribed drug for psoriasis worldwide. The aim of this review is to present a detailed account of MTX therapy and its use in psoriasis, along with its current relevance in disease management in the evolving era of biological drugs. © 2013 British Association of Dermatologists.

  5. Psoriasis in identical twins: simultaneous occurrence on same sites

    Directory of Open Access Journals (Sweden)

    Singh Sanjay

    1996-01-01

    Full Text Available A pair of 12-year-old identical male twins presented to us with dull erythematous plaques with coarse scaling and deep fissuring over soles of both feet starting simultaneously 18 months ago. The diagnosis of psoriasis was confirmed by histopathological examination of the biopsy specimen.

  6. Herpes zoster in psoriasis patients treated with tofacitinib

    DEFF Research Database (Denmark)

    Winthrop, Kevin L; Lebwohl, Mark; Cohen, Arnon D

    2017-01-01

    BACKGROUND: Tofacitinib is an oral Janus kinase (JAK) inhibitor. Immunomodulatory therapies can increase the risk for herpes zoster (HZ) in patients with psoriasis. OBJECTIVE: To evaluate the relationship between tofacitinib use and HZ risk. METHODS: We used phases 2 and 3 and long-term extension...

  7. Case Report - Osteomalacia associated with cutaneous psoriasis as ...

    African Journals Online (AJOL)

    ... diet, and full recovery with calcium and vitamin D replacement. Coeliac disease is frequently misdiagnosed leading to major complications such as osteolamacia. In the other hand, osteomalacia can still be the presenting feature of undiagnosed celiac disease. Association between osteomalacia and cutaneous psoriasis ...

  8. Patient-relevant needs and treatment goals in nail psoriasis

    DEFF Research Database (Denmark)

    Blome, C; Costanzo, A; Dauden, E.

    2016-01-01

    PURPOSE: Patient-centered health care implies that medical decisions are made jointly by physician and patient, based on patient needs. Aims were to (a) identify treatment goals for a new questionnaire on patient needs and benefits in nail psoriasis treatment; (b) analyze the importance of treatm...

  9. Ultraviolet B radiation therapy for psoriasis: Pursuing the optimal regime

    NARCIS (Netherlands)

    Matos, Tiago R.; Ling, Tsui C.; Sheth, Vaneeta

    2016-01-01

    Psoriasis is a chronic and common disease mediated by resident memory T cells that negatively affects a broad range of people worldwide. One of the oldest and most commonly used treatments is phototherapy. We reviewed the existing literature on the four main ultraviolet B (UVB) modalities of

  10. Treatment of psoriasis with cyclosporin | Nevin | South African ...

    African Journals Online (AJOL)

    South African Medical Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 85, No 11 (1995) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Treatment of psoriasis with cyclosporin. R.J. Nevin, E.J. Schulz. Abstract.

  11. Building an Image-Based System to automatically Score psoriasis

    DEFF Research Database (Denmark)

    G{'o}mez, D. Delgado; Carstensen, Jens Michael; Ersbøll, Bjarne Kjær

    2003-01-01

    the images. The system is tested on patients with the dermatological disease psoriasis. Temporal series of images are taken for each patient and the lesions are automatically extracted. Results indicate that to the images obtained are a good source for obtaining derived variables to track the lesion....

  12. Significance of the S100A4 protein in psoriasis

    DEFF Research Database (Denmark)

    Zibert, John R; Skov, Lone; Thyssen, Jacob P

    2010-01-01

    the expression and significance of S100A4 in psoriasis. We found significant upregulation of S100A4 in the dermis of psoriatic skin compared with normal skin. This pattern of S100A4 expression differs considerably from that of other S100 proteins, S100A7 and S100A8/9, with predominant expression in the epidermis...... of psoriasis. Furthermore, we revealed a massive release of the biologically active forms of S100A4 from psoriatic skin. Interestingly, we found stabilization (increase) of p53 in the basal layer of epidermis in close proximity to cells expressing S100A4. To examine the possible implication of S100A4...... in the pathogenesis of psoriasis, we analyzed the effect of S100A4 blocking antibodies in a human psoriasis xenograft SCID mouse model and observed a significant reduction of the epidermal thickness and impairment in cell proliferation and dermal vascularization. In conclusion, we showed strong upregulation...

  13. Chronic plaque psoriasis | Luba | South African Family Practice

    African Journals Online (AJOL)

    Patients with psoriasis involving more than 20 percent of their skin or those not responding to topical therapy are candidates for light therapy; traditional systemic therapy; or systemic treatment with immunomodulatory drugs such as alefacept, efalizumab, and etanercept. For full text, click here:South African Family ...

  14. Psoriatic – Arthritis among Psoriasis Patients Attending Skin Clinics ...

    African Journals Online (AJOL)

    Background: Psoriasis is an autoimmune inflammatory disease which primarily affects the skin but joints may also be targeted. Psoriatic arthritis is a destructive inflammatory arthropathy and ensethopathy which is considered to be rare in sub Saharan Africa. Left untreated the condition is permanently disabling. There are ...

  15. COSTE EFECTIVIDAD DE DIFERENTES TRATAMIENTOS PARA LA PSORIASIS

    Directory of Open Access Journals (Sweden)

    Fernando Alfageme Roldán

    2016-01-01

    Full Text Available Fundamentos: Los nuevos tratamientos biológicos, si bien mejoran la calidad de vida del paciente, incrementan los costes exponencialmente en relación al resto de tratamientos. El objetivo fue calcular el tratamiento más coste efectivo de los existentes para la psoriasis. Métodos: Se desarrolló un modelo de evaluación económica en psoriasis recogiendo todos los costes directos e indirectos de cada tratamiento. El indicador de efectividad que se utilizó fue Psoriasis Area Severity Index (PASI 75, que es el aceptable de manera general en estudios de psoriasis. Posteriormente se realizó un análisis de incremento coste efectividad (ICER para el periodo de 12 semanas y PASI 75, ordenando los tratamientos por nivel de efectividad en detrimento de los costes de los tratamientos. Resultados: El tratamiento más coste efectivo fue el metotrexato (ICER -7,5 seguido de acitretina (ICER 29,5. El menos coste efectivo resultó ser PUVA (ICER 4.651 seguido de UVB de banda estrecha (2.886,1. Conclusiones: Aunque el tratamiento más económico teniendo en cuenta solo los costes directos sería el UVBbe, al incluir los costes indirectos y ajustarlos por la efectividad el tratamiento más coste efectivo es el metotexato.

  16. Biologiske behandlinger af andre dermatologiske sygdomme end psoriasis

    DEFF Research Database (Denmark)

    Gniadecki, Robert; Skov, Lone

    2008-01-01

    Psoriasis is the only disease in dermatology where biologics have been studied in placebo controlled trials. However, drugs have been used for several other indications in dermatology, e.g. pyoderma gangrenosum and pemphigus. We give a brief overview of the indications for biologics in skin disea...

  17. Glycosphingolipids and insulin resistance

    NARCIS (Netherlands)

    Langeveld, Mirjam; Aerts, Johannes M. F. G.

    2009-01-01

    Obesity is associated with an increased risk for insulin resistance, a state characterized by impaired responsiveness of liver, muscle and adipose tissue to insulin. One class of lipids involved in the development of insulin resistance are the (glyco)sphingolipids. Ceramide, the most simple

  18. Colorectal cancer presenting as bone metastasis

    Directory of Open Access Journals (Sweden)

    M C Suresh Babu

    2017-01-01

    Conclusions: In this study, the patients of colorectal cancer presenting with bone metastasis were of male sex and younger age. The factors that were associated with reduced survival were extraosseous and liver involvement.

  19. Leptomeningeal metastasis mimicking Chronic Subdural Hematoma

    OpenAIRE

    Jain Saurabh

    2017-01-01

    The presentation of Leptomeningeal Metastasis varies widely. It can also present a condition very similar to Chronic Subdural Hematoma. One should have a low threshold for suspicion while diagnosing such conditions to avoid catastrophic events.

  20. Leptomeningeal metastasis mimicking Chronic Subdural Hematoma

    Directory of Open Access Journals (Sweden)

    Jain Saurabh

    2017-12-01

    Full Text Available The presentation of Leptomeningeal Metastasis varies widely. It can also present a condition very similar to Chronic Subdural Hematoma. One should have a low threshold for suspicion while diagnosing such conditions to avoid catastrophic events.