WorldWideScience

Sample records for scalp psoriasis european

  1. 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

  2. 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 ...

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. Histopathological Differential Diagnosis of Psoriasis and Seborrheic Dermatitis of the Scalp.

    Science.gov (United States)

    Park, Ji-Hye; Park, Young Joon; Kim, Sue Kyoung; Kwon, Ji Eun; Kang, Hee Young; Lee, Eun-So; Choi, Jee Ho; Kim, You Chan

    2016-08-01

    The differential diagnosis of psoriasis and seborrheic dermatitis can be difficult when both conditions are localized to the scalp without the involvement of other skin sites. We aimed to evaluate the histopathological differences between psoriasis and seborrheic dermatitis on the scalp and identify favorable criteria for their differential diagnosis. We evaluated 15 cases of psoriasis and 20 cases of seborrheic dermatitis of the scalp that had been clinicopathologically diagnosed. Skin biopsy sections stained with H&E were examined. Additional immunohistochemistry was performed, including Ki-67, keratin 10, caspase-5, and GLUT-1. On histopathological examination, mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, and clubbed and evenly elongated rete ridges were significantly more frequently observed in psoriasis. Follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis were significantly more common in seborrheic dermatitis. Moreover, significantly higher mitotic figures were observed in psoriatic lesions than in seborrheic dermatitis. Immunohistochemistry did not show any difference between psoriasis and seborrheic dermatitis. Histopathological features favoring psoriasis include mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, clubbed and evenly elongated rete ridges, and increased mitotic figures (≥6/high-powered field). Features indicating seborrheic dermatitis are follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis. Immunohistochemistry was not helpful in differentiating psoriasis from seborrheic dermatitis.

  8. [Roles of dermoscopy in the diagnosis and differential diagnosis of scalp psoriasis and seborrheic dermatitis].

    Science.gov (United States)

    Xu, Chenchen; Chen, Dian; Liu, Jie; Liu, Yuehua; Sun, Qiuning

    2014-12-02

    To describe the dermoscopic patterns of scalp psoriasis and seborrheic dermatitis and explore the roles of dermoscopy in their diagnosis and differential diagnosis. A total of 40 patients with scalp psoriasis (n = 20) and seborrheic dermatitis (n = 20) were recruited from Department of Dermatology, Peking Union Medical College Hospital from December 2013 to May 2014. They were examined both dermoscopically and histopathologically. And characteristic dermoscopic features were evaluated. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for predefined dermoscopic criteria in relation to the diagnosis of two diseases. The most significant dermoscopic features of scalp psoriasis included dotted vessels (10/20, 50%), glomerular vessels (13/20, 65%), red loops (16/20, 80%), hairpin vessels (17/20, 85%), white scales (10/20, 50%) and punctate hemorrhages (12/20, 60%). In contrast, seborrheic dermatitis was characterized by arborizing vessels (16/20, 80%), atypical red vessels (13/20, 65%), featureless areas (20/20, 100%) and honeycomb pigment (9/20, 45%) (all P seborrheic dermatitis have different dermoscopic patterns. Dermoscopy may be valuable for clinical diagnosis and differential diagnosis of scalp psoriasis and seborrheic dermatitis.

  9. Efalizumab in the Treatment of Scalp, Palmoplantar and Nail Psoriasis: Results of a 24-Week Latin American Study.

    Science.gov (United States)

    Takahashi, María Denise; Chouela, Edgardo Néstor; Dorantes, Gladys Leon; Roselino, Ana Maria; Santamaria, Jesùs; Allevato, Miguel Angel; Cestari, Tania; de Aillaud, Maria Eugenia Manzanera; Stengel, Fernando Miguel; Licu, Daiana

    2010-03-01

    INTRODUCTION: Plaque-type psoriasis affecting the nails, scalp, hands or feet can often be difficult to treat; for example, topical treatments and phototherapy may not penetrate the nail plate or scalp. The objective of this large, international, multicentre study was to investigate the efficacy of efalizumab in a Latin American population of adult patients with moderate-to-severe chronic plaque psoriasis who were candidates for systemic therapy or phototherapy. METHODS: Eligible patients were enrolled in a 24-week, open-label, single-arm, Phase IIIb/IV study of continuous treatment with subcutaneous efalizumab, 1.0 mg/kg/wk. Involvement of the nails, scalp, or hands or feet was assessed using the Nail Psoriasis Severity Index (NAPSI), the Psoriasis Scalp Severity Index (PSSI), or the Palmoplantar Pustulosis Psoriasis Area and Severity Index (PPPASI), respectively. Missing data were handled using a last observation carried forward or nonresponder imputation approach. RESULTS: Of the 189 patients who received treatment, 112 patients had nail involvement, 172 had scalp involvement, and 19 had palmoplantar disease at baseline. At Week 24, >/=50% improvement on the NAPSI, PSSI and PPPASI was observed in 31%, 71% and 68% of patients, respectively, whereas >/=75% improvement on these scores was observed in 17%, 52% and 63%, respectively. Descriptive statistics showed lower NAPSI-75 and higher PSSI-75 and -50 response rates among patients with higher baseline scores. CONCLUSIONS: This open-label, uncontrolled study provides supportive evidence of the potential of efalizumab as a treatment for nail, scalp and palmoplantar psoriasis.

  10. Dermoscopic findings in scalp psoriasis and seborrheic dermatitis; two new signs; signet ring vessel and hidden hair.

    Science.gov (United States)

    Kibar, Melike; Aktan, Şebnem; Bilgin, Muzaffer

    2015-01-01

    Psoriasis and seborrheic dermatitis are both chronic erythemato-squamous dermatoses that can involve the scalp. It may be difficult to differentiate these two diseases when there is isolated scalp involvement. Recently, trichoscopy is commonly used to differentiate noncicatricial alopecias including psoriasis and seborrheic dermatitis that can lead to telogen effluvium (TE). The objective of this study is to evaluate the trichoscopic figures that may help to differentiate scalp psoriasis and seborrheic dermatitis. Thirty one with scalp psoriasis and 112 patients with seborrheic dermatitis were enrolled. Trichoscopic examinations were performed using a videodermatoscope (MoleMax 3(®)). Trichoscopic findings of scalp psoriasis and seborrheic dermatitis were compared with each other, with 100 healthy individuals and with other noncicatricial alopecias including female androgenetic alopecia (FAGA) (n: 138), male androgenetic alopecia (n: 63), FAGA of male pattern (FAGA.M) (n: 5), alopecia areata (39), TE (n: 22) and trichotillomania (n: 4). Atypical red vessels, red dots and globules (RDG), signet ring vessels (SRV), structureless red areas and hidden hairs (HH) were statistically more common in psoriasis while twisted red loops and comma vessels (CV) in seborrheic dermatitis. RDG were considered as the characteristic videodermatoscopic figure for psoriasis and arborizing red lines and CV for seborrheic dermatitis. In comparison with previous reports, our study yielded two new trichoscopic structures supporting the diagnosis of psoriasis; HH and SRV. Besides, according to our study, CV were described for the first time in seborrheic dermatitis and considered to be specific for seborrheic dermatitis. This study confirmed that trichoscopy might be useful in differentiating scalp psoriasis and seborrheic dermatitis from each other and from other noncicatricial alopecia with three trichoscopic structures as HH, SRV and CV.

  11. Dermoscopic findings in scalp psoriasis and seborrheic dermatitis; Two new signs; Signet ring vessel and hidden hair

    Directory of Open Access Journals (Sweden)

    Melike Kibar

    2015-01-01

    Full Text Available Background: Psoriasis and seborrheic dermatitis are both chronic erythemato-squamous dermatoses that can involve the scalp. It may be difficult to differentiate these two diseases when there is isolated scalp involvement. Recently, trichoscopy is commonly used to differentiate noncicatricial alopecias including psoriasis and seborrheic dermatitis that can lead to telogen effluvium (TE. Objectives: The objective of this study is to evaluate the trichoscopic figures that may help to differentiate scalp psoriasis and seborrheic dermatitis. Materials and Methods: Thirty one with scalp psoriasis and 112 patients with seborrheic dermatitis were enrolled. Trichoscopic examinations were performed using a videodermatoscope (MoleMax 3 ® . Trichoscopic findings of scalp psoriasis and seborrheic dermatitis were compared with each other, with 100 healthy individuals and with other noncicatricial alopecias including female androgenetic alopecia (FAGA (n: 138, male androgenetic alopecia (n: 63, FAGA of male pattern (FAGA.M (n: 5, alopecia areata (39, TE (n: 22 and trichotillomania (n: 4. Results: Atypical red vessels, red dots and globules (RDG, signet ring vessels (SRV, structureless red areas and hidden hairs (HH were statistically more common in psoriasis while twisted red loops and comma vessels (CV in seborrheic dermatitis. RDG were considered as the characteristic videodermatoscopic figure for psoriasis and arborizing red lines and CV for seborrheic dermatitis. In comparison with previous reports, our study yielded two new trichoscopic structures supporting the diagnosis of psoriasis; HH and SRV. Besides, according to our study, CV were described for the first time in seborrheic dermatitis and considered to be specific for seborrheic dermatitis. Conclusion: This study confirmed that trichoscopy might be useful in differentiating scalp psoriasis and seborrheic dermatitis from each other and from other noncicatricial alopecia with three trichoscopic

  12. Do Malassezia species play a role in exacerbation of scalp psoriasis?

    Science.gov (United States)

    Gomez-Moyano, E; Crespo-Erchiga, V; Martínez-Pilar, L; Godoy Diaz, D; Martínez-García, S; Lova Navarro, M; Vera Casaño, A

    2014-06-01

    Clinical expression of psoriasis is in part dependent on external factors, such as drugs, microorganisms or stress. However convincing evidence of the role of Malassezia species in the pathogenesis of the psoriasis is still lacking. Samples taken from scalp skin of 40 psoriatic patients and the same number of healthy individuals were observed under direct microsocopic examination and cultured on modified Dixon agar. Direct microscopy examination of psoriatic scalp scales was positive in 30 (75%) patients; while it was positive in only 12 (30%) healthy subjects (P=0.003). Half of the cultures from healthy subjects showed no growth of colonies, but only 8 (15%) of psoriatic patients were negative. When an exacerbation has occurred in the previous weeks, pseudohyphaes were observed in 12 (40%) patients, Malassezia globosa was isolated in 18 (45%) patients and Malassezia restricta was isolated in 12 (30%) patients. In the group of patients having stable lesion, without any exacerbation in the previous weeks, no pseudohypahes were observed, M. globosa was not isolated, M. restricta was isolated in 4 (10%), and cultures were negative in 6 of them (15%). Malassezia species form an integral part of normal cutaneous microflora in humans, however we found that during the episodes of exacerbation of the disease the presence of these yeasts, and particularly M. globosa, was increased. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  13. Salicylic Acid 6% in an ammonium lactate emollient foam vehicle in the treatment of mild-to-moderate scalp psoriasis.

    Science.gov (United States)

    Kircik, Leon

    2011-03-01

    Scalp psoriasis is a common life-altering skin condition causing a great deal of distress. It significantly affects quality of life and is difficult to manage. Treatment can provide variable results, often impacting patient compliance with therapy. Salicylic acid is used as adjunctive therapy to other topical treatments because of its marked keratolytic effect. Its effectiveness as a monotherapy is not fully understood. An emollient foam formulation of 6% salicylic acid (Salkera) in an ammonium lactate vehicle has recently become available. Efficacy, tolerability and patient acceptability of salicylic acid 6% emollient foam were assessed in an open-label pilot study of 10 subjects with scalp psoriasis. All psoriasis severity parameters were reduced with a significant decrease in Psoriasis Scalp Severity Index (PSSI) score from 15.3 to 3.0 after four weeks of monotherapy (Poiliness severity and patient-reported burning tolerability. Salicylic acid 6% emollient foam provides a useful option in the treatment of psoriasis that is highly effective, well tolerated and acceptable to patients.

  14. Analysis of the Cochrane Review: Topical Treatments for Scalp Psoriasis. Cochrane Database Syst Rev. 2016;2:CD009687.

    Directory of Open Access Journals (Sweden)

    Catarina Soares Queirós

    2017-03-01

    Full Text Available Regardless the psoriasis subtype, up to 79% of people with this skin condition present scalp involvement, which is often the first site to show symptoms of the disease. In addition to being itchy, the red and scaly lesions are usually easy to see, and may be embarrassing. Topical therapy is usually the first line of treatment; however the wide array of available interventions can make the choice difficult, and may even lead to an inadequate treatment. The objective of this review was to evaluate the efficacy and safety of topical treatments for scalp psoriasis. A systematic review was performed according to the methodology recommended by Cochrane in order to evaluate the clinical severity of psoriasis, quality of life, and adverse events that led to treatment discontinuation. To evaluate this, 59 studies were included, with a total of 11 561 participants, and 15 comparisons were made between the various drugs and application vehicles tested. The principal conclusion is that corticosteroids of high or very high potency are more effective than vitamin D. The combination of a corticosteroid with vitamin D has only a marginal benefit over corticosteroid monotherapy, but is superior to vitamin D alone. Given the similar safety profile and only marginal benefit of the combination of corticosteroid with vitamin D over the corticosteroid alone, topical corticosteroid monotherapy appears to be fully acceptable for short-term therapy of scalp psoriasis.

  15. The effect of secukinumab on moderate-to-severe scalp psoriasis: Results of a 24-week, randomized, double-blind, placebo-controlled phase 3b study.

    Science.gov (United States)

    Bagel, Jerry; Duffin, Kristina Callis; Moore, Angela; Ferris, Laura K; Siu, Kimberly; Steadman, Jennifer; Kianifard, Farid; Nyirady, Judit; Lebwohl, Mark

    2017-10-01

    Moderate-to-severe scalp psoriasis has not been evaluated in prospective trials of patients without moderate-to-severe body psoriasis. Evaluate the efficacy and safety of secukinumab in moderate-to-severe scalp psoriasis. In this 24-week, double-blind, phase 3b study, 102 patients were randomized 1:1 to subcutaneous secukinumab 300 mg or placebo at baseline, weeks 1, 2, and 3, and then every 4 weeks from week 4 to 20. The primary efficacy variable was 90% improvement of Psoriasis Scalp Severity Index (PSSI 90) score from baseline to week 12. At week 12, PSSI 90 (secukinumab 300 mg vs placebo, 52.9% vs 2.0%) and Investigator's Global Assessment modified 2011 scalp responses of 0 or 1 (secukinumab 300 mg vs placebo, 56.9% vs 5.9%) were significantly greater with secukinumab 300 mg than placebo (P psoriasis at week 12 with secukinumab 300 mg than placebo (35.3% vs 0%; P psoriasis. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  16. Sustained response with ixekizumab treatment of moderate-to-severe psoriasis with scalp involvement: results from three phase 3 trials (UNCOVER-1, UNCOVER-2, UNCOVER-3).

    Science.gov (United States)

    Reich, Kristian; Leonardi, Craig; Lebwohl, Mark; Kerdel, Francisco; Okubo, Yukari; Romiti, Ricardo; Goldblum, Orin; Dennehy, Ellen B; Kerr, Lisa; Sofen, Howard

    2017-06-01

    Scalp is a frequently affected and difficult-to-treat area in psoriasis patients. We assessed the efficacy of ixekizumab in the treatment of patients with scalp psoriasis over 60 weeks using the Psoriasis Scalp Severity Index (PSSI). In three Phase 3, multicenter, double-blind, placebo-controlled trials, patients with moderate-to-severe psoriasis in UNCOVER-1 (N = 1296), UNCOVER-2 (N = 1224) and UNCOVER-3 (N = 1346) were randomized to subcutaneous 80 mg ixekizumab every two weeks (Q2W) or every four weeks (Q4W) after a 160 mg starting dose, or placebo through Week 12. Additional UNCOVER-2 and UNCOVER-3 cohorts were randomized to 50 mg bi-weekly etanercept through Week 12. Patients entering the open-label long-term extension (LTE) (UNCOVER-3) received ixekizumab Q4W; UNCOVER-1 and UNCOVER-2 included a blinded maintenance period in which static physician global assessment (sPGA) 0/1 responders were re-randomized to placebo, ixekizumab Q4W, or 80 mg ixekizumab every 12 weeks (Q12W) through Week 60. In patients with moderate-to-severe psoriasis with baseline scalp involvement, PSSI 90 and 100 were achieved at Week 12 in higher percentages of patients treated with ixekizumab Q2W (81.7% and 74.6%) or ixekizumab Q4W (75.6% and 68.9%) compared with patients treated with placebo (7.6% and 6.7%; p psoriasis in patients with moderate-to-severe psoriasis, with most patients achieving complete or near-complete resolution of scalp psoriasis and maintaining this response over 60 weeks.

  17. Evidence-based guidelines of the spanish psoriasis group on the use of biologic therapy in patients with psoriasis in difficult-to-treat sites (nails, scalp, palms, and soles).

    Science.gov (United States)

    Sánchez-Regaña, M; Aldunce Soto, M J; Belinchón Romero, I; Ribera Pibernat, M; Lafuente-Urrez, R F; Carrascosa Carrillo, J M; Ferrándiz Foraster, C; Puig Sanz, L; Daudén Tello, E; Vidal Sarró, D; Ruiz-Villaverde, R; Fonseca Capdevila, E; Rodríguez Cerdeira, M C; Alsina Gibert, M M; Herrera Acosta, E; Marrón Moya, S E

    2014-12-01

    Psoriatic lesions affecting the scalp, nails, palms, and the soles of the feet are described as difficult-to-treat psoriasis and require specific management. Involvement of these sites often has a significant physical and emotional impact on the patient and the lesions are difficult to control with topical treatments owing to inadequate penetration of active ingredients and the poor cosmetic characteristics of the vehicles used. Consequently, when difficult-to-treat sites are involved, psoriasis can be considered severe even though the lesions are not extensive. Scant information is available about the use of biologic therapy in this setting, and published data generally comes from clinical trials of patients who also had moderate to severe extensive lesions or from small case series and isolated case reports. In this article we review the quality of the scientific evidence for the 4 biologic agents currently available in Spain (infliximab, etanercept, adalimumab, and ustekinumab) and report level i evidence for the use of biologics to treat nail psoriasis (level of recommendation A) and a somewhat lower level of evidence in the case of scalp involvement and palmoplantar psoriasis. Copyright © 2013 Elsevier España, S.L.U. y AEDV. All rights reserved.

  18. European patient perspectives on the impact of psoriasis: the EUROPSO patient membership survey.

    NARCIS (Netherlands)

    Dubertret, L.; Mrowietz, U.; Ranki, A.; Kerkhof, P.C.M. van de; Chimenti, S.; Lotti, T.; Schafer, G.

    2006-01-01

    BACKGROUND: EUROPSO (European Federation of Psoriasis Patient Associations) undertook a Europe-wide survey examining quality of life and patients' perspectives on treatment and their disease. OBJECTIVES: To explore patients' perspectives of psoriasis on their lifestyle and well-being and to gain

  19. 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

  20. 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 ...

  1. Comparison of Treatment Goals for Moderate-to-Severe Psoriasis between Korean Dermatologists and the European Consensus Report.

    Science.gov (United States)

    Youn, Sang Woong; Kim, Bo Ri; Lee, Joo Heung; Song, Hae Jun; Choe, Yong Beom; Choi, Ji Ho; Kim, Nack In; Kim, Kwang Joong; Youn, Jai Il

    2015-04-01

    The development of therapies for psoriasis has led to the need for a new strategy to the treatment of patients with moderate-to-severe psoriasis. New consensus guidelines for psoriasis treatment have been developed in some countries, some of which have introduced treatment goals to determine the timing of therapeutic regimens for psoriasis. To investigate the opinions held by Korean dermatologists who specialize in psoriasis about treatment goals, and to compare these with the European consensus. Korean dermatologists who specialize in psoriasis were asked 11 questions about defining the treatment goals for psoriasis. The questionnaire included questions about the factors used to classify the severity of psoriasis, defining the induction and maintenance phases of psoriasis treatment, defining treatment responses during the induction phase, and defining treatment responses during the maintenance phase. The Korean consensus showed responses that were almost similar to the European consensus, even without using the Delphi technique, which uses repeated rounds of questions to reach a consensus. Only one response that related to psoriasis severity in the context of the quality of patients' lives differed from the European consensus. The concept of using treatment goals in the treatment of moderate-to-severe psoriasis can be applied to Korean psoriasis patients. Since a tool for assessing the quality of patients' lives is not commonly used in Korea, the development of a simple, rapidly completed, and region-specific health-related quality of life assessment tool would enable treatment goals to be used in routine clinical practice.

  2. 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...

  3. 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.

  4. 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...

  5. A critical appraisal of evidence-based guidelines for the treatment of psoriasis vulgaris: 'AGREE-ing' on a common base for European evidence-based psoriasis treatment guidelines

    NARCIS (Netherlands)

    Nast, A.; Spuls, Ph; Ormerod, A. D.; Reytan, N.; Saiag, P. H.; Smith, C. H.; Rzany, B.

    2009-01-01

    BACKGROUND: To further improve the standard of care provided to psoriasis patients in Europe, the European Dermatology Forum and the European Academy of Dermatology and Venereology have initiated a project to develop common European psoriasis guidelines. OBJECTIVE: This paper aims to assess the

  6. Scalp Psoriasis: Diagnosis and Treatment

    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 ...

  7. Scalp Psoriasis: Signs and Symptoms

    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 ...

  8. [Scalp lipedema].

    Science.gov (United States)

    Chaplain, L; Moguelet, P; Barbaud, A; Senet, P

    2018-02-01

    Lipedematous scalp, with or without alopecia, is a poorly known and rarely reported entity. It was first described in 1935 by Cornbleet. It involves increased thickness of the subcutaneous tissue of the scalp, responsible for an overall thickening of the scalp, which may be associated with alopecia, pruritus or painful sensations. Currently, fewer than 50 cases of lipedematous scalp, both with and without alopecia, have been reported in the literature. Herein we present the case of a 36-year-old woman from the Ivory Coast, who presented scalp pain associated with infiltration of the entire subcutaneous tissue of the scalp seen clinically and confirmed at MRI. Histology added nothing. We diagnosed a new case of lipedematous scalp in an African woman. No cause was found. Therapeutic abstention appears the best management strategy. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. 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 ...

  10. Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Belinchón I

    2016-11-01

    Full Text Available I Belinchón,1 R Rivera,2 C Blanch,3 M Comellas,4 L Lizán4,5 1Department of Dermatology, Hospital General Universitario de Alicante, Alicante, 2Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, 3Novartis Farmacéutica S.A., Barcelona, 4Outcomes’10, Castellón, Spain; 5Medical Department, University Jaime I, Castellón, Spain Background and objective: Adherence to treatment in patients with psoriasis is often poor. An investigation of patient preferences and satisfaction with treatment may be important, based on the expected correlation with therapy compliance. This paper aims to examine and describe the current literature on patient preferences, satisfaction and adherence to treatment for psoriasis in the European Union (EU.Methods: Electronic searches were conducted using PubMed, ISI Web of Knowledge, Scopus, Spanish databases and Google Scholar. European studies published in English or Spanish between January 1, 2009 and December 31, 2014 regarding patient-reported outcomes in psoriatic patients were included. Studies conducted in non-EU countries, letters to the editor, editorials, experts’ opinions, case studies, congress proceedings, publications that did not differentiate between patients with psoriasis and psoriatic arthritis or studies related to specific treatment were excluded.Results: A total of 1,769 titles were identified, of which 1,636 were excluded as they were duplicates or did not provide any relevant information. After a full-text reading and application of the inclusion/exclusion criteria, 46 publications were included. This paper will describe publications on adherence (n=4, preferences (n=5 and satisfaction with treatment (n=7. Results related to health-related quality of life articles (n=30 have been published elsewhere. Adherence rates are generally low in psoriasis patients regardless of the type of treatment, severity of disease or methods used to measure adherence. Biologic therapy is

  11. Definition of treatment goals for moderate to severe psoriasis: A European consensus

    NARCIS (Netherlands)

    U. Mrowietz (Ulrich); K. Kragballe (Knud); K. Reich; P. Spuls; C.E.M. Griffiths; A. Nast (Alexander); J. Franke; A.C. Antoniou (Antonis); P. Arenberger (Petr); F. Balieva (Flora); M. Bylaite (Matilda); O. Correia; E. Daudén (Esteban); P. Gisondi (Paolo); L. Iversen; L. Kemény (Lajos); M. Lahfa (Mourad); T.E.C. Nijsten (Tamar); T. Rantanen; A. Reich; T. Rosenbach; S. Segaert (Siegfried); C. Smith; T. Talme (Toomas); B. Volc-Platzer (Beatrice); N. Yawalkar (Nikhil)

    2011-01-01

    textabstractPatients with moderate to severe psoriasis are undertreated. To solve this persistent problem, the consensus programme was performed to define goals for treatment of plaque psoriasis with systemic therapy and to improve patient care. An expert consensus meeting and a collaborative Delphi

  12. Association of beta-Defensin Copy Number and Psoriasis in Three Cohorts of European Origin

    NARCIS (Netherlands)

    Stuart, P.E.; Huffmeier, U.; Nair, R.P.; Palla, R.; Tejasvi, T.; Schalkwijk, J.; Elder, J.T.; Reis, A.; Armour, J.A.

    2012-01-01

    A single previous study has demonstrated significant association of psoriasis with copy number of beta-defensin genes, using DNA from psoriasis cases and controls from Nijmegen and Erlangen. In this study, we attempted to replicate that finding in larger new cohorts from Erlangen (N=2,017) and

  13. Significant one week efficacy of a calcipotriol plus betamethasone dipropionate scalp formulation

    DEFF Research Database (Denmark)

    Jemec, G.B.E.; Van De Kerkhof, P.C.M.; Enevold, A.

    2011-01-01

    Background A two-compound scalp formulation containing calcipotriol (50 μg/g) and betamethasone (0.5 mg/g; as dipropionate) (Xamiol, Taclonex Scalp) has been shown to be an effective and safe treatment for scalp psoriasis. Objective The aim of this study was to investigate the clinical efficacy o...

  14. Scalp meningioma

    Directory of Open Access Journals (Sweden)

    Singh Sunil

    2008-01-01

    Full Text Available Primary extracranial meningiomas occur very rarely. We present a rare case of extracranial meningioma of the transitional variant which was excised satisfactorily. There was no suggestion of any connection to the intracranial compartment or cranial nerves. The underlying galea was uninvolved, suggesting the true extracranial nature of this tumour. This rare diagnosis should nonetheless be kept in the differential diagnosis of scalp tumors.

  15. National Registries of Systemic Treatment for Psoriasis and the European 'Psonet' Initiative

    NARCIS (Netherlands)

    Lecluse, L. L. A.; Naldi, L.; Stern, R. S.; Spuls, P. I.

    2009-01-01

    About 11 million people suffer from psoriasis in Europe. This chronic condition may have a dramatic impact on quality of life. About 20% of patients may need systemic treatment to effectively control their disease activity. The introduction of biological agents greatly increased the options of

  16. Association of β-defensin copy number and psoriasis in three cohorts of European origin

    Science.gov (United States)

    Stuart, Philip E; Hüffmeier, Ulrike; Nair, Rajan P; Palla, Raquel; Tejasvi, Trilokraj; Schalkwijk, Joost; Elder, James T; Reis, Andre; Armour, John AL

    2012-01-01

    A single previous study has demonstrated significant association of psoriasis with copy number of beta-defensin genes, using DNA from psoriasis cases and controls from Nijmegen and Erlangen. In this study we attempted to replicate that finding in larger new cohorts from Erlangen (N = 2017) and Michigan (N = 5412), using improved methods for beta-defensin copy number determination based on the paralog ratio test (PRT), and enhanced methods of analysis and association testing implemented in the CNVtools resource. We demonstrate that the association with psoriasis found in the discovery sample is maintained after applying improved typing and analysis methods (p = 5.5 × 10−4, OR = 1.25). We also find that the association is replicated in 2616 cases and 2526 controls from Michigan, although at reduced significance (p = 0.014), but not in new samples from Erlangen (1396 cases and 621 controls, p = 0.38). Meta-analysis across all cohorts suggests a nominally significant association (p = 6.6 × 10−3/2 × 10−4) with an effect size (OR = 1.081) much lower than found in the discovery study (OR = 1.32). This reduced effect size and significance on replication is consistent with a genuine but weak association. PMID:22739795

  17. Association of β-defensin copy number and psoriasis in three cohorts of European origin.

    Science.gov (United States)

    Stuart, Philip E; Hüffmeier, Ulrike; Nair, Rajan P; Palla, Raquel; Tejasvi, Trilokraj; Schalkwijk, Joost; Elder, James T; Reis, Andre; Armour, John A L

    2012-10-01

    A single previous study has demonstrated significant association of psoriasis with copy number of β-defensin genes, using DNA from psoriasis cases and controls from Nijmegen and Erlangen. In this study, we attempted to replicate that finding in larger new cohorts from Erlangen (N=2,017) and Michigan (N=5,412), using improved methods for β-defensin copy number determination based on the paralog ratio test, and enhanced methods of analysis and association testing implemented in the CNVtools resource. We demonstrate that the association with psoriasis found in the discovery sample is maintained after applying improved typing and analysis methods (P=5.5 × 10(-4), odds ratio (OR)=1.25). We also find that the association is replicated in 2,616 cases and 2,526 controls from Michigan, although at reduced significance (P=0.014), but not in new samples from Erlangen (1,396 cases and 621 controls, P=0.38). Meta-analysis across all cohorts suggests a nominally significant association (P=6.6 × 10(-3)/2 × 10(-4)) with an effect size (OR=1.081) much lower than found in the discovery study (OR=1.32). This reduced effect size and significance on replication is consistent with a genuine but weak association.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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®

  3. Effects of scalp dermatitis on chemical property of hair keratin

    Science.gov (United States)

    Kim, Kyung Sook; Shin, Min Kyung; Park, Hun-Kuk

    2013-05-01

    The effects of scalp dermatitis (seborrheic dermatitis (SD), psoriasis, and atopic dermatitis (AD)) on chemical properties of hair keratin were investigated by Fourier transform infrared (FT-IR) spectroscopy. Hairs were collected from lesional regions affected by SD, psoriasis, and AD and non-lesional regions separately. The hairs with SD were taken from patients with ages of 16-80 years. The ages of patients with psoriasis ranged from 8 to 67 years, and all patients exhibited moderate disease. Hairs with AD were taken from the patients with ages of 24-45 years and the average SCORing atopic dermatitis (SCORAD) was 48.75. Hairs from 20 normal adults were collected as a control. The FT-IR absorbance bands were analyzed by the Gaussian model to obtain the center frequency, half width, height, and area of each band. The height and area of all bands in the spectra were normalized to the amide I centered at 1652 cm-1 to quantitatively analyze the chemical composition of keratin. The spectra of hair with scalp dermatitis were different with that of control, the amide A components centered at 3278 cm-1 were smaller than those of the control. The psoriasis hair showed a large difference in the IR absorbance band between lesional and non-lesional hairs indicating good agreement with the morphological changes. The hairs with diseases did not show differences in the content of cystine, which was centered at 1054 cm-1, from the control. The chemical properties of keratin were not significantly different between the hairs affected by SD, psoriasis, and AD. However, the changes induced by scalp dermatitis were different with weathering. Therefore, FT-IR analysis could be used to screen differences between the physiological and pathological conditions of scalp hair.

  4. Achievements in scalp reconstruction.

    Science.gov (United States)

    Fowler, Nicole M; Futran, Neal D

    2014-04-01

    Reconstruction of scalp defects remains a challenge. This article reviews the reconstructive options and provides recommendations for scalp restoration based on current literature. It is difficult to apply the standard reconstructive ladder to scalp defects due to the scalp's unique properties and paucity of adjacent tissue. Because of the frequency of large resections and the limited local tissue options microvascular free tissue transfer is a mainstay in scalp reconstruction and has been shown to be well tolerated and reliable with acceptable cosmetic and functional results. With advances in both surgery and anesthesia, increasing numbers of patients are candidates for free tissue transfer. The latissimus dorsi flap is a fundamental flap in scalp reconstruction. Recently, use of the anterolateral thigh (ALT) flap has risen. The radial forearm (RFF) free flap is also an extremely reliable, thin flap with great pedicle length well suited for the restoration of scalp contouring. Microvascular free tissue transfer provides well tolerated, reliable, functional and cosmetically pleasing scalp restoration in a single surgery. The latissimus dorsi flap, ALT flap and RFF are the three most utilized free tissue options.

  5. 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.

  6. 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.

  7. Scales on the scalp

    Directory of Open Access Journals (Sweden)

    Jamil A

    2013-05-01

    Full Text Available A five-year-old boy presented with a six-week history of scales, flaking and crusting of the scalp. He had mild pruritus but no pain. He did not have a history of atopy and there were no pets at home. Examination of the scalp showed thick, yellowish dry crusts on the vertex and parietal areas and the hair was adhered to the scalp in clumps. There was non-scarring alopecia and mild erythema (Figure 1 & 2. There was no cervical or occipital lymphadenopathy. The patient’s nails and skin in other parts of the body were normal.

  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. Core temperature affects scalp skin temperature during scalp cooling

    NARCIS (Netherlands)

    Daanen, H.A.M.; Peerbooms, M.; van den Hurk, C.J.G.; van Os, B.; Levels, K.; Teunissen, L.P.J.; Breed, W.P.M.

    2015-01-01

    Background: The efficacy of hair loss prevention by scalp cooling to prevent chemotherapy induced hair loss has been shown to be related to scalp skin temperature. Scalp skin temperature, however, is dependent not only on local cooling but also on the thermal status of the body. Objectives: This

  10. Angiosarcoma of the Scalp

    DEFF Research Database (Denmark)

    Andersen, Kim Francis; Albrecht-Beste, Elisabeth; Berthelsen, Anne Kiil

    2015-01-01

    Angiosarcomas are rare and only represent about 2% of all soft tissue sarcomas. They arise from vascular or lymphatic endothelial cells and are most commonly located in the heart, liver, breast, and skin. Cutaneous angiosarcoma of the scalp is highly malignant and with dismal prognosis. Reported...... five-year survival is morphologic patterns on imaging. Metastatic...

  11. 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, ...

  12. 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.

  13. 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.

  14. 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- ...

  15. Multispectral imaging based on a Smartphone with an external C-MOS camera for detection of seborrheic dermatitis on the scalp

    Science.gov (United States)

    Kim, Manjae; Kim, Sewoong; Hwang, Minjoo; Kim, Jihun; Je, Minkyu; Jang, Jae Eun; Lee, Dong Hun; Hwang, Jae Youn

    2017-02-01

    To date, the incident rates of various skin diseases have increased due to hereditary and environmental factors including stress, irregular diet, pollution, etc. Among these skin diseases, seborrheic dermatitis and psoriasis are a chronic/relapsing dermatitis involving infection and temporary alopecia. However, they typically exhibit similar symptoms, thus resulting in difficulty in discrimination between them. To prevent their associated complications and appropriate treatments for them, it is crucial to discriminate between seborrheic dermatitis and psoriasis with high specificity and sensitivity and further continuously/quantitatively to monitor the skin lesions during their treatment at other locations besides a hospital. Thus, we here demonstrate a mobile multispectral imaging system connected to a smartphone for selfdiagnosis of seborrheic dermatitis and further discrimination between seborrheic dermatitis and psoriasis on the scalp, which is the more challenging case. Using the system developed, multispectral imaging and analysis of seborrheic dermatitis and psoriasis on the scalp was carried out. It was here found that the spectral signatures of seborrheic dermatitis and psoriasis were discernable and thus seborrheic dermatitis on the scalp could be distinguished from psoriasis by using the system. In particular, the smartphone-based multispectral imaging and analysis moreover offered better discrimination between seborrheic dermatitis and psoriasis than the RGB imaging and analysis. These results suggested that the multispectral imaging system based on a smartphone has the potential for self-diagnosis of seborrheic dermatitis with high portability and specificity.

  16. Developing Shingles-Induced Koebner Phenomenon in a Patient With Psoriasis

    Science.gov (United States)

    Zhao, Yu-Kun; Zhang, Yun-Qing; Wang, Fang; Wu, Hui-Hui; Luo, Ze-Yu; Luo, Di-Qing; Chen, Wen-Na

    2015-01-01

    Abstract Both shingles and psoriasis are common cutaneous diseases. About 25% of the psoriatic patients develop Koebner phenomenon (KP) after various injuries, and in rare instance, KP may occur at the site of healed or healing shingles. We report a 30-year-old man with 7-month history of scalp psoriasis who developed KP at the areas of developing shingles. Cutaneous examination revealed scaly erythematous papules and plaques located on the scalp and forehead, and groups of clustered erythematous papules with silver scales in the dermatome distributed on the right side of chest wall the prior herpes zoster lesions involved. After removal of the scales on the papules, underlying bleeding points were present. The lesions on chest had good response to anti-psoriatic therapies, as the lesions on scalp did. After a year of follow-up, recurrent psoriasis occurred, but the lesions were located only on the scalp, and the areas of prior occurrence of shingles, because of which we considered diagnosis of recurrent psoriasis rather than relapsing KP for the chest lesions. Not only the healing and healed shingles can trigger KP in psoriasis, but also the developing shingles can cause psoriatic KP at the site of herpes zoster lesions. PMID:26131802

  17. 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...

  18. Sweat gland adenocarcinoma of scalp.

    Science.gov (United States)

    Nair, Pragya A; Rathod, Kirti M; Chaudhary, Arvind H; Pilani, Abhishek P

    2013-10-01

    Sweat gland adenocarcinoma is a rare tumor particularly over scalp. They have potential to be benign as well as distant metastasis. Usually presents with papules or nodules. Ulcerative morphology is uncommon. Wide surigical excision with regional lymph not dissection is the treatment of choice. A 42-year-old female with sweat gland adenocarcinoma of scalp is reported with cervical lymph node involvement.

  19. Sweat Gland Adenocarcinoma of Scalp

    OpenAIRE

    Nair, Pragya A; Rathod, Kirti M; Chaudhary, Arvind H; Pilani, Abhishek P

    2013-01-01

    Sweat gland adenocarcinoma is a rare tumor particularly over scalp. They have potential to be benign as well as distant metastasis. Usually presents with papules or nodules. Ulcerative morphology is uncommon. Wide surigical excision with regional lymph not dissection is the treatment of choice. A 42-year-old female with sweat gland adenocarcinoma of scalp is reported with cervical lymph node involvement.

  20. Malignant nodular hidradenoma of scalp

    Directory of Open Access Journals (Sweden)

    Tanmoy Maiti

    2014-01-01

    Full Text Available Malignant nodular hidradenoma (MNH is a rare tumor of sweat gland known by many names in the literature. Scalp is a known and yet uncommon site of occurrence. We describe two patients with scalp MNH with brain parenchymal invasion. Both tumors recurred in spite of total excision and radiotherapy.

  1. 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....

  2. 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...

  3. 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.

  4. Diffuse heterochromia of scalp hair.

    Science.gov (United States)

    Lee, W S; Lee, I W; Ahn, S K

    1996-11-01

    Heterochromia of hair is the presence of more than one distinct color of hair in the same person. A color difference between scalp hair and a mustache or sideburns is not uncommon. Pubic and axillary hair and eyebrows and eyelashes are often darker than scalp hair in a fair-haired person. Rarely, a circumscribed patch of hair of different colors occurs. However, diffuse heterochromia of black and red scalp hair has not been previously reported. We describe a father and son with this condition.

  5. 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...

  6. 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

  7. 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.

  8. 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.

  9. 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....

  10. 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

  11. 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.

  12. 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.

  13. 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...

  14. 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....

  15. 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

  16. Two cases of halo scalp ring.

    Science.gov (United States)

    Douri, Thaer Hasan

    2016-11-15

    Halo scalp ring (HSR) is a rare form of non-scarring annular alopecia that is attributed to caput succedaneum. It arises perinatally because of prolonged pressure on the scalp by the cervix during or before the delivery. We report two new cases of halo scalp ring in full term pregnancy - newborns.

  17. Two cases of halo scalp ring

    OpenAIRE

    Douri, Thaer Hasan

    2016-01-01

    Halo scalp ring (HSR) is a rare form of non-scarring annular alopecia that is attributed to caput succedaneum. It arises perinatally because of prolonged pressure on the scalp by the cervix during or before the delivery. We report two new cases of halo scalp ring in full term pregnancy - newborns.

  18. Treatment of multiple scalp cylindroma

    Directory of Open Access Journals (Sweden)

    Radmilo Rončević

    2016-07-01

    Full Text Available Cylindroma is a rare, benign adnexal tumor of the skin. The most frequent tumor location is the head, especially the scalp, and neck area. This type of tumor can occur as solitary or multiple tumors. Tumor diagnosis is relatively easy and is based on clinical findings and biopsy. The therapy of choice is surgical excision with parts or entire scalp excision depending on whether it is solitary or multiple tumor. We presented a 65-year-old male patient with multiple scalp tumors of 0.5–6 cm in diameter. An entire scalp excision was performed and the postoperative wounds (i.e., the periosteum of the skull and the fascia galea were covered with free skin graft of partial thickness. In order to prevent profuse bleeding, we placed a tourniquet around his head and performed bilateral temporary ligature of temporal artery prior to surgery. During the nine-year follow-up, there were no new tumors or tumor recurrence reported.

  19. Segmented heterochromia in scalp hair.

    Science.gov (United States)

    Yoon, Kyeong Han; Kim, Daehwan; Sohn, Seonghyang; Lee, Won Soo

    2003-12-01

    Segmented heterochromia of scalp hair is characterized by the irregularly alternating segmentation of hair into dark and light bands and is known to be associated with iron deficiency anemia. The authors report the case of an 11-year-old boy with segmented heterochromia associated with iron deficiency anemia. After 11 months of iron replacement, the boy's segmented heterochromic hair recovered completely.

  20. Secukinumab shows significant efficacy in two patients with difficult-to-treat areas of psoriasis: a Greek experience.

    Science.gov (United States)

    Platsidaki, Eftychia; Kostopoulos, Nikolaos; Marnelakis, Ioannis; Panagakis, Pantelis

    2018-03-15

    Psoriasis is one of the most frequently occurring chronic inflammatory skin diseases. There are some specialized regions of the body that are considered difficult to treat. Secukinumab is a human monoclonal immunoglobulin G antibody that blocks the interleukin 17A ligand and has been shown to be highly efficacious in treating moderate-to-severe psoriasis. We studied two Greek patients, one with scalp psoriasis and the other with palmoplantar psoriasis, both resistant to treatment. Patients were treated with secukinumab and efficacy and safety were recorded. The patient with severe, refractory palmoplantar psoriasis achieved complete clearance at the end of the 4-week treatment period with secukinumab. The patient with moderate to severe, chronic scalp psoriasis was successfully treated with secukinumab, obtaining complete clearance of symptoms and remission of disease after approximately 16 weeks. In both cases clinical response was maintained through week 52. Secukinumab has been shown to be highly efficacious in the treatment of psoriasis of specific anatomical sites with an acceptable safety profile.

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. Study of efficacy of bath PUVA therapy in the treatment of generalized plaque type psoriasis

    Directory of Open Access Journals (Sweden)

    Azadeh S

    1999-09-01

    Full Text Available Psoriasis is a chronic, inflammatory scaling disorder of the skin. Different patterns of psoriasis exist including plaque type, erythrodemic, pustular, palmoplantar and guttate. The most commonly involved sites are the elbows, knees, lumbosacral area and scalp. PUVA (Psoriasis Plus UVA therapy [administration of oral psoralen followed by exposure to UVA (320 to 440 nm] is widely used to treat severe psoriasis. Oral PUVA produces some adverse effects that may limit its applicability in a number of patients. The carcinogenic potential limits its use in patients with psoriasis who probably receive other carcinogenic treatments. Oral PUVA may induce complications such as nausea, vomiting and headache. In light of these problems Bath PUVA therapy is an important alternative to oral PUVA therapy. Bath PUVA is a kind of photochemotherapy in which UVA radiation after administration of topical psoralen in a warm water bath is used. We treated 30 patients with generalized plaque type psoriasis with 8-Mop Bath PUVA in Razi hospital. Bath PUVA cleared psoriasis more rapidly than oral PUVA and required fewer treatments (mean number of sessions: (17.6±2.1 and lower cumulative UVA dose. (49.2±15.4 J/cm². 83.3 percent of our patients showed complete response to treatment and 13.4 percent showed good response.

  8. 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 ...

  9. 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.

  10. [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.

  11. 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...

  12. 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...

  13. 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...

  14. 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....

  15. 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.

  16. 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

  17. 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

  18. [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.

  19. 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

  20. 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...

  1. Single-center, noninterventional clinical trial to assess the safety, efficacy, and tolerability of a dimeticone-based medical device in facilitating the removal of scales after topical application in patients with psoriasis corporis or psoriasis capitis

    Directory of Open Access Journals (Sweden)

    Hengge UR

    2017-06-01

    Full Text Available Ulrich R Hengge,1 Kristina Röschmann,2 Henning Candler3 1Skin Center, Düsseldorf, 2Department of Clinical Research, 3Department of Medical Affairs, G. Pohl‑Boskamp GmbH & Co. KG, Hohenlockstedt, Germany Introduction: Psoriasis is a frequent inflammatory skin disease affecting ~2%–3% of the population in western countries. Scaling of the psoriatic lesions is the most impairing symptom in patients with psoriasis. In contrast to conventional keratolytic treatment concepts containing salicylic acid or urea, a dimeticone-based medical device (Loyon® removes scales in a physical way without any pharmacological effect.Objective: To assess the efficacy and tolerability of a dimeticone-based medical device in removal of scales in patients with psoriasis corporis/capitis under real-life conditions.Methods: Forty patients with psoriasis capitis or corporis were included and received once-daily treatments for 7 days. Clinical assessment of the psoriasis area severity index score (psoriasis corporis and the psoriasis scalp severity index score (psoriasis capitis was performed and evaluated at baseline, after 3 and 7 days of treatment. Baseline scaling scores and redness scores were calculated for two target lesions of the scalp or the body on a 5-point scale each.Results: For the primary efficacy variable scaling score, a statistically significant decrease was observed after treatment, with a relative reduction in scaling of 36.8% after 7 days of treatment within patients affected by psoriasis capitis. Treatment success was achieved in 76.8% of patients with psoriasis capitis, and time to treatment success was evaluated to be 4.14 days for these patients and 4.33 days for patients suffering from psoriasis corporis.Conclusion: In conclusion, this trial demonstrated that the dimeticone-based medical device is a safe, well-tolerated, practicable, and efficient keratolytic compound, which can be well implemented in and recommended for standard therapy

  2. 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

  3. Fetal scalp blood sampling during labor

    DEFF Research Database (Denmark)

    Chandraharan, Edwin; Wiberg, Nana

    2014-01-01

    Fetal cardiotocography is characterized by low specificity; therefore, in an attempt to ensure fetal well-being, fetal scalp blood sampling has been recommended by most obstetric societies in the case of a non-reassuring cardiotocography. The scientific agreement on the evidence for using fetal...... scalp blood sampling to decrease the rate of operative delivery for fetal distress is ambiguous. Based on the same studies, a Cochrane review states that fetal scalp blood sampling increases the rate of instrumental delivery while decreasing neonatal acidosis, whereas the National Institute of Health...... and Clinical Excellence guideline considers that fetal scalp blood sampling decreases instrumental delivery without differences in other outcome variables. The fetal scalp is supplied by vessels outside the skull below the level of the cranial vault, which is likely to be compressed during contractions...

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. Extent of misconceptions, negative prejudices and discriminatory behaviour to psoriasis patients in France.

    Science.gov (United States)

    Halioua, B; Sid-Mohand, D; Roussel, M E; Maury-le-Breton, A; de Fontaubert, A; Stalder, J F

    2016-04-01

    The perception of stigmatization of patients with psoriasis is largely due to misconceptions and negative prejudice about this skin disease. 'Uneducated' judgments can give rise to discriminatory behaviours. Evaluate the prevalence, in France, of misconceptions, negative prejudice and discriminatory behaviour towards psoriasis patients. Online survey conducted in June 2011, aimed at 1005 persons aged 16-64 years, representative of the French population. The representativeness of the sample was ensured by quota methodology (gender, age, occupation of the interviewed person) after stratification by region and location category. The respondents were asked to respond to a questionnaire on their knowledge of psoriasis, their attitude and main feelings/perceptions towards psoriasis patients. About 62.4% of respondents recognize a lack of information about psoriasis and 19.7% have misconceptions about this disease. About 16.5% believe that psoriasis is contagious, 6.8% believe this skin disease is related to personal hygiene and 3.2% believe that it affects more people with low personal hygiene. About 50.0% of respondents show discriminatory behaviour towards psoriasis patients, reflected by reluctance to maintain friendship ties/a relationship of friendliness (7.6%), to have lunch or dinner with a person with visible manifestations (17.9%), to give a kiss on the cheek in greeting (29.7%), to shake hands (28.8%) and to have sexual relations/intercourse (44.1%). Patients with negative prejudice about the psoriasis frequently have misconceptions towards psoriasis patients. About 52.8% of respondents do not know anyone with psoriasis. Socio-demographic indicators such as gender, education level and rural or urban way of life are not associated with an increased prevalence of misconceptions and/or discriminatory behaviour. The lack of knowledge about psoriasis in France is important. There is an urgent need to strengthen information campaigns about psoriasis intended for the

  9. A novel LCD (coal tar) solution for psoriasis does not discolor naturally light or color-processed hair in an exaggerated exposure test model.

    Science.gov (United States)

    Johnson, Colleen; Edison, Brenda; Brouda, Irina; Green, Barbara

    2009-09-01

    Scalp psoriasis is reported to occur in 50-80% of psoriasis sufferers. Treatment of scalp psoriasis requires special consideration of product esthetics and staining potential due to the presence of hair. To evaluate the potential of a new, marketed liquor carbonis distillate (LCD; coal tar) solution to discolor naturally light or color-processed hair under exaggerated exposure conditions. Samples of naturally light and color-processed hair from a single donor were exposed to LCD solution repeatedly over 14 days and via submergence for 24 h. Color of LCD-treated hair samples was compared with untreated control hair samples. LCD solution did not discolor naturally light or color-processed hair following repeated exposures and 24 h submergence. The marketed LCD solution does not appear to discolor naturally light or color-processed hair.

  10. Impact of smoking on disease severity in patients with plaque type psoriasis

    Directory of Open Access Journals (Sweden)

    Nuriye Kayıran

    2015-12-01

    Full Text Available Background and Design: Psoriasis is a chronic enflammatory systemic disease involving skin, scalp, nails and joints and is characterized by remission and activation periods. Although the etiopathogenesis of psoriasis has not been fully elucidated, many genetic and environmental factors are believed to have a role in the development of the disease. Obesity, smoking, family history of psoriasis, repetitive physical traumas and stress are the factors thought to affect the severity and progress of the disease. In this study, we aimed to investigate the effects of smoking on the clinical severity of psoriasis in patients with chronic plaque psoriasis. Materials and Methods: Three hundred outpatients with chronic plaque-type psoriasis were enrolled in the study. Data on age, gender, family history, smoking history, educational status, history of chronic illness, and psoriasis area severity index (PASI scores were recorded for each patient. The effects of these factors on PASI were evaluated. Results: Current smokers, never smokers and former smokers were compared in terms of disease severity. The median PASI values of current smokers and never smokers were compared. The mean PASI value was statistically significantly higher in smokers (p=0.049. In multiple logistic regression analysis, it was detected that the risk of moderate and severe disease increased by male sex 2 times, by family history 2.3 times, and by smoking period above 20 years, 10 times. In smokers of more than 1 pack a day, this risk further increased. Conclusion: On the basis of these data, it may be concluded that smoking affects the severity of disease significantly. In addition to amount of daily cigarette consumption, smoking period was shown to have an effect on the severity of disease. Elimination of risk factors such as smoking, which appears to increase the severity of diseases, may be helpful in the management of psoriasis.

  11. 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

  12. 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....

  13. Fetal scalp pH testing

    Science.gov (United States)

    Sometimes fetal heart monitoring doesn't provide enough information about the well-being of a baby. In these cases, testing the scalp pH can help the doctor decide whether the fetus is getting enough oxygen ...

  14. 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

  15. 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...

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. IMPORTANCE OF THE TRICHOSCOPY IN SCALP DYSESTHESIA

    Directory of Open Access Journals (Sweden)

    Maria Bibiana Leroux

    2013-10-01

    Full Text Available The trichoscopy has been incorporated as a first hand method in patients consulting for scalp problems. Magnifying glass or digital microscope that permit the direct visualization of the hair shaft and the perifolicullar skin are utilized to diagnose cicatricial and non-cicatricial alopecia. A female patient with an alopecia plaque associated with a scalp dysesthesia in which trichoscopy was very useful in its diagnosis is presented.

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

    Science.gov (United States)

    Reich, K

    2012-03-01

    psoriasis. Tumour necrosis factor-α (TNF-α) inhibitors are known to counteract insulin resistance and emerging studies demonstrate an even higher protective effect of TNF-α antagonist therapy against the development of diabetes or CV co-morbidities in patients. The recent data reviewed here indicate a role for earlier and more appropriate treatment of psoriasis with drugs such as TNF-α antagonists. Such an approach has the potential to significantly improve patient outcomes through the treatment of psoriasis itself and possibly also in protection against co-morbidities. © 2012 The Author. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  3. 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

  4. 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

  5. Genetic and Hormonal Determinations in a Pair of Identical Twins with Early Onset Psoriasis Vulgaris: Case Report and a Brief Review of the Literature

    Directory of Open Access Journals (Sweden)

    Roman Iulia Ioana

    2017-07-01

    Full Text Available Psoriasis vulgaris is a chronic inflammatory dermatosis with major impact on patients’ life quality. The etiopathogenesis is multifactorial, depending on complex interactions between genetic and environmental factors. We present the case of two female patients, identical twins of 33 years old, suffering from psoriasis vulgaris since childhood. Patient A developed specific lesions of psoriasis at the age of 7 and patient B started to develop psoriasis lesions on the scalp two years later. At the age of 31, patient A was diagnosed with psoriatic arthritis. Laboratory test results were within the normal ranges for both patients. Hormonal and immunological determinations revealed the presence of a high level of antithyroidperoxidase antibody in patient A and increased level of prolactin in patient B. Ultrasonographic assessment of the thyroid detected the presence of bilateral micronodules in the first subject. Knowing that early onset psoriasis is associated with the presence of Human Leukocyte Antigen Cw6(HLA-Cw6, we aimed to confirm this hypothesis for our subjects. Although HLA-Cw6 is the most frequent mutation in psoriasis patients and it is present in about two-thirds of the tested subjects,the genetic results for both patients were negative, strengthening the fact that other factors, the environmental one and the hormonal disorders had an important role in their psoriasis pathogenesis. Under these conditions, we emphasize the importance of including a hormonal evaluation approach of psoriasis patients in order to diagnose and treat pathologies that may be related with disease exacerbations

  6. Adalimumab for nail psoriasis: Efficacy and safety from the first 26 weeks of a phase 3, randomized, placebo-controlled trial.

    Science.gov (United States)

    Elewski, Boni E; Okun, Martin M; Papp, Kim; Baker, Christopher S; Crowley, Jeffrey J; Guillet, Gérard; Sundaram, Murali; Poulin, Yves; Gu, Yihua; Geng, Ziqian; Williams, David A; Rich, Phoebe A

    2018-01-01

    Previous clinical trials have not evaluated improvement in nail psoriasis as a primary end point. This phase 3 trial evaluated the safety and efficacy of adalimumab in patients with moderate-to-severe fingernail psoriasis and moderate-to-severe plaque psoriasis. Patients were randomized 1:1 to 40 mg adalimumab every other week or placebo. The primary efficacy end point was at least 75% improvement in total-fingernail modified Nail Psoriasis Severity Index (NAPSI75) response rate at week 26. Ranked secondary end point scores evaluated at week 26 were total-fingernail NAPSI and modified NAPSI, nail pain, Nail Psoriasis Physical Functioning Severity, Brigham Scalp Nail Inverse Palmo-Plantar Psoriasis Index, and Physician's Global Assessment (fingernail psoriasis). Of the 217 randomized patients (108 received placebo and 109 received adalimumab), 188 (86.6%) completed 26 weeks of treatment (period A) or escaped early to the open-label period. The study met the primary end point (response rate of 3.4% with placebo vs 46.6% with adalimumab [P psoriasis versus with placebo and no new safety risks were identified. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  7. 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.

  8. The relationship between local scalp skin temperature and cutaneous perfusion during scalp cooling

    NARCIS (Netherlands)

    Janssen, Francis-Paul E.M.; Rajan, Vinayakrishnan; Steenbergen, Wiendelt; van Leeuwen, Gerard M.J.; van Steenhoven, Anton A.

    2007-01-01

    Cooling the scalp during administration of chemotherapy can prevent hair loss. It reduces both skin blood flow and hair follicle temperature, thus affecting drug supply and drug effect in the hair follicle. The extent to which these mechanisms contribute to the hair preservative effect of scalp

  9. Pediatric scalp burns: hair today, gone tomorrow?

    Science.gov (United States)

    Menon, Seema; Jacques, Madeleine; Harvey, John G; Holland, Andrew J A

    2015-01-01

    Scalp burns in the pediatric population appear relatively uncommon, with most reported cases occurring in adults secondary to electrical burns. We reviewed our experience with the management of these injuries in children. A retrospective review was conducted at our institution from March 2004 to July 2011. Scalp burns were defined as any burn crossing over the hairline into the scalp region. During the 7-year 4-month study, there were 107 scalp burns, representing 1.8% of the 6074 burns treated at our institution during that time. The cause was scald in 97, contact in 4, flame in 3, friction in 2, and chemical in 1. The majority (n = 93, 87%) appeared superficial to mid-dermal, with an average time to complete healing of 10.3 days. The remaining 14 cases (13%) were mid-dermal to full thickness, with an average time to complete healing of 50.8 days. Grafting was required in 12 cases (11%). The mean time to grafting was 4 weeks (range, 2 weeks to 2.5 months). The main complication of scalp burns was alopecia, which occurred in all grafted sites as well as in 4 patients treated conservatively. There were no other complications after grafting and no cases of graft loss. In our pediatric series, scalp burns were most commonly caused by scald injuries and were superficial to mid-dermal in depth. These generally healed rapidly but occasionally resulted in alopecia. The management of deep dermal and full-thickness scalp burns remains challenging in children, with the decision to graft often delayed.

  10. 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

  11. Effects of Malassezia yeasts on serum Th1 and Th2 cytokines in patients with guttate psoriasis.

    Science.gov (United States)

    Aydogan, Kenan; Tore, Okan; Akcaglar, Sevim; Oral, Barbaros; Ener, Beyza; Tunalı, Sukran; Saricaoglu, Hayriye

    2013-01-01

    Systemic and focal infections caused by microorganisms have been known to induce or exacerbate psoriasis. Although the role of yeast species of the genus Malassezia in the pathogenesis of psoriasis is not fully understood, it is thought that these lipophilic yeasts may represent a triggering factor in the exacerbation of psoriatic lesions. This study investigated the effects of Malassezia yeasts on serum Th1 and Th2 cytokines in patients with guttate psoriasis (GP) in order to define their role in the pathogenesis of psoriasis. Fifty patients with GP and 29 clinically healthy individuals were included in the study. All samples consisted of scales and scrapings taken from the scalps, trunks, and upper limbs of both psoriasis patients and healthy subjects. Psoriasis patients and healthy subjects were grouped according to their positivity or negativity for Malassezia yeasts as ascertained by direct microscopy and/or culture. An enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of Th1 and Th2 cytokines in these groups. No significant differences in positivity for Malassezia yeasts were found between psoriatic skin and healthy skin in samples taken from different body sites. Serum interleukin-13 (IL-13) levels were significantly lower in the psoriasis group compared with the control group (P = 0.04). Levels of other cytokines did not differ significantly between the psoriasis and control groups. Mean levels of Th2 cytokines (IL-4, IL-10, IL-13), but not of Th1 cytokines (IL-2 and IFN-γ), were significantly lower in psoriasis patients positive for Malassezia yeasts compared with those negative for Malassezia yeasts and control subjects (P = 0.04, P Malassezia yeasts from GP lesions does not necessarily mean that these species are pathogenic, but their downregulating effects on anti-inflammatory Th2 cytokines may contribute to the occurrence of GP. © 2012 The International Society of Dermatology.

  12. 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.

  13. 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 ...

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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...

  19. 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.

  20. 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...

  1. Neglected giant scalp Basal cell carcinoma

    DEFF Research Database (Denmark)

    Larsen, Anne Kristine; El-Charnoubi, Waseem-Asim Ghulam; Gehl, Julie

    2014-01-01

    SUMMARY: Rarely, basal cell carcinoma grows to a giant size, invading the underlying deep tissue and complicating the treatment and reconstruction modalities. A giant basal cell carcinoma on the scalp is in some cases treated with a combination of surgery and radiation therapy, resulting in local...... control, a satisfactory long-term cosmetic and functional result. We present a case with a neglected basal cell scalp carcinoma, treated with wide excision and postoperative radiotherapy, reconstructed with a free latissimus dorsi flap. The cosmetic result is acceptable and there is no sign of recurrence...

  2. Neglected Giant Scalp Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Anne Kristine Larsen, MD

    2014-03-01

    Full Text Available Summary: Rarely, basal cell carcinoma grows to a giant size, invading the underlying deep tissue and complicating the treatment and reconstruction modalities. A giant basal cell carcinoma on the scalp is in some cases treated with a combination of surgery and radiation therapy, resulting in local control, a satisfactory long-term cosmetic and functional result. We present a case with a neglected basal cell scalp carcinoma, treated with wide excision and postoperative radiotherapy, reconstructed with a free latissimus dorsi flap. The cosmetic result is acceptable and there is no sign of recurrence 1 year postoperatively.

  3. Nonsynchronized segmented heterochromia in black scalp hair.

    Science.gov (United States)

    Faulkner, C; Godbolt, A M; Messenger, A G; Jones, S K

    2003-05-01

    Nonsynchronized segmented heterochromia in black scalp hair is a rarely reported entity, the only previous report being described in association with iron deficiency anaemia. A 14-year-old girl presented with a 2-year history of nonsynchronized segmented heterochromia. She was otherwise well and her serum iron, copper, zinc and protein levels were all within the normal range. She had no clinical evidence of vitiligo or alopecia areata. This patient is believed to represent the first reported case of nonsynchronized segmented heterochromia in black scalp hair as a presentation of premature greying of the hair.

  4. How relevant are vascular endothelial growth factor and intercellular adhesion molecule in the systemic capillary leak syndrome of psoriasis?*

    Science.gov (United States)

    Bressan, Aline Lopes; Pereira, Daniele; Medeiros, Paula Mota; Carneiro, Sueli; Azulay-Abulafia, Luna

    2017-01-01

    Psoriasis is a chronic disease, characterized by erythematous scaly lesions, presented in eight different forms: plaques, guttate, pustular, erythrodermic, inverse, nail and scalp psoriasis, and psoriatic arthritis. Its development depends on genetic factors, external stimulus and immune response alteration.1 Proinflammatory cytokines such as TNF-alpha, IL-12 and 23 may also be involved. In the worst cases, systemic complications linked to endothelial alterations may occur. A literature review was conducted for a better understanding of what roles VEGF (vascular endothelial growth factor) and ICAM-1 (intercellular adhesion molecule) have, among other cytokines, in systemic capillary leak syndrome, involved in erythrodermic and pustular psoriasis, the most unstable forms of the disease. PMID:29364440

  5. The Diagnosis and Treatment of Hair and Scalp Diseases.

    Science.gov (United States)

    Wolff, Hans; Fischer, Tobias W; Blume-Peytavi, Ulrike

    2016-05-27

    Hair loss is caused by a variety of hair growth disorders, each with its own pathogenetic mechanism. This review is based on pertinent articles retrieved by a selective search in PubMed, on the current German and European guidelines, and on the authors' clinical and scientific experience. Excessive daily hair loss (effluvium) may be physiological, as in the postpartum state, or pathological, due for example to thyroid disturbances, drug effects, iron deficiency, or syphilis. Androgenetic alopecia generally manifests itself in women as diffuse thinning of the hair over the top of the scalp, and in men as receding temporal hairlines and loss of hair in the region of the whorl on the back of the head. Alopecia areata is patchy hair loss arising over a short time and involving the scalp, eyebrows, beard, or entire body. The hair loss of alopecia areata is reversible in principle but hard to treat. Folliculitis decalvans is a form of alopecia with scarring, characterized by inflamed papules, pustules, and crusts at the edges of the lesions. Lichen planopilaris generally presents with small patches of baldness, peripilar erythema, and round areas of skin scaling. Kossard's frontal fibrosing alopecia is characterized by a receding hairline and loss of eyebrows. Hair loss is a symptom, not a diagnosis. The pathogenesis of the alopecias involves a range of genetic, endocrine, immune, and inflammatory processes, each of which calls for its own form of treatment.

  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. The impact of psoriasis on work-related problems: a multicenter cross-sectional survey.

    Science.gov (United States)

    Ayala, F; Sampogna, F; Romano, G V; Merolla, R; Guida, G; Gualberti, G; Paparatti, U D L; Amerio, P; Balato, N; Potenza, C

    2014-12-01

    Psoriasis can have cumulative physical and psychosocial effects preventing sufferers from achieving their full-life potential. Few studies have addressed the impact of psoriasis on work-related characteristics. To evaluate the impact of psoriasis on education prospects and work limitations in patients with moderate-to-severe psoriasis. This study was conducted in 29 dermatology centres across Italy. Information was collected by questionnaire during office visits. A total of 787 patients (64% male, aged 50 years) completed the questionnaire. At the time of the survey, mean Psoriasis Area and Severity Index (PASI) score and disease duration were 10 and 19 years respectively. Current smokers had higher PASI scores compared to non-smokers (10.8 vs. 9.4, P = 0.02). Plaque psoriasis was the most frequently described (91.2%). Fifty-five percent of patients had limited expectations of career progression. Similarly, in 42% of cases, psoriasis reduced the prospects of improvement in employment status and 35% of patients reported having reduced earning potential. Approximately 60% of patients reported that psoriasis localized to their hands or feet caused work limitations, whilst in about 25%, it caused them to quit their job. Approximately 37% of patients reported having lost between 3-10 work days in the past 3 months due to clinical assessment or treatment. Logistic regression revealed that gender, low standard of education, number of localizations, shame, anger and self-esteem were predictors significantly associated with limitations in work. Moderate-to-severe psoriasis has a profound negative impact on the employment capacity of patients in Italy. Psoriasis also contributes to days lost from work, affects job opportunity, career prospects and revenue potential. © 2013 European Academy of Dermatology and Venereology.

  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. Scalp arteriovenous malformation : a case report.

    Science.gov (United States)

    Mohamed, Wan Najwa Zaini Wan; Abdullah, Noreen Norfaraheen Lee; Muda, Ahmad Sobri

    2008-07-01

    We report a rare case of Arteriovenous malformation (AVM) of the scalp in a 30 year-old Malay gentleman who presented with painless forehead swelling since birth. Magnetic Resonance Imaging (MRI) and cerebral angiogram performed and the findings are discussed.

  12. The higher proportion of men with psoriasis treated with biologics may be explained by more severe disease in men.

    Directory of Open Access Journals (Sweden)

    David Hägg

    Full Text Available OBJECTIVES: Moderate to severe psoriasis, once regarded as merely a skin disease, is today seen as an inflammatory systemic disease. The sex ratio of the prevalence of psoriasis is balanced. In recent years several reports have documented that men receive more systemic or UV treatment than women, and different hypotheses were made. In PsoReg, the national registry for systemic treatment of psoriasis in Sweden, we have, like other European registries, observed a predominance of men (59%, especially of men treated with biologics (63%. Biologics are a relatively new group of very effective but high-priced drugs. The objective of this study was to analyse if women are discriminated by not having the same access to the high-priced biologics. DESIGN: Population based cohort study using data from a nationwide quality register of psoriasis patients. POPULATION: 2294 patients with moderate to severe psoriasis receiving systemic treatment from a specialist in dermatology. MAIN OUTCOME MEASURES: Time to initiation of biologic treatment. A multiple Cox proportional hazard's regression was performed, with time to initiating a biologic treatment as the outcome in order to assess the independent role of the patient's sex in initiating such therapy. The psoriasis severity was defined as a time-varying variable. RESULTS: Men had more severe psoriasis than women according to the Psoriasis Area and Severity Index (PASI, regardless of age at enrolment, and throughout the study period. The analysis in the multiple Cox regression show that age, psoriasis severity and psoriasis arthropathy were relevant factors for initiating biologic therapy, whereas sex is not. CONCLUSIONS: Although as many women as men are believed to suffer from psoriasis, men seem to be more severely affected by psoriasis. The asymmetry in allocation of biologic therapy thereby probably reflects the differing disease activity between the sexes, and is not a discrimination against women per se.

  13. 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....

  14. 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.

  15. Reconstruction of post burn scalp alopecia by using expanded hair-bearing scalp flaps.

    Science.gov (United States)

    Tayyaba, Farhat Ul Ann; Amin, Mohammad Mughees; Attaur-Rasool, Sohail; Naseer, Uzma; Ambar, Akashah

    2015-01-01

    Tissue expansion is a time-tested and frequently used procedure for utilizing local tissue to replace large defects. We aimed to assess the success & complications of tissue expansion in correction of post burn scalp alopecia. In this study, 30 patients of scalp burn alopecia of 5 to 35 years age group were treated with tissue expansion of the scalp at Bahawal-Victoria Hospital from January 2013 to December 2014. The area of the scalp loss was within 1/5 to 2/5. Our technique employed an insertion site distal to the area needed to be expanded, attempting to minimize complication like extrusion & wound dehiscence. The patients were followed-up weekly during first month and then fortnightly for next four months. Our study involved 8 male (26.67%) and 22 female subjects (73.33%) with a mean age of 21years. Flame burn accounted for the mostly 53.3% (n=16) of scalp burns & parieto-temporal region was most commonly affected in 33.4% (n=10) of subjects. Desired aesthetic results were achieved in all the patients without any major complication. Minor complication included mild infection in 8 (26.67%), seroma in 4 (13.33%) & wound dehiscence in 2 (6.67%) patients. Tissue expansion is a simple, safe, & efficient technique for aesthetic scalp reconstruction. With a simple modification of distal incision and tunneling, we succeeded in minimizing complications. Versatile design of the expanded scalp flap can distribute the expanded hair-bearing scalp properly in the reconstructed recipient site.

  16. Review of Clinical Applications of Scalp Acupuncture for Paralysis: An Excerpt From Chinese Scalp Acupuncture

    OpenAIRE

    Hao, Jason Jishun; Hao, Linda Lingzhi

    2012-01-01

    Chinese scalp acupuncture is a contemporary acupuncture technique integrating traditional Chinese needling methods with Western medical knowledge of representative areas of the cerebral cortex. It has been proven to be a most effective technique for treating acute and chronic central nervous system disorders. Scalp acupuncture often produces remarkable results with just a few needles and usually brings about immediate improvement, sometimes taking only several seconds to a minute. Acupuncture...

  17. 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.

  18. 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.

  19. 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.

  20. 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...

  1. 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.

  2. 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 ...

  3. 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.

  4. 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...

  5. 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...

  6. Genital psoriasis: a questionnaire-based survey on a concealed skin disease in the Netherlands.

    Science.gov (United States)

    Meeuwis, K A P; de Hullu, J A; de Jager, M E A; Massuger, L F A G; van de Kerkhof, P C M; van Rossum, M M

    2010-12-01

    Psoriatic lesions may involve nearly all sites of the body. Involvement of the genital skin is frequently classified as part of intertriginous psoriasis without special awareness and treatment for this presentation of the disease. Gaining knowledge about the frequency of the involvement of genital skin in these patients will improve the overall care for patients with psoriasis. We studied the prevalence of genital psoriasis in the Netherlands and epidemiological characteristics of this specific presentation of the disease. Furthermore, we studied the relation between flexural and genital psoriasis. A self-administered questionnaire was sent to all 5300 members of the Dutch Psoriasis Society. Sociodemographic patient characteristics and disease-related data (such as localization of psoriatic lesions, involvement of the genitalia, age at onset of genital psoriasis and severity of genital psoriatic lesions) were collected and analysed. A response rate of 37% was achieved. Almost 46% of the responding patients with psoriasis, that is 16.5% of all potential responders (n = 5300), report genital involvement at some time during the course of their disease. The genitalia can become affected at any age. Many patients with current genital involvement (38%) do not have the flexural skin affected. A large part of patients with psoriasis suffer from genital psoriasis, which was not associated with flexural involvement in at least one third of them. More attention to the genital region is required in the current standard treatment of both male and female psoriatic patients at any age. © 2010 The Authors. Journal compilation © 2010 European Academy of Dermatology and Venereology.

  7. Treatment policy for psoriasis and eczema: a survey among dermatologists in the Netherlands and Belgian Flanders.

    Science.gov (United States)

    Roelofzen, Judith H J; Aben, Katja K H; Khawar, Ali J M; Van de Kerkhof, Peter C M; Kiemeney, Lambertus A L M; Van Der Valk, Pieter G M

    2007-01-01

    Today, many therapies are available for the treatment of psoriasis and eczema. One of the oldest topical therapies is coal tar. Coal tar has been used for decades, but over the past years, the use of coal tar has decreased for several reasons, including the supposed carcinogenicity of coal tar. We investigated the current and past treatment policies for psoriasis and eczema with special emphasis on the use of tar products; a postal survey was conducted among all dermatologists in two European countries: the Netherlands (n = 360) and the Flemish speaking part of Belgium (Flanders) (n = 328). This study was conducted as part of the ongoing LATER-study ("Late effects of coal tar treatment in eczema and psoriasis; the Radboud study"). All practising dermatologists received a questionnaire. Dermatologists were asked to describe their treatment policies in mild/moderate psoriasis, severe psoriasis, mild/moderate eczema and severe eczema. The response rate to the questionnaire was 62.5% for the Dutch dermatologists and 45.7% for the Flemish dermatologists. Almost all dermatologists prescribe topical corticosteroids. In eczema, most of the dermatologists prescribe the recently introduced calcineurin inhibitors (95%). Coal tar is a second choice topical therapy. Dutch dermatologists mainly use tar in the treatment of eczema (72% vs. 48% in Flanders), whereas in Flanders, tar is mainly prescribed in psoriasis (60% vs. 41% in Holland). Flemish dermatologists very frequently prescribe PUVA in psoriasis (93% vs. 63%). Topical treatment, especially topical corticosteroids, is the mainstay in psoriasis and eczema. Coal tar still is an important (second choice) therapy for the topical treatment of psoriasis and eczema, but its use varies from country to country. Despite the carcinogenicity of PUVA, this photochemotherapy is frequently prescribed by dermatologists, mainly in Flanders.

  8. Nail psoriasis in an adult successfully treated with a series of herbal skin care products family – a case report.

    Science.gov (United States)

    Tirant, M; Hercogovấ, J; Fioranelli, M; Gianfaldoni, S; Chokoeva, A A; Tchernev, G; Wollina, U; Novotny, F; Roccia, M G; Maximov, G K; França, K; Lotti, T

    2016-01-01

    Psoriasis is a common chronic inflammatory dermatosis that causes significant distress and morbidity. Approximately 50% of patients with cutaneous psoriasis and 90% of patients with psoriatic arthritis demonstrate nail involvement of their psoriasis. Left untreated, nail psoriasis may progress to debilitating nail disease that leads to not only impairment of function but also on quality of life. We report the case of a 50-year-old male patient with recalcitrant nail dystrophies on the fingers since the age of 40, who responded successfully to Dr. Michaels® product family. The patient had a 35-year history of plaque psoriasis localised on the scalp, ears, groin, limbs, and trunk and with psoriatic arthritis. The nail symptoms consisted of onycholysis, onychomycosis, leukonychia, transverse grooves, nail plate crumbling and paronychia of the periungal skin. This case represents the efficacy and safety of the Dr. Michaels® (Soratinex® and Nailinex®) product family with successful resolution of nail dystrophies and surrounding paronychia with no reported adverse events.

  9. Scalp abscess--a cautionary tale.

    LENUS (Irish Health Repository)

    Nugent, Nora F

    2010-08-01

    Transcranial extension of frontal sinus infection is a rare, but not eradicated entity. We present a 21-year-old male, in whom a persistent scalp abscess heralded the discovery of skull vault osteomyelitis and extradural abscesses secondary to frontal sinusitis. Patients with prolonged or unusual symptoms with a history of sinusitis or trauma warrant further investigation as they may have developed serious intracranial complications. Urgent management, both surgical and antimicrobial, is indicated in such scenarios.

  10. Focal Scalp Hair Heterochromia in an Infant.

    Science.gov (United States)

    Kumar, Pramod

    2017-02-01

    Hair heterochromia involves the presence of two different non-artificially induced colours of hair in the same individual which can be due to either iron deficiency anaemia, genetic mutations or mosaicism. We report a six-month old male infant who presented to the Department of Dermatology, Saham Hospital, Saham, Oman, in 2013 with focal scalp hair heterochromia without any detectable underlying abnormalities. The area of heterochromia was still noticeable at a one-year follow-up.

  11. Focal Scalp Hair Heterochromia in an Infant

    OpenAIRE

    Kumar, Pramod

    2017-01-01

    Hair heterochromia involves the presence of two different non-artificially induced colours of hair in the same individual which can be due to either iron deficiency anaemia, genetic mutations or mosaicism. We report a six-month old male infant who presented to the Department of Dermatology, Saham Hospital, Saham, Oman, in 2013 with focal scalp hair heterochromia without any detectable underlying abnormalities. The area of heterochromia was still noticeable at a one-year follow-up.

  12. Focal Scalp Hair Heterochromia in an Infant

    Directory of Open Access Journals (Sweden)

    Pramod Kumar

    2017-03-01

    Full Text Available Hair heterochromia involves the presence of two different non-artificially induced colours of hair in the same individual which can be due to either iron deficiency anaemia, genetic mutations or mosaicism. We report a six-month old male infant who presented to the Department of Dermatology, Saham Hospital, Saham, Oman, in 2013 with focal scalp hair heterochromia without any detectable underlying abnormalities. The area of heterochromia was still noticeable at a one-year follow-up.

  13. Association between psoriasis and viral infections in the United States: focusing on hepatitis B, hepatitis C and human immunodeficiency virus.

    Science.gov (United States)

    Kanada, K N; Schupp, C W; Armstrong, A W

    2013-10-01

    No published data in the U.S. population regarding an association between viral infections and psoriasis are currently available. Assessment of infection and immunosuppression risk is critical in managing psoriasis patients. To examine the association between psoriasis and viral infections including hepatitis B, hepatitis C and human immunodeficiency viral infections in the general U.S. population. Population data representative of the U.S. cohort were analysed from the National Health and Nutrition Examination Survey (NHANES), 2003-2006. Hepatitis B, hepatitis C, and human immunodeficiency antibodies status were ascertained from laboratory evaluations. Univariate and multivariate analyses were performed to assess the associations between psoriasis and these viral infections. Among 6532 participants aged 20-59 years who provided responses to their psoriasis status, 162 patients reported having psoriasis. Based on multivariate regression analyses, psoriasis was not significantly associated with positive serology for hepatitis B core [odds ratio (OR), 0.83; 95% confidence interval (CI), 0.32-2.17; P = 0.7060], hepatitis B surface [OR, 7.89; CI, 0.52-119; P = 0.1355], hepatitis C [OR, 0.24; CI, 0.03-2.01; P = 0.1915], or human immunodeficiency virus [OR, 0.73; CI, 0.09-5.93; P = 0.7646] antibodies, after adjusting for age, gender, race and smoking status. From the limited sample of the NHANES database on psoriasis and viral infections, psoriasis does not appear to be associated with an increased risk of hepatitis B, hepatitis C, or HIV infection in the U.S. population. Epidemiology of these viral infections in psoriasis needs to be continually studied and updated given their importance in management considerations. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  14. MR findings of primary scalp mass

    International Nuclear Information System (INIS)

    Kim, Jee Eun; Hwang, Hee Young; Park, Sung Hye; Kim, Young Chae; Lee, Young Suk

    1996-01-01

    To evaluate the diagnostic value of MRI, we compared MR images of primary scalp mass with pathological findings. Eight cases in seven patients who had presented primary scalp mass during the previous three years were evaluated by MRI and confirmed with surgical excision and pathologic evaluation. 0.38T(Resonex 4000, USA) MRI was used and all MR images were analysed retrospectively. Eight pathologically confirmed cases consisted of three cases of epidermal cysts, one of steatocystoma simplex, three of neurofibromatosis and one of lymphangioma. All epidermal cysts were located in the occipital area and showed a higher signal intensity than CSF in T1WI, and proton density and variable signal intensity in T2WI. The Steatocystoma showed a signal iniensity similar to fat in T1WI and proton density and a lower signal intensity than fat in T2WI. Neurofibromatosis accounted for three cases in two neurofibromatosis patients;one was located in the right parieto-occipital area and accompanied by hematoma and skull defect; two cases were located in the occipital and posterior cervical area of the same patient. The masses showed a higher signal intensity than muscle in T1WI and hyper or isointensity in T2WI with well enhancement. The lymphangioma showed a signal intensity similar to CSF in all pulse sequences and contained a fat component. MRI is a useful modality for evaluating primary scalp mass

  15. 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...

  16. Review of Clinical Applications of Scalp Acupuncture for Paralysis: An Excerpt From Chinese Scalp Acupuncture

    Science.gov (United States)

    Hao, Linda Lingzhi

    2012-01-01

    Chinese scalp acupuncture is a contemporary acupuncture technique integrating traditional Chinese needling methods with Western medical knowledge of representative areas of the cerebral cortex. It has been proven to be a most effective technique for treating acute and chronic central nervous system disorders. Scalp acupuncture often produces remarkable results with just a few needles and usually brings about immediate improvement, sometimes taking only several seconds to a minute. Acupuncture, a therapeutic technique of Oriental Medicine, can be traced back more than 2500 years. Throughout its long history, acupuncture has evolved as its own unique traditional medicine. By embracing newly developed knowledge and technology, the profession continues to create additional methods of treatment. Techniques such as electrical and laser acupuncture and even new acupuncture points are currently being developed. We believe scalp acupuncture, which integrates Western medicine with Traditional Chinese Medicine, to be the most significant development that Chinese acupuncture has made in the past 60 years. PMID:24278807

  17. Maggots in the Brain: Sequelae of Ignored Scalp Wound.

    Science.gov (United States)

    Aggarwal, Ashish; Maskara, Prasant

    2018-01-01

    A 26-year-old male had suffered a burn injury to his scalp in childhood and ignored it. He presented with a complaint of something crawling on his head. Inspection of his scalp revealed multiple maggots on the brain surface with erosion of overlying bone and scalp. He was successfully managed by surgical debridement and regular dressing. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. 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.

  19. 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.

  20. Systematic review and meta-analysis of the association between psoriasis and metabolic syndrome.

    Science.gov (United States)

    Rodríguez-Zúñiga, Milton José Max; García-Perdomo, Herney Andrés

    2017-10-01

    Several studies have shown a relationship between psoriasis and metabolic syndrome (MS), but no meta-analysis has been restricted to studies that adjusted for confounders. To determine the association between psoriasis and MS. A systematic review and meta-analysis of observational studies on psoriasis and MS in adults was performed from MEDLINE, Scopus, SciELO, Google Scholar, Science Direct, and LILACS from inception to January 2016. We performed a random effects model meta-analysis for those studies reporting adjusted odds ratios (ORs) with 95% confidence intervals (CIs). The subgroup analysis was related to geographic location, diagnosis criteria and risk of bias. In all, 14 papers including a total of 25,042 patients with psoriasis were analyzed. We found that MS was present in 31.4% of patients with psoriasis (OR, 1.42; 95% CI, 1.28-1.65). Middle Eastern studies (in Israel, Turkey, and Lebanon) (OR, 1.76, 95% CI, 0.86-2.67) reported a greater risk for MS than European studies (in Germany, Italy, the United Kingdom, Norway, and Denmark) (OR, 1.40; 95% CI, 1.25-1.55). Few adjusted studies existed, and there was inconsistency between publications. Because of the increased risk for MS, clinicians should consider screening patients with psoriasis for metabolic risk factors. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Astrocytoma following scalp radiotherapy in infancy

    Energy Technology Data Exchange (ETDEWEB)

    Zochadne, D.W.; Cairncross, J.G.; Arce, F.P.; MacDonald, J.C.F.; Blume, W.T.; Girvin, J.P.; Kaufmann, J.C.E. (University of Western Ontario, London (Canada))

    1984-11-01

    A 24 year old woman with a 15 year history of intractable seizures underwent resection of a small low grade astrocytoma of the right mesial frontal lobe. The tumor arose beneath a benign scalp nevus that had been treated in infancy with radium patches and focal x-irradiation. Neuropathological changes within the tumor were compatible with radiation injury. Meningiomas and sarcomas complicate cranial irradiation but the evidence that gliomas do so is less convincing. Our observations support an association between radiation exposure and the subsequent development of glial tumors.

  2. 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...

  3. [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.

  4. Impact of psoriasis severity on family income and quality of life.

    Science.gov (United States)

    Hawro, T; Zalewska, A; Hawro, M; Kaszuba, A; Królikowska, M; Maurer, M

    2015-03-01

    Psoriasis is a common disease and the costs of its therapy, medical care and loss of productivity are a major financial burden for patients and society. The financial status of psoriasis patients and its relationship with disease severity and quality of life (QoL) remains ill characterized. The aim of this study was to assess the economic status of psoriasis patients and to investigate its correlation with disease severity and its impact on QoL. A total of 83 (45 male) psoriasis patients, treated at a Polish specialty clinic, were assessed for their financial and employment status. QoL was measured with a generic (WHOQOL-BREF) and a skin disease-related QoL instrument (dermatology life quality index--DLQI). The effects of demographic and clinical variables, including disease severity measured by Psoriasis Area and Severity Index (PASI), on the family income of patients were analyzed by multiple logistic regression. The mediating effect of family income between PASI and QoL was assessed by using the Baron and Kenny's procedure. Patients' family income correlate negatively with psoriasis severity (Spearman's rho = -0.356; P family income below the social minimum was significantly higher (PASI: 20.5 ± 12.2) than in patients with a higher family income (PASI: 11.7 ± 7.7, P family income (P Family income was found to link disease severity to global QoL impairment (P < 0.05). Disease severity negatively affects the financial status of psoriasis patients, which in turn, is a mediator of global QoL impairment. Our findings are alarming and call for long-term solutions that equalize employment opportunities for patients with psoriasis. © 2014 European Academy of Dermatology and Venereology.

  5. 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

  6. 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

  7. [Scalp burns induced by hair bleaching].

    Science.gov (United States)

    Bouschon, P; Bursztejn, A-C; Waton, J; Brault, F; Schmutz, J-L

    2018-03-14

    Hair bleaching is increasingly being carried out in hairdressing salons. The products used are a mixture of hydrogen peroxide and persulfates, both active chemical agents. Scalp burns secondary to hair bleaching are a traumatic adverse effect rarely discussed in publications that continue to be little known among healthcare professionals. We report the case of a 15-year-old girl with a plaque of scarring alopecia on the vertex. This lesion resulted from a deep burn following a hair-bleaching procedure. Healing took around 4 months, resulting in discomfort for our patient. This is a rare case of scarring alopecia following a basic chemical burn to the scalp. The oxidation reaction induced by the mixture of hydrogen peroxide and persulfates, prepared in a basic medium, causes bleaching of the melanin pigments in hair. The clinical presentation of a single, well limited, painful, oozing ulceration located at the vertex was similar to the other cases published in the literature. Although a chemical burning mechanism is most often incriminated, the procedure is always coupled with use of a heat source and associated thermal burn may occur. The delayed appearance of the lesion appears to be caused by the forming of surfactants by the hydrogen peroxide/persulfate mixture, resulting in slow dissolution of the oxidizing compounds within the stratum corneum. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  8. Prolific plant regeneration through organogenesis from scalps of ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-11-16

    Nov 16, 2009 ... Malaysia. 2Faculty of Agriculture and Biotechnology, Universiti Darul Iman Malaysia, 20400 Kuala Terengganu, Malaysia. Accepted 17 September, 2009. A prolific plant regeneration system using scalps derived from shoot tips of Musa spp. cv. Tanduk was developed. Highly proliferating scalps, produced ...

  9. Heterochromia of the scalp hair following Blaschko lines.

    Science.gov (United States)

    Iorizzo, Matilde; Piraccini, Bianca Maria; Tosti, Antonella

    2007-01-01

    Heterochromia of the scalp hair is characterized by the presence of tufts of hair of a color that differs from the general hair color. It is considered a disorder of pigmentation when the tufts are asymmetrically distributed. We report four patients with isolated congenital tufts of heterochromia in the scalp hair following the Blaschko lines of the head.

  10. 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 ...

  11. 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

  12. 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,.

  13. 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

  14. 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

  15. 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.

  16. Radiation therapy for angiosarcoma of the scalp: treatment outcomes of total scalp irradiation with X-rays and electrons.

    Science.gov (United States)

    Hata, Masaharu; Wada, Hidefumi; Ogino, Ichiro; Omura, Motoko; Koike, Izumi; Tayama, Yoshibumi; Odagiri, Kazumasa; Kasuya, Takeo; Inoue, Tomio

    2014-10-01

    Wide surgical excision is the standard treatment for angiosarcoma of the scalp, but many patients are inoperable. Therefore, we investigated the outcome of radiation therapy for angiosarcoma of the scalp. Seventeen patients with angiosarcoma of the scalp underwent radiation therapy with total scalp irradiation. Four patients had cervical lymph node metastases, but none had distant metastases. A median initial dose of 50 Gy in 25 fractions was delivered to the entire scalp. Subsequently, local radiation boost to the tumor sites achieved a median total dose of 70 Gy in 35 fractions. Fourteen of the 17 patients developed recurrences during the median follow-up period of 14 months after radiation therapy; 7 had recurrences in the scalp, including primary tumor progression in 2 patients and new disease in 5, and 12 patients developed distant metastases. The primary progression-free, scalp relapse-free, and distant metastasis-free rates were 86, 67, and 38 % at 1 year and 86, 38, and 16 % at 3 years, respectively. Thirteen patients died; the overall and cause-specific survival rates were both 73 % at 1 year and 23 and 44 % at 3 years, respectively. The median survival time was 16 months. There were no therapy-related toxicities ≥ grade 3. Total scalp irradiation is safe and effective for local tumor control, but a dose of ≤ 50 Gy in conventional fractions may be insufficient to eradicate microscopic tumors. For gross tumors, a total dose of 70 Gy, and > 70 Gy for tumors with deep invasion, is recommended.

  17. The role of IL 23 in the treatment of psoriasis.

    Science.gov (United States)

    Puig, Lluís

    2017-06-01

    The IL-23/IL-17 axis is currently considered to be crucial in the pathogenesis of psoriasis. Human IL-23 is primarily produced by antigen-presenting cells and induces and maintains differentiation of Th17 cells and Th22 cells, a primary cellular source of proinflammatory cytokines such as IL-17 and IL-22, which mediate the epidermal hyperplasia, keratinocyte immune activation and tissue inflammation inherent in psoriasis. Agents that target the p40 subunit common to both IL-12 and IL-23 have shown robust clinical activity, but selectivity for IL-23p19 could offer advantages in efficacy and safety with respect to anti-p40 blockade. Areas covered: Relevant references regarding the role of the IL-23/IL-17 pathway in the pathogenesis of psoriasis/psoriatic arthritis and clinical trials with IL-23p40 and IL-23p19 blocking agents were obtained through a literature search in MEDLINE/Pubmed for articles published until November 2016. Moreover, ongoing registered clinical trials (RCTs) of moderate-to-severe psoriasis and psoriatic arthritis were searched through clinicaltrials.gov website, and a manual search was made for pertinent communications at the 2016 American Academy of Dermatology and European Academy of Dermatology and Venereology meetings. Expert commentary: There are potential advantages in selective blockade of the IL23-specific p19 subunit with respect to distal blockade of IL-17A or its receptor. Acting upstream in the IL-23/IL-17 cytokine pathway is likely to reduce the expression of multiple pro-inflammatory cytokines acting on keratinocytes -including IL-17F, IL-21 and IL-22-, in addition to IL-17A. On the other hand, safety data thus far suggest that these drugs might be devoid of some adverse effects of IL-17A blockade that seem to be class related, such as mucocutaneous Candida infections or triggering or worsening of inflammatory bowel disease. Specific IL-23p19 blockade with high-affinity monoclonal antibodies seems to be able to induce long

  18. 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.

  19. 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.

  20. 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

  1. 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....

  2. 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....

  3. Scalp hyperkeratosis and alopecia in children of color.

    Science.gov (United States)

    Coley, Marcelyn K; Bhanusali, Dhaval G; Silverberg, Jonathan I; Alexis, Andrew F; Silverberg, Nanette B

    2011-05-01

    Scalp hyperkeratosis and/or alopecia are common pediatric dermatologic findings. In Caucasian children, scalp hyperkeratosis of childhood is most often associated with atopic and seborrheic dermatides. Recent data is lacking on the clinical meaning of scalp hyperkeratosis and alopecia in children of color. To determine diagnosis associated with scalp hyperkeratosis and/or alopecia in a predominately Black and Hispanic pediatric patient population. A retrospective chart review was conducted for all children (0-17 years of age) seen at our institution who had a scalp fungal culture for the evaluation of scalp hyperkeratosis and/or alopecia from January 2007 to September 2009. Fungal culture was performed using cotton swab technique, plating onto Sabouraud's and Mycosel media. Demographic features, fungal culture results, clinical symptoms, physical findings and final diagnosis were reviewed. 164 children were identified who were eligible for inclusion in the study, 75 of whom were Black and 56 Hispanic/Latino. Scalp hyperkeratosis was noted in 106 patients and alopecia was noted in 71 subjects. Tinea capitis was the final diagnosis in 50 out of 80 children who had hyperkeratosis without alopecia (60%), 16 of 43 children with alopecia alone (37.2%) and 23 of 28 children with both hyperkeratosis and alopecia (82.1%, P=0.0007). The odds ratio of tinea capitis in the presence of hyperkeratosis with alopecia was 7.49 with a 95 percent confidence limit of 2.19-25.70. Scalp hyperkeratosis, especially when accompanied by alopecia, is usually associated with tinea capitis in Black and Hispanic children. Fungal culture and empirical anti-fungal therapy are warranted in children of color with scalp hyperkeratosis.

  4. Association of psoriasis and/or psoriatic arthritis with autoimmune diseases: the experience of two Italian integrated Dermatology/Rheumatology outpatient clinics.

    Science.gov (United States)

    Carubbi, F; Chimenti, M S; Blasetti, G; Cipriani, P; Musto, A; Fargnoli, M C; Perricone, R; Giacomelli, R; Peris, K

    2015-11-01

    The systemic nature of psoriasis and its association with arthropathy, metabolic syndrome and cardiovascular disease is well established. In contrast, the association between psoriatic disease and other autoimmune disorders is still a matter of debate and data available in the literature are scarce. The aim of this study was to examine the association of common autoimmune diseases (ADs), specified a priori, in an Italian cohort of patients affected by psoriasis and/or psoriatic arthritis (PsA), referred to two integrated Dermatology/Rheumatology outpatient clinics, over a 3-year period. Five hundred and two patients, affected by plaque psoriasis, PsA 'sine psoriasis' or a combination of psoriasis and PsA and with a diagnosis of at least one AD, were retrospectively evaluated. Univariate and multivariate binary logistic regression was employed to identify possible association between psoriasis, PsA, psoriasis-PsA and ADs, by calculating corresponding odds ratios and 95% confidence intervals. Patients with psoriasis or PsA may develop one or more autoimmune diseases during their lifetime, with a higher prevalence of most ADs in psoriasis subgroup. We demonstrated for the first time that the combination of psoriasis-PsA appears to be protective towards some autoimmune diseases. However, a gender effect should always be considered due to the different distribution of autoimmune disorders between males and females. The new concept of psoriatic disease, focusing on genetic and molecular aspects which are at the basis of the pathogenesis of psoriasis and its related manifestations, extended the traditional idea of a disease confined to skin and joints. In this context, the multidisciplinary assessment of patients in the combined Dermatology/Rheumatology outpatient clinics would allow to identify early clinical and laboratory abnormalities not limited to skin and joint. © 2015 European Academy of Dermatology and Venereology.

  5. Periodontitis and risk of psoriasis: a systematic review and meta-analysis.

    Science.gov (United States)

    Ungprasert, P; Wijarnpreecha, K; Wetter, D A

    2017-05-01

    The association between periodontitis and systemic diseases has been increasingly recognized. However, the data on the association between periodontitis and psoriasis are still limited. To summarize all available data on the association between periodontitis and the risk of psoriasis. Two investigators independently searched published studies indexed in MEDLINE and EMBASE databases from inception to July 2016 using a search strategy that included terms for psoriasis and periodontitis. Studies were included if the following criteria were met: (i) case-control or cohort study comparing the risk of psoriasis in subjects with and without periodontitis; (ii) subjects without periodontitis were used as comparators in cohort studies while participants without psoriasis were used as controls in case-control studies; and (iii) effect estimates and 95% confidence intervals (CI) were provided. Point estimates and standard errors from each study were extracted and combined together using the generic inverse variance technique described by DerSimonian and Laird. Two cohort studies and three case-control studies met the inclusion criteria and were included in the meta-analysis. The pooled risk ratio of psoriasis in patients with periodontitis versus comparators was 1.55 (95% CI, 1.35-1.77). The statistical heterogeneity was insignificant with an I 2 of 18%. Subgroup analysis according to study design revealed a significantly higher risk among patients with periodontitis with a pooled RR of 1.50 (95% CI, 1.37-1.64) for cohort studies and a pooled RR of 2.33 (95% CI, 1.51-3.60) for case-control studies. Patients with periodontitis have a significantly elevated risk of psoriasis. © 2016 European Academy of Dermatology and Venereology.

  6. The mechanistic basis for psoriasis immunopathogenesis: translating genotype to phenotype. Report of a workshop, Venice, 2012.

    Science.gov (United States)

    Bachelez, H; Viguier, M; Tebbey, P W; Lowes, M; Suárez-Fariñas, M; Costanzo, A; Nestle, F O

    2013-08-01

    The International Psoriasis Council, a global nonprofit organization dedicated to advancing psoriasis research and treatment, led an initiative to better define the pathogenic mechanisms that constitute psoriasis. In September 2012, a workshop was held at the 42nd Annual European Society for Dermatological Research in Venice, Italy. By assembling a panel of global dermatology and immunology experts, the objective was to evaluate the current status of the science explaining the mechanism of disease in psoriasis, e.g. dysregulation of the skin immune system and perturbations of epidermal homeostasis. The workshop consisted of four oral presentations, which addressed key topics in psoriasis, delivered by Hervé Bachelez (Paris, France), Antonio Costanzo (Rome, Italy), Michelle Lowes (New York, NY, U.S.A.) and Frank Nestle (London, U.K.). A global expert panel was assembled to stimulate dialogue and debate: Kevin Cooper (Cleveland, OH, U.S.A.), Michel Gilliet (Lausanne, Switzerland), Joerg Prinz (Munich, Germany), Martin Röcken (Tubingen, Germany), Jens Schroeder (Kiel, Germany), Manuelle Viguier (Paris, France), Mayte Suárez-Fariñas (New York, NY, U.S.A.) and Cristina Zielinski (Berlin, Germany). Collectively, the presentations demonstrated the significant advances in understanding immune regulation that have occurred over the past decade by virtue of the study of psoriasis subtypes, phenotypic manifestations and genetic associations. Elucidating the pathogenic and genetic basis of psoriasis holds the promise of a complete understanding of disease mechanisms, predictors of treatment response, novel drug development strategies and customized therapeutic regimens for the individual patient. © 2013 The Authors BJD © 2013 British Association of Dermatologists.

  7. 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...

  8. Fixed Combination Aerosol Foam Calcipotriene 0.005% (Cal) Plus Betamethasone Dipropionate 0.064% (BD) is More Efficacious than Cal or BD Aerosol Foam Alone for Psoriasis Vulgaris

    Science.gov (United States)

    Tyring, Stephen; Bukhalo, Michael; Alonso-Llamazares, Javier; Olesen, Martin; Lowson, David; Yamauchi, Paul

    2016-01-01

    Objective: To evaluate the efficacy of fixed combination aerosol foam calcipotriene 0.005% (Cal) plus betamethasone dipropionate 0.064% (BD). Design: Patients were randomized (100:101:101) to receive Cal/BD foam, Cal foam, or BD foam once daily for four weeks. Setting: Twenty-eight United States centers. Participants: 302 patients (≥18 years) with Psoriasis vulgaris (plaque Psoriasis; ≥mild disease severity by physicians global assessment). Measurements: Treatment success of the body (“clear”/”almost clear” from baseline moderate/severe disease; “clear” from baseline mild disease). Involved scalp treatment success was an additional endpoint. Results: Most patients (76%) had moderate Psoriasis of the body (66% for scalp). At Week 4, 45 percent of Cal/BD foam patients achieved treatment success, significantly more than Cal foam (14.9%; OR 4.34 [95%CI 2.16,8.72] Pfoam (30.7%; 1.81 [1.00,3.26] P=0.047). Fifty-three percent of Cal/BD foam patients achieved treatment success of the scalp, significantly greater than Cal foam (35.6%; 1.91 [1.09,3.35] P=0.021), but not BD foam (47.5%; 1.24 [0.71,2.16] P=0.45). Mean modified Psoriasis area and severity index (population baseline 7.6) improved in all groups, with statistically significant differences in Week 4 Cal/BD foam score (2.37) versus Cal foam (4.39; mean difference -2.03 [-2.63][-1.43] Pfoam (3.37; -1.19 [-1.80][-0.59] Pfoam was significantly more effective than Cal foam and BD foam in providing treatment success at Week 4 and effective on involved scalp. Trial registration: NCT01536938. PMID:27313822

  9. 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).

  10. Scalp Seborrheic Dermatitis and Dandruff Therapy Using a Herbal and Zinc Pyrithione-based Therapy of Shampoo and Scalp Lotion.

    Science.gov (United States)

    Barak-Shinar, Deganit; Green, Lawrence J

    2018-01-01

    Objective: The aim of this study was to evaluate the safety and efficacy of an herbal and zinc pyrithione shampoo and a scalp lotion (Kamedis Derma-Scalp Dandruff Therapy, Kamedis Ltd., Tel Aviv, Israel) for the treatment of scalp seborrheic dermatitis and dandruff. Design: This was an interventional, open-label, safety and efficacy study. Setting: This open-label study was conducted at Consumer Product Testing Company Inc. in Fairfield, New Jersey. At the baseline visit (Day 0), an examination of the scalp was conducted by a board-certified dermatologist. The entire scalp was evaluated for evidence of seborrheic dermatitis using the Adherent Scalp Flaking Score with a 10-point scale. Only subjects with evidence of moderate-to-greater seborrheic dermatitis or moderate-to-greater dandruff were deemed qualified for inclusion in the study. Participants: Fifty subjects were recruited and included in the study. Measurements: Study subjects were evaluated by the same dermatologist for erythema and flaking at Days 0, 14, 28, and 42 using a five-point scale for each parameter. At each time point, a total severity score was calculated based on the findings of the evaluations. Following the scalp evaluation, each subject had a standardized digital photograph taken of his or her scalp. Each subject was also asked to answer a satisfaction questionnaire regarding the product treatment enhancement and characteristics. Results: A reduction in both parameters evaluated was seen at all time points. Statistical significance was achieved at each time point when compared with the baseline visit. In addition, the subjects expressed a high degree of satisfaction with the treatment. No adverse events were reported during this study. Conclusion: The study showed that the herbal zinc pyrithione shampoo and scalp lotion provided improvement in the main symptoms of seborrheic dermatitis.

  11. 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

  12. 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...

  13. 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

  14. Psoriasis and psoriatic arthritis in Peruvian aborigines: a report from the GRAPPA 2011 annual meeting.

    Science.gov (United States)

    Toloza, Sergio M A; Vega-Hinojosa, Oscar; Chandran, Vinod; Valle Onate, Rafael; Espinoza, Luis R

    2012-11-01

    To determine the presence of psoriasis and psoriatic arthritis (PsA) in aboriginal people living in the Andean Mountains of Peru. Consecutive patients with psoriasis and PsA attending an arthritis clinic in Juliaca, Puno, Peru, located 3824 m above sea level were examined. The CASPAR (ClASsification of Psoriatic ARthritis) criteria were used for classification of PsA. Diagnosis of psoriasis was confirmed by a dermatologist. Seventeen patients [11 (65%) men and 6 (35%) women] fulfilled classification criteria for PsA; one patient was of European ancestry and is not included in this report. Of the 16 aboriginal patients in this report, 5 were natives of Quechua ancestry and one was native Aymara. At the time of their first clinic visit, no native patient with PsA had a family history of psoriasis or PsA, and all patients exhibited an established disease of long duration and severity. Methotrexate was the drug of choice for all patients; 2 patients are currently receiving biological therapy. Contrary to what has been reported in the literature, both psoriasis and PsA are present in aboriginal people from the Andean Mountains of Peru. More studies are needed to further define the phenotype of these disorders, as well as the pathogenetic role of genetic and environmental factors.

  15. Long-term safety of biologics in the treatment of psoriasis

    Directory of Open Access Journals (Sweden)

    Panchal MR

    2013-12-01

    Full Text Available Manisha R Panchal,1 Helen Coope,2 D John McKenna,3 Anton B Alexandroff31Department of Dermatology, Sherwood Forest Hospitals, Kingsmill Hospital, Nottinghamshire, 2Novartis Pharmaceuticals UK Ltd, West Sussex, 3Department of Dermatology, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, UKAbstract: Biologics are novel and important agents in the treatment of severe psoriasis. These agents block specific molecular steps in the inflammatory cascade, thereby reducing activation and proliferation of keratinocytes. Prescreening for biologic agents and careful monitoring of patients is important. There are four biologics currently licensed and used in the treatment of psoriasis in the European Union. This is an evidence-based review examining clinical trials and focusing on the long-term safety data for four biologic agents. Current British Association of Dermatology guidance for the use of biologics in psoriasis and guidelines on the management of psoriasis from the National Institute for Health and Clinical Excellence have been used. Advances on safety information since 2009 in clinical trials are reviewed. The results show that overall there is no statistical significance in the incidence of adverse effects of biologics versus placebo. However, there are serious adverse effects that are reported for biologics that need to be assessed for and addressed promptly. Results of studies discussing major adverse cardiovascular events are also reviewed.Keywords: psoriasis, biologic agents, safety profile, major cardiovascular events

  16. Body to scalp: Evolving trends in body hair transplantation

    Directory of Open Access Journals (Sweden)

    Kuldeep Saxena

    2017-01-01

    Full Text Available Follicular unit extraction (FUE is becoming an increasingly popular method for hair restoration. As FUE leaves behind no linear scars, it is more suitable to harvest from various body areas including beard, chest, and extremities in hirsute individuals. Body hair characteristics such as thickness, length, and hair cycle may not completely match to that of the scalp hair. The techniques of harvesting body hairs are more time consuming, requiring higher degree of skill than regular scalp FUE. Body hair transplantation can be successfully used either alone or in combination with scalp hair in advanced grades of baldness, for improving the cosmetic appearance of hairlines and in scarring alopecia when there is paucity of donor scalp hair. Harvesting of body hairs opens up a new viable donor source for hair restoration surgeons, especially in cases of advanced Norwood grades five and above of androgenetic alopecia.

  17. Body to Scalp: Evolving Trends in Body Hair Transplantation.

    Science.gov (United States)

    Saxena, Kuldeep; Savant, Sandeep S

    2017-01-01

    Follicular unit extraction (FUE) is becoming an increasingly popular method for hair restoration. As FUE leaves behind no linear scars, it is more suitable to harvest from various body areas including beard, chest, and extremities in hirsute individuals. Body hair characteristics such as thickness, length, and hair cycle may not completely match to that of the scalp hair. The techniques of harvesting body hairs are more time consuming, requiring higher degree of skill than regular scalp FUE. Body hair transplantation can be successfully used either alone or in combination with scalp hair in advanced grades of baldness, for improving the cosmetic appearance of hairlines and in scarring alopecia when there is paucity of donor scalp hair. Harvesting of body hairs opens up a new viable donor source for hair restoration surgeons, especially in cases of advanced Norwood grades five and above of androgenetic alopecia.

  18. 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 — ...

  19. Body to Scalp: Evolving Trends in Body Hair Transplantation

    OpenAIRE

    Saxena, Kuldeep; Savant, Sandeep S.

    2017-01-01

    Follicular unit extraction (FUE) is becoming an increasingly popular method for hair restoration. As FUE leaves behind no linear scars, it is more suitable to harvest from various body areas including beard, chest, and extremities in hirsute individuals. Body hair characteristics such as thickness, length, and hair cycle may not completely match to that of the scalp hair. The techniques of harvesting body hairs are more time consuming, requiring higher degree of skill than regular scalp FUE. ...

  20. Congenital skull defect and neurofibroma: without scalp and other abnormalities.

    Science.gov (United States)

    Wang, Jie-Cong; Wei, Liu; Xu, Jia; Liu, Jian-Feng; Gui, Lai

    2012-07-01

    Congenital skull defect is a rare malformation that is usually associated with congenital anomalies of the scalp and comparable lesions in the brain, spinal cord, limbs, and skeletal muscle. Most previously reported cases have described skull defects with aplasia cutis congenita and other congenital abnormalities. Very few patients with skull defects present with an intact scalp or neurofibroma. The authors report an adult patient with a rare congenital skull defect and local neurofibroma.

  1. 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...

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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...

  11. 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...

  12. 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...

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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...

  19. 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

  20. 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

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. Sarcoidosis presenting as non-scarring non-scalp alopecia.

    Science.gov (United States)

    Dan, Luke; Relic, John

    2016-08-01

    In this article we describe a 39-year-old man who presented with non-scarring non-scalp alopecia of his limbs as the initial presentation of sarcoidosis. Alopecia is a rare cutaneous manifestation of sarcoidosis. A literature review has found only one other example of sarcoidosis presenting as non-scarring non-scalp alopecia in an area other than the scalp in a patient who was otherwise asymptomatic. Several reported cases have described scarring alopecia of the scalp, which is the area of skin most commonly affected by sarcoidosis. There has been one documented case of sarcoidosis manifesting as total body non-scarring alopecia in a patient who had systemic symptoms of sarcoidosis. Other cases have presented rare cutaneous manifestations of sarcoidosis but in all these cases several other organ systems have been involved, and the patient has had systemic symptoms on presentation or the cutaneous presentation did not include non-scalp non-scarring alopecia. © 2015 The Australasian College of Dermatologists.

  6. Deep Neural Architectures for Mapping Scalp to Intracranial EEG.

    Science.gov (United States)

    Antoniades, Andreas; Spyrou, Loukianos; Martin-Lopez, David; Valentin, Antonio; Alarcon, Gonzalo; Sanei, Saeid; Took, Clive Cheong

    2018-03-19

    Data is often plagued by noise which encumbers machine learning of clinically useful biomarkers and electroencephalogram (EEG) data is no exemption. Intracranial EEG (iEEG) data enhances the training of deep learning models of the human brain, yet is often prohibitive due to the invasive recording process. A more convenient alternative is to record brain activity using scalp electrodes. However, the inherent noise associated with scalp EEG data often impedes the learning process of neural models, achieving substandard performance. Here, an ensemble deep learning architecture for nonlinearly mapping scalp to iEEG data is proposed. The proposed architecture exploits the information from a limited number of joint scalp-intracranial recording to establish a novel methodology for detecting the epileptic discharges from the sEEG of a general population of subjects. Statistical tests and qualitative analysis have revealed that the generated pseudo-intracranial data are highly correlated with the true intracranial data. This facilitated the detection of IEDs from the scalp recordings where such waveforms are not often visible. As a real-world clinical application, these pseudo-iEEGs are then used by a convolutional neural network for the automated classification of intracranial epileptic discharges (IEDs) and non-IED of trials in the context of epilepsy analysis. Although the aim of this work was to circumvent the unavailability of iEEG and the limitations of sEEG, we have achieved a classification accuracy of 68% an increase of 6% over the previously proposed linear regression mapping.

  7. 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

  8. 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...

  9. 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...

  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. Actinomycetoma of the scalp after a car accident.

    Science.gov (United States)

    Welsh, Oliverio; Morales-Toquero, Amelia; Vera-Cabrera, Lucio; Cabrera-Vera, Lucio; Vazquez-Martinez, Osvaldo; Gómez-Flores, Minerva; Ocampo-Candiani, Jorge

    2011-07-01

    Actinomycetoma is the most frequent type of mycetoma in Mexico. Localization on the scalp is very rare. Because of this topography and potential spread to the brain, the present case became a diagnostic and therapeutic challenge. We report the case of a 44-year-old woman with a 6 × 5 cm red, friable, granulomatous, vascular neoformation on the scalp and eye diagnosed as Nocardia brasiliensis actinomycetoma. A combination of amikacin and oral trimethoprim-sulfamethoxazole (SXT) was successfully administered with an excellent outcome and no side effects. This is a rare presentation of mycetoma of the scalp that was cured in 12 weeks with a combination of amikacin and SXT. © 2011 The International Society of Dermatology.

  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. 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.

  14. 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...

  15. 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.

  16. 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,

  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. 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...

  19. 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...

  20. 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...

  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. 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....

  3. 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...

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. Minoxidil topical treatment may be more efficient if applied on damp scalp in comparison with dry scalp.

    Science.gov (United States)

    Angelo, T; Barbalho, G N; Gelfuso, G M; Gratieri, T

    2016-09-01

    There is yet no consensus among prescribers whether minoxidil (MXD) formulations should be applied on wet/damp or dry scalp and no clear FDA guidelines on the matter. We hypothesized that the use of MXD on damp scalp may lead to higher drug penetration. First, because the drug diffusion and consequent deposition into the hair follicle may be favored when follicle cast is humid. Second, because humidity may also prevent drug crystallization and, therefore, maintain a higher thermodynamic activity for longer periods, which leads to increased penetration. Following in vitro experiments on rat and porcine skin we confirmed the hypothesis, which could markedly improve treatment effectiveness. © 2016 Wiley Periodicals, Inc.

  10. 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.

  11. 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, ...

  12. 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

  13. Physiological changes in scalp, facial and body hair after the menopause: a cross-sectional population-based study of subjective changes.

    Science.gov (United States)

    Ali, I; Wojnarowska, F

    2011-03-01

    Significant changes in scalp, facial and body hair occur after the menopause. These can have a significant negative impact on self-esteem and are also potential markers of endocrine or metabolic diseases. Knowledge of postmenopausal hair changes is important for clinicians to distinguish between normal physiological change and those that require further medical investigation. To assess the subjective experience of scalp, facial and body hair change in a large cohort of normal postmenopausal females. Postmenopausal females aged 45 years or over of northern European origin completed a questionnaire detailing scalp, facial and body hair changes following the menopause. Women with a history of thyroid disease, oophorectomy or premature menopause were excluded from the study. The Mann-Whitney U-test and the χ(2) test were used to assess the correlation between scalp, facial and body hair changes with age. Diffuse generalized hair loss was the most common form of scalp hair loss, reported by 26% of women. Frontal hair loss was reported by 9% of women. Facial hair gain was cited by 39% of females with the chin being the most frequent site for new growth (32% of women). Body hair loss was significantly correlated with older age (P hair loss in which diffuse generalized scalp hair loss was significantly correlated with body hair loss and increasing age (P hair loss which was associated with higher facial hair scores and relatively younger age (P women with diffuse hair loss. This is the first comprehensive study of the subjective hair changes in postmenopausal women. This study demonstrates two distinct patterns of hair change relating to age, which may reflect different underlying pathophysiological mechanisms and are of relevance to the medical management of these women as well as being possible predictors of health outcomes. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

  14. Effect of clonidine, by infiltration and by intravenous route, on scalp

    African Journals Online (AJOL)

    2010-04-27

    Apr 27, 2010 ... Abstract. Background: The aim of this research was to study and compare the haemodynamic and analgesic effects of (A) scalp block with bupivacaine 0.25%; (B) scalp block with bupivacaine 0.25% plus clonidine 2 µg/ kg; and (C) scalp block with bupivacaine 0.25%, plus intravenous (IV) clonidine 2 µg/kg ...

  15. Effect of clonidine, by infi ltration and by intravenous route, on scalp ...

    African Journals Online (AJOL)

    Effect of clonidine, by infi ltration and by intravenous route, on scalp block for supratentorial craniotomy. SK Dash, KS Gosav, HG Parikh, B Kondwilkar. Abstract. Background: The aim of this research was to study and compare the haemodynamic and analgesic effects of (A) scalp block with bupivacaine 0.25%; (B) scalp ...

  16. Scalp cooling to prevent alopecia after chemotherapy can be considered safe in patients with breast cancer

    NARCIS (Netherlands)

    van den Hurk, C.J.; van de Poll-Franse, L.V.; Breed, W.P.M.; Coebergh, J.W.W.; Nortier, J.

    2013-01-01

    With modern scalp cooling equipment cytotoxic damage of hair root cells can be prevented in half of the patients with cancer at high risk of alopecia. However, traditionally doubt has existed whether scalp cooling might facilitate hiding and disseminating scalp skin metastases and thus decrease

  17. Atopic dermatitis of the face, scalp, and neck

    DEFF Research Database (Denmark)

    Jensen-Jarolim, E; Poulsen, L K; With, H

    1992-01-01

    We have previously reported that a lipophilic yeast, Pityrosporum ovale (P. ovale) produced a high frequency of positive skin prick tests and in vitro histamine-release (HR) tests in patients suffering from atopic dermatitis (AD) of the face, scalp, and neck. In the present study, our aim was to ...

  18. Dosimetric verification of helical tomotherapy for total scalp irradiation

    International Nuclear Information System (INIS)

    Hardcastle, Nicholas; Soisson, Emilie; Metcalfe, Peter; Rosenfeld, Anatoly B.; Tome, Wolfgang A.

    2008-01-01

    Total scalp irradiation is a treatment technique used for a variety of superficial malignancies. Helical tomotherapy is an effective technique used for total scalp irradiation. Recent published work has shown the TomoTherapy planning system to overestimate the superficial dose. In this study, the superficial doses for a helical tomotherapy total scalp irradiation have been measured on an anthropomorphic phantom using radiochromic and radiographic film as well as a new skin dosimeter, the MOSkin. The superficial dose was found to be accurately calculated by the TomoTherapy planning system. This is in contrast to recent reports, probably due to a combination of the smaller dose grid resolution used in planning and this particular treatment primarily consisting of beamlets tangential to the scalp. The superficial dose was found to increase from 33.6 to 41.2 Gy and 36.0 to 42.0 Gy over the first 2 mm depth in the phantom in selected regions of the PTV, measured with radiochromic film. The prescription dose was 40 Gy. The superficial dose was at the prescription dose or higher in some regions due to the bolus effect of the thermoplastic head mask and the head rest used to aid treatment setup. It is suggested that to achieve the prescription dose at the surface (≤2 mm depth) bolus or a custom thermoplastic helmet is used.

  19. White piedra of scalp hair by Trichosporon inkin

    Directory of Open Access Journals (Sweden)

    Vishalakshi Viswanath

    2011-01-01

    Full Text Available White piedra is a rare fungal infection of hair and is reported to be all the more rare on scalp. Trichosporon inkin is usually associated with white piedra of pubic hair. We report a case of white piedra of scalp hair caused by T. inkin. This is the first case reported from India and the fifth case reported worldwide. A 50-year-old Muslim female presented with white knots over scalp hair. Diagnosis of Trichosporon was made by examining KOH mounts of epilated hair and Lactophenol Cotton Blue preparations of the growth in culture. Automated mini-API test (for biochemical profiles and Electronmicroscopy studies (for cell wall structures helped in identification of the species. Mini-API test was also positive for Cryptococcus curvatus which could be due to similarity in biochemical and physiological properties of the two species. Absence of C. curvatus on culture further supports this view. Topical antifungal therapy resulted in clinical clearance within 2 months. Higher incidence of scalp white piedra is observed in Muslim females; contributing factor being the custom of using a veil, leading to higher humidity and limited sunlight exposure.

  20. Multiple Scalp Infarctions and Bilateral Orbital Compression in A ...

    African Journals Online (AJOL)

    ... with bilateral orbital compression syndrome and multiple scalp infarctions, treated conservatively but at the end she undergoes operative orbital decompression when she start to developsings of optic nerve dysfunction and rapidly increasing hematomas to prevent loss of vision and to speed recovery, The ophthalmologist ...

  1. Excess of counterclockwise scalp hair-whorl rotation in homosexual ...

    Indian Academy of Sciences (India)

    It was recently discovered that the human right-versus-left-hand use preference and the direction of scalp hair-whorl rotation develop from a common genetic mechanism. Such a mechanism controls functional specialization of brain hemispheres. Whether the same mechanism specifying mental makeup influences sexual ...

  2. Fetal scalp blood sampling in labor - a review

    DEFF Research Database (Denmark)

    Jørgensen, Jan Stener; Weber, Tom

    2014-01-01

    During the 1970s and 1980s, electronic fetal monitoring and fetal scalp blood sampling (FBS) were introduced without robust evidence. With a methodical review of the published literature, and using one randomized controlled trial, seven controlled studies, nine randomized studies of various...... in the interpretation of CTG patterns. This article is protected by copyright. All rights reserved....

  3. 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....

  4. 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...

  5. 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...

  6. 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.

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. Salivary electrolytes in psoriasis: A preliminary study

    Directory of Open Access Journals (Sweden)

    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.

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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

  18. Simple flaps for reconstruction of pediatric scalp defects after electrical burn

    Directory of Open Access Journals (Sweden)

    Makboul Mohamed

    2013-08-01

    Full Text Available 【Abstract】 Objective: To analyze the management of high-voltage electrical burn injury of the scalp in our hospital. Methods: This study involved 10 patients who suf-fered from high-voltage electrical burn injury of the scalp. Scalp reconstruction was done by different modalities ac-cording to the size and location of the defect. Results: Complete flap viability was achieved in all the cases. We had one case of gapped wound which was managed only by dressing. Widening of the scar was found in 2 cases. Conclusion: Rotation, advancement and transposi-tion scalp flaps are used for reconstructing scalp defects caused by electrical burn. The choice of ideal flaps for re-construction depends upon the size and site of scalp defect. Key words: Burns, electric; Scalp; Reconstructive surgical procedures; Surgical flaps; Skull

  19. The Immunogenetics of Psoriasis and Implications for Drug Repositioning

    Directory of Open Access Journals (Sweden)

    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.

  20. Therapy of moderate and severe psoriasis

    Directory of Open Access Journals (Sweden)

    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

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. Immunomodulators in the treatment of psoriasis

    Directory of Open Access Journals (Sweden)

    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.

  6. 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)

  7. 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....

  8. 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

  9. 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.

  10. 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...

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Ulcerative giant solitary trichoepithelioma of scalp: a rare presentation

    Directory of Open Access Journals (Sweden)

    Sundeep Chowdhry

    2016-07-01

    Full Text Available Trichoepithelioma is a trichogenic tumor which arises from the inferior segment of hair follicle epithelium as hamartoma. Giant solitary trichoepithelioma (GST has been defined as a solitary trichoepithelioma with a diameter greater than 2 cm. A 49-year-old female presented with a slow growing skin coloured swelling on the scalp of 8 years duration with recent history of ulceration and occasional bleeding. The local examination revealed a single well defined nodular swelling which was irregular in shape measuring approximately 2 × 2.5 cm. Histopathology from biopsy specimen revealed dark basaloid cells with scanty cytoplasm and darkly stained nucleus arranged in nests with horn cysts lacking high-grade atypia and mitosis, which was consistent with features of trichoepithelioma. Giant solitary trichoepithelioma of scalp is itself a rare entity and the present case is being reported with the additional component of ulceration in the lesion.

  16. Sweat gland tumor (Eccrine Porocarcinoma of scalp: A rare tumor

    Directory of Open Access Journals (Sweden)

    Rana Roshani

    2005-01-01

    Full Text Available Eccrine Porocarcinoma is a rare neoplasm arising from sweat glands. It was first described by Pinkus and Mehregan as ′Epidermotropic eccrine carcinoma′. It may occur de novo or as a malignant transformation of an eccrine poroma. It is commonly found in older age group and in the lower extremities. Clinically, it may present as a verrucous plaque, polypoid growth or an ulcerative lesion of long duration. Local recurrence and metastasis to skin, lymphnodes, viscera, and bone may occur. Treatment is wide local excision. Metastatic lesions can be treated with chemotherapy. We report a case of eccrine porocarcinoma of the scalp in a 50 years old female who presented to us with a bosselated, firm, painless, non-tender, freely mobile swelling over left fronto-parietal region of 12 years duration. It was excised and histopathological diagnosis was Eccrine Porocarcinoma. In literature, scalp porocarcinoma is a very rare tumor.

  17. Syringocystadenoma papilliferum of the scalp arising from a nevus sebaceous

    Directory of Open Access Journals (Sweden)

    Mathangi Chandramouli

    2016-01-01

    Full Text Available Syringocystadenoma papilliferum (SCAP is a rare, benign tumour with varied presentations that arises from the apocrine glands and at times can lead to a diagnostic dilemma. A 53-year-old male presented with a 40-year history of a scalp nodule and a recent 2-year change in its character, and a sanguinopurulent discharge. Examination revealed a 4 cm × 2 cm firm nodule upon left side of the scalp vertex, actively discharging pus and blood. No regional lymph nodes were noticeably palpable. Incision biopsy performed elsewhere showed evidence of a squamous cell carcinoma-in-situ. He underwent a wide local excision with a bilobed flap reconstruction. Histopathologically, the lesion was reported to be SCAP. On follow-up, the patient has since remained asymptomatic with an acceptable cosmetic recovery.

  18. 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.

  19. 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.

  20. 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...

  1. Analysis of pollutants in human scalp hair in Cairo

    International Nuclear Information System (INIS)

    Abdel-Wahab, M.F.; Abdulla, W.A.; Rashid, S.M.; Yousef, A.

    1985-01-01

    Scalp hair, urine and blood samples from volunteers selected from different areas surrounding Cairo were collected for study by neutron activation analysis (NAA) and conventional methods. The results for 14 elements in hair show some variation between the different regions. Qualitatively there is a slight difference of abundance of the investigated elements. Broadly speaking the presence of major elements is dominant. No relationship was observed between the elemental composition of hair and urine. (author)

  2. RADIOLOGICAL AND PATHOLOGICAL EVALUATION OF TRICHILEMMAL CYSTS OF THE SCALP

    Directory of Open Access Journals (Sweden)

    Deb Kumar Boruah

    2017-09-01

    Full Text Available BACKGROUND Trichilemmal cysts or pilar tumours are slow growing scalp lesion commonly found in elderly women. These slow growing lesions may cause morbidity and even mortality. Recurrence of the lesions after local excision is common. These trichilemmal cyst usually indolent with benign nature or may transform to proliferating trichilemmal cyst or Proliferating Pilar Tumour (PPT or may show malignant transformation. The aim of the study is to study the radiological and pathological evaluation of trichilemmal cysts of scalp. MATERIALS AND METHODS A hospital-based cross-sectional retrospective study was conducted. The study group comprised of 20 patients presenting to the Departments of Radiodiagnosis, Radiotherapy, General Surgery, Plastic Surgery and Dermatology in a tertiary care hospital from July 2015 to August 2017. All patients were initially evaluated clinically followed by cross-sectional imaging modality like Computed Tomography (CT or Magnetic Resonance Imaging (MRI. RESULTS In 20 patients, a total of 51 trichilemmal cysts were evaluated where 46 (90.2% were benign trichilemmal cysts and 5 (9.8% showed malignant transformation. The mean age of presentation was 47.9 yrs. ± 1.5 (SD with male:female ratio of 1:3.The mean duration of presence of trichilemmal cyst was 5.9 yrs. ± 3.2 (SD. Out of 5 malignant trichilemmal cysts 3 patients (15% showed bony calvarial erosion and 2 patients (10% showed intracranial extensions. Statistical significance with ‘p’ value of 0.003 was noted between the size of largest dimension of trichilemmal cyst and their histopathology without any statistical significance between duration of swelling and their histopathology. CONCLUSION Even though, the trichilemmal cysts of scalp are denoted as benign lesion, as they usually shows recurrence and its affinity to become locally aggressive and turn into malignancy is there. Hence, clinical, radiological and pathological correlation isnecessary to decreased

  3. Deep cerebral invasion by basal cell carcinoma of the scalp

    Energy Technology Data Exchange (ETDEWEB)

    Parizel, P.M. [Dept. of Radiology, Univ. of Antwerp, Universitair Ziekenhuis, Edegem (Belgium); Dirix, L. [Dept. of Oncology, Univ. of Antwerp, Universitair Ziekenhuis, Edegem (Belgium); Weyngaert, D. van den [Dept. of Radiation Therapy, Univ. of Antwerp, Algemeen Ziekenhuis Middelheim (Belgium); Lambert, J.R. [Dept. of Dermatology, Univ. of Antwerp, Universitair Ziekenhuis, Edegem (Belgium); Scalliet, P. [Dept. of Oncology, Univ. of Antwerp, Universitair Ziekenhuis, Edegem (Belgium); Oosterom, A.T. van [Dept. of Oncology, Univ. of Antwerp, Universitair Ziekenhuis, Edegem (Belgium); Schepper, A.M. de [Dept. of Radiology, Univ. of Antwerp, Universitair Ziekenhuis, Edegem (Belgium)

    1996-08-01

    We report recurrent basal cell carcinoma of the scalp with deep cerebral invasion in a 82-year-old man. Plain films and CT showed extensive, full thickness, skull destruction at the vertex. Gadolinium-enhanced MRI revealed neoplastic invasion of the meninges and left cerebral hemisphere, down to the lateral ventricle. We postulate that tumour extended into the brain along perivascular spaces of transcerebral vessels. This hypothesis is supported by the cleft-like contrast enhancement on MRI. (orig.)

  4. Comparison of suture types in the closure of scalp wounds.

    LENUS (Irish Health Repository)

    Bonham, Joseph

    2011-06-01

    Innovation in practice can benefit patients and healthcare providers but must be evidence based. This article describes a quantitative study of whether absorbable sutures are as beneficial as non-absorbable sutures in the management of simple scalp lacerations in adults. The results suggest that absorbable sutures can provide the same cosmetic and functional results as non-absorbable sutures. Their use can also reduce patient returns and save money and resources.

  5. Apocrine Hidradenocarcinoma of the Scalp: A Classification Conundrum

    OpenAIRE

    Cohen, Marc; Cassarino, David S.; Shih, Hubert B.; Abemayor, Elliot; John, Maie St.

    2008-01-01

    Introduction The classification of malignant sweat gland lesions is complex. Traditionally, cutaneous sweat gland tumors have been classified by either eccrine or apocrine features. Methods A case report of a 33-year-old Hispanic man with a left scalp mass diagnosed as a malignancy of adnexal origin preoperatively is discussed. After presentation at our multidisciplinary tumor board, excision with ipsilateral neck dissection was undertaken. Results Final pathology revealed an apocrine hidrade...

  6. [Scalp acupuncture for epileptiform discharges of children with cerebral palsy].

    Science.gov (United States)

    Li, Suyun; Liu, Zhenhuan; Zhao, Wenjian; Jin, Bingxu; Li, Nuo; Luo, Guanjun

    2017-03-12

    To explore the effect of scalp acupuncture for children with cerebral palsy whose video-electroencephalogram(VEEG) showed epileptiform discharges. A total of 184 children with cerebral palsy whose VEEG showed epileptiform discharges or those combined with epilepsy were randomly assigned into a combination group (99 cases) and a rehabilitation group (85 cases). All the cases were treated with the original antiepileptic drugs. The conventional physical training and massage were applied in the rehabilitation group for 3 courses with 20 d at the interval, once a day, 5 times a week and 15 times as one course. Based on the treatment as the rehabilitation group, scalp acupuncture was used in the combination group for 3 courses with 15 d at the interval, once the other day and 10 times as one course. Shenting (GV 24), Benshen (GB 13), Sishencong (EX-HN 1) were selected as the main acupoints, combined with motor zone, foot motor-sensory area, balance zone,and temple-three-needle etc. Clinical onset and VEEG results were observed before and after treatment. After treatment in the combination group, 27 cases improved; 47 cases had no effect; 25 cases aggravated. While in the rehabilitation group, 11 cases improved; 46 cases had no effect; 28 cases aggravated. There was no statistically significance between the two groups ( P >0.05). As for the cases with epilepsy onset in the combination group, 8 cases improved; 4 cases had no effect; 4 cases aggravated. In the rehabilitation group, 4 cases had no effect; 7 cases aggravated. The result in the combination group was better than that in the rehabilitation group ( P 0.05). Scalp acupuncture therapy does not increase the risk of onset or epileptiform discharges in the children with cerebral palsy combined with epilepsy or epileptiform discharges. Scalp acupuncture combined with rehabilitation is better than simple rehabilitation for thosewith cerebral palsy and epilepsy onset.

  7. Prolific plant regeneration through organogenesis from scalps of ...

    African Journals Online (AJOL)

    Four types of potting media comprising of sand, peat, sand + top soil + goat dung (3:2:1 v/v) and top soil + sand (1:1 v/v) were evaluated during acclimatization of the plantlets. Prolific shoot regeneration from scalps was obtained on MS medium containing 2.5 mM BAP, at 9.61 and 40.6 shoots per explant after 4 and 8 weeks ...

  8. Protein biosynthesis in isolated human scalp hair follicles.

    Science.gov (United States)

    Vermorken, A J; Weterings, P J; Bloemendal, H

    1979-02-15

    The present study demonstrates that protein biosynthesis can be studied in single isolated human scalp hair follicles. The matrix and the sheath are the main regions where amino acids are built in. Incorporation is linear for at least five hours. The newly synthesized proteins can be separated into a water-soluble, a urea-soluble and a urea-insoluble fraction. Product analysis has been performed on the first two fractions, revealing different protein patterns.

  9. [Development of Researches on Scalp Acupuncture for Ischemic Stroke].

    Science.gov (United States)

    Tian, Liang; Wang, Jin-hai; Sun, Run-jie; Zhang, Xing-hua; Yuan, Bo; Du, Xiao-zheng

    2016-02-01

    Ischemic stroke is one of the commonly met diseases in clinical practice nowadays. Acupuncture therapy is widly used in the treatment of sequela of ischemic stroke in China and its mechanisms have been extensively studied in recen years. In the present paper, the authors focus on the development of studies on the mechanism of scalp acupuncture therapy in the treatment of ischemic stroke. Results indicate that scalp acupuncture intervention can 1) improve cerebral blood circulation to promote regional energy metabolism, 2) up-regulate expression of glial cell-line derived neurotrophic factor (GDNF), etc., possibly promoting proliferation and differentiation of neural stem cells in the focal cerebral cortex and hippocampus, 3) reduce contents of excitatory amino acid and increase level of gamma-aminobutyric acid (GABA) to lower neurogenic toxicity, and relieve cerebral injury, 4) ease cerebral vascular immunoinflammatory reactions, 5) regulate blood lipid metabolism to resist cerebral free radical damage, and 6) inhibit cerebral cortical apoptosis. However, these results only revealed very limited intrinsic mechanisms of scalp acupuncture in improving ischemic stroke. Further studies using comprehensive techniques of multi-disciplines as molecular biology, electrophysiology, etc. are definitely needed.

  10. Scalp simulation - A novel approach to site-specific biomechanical modeling of the skin.

    Science.gov (United States)

    Pittar, N; Winter, T; Falland-Cheung, L; Tong, D; Waddell, J N

    2018-01-01

    This study aimed to determine the hardness of the human scalp in vivo in order to identify an appropriate scalp simulant, from a range of commercially available silicone materials, for force impact assessment. Site-dependent variation in scalp hardness, and the applicability of contemporary skin simulants to the scalp were also considered. A Shore A-type durometer was used to collected hardness data from the scalps of 30 human participants (five males and five females in each of the three age categories: 18-30, 31-40, 41-50) and four commercially available silicones (light, medium, and heavy-bodied PVS, and duplication silicone). One-sample t-tests were used to compare the mean hardness of simulants to that of the scalp. Site-dependent variation in the hardness of the scalp was assessed using a mixed-model repeated measures ANOVA. Mean human scalp hardness derived from participants was 20.6 Durometer Units (DU; SD = 3.4). Analysis revealed only the medium-bodied PVS to be an acceptable scalp simulant when compared to the mean hardness of the human scalp (p = 0.869). Scalp hardness varied significantly anteroposteriorly (with an observable linear trend, p < 0.001), but not mediolaterally (p = 0.271). Comparisons of simulants to site-specific variation in scalp hardness anteroposteriorly found the medium-bodied PVS to be only suitable in the central region of the scalp (p = 0.391). In contrast, the duplication silicone (p = 0.074) and light-bodied PVS (p = 0.147) were only comparable to the posterior region. Contemporary skin simulants fail to accurately represent the scalp in terms of hardness. There is strong support for the use of medium-bodied PVS as a scalp simulant. Human scalp hardness varies significantly anteroposteriorly, but not mediolaterally, corresponding to regional anatomical variation within the scalp. A number of materials were identified as potential simulants for different regions of the scalp when more site-specific simulant research is required

  11. Radiation therapy for angiosarcoma of the scalp. Treatment outcomes of total scalp irradiation with X-rays and electrons

    Energy Technology Data Exchange (ETDEWEB)

    Hata, Masaharu; Koike, Izumi; Kasuya, Takeo; Inoue, Tomio [Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama, Kanagawa (Japan); Wada, Hidefumi [Yokohama City University Graduate School of Medicine, Department of Dermatology, Yokohama, Kanagawa (Japan); Ogino, Ichiro [Yokohama City University Medical Center, Department of Radiation Oncology, Yokohama, Kanagawa (Japan); Omura, Motoko [Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama, Kanagawa (Japan); Shonankamakura General Hospital, Department of Radiation Oncology, Kamakura, Kanagawa (Japan); Tayama, Yoshibumi [Yokohama Minami Kyousai Hospital, Department of Radiology, Yokohama, Kanagawa (Japan); Odagiri, Kazumasa [Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama, Kanagawa (Japan); Yokohama Municipal Citizen' s Hospital, Department of Radiation Oncology, Yokohama, Kanagawa (Japan)

    2014-10-15

    Wide surgical excision is the standard treatment for angiosarcoma of the scalp, but many patients are inoperable. Therefore, we investigated the outcome of radiation therapy for angiosarcoma of the scalp. Seventeen patients with angiosarcoma of the scalp underwent radiation therapy with total scalp irradiation. Four patients had cervical lymph node metastases, but none had distant metastases. A median initial dose of 50 Gy in 25 fractions was delivered to the entire scalp. Subsequently, local radiation boost to the tumor sites achieved a median total dose of 70 Gy in 35 fractions. Fourteen of the 17 patients developed recurrences during the median follow-up period of 14 months after radiation therapy; 7 had recurrences in the scalp, including primary tumor progression in 2 patients and new disease in 5, and 12 patients developed distant metastases. The primary progression-free, scalp relapse-free, and distant metastasis-free rates were 86, 67, and 38 % at 1 year and 86, 38, and 16 % at 3 years, respectively. Thirteen patients died; the overall and cause-specific survival rates were both 73 % at 1 year and 23 and 44 % at 3 years, respectively. The median survival time was 16 months. There were no therapy-related toxicities ≥ grade 3. Total scalp irradiation is safe and effective for local tumor control, but a dose of ≤ 50 Gy in conventional fractions may be insufficient to eradicate microscopic tumors. For gross tumors, a total dose of 70 Gy, and > 70 Gy for tumors with deep invasion, is recommended. (orig.) [German] Umfangreiche chirurgische Exzision ist die Standardbehandlung fuer Angiosarkome der Kopfhaut, aber viele Patienten sind nicht operierbar. Daher haben wir die Ergebnisse einer Strahlenbehandlung fuer Angiosarkome der Kopfhaut untersucht. Insgesamt 17 Patienten mit Angiosarkom der Kopfhaut erhielten eine Strahlenbehandlung der gesamten Kopfhaut. Vier Patienten hatten zervikale Lymphknotenmetastasen, aber keine Fernmetastasen. Die gesamte Kopfhaut

  12. 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.

  13. The risk of post-operative complications in psoriasis and psoriatic arthritis patients on biologic therapy undergoing surgical procedures.

    Science.gov (United States)

    Bakkour, W; Purssell, H; Chinoy, H; Griffiths, C E M; Warren, R B

    2016-01-01

    There is limited evidence as to whether biologic therapy should be stopped or continued in patients with psoriasis and/or psoriatic arthritis (PsA) who are undergoing surgical procedures. Current guidelines of care recommend a planned break from biologic therapy in those undergoing major surgical procedures. To audit current practice of managing biologic therapy peri-operatively in a tertiary referral psoriasis clinic against guidelines of care and to investigate the effects of continuing/stopping biologic therapy in psoriasis and PsA patients. A retrospective audit of psoriasis and PsA patients who had a surgical procedure whilst on biologic therapy. A proforma was used to collect information on the biologics used, whether they were stopped peri-operatively and whether patients developed post-operative complications and/or disease flare. A total of 42 patients who had 77 procedures were identified. Procedures ranged from skin surgery to orthopaedic and cardiothoracic surgery. Biologic therapy was continued in the majority of procedures (76%). There was no significant difference in post-operative risk of infection and delayed wound healing between those patients who continued and those who stopped biologic therapy, including those undergoing major surgery. Interrupting biologic therapy peri-operatively was associated with a significant (P = 0.003) risk of flare of psoriasis or PsA. Continuing biologic therapy in psoriasis and PsA patients peri-operatively did not increase the risk of post-operative complications. Interrupting biologic therapy peri-operatively significantly increased the risk of disease flare. This study is limited by cohort size and requires replication, ideally in a prospective randomized controlled manner. © 2015 European Academy of Dermatology and Venereology.

  14. 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

  15. Replication of LCE3C-LCE3B CNV as a risk factor for psoriasis and analysis of interaction with other genetic risk factors.

    NARCIS (Netherlands)

    Huffmeier, U.; Bergboer, J.G.M.; Becker, T.; Armour, J.A.; Traupe, H.; Estivill, X.; Riveira-Munoz, E.; Mossner, R.; Reich, K.; Kurrat, W.; Wienker, T.F.; Schalkwijk, J.; Zeeuwen, P.L.J.M.; Reis, A.

    2010-01-01

    Recently, a deletion of two late cornified envelope (LCE) genes within the epidermal differentiation complex on chromosome 1 was shown to be overrepresented in 1,426 psoriasis vulgaris (PsV) patients of European ancestry. In this study, we report a confirmation of this finding in 1,354 PsV patients

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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...

  5. 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...

  6. 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...

  7. 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

  8. 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

  9. 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.

  10. 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...

  11. 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...

  12. 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.

  13. 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

  14. 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

  15. Scalp Dose Evaluation According Radiation Therapy Technique of Whole Brain Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Joon Yung; Park, Soo Yun; Kim, Jong Sik; Choi, Byeong Gi; Song, Gi Won [Dept. of Radiation Oncology, Samsung Medical Center, Seoul (Korea, Republic of)

    2011-09-15

    Opposing portal irradiation with helmet field shape that has been given to a patient with brain metastasis can cause excess dose in patient's scalp, resulting in hair loss. For this reason, this study is to quantitatively analyze scalp dose for effective prevention of hair loss by comparing opposing portal irradiation with scalp-shielding shape and tomotherapy designed to protect patient's scalp with conventional radiation therapy. Scalp dose was measured by using three therapies (HELMET, MLC, TOMO) after five thermo-luminescence dosimeters were positioned along center line of frontal lobe by using RANDO Phantom. Scalp dose and change in dose distribution were compared and analyzed with DVH after radiation therapy plan was made by using Radiation Treatment Planning System (Pinnacle3, Philips Medical System, USA) and 6 MV X-ray (Clinac 6EX, VARIAN, USA). When surface dose of scalp by using thermo-luminescence dosimeters was measured, it was revealed that scalp dose decreased by average 87.44% at each point in MLC technique and that scalp dose decreased by average 88.03% at each point in TOMO compared with HELMET field therapy. In addition, when percentage of volume (V95%, V100%, V105% of prescribed dose) was calculated by using Dose Volume Histogram (DVH) in order to evaluate the existence or nonexistence of hotspot in scalp as to three therapies (HELMET, MLC, TOMO), it was revealed that MLC technique and TOMO plan had good dose coverage and did not have hot spot. Reducing hair loss of a patient who receives whole brain radiotherapy treatment can make a contribution to improve life quality of the patient. It is expected that making good use of opposing portal irradiation with scalp-shielding shape and tomotherapy to protect scalp of a patient based on this study will reduce hair loss of a patient.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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...

  3. Enhanced meta-analysis and replication studies identify five new psoriasis susceptibility loci

    Science.gov (United States)

    Tsoi, Lam C; Spain, Sarah L; Ellinghaus, Eva; Stuart, Philip E; Capon, Francesca; Knight, Jo; Tejasvi, Trilokraj; Kang, Hyun M; Allen, Michael H; Lambert, Sylviane; Stoll, Stefan; Weidinger, Stephan; Gudjonsson, Johann E; Koks, Sulev; Kingo, Külli; Esko, Tonu; Das, Sayantan; Metspalu, Andres; Weichenthal, Michael; Enerback, Charlotta; Krueger, Gerald G.; Voorhees, John J; Chandran, Vinod; Rosen, Cheryl F; Rahman, Proton; Gladman, Dafna D; Reis, Andre; Nair, Rajan P; Franke, Andre; Barker, Jonathan NWN; Abecasis, Goncalo R; Trembath, Richard C; Elder, James T

    2015-01-01

    Psoriasis is a chronic autoimmune disease with complex genetic architecture. Previous genomewide association studies (GWAS) and a recent meta-analysis using Immunochip data have uncovered 36 susceptibility loci. Here, we extend our previous meta-analysis of European ancestry by refined genotype calling and imputation and by the addition of 5,033 cases and 5,707 controls. The combined analysis, consisting of over 15,000 cases and 27,000 controls, identifies five new psoriasis susceptibility loci at genomewide significance (p < 5 × 10−8). The newly identified signals include two that reside in intergenic regions (1q31.1 and 5p13.1) and three residing near PLCL2 (3p24.3), NFKBIZ (3q12.3), and CAMK2G (10q22.2). We further demonstrate that NFKBIZ is a TRAF3IP2–dependent target of IL-17 signaling in human skin keratinocytes, thereby functionally linking two strong candidate genes. These results further integrate the genetics and immunology of psoriasis, suggesting new avenues for functional analysis and improved therapies. PMID:25939698

  4. 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....

  5. 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...

  6. 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....

  7. Apocrine hidradenocarcinoma of the scalp: a classification conundrum.

    Science.gov (United States)

    Cohen, Marc; Cassarino, David S; Shih, Hubert B; Abemayor, Elliot; St John, Maie

    2009-03-01

    The classification of malignant sweat gland lesions is complex. Traditionally, cutaneous sweat gland tumors have been classified by either eccrine or apocrine features. A case report of a 33-year-old Hispanic man with a left scalp mass diagnosed as a malignancy of adnexal origin preoperatively is discussed. After presentation at our multidisciplinary tumor board, excision with ipsilateral neck dissection was undertaken. Final pathology revealed an apocrine hidradenocarcinoma. The classification and behavior of this entity are discussed in this report. Apocrine hidradenocarcinoma can be viewed as an aggressive malignant lesion of cutaneous sweat glands on a spectrum that involves both eccrine and apoeccrine lesions.

  8. Trace-element content of human scalp hair

    International Nuclear Information System (INIS)

    Gordus, A.A.; Wysocki, C.M.; Maher, C.C. III; Wieland, R.C.

    1974-01-01

    The importance of some of the factors that could affect the measured trace-element content of human scalp hair have been evaluated. Included are frequency of hair washing and swimming, shampoos used, gross differences in diet, and the variation in content along the strands of hair. The data for length-content variation suggest that, for some elements, eccrine sweat may contribute significantly to the measured trace-element content of hair and that such variation must be taken into account in assessing data for historical hair samples, many of which represent clippings of distal segments of hair

  9. Treatment patterns in moderate-to-severe plaque psoriasis: results from a Belgian cross-sectional study (DISCOVER).

    Science.gov (United States)

    Lambert, Julien; Ghislain, Pierre-Dominique; Lambert, Jo; Cauwe, Bénédicte; Van den Enden, Maria

    2017-08-01

    The present study aimed to evaluate current treatment patterns and achievement of treatment goals in Belgian patients with moderate-to-severe plaque psoriasis. This cross-sectional observational study (DISCOVER) was conducted in 2011 - 2012 in Belgian dermatology centers. Patient data were collected during a single visit and included information on psoriasis management and severity (PASI and DLQI). Treatment success was defined according to the current European consensus treatment goal algorithm. Of the 556 patients included in the study, 38.1% reported no current treatment or only topicals, 34.2% were being treated with traditional systemics and/or phototherapy, and 29.5% with biologics. Methotrexate (11.7%) was the most commonly prescribed traditional systemic and adalimumab (14.2%) was the most commonly prescribed biologic agent at the time of the study. The percentage of patients achieving treatment goals was significantly higher in biologic-treated patients (73.1%) compared to those using traditional systemics (50.6%), phototherapy (41.1%), or no treatment/only topicals (20.9%; p psoriasis in the DISCOVER study were undertreated despite the severity of their disease. Undertreatment of psoriasis remains a problem in Belgium and more effective educational strategies are needed to ensure the best treatment outcome for these patients. [Formula: see text].

  10. 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...

  11. 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.

  12. "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.

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. Predictors of long-term drug survival for infliximab in psoriasis.

    Science.gov (United States)

    Magis, Q; Jullien, D; Gaudy-Marqueste, C; Baumstark, K; Viguier, M; Bachelez, H; Guibal, F; Delaporte, E; Karimova, E; Montaudié, H; Boye, T; Aubin, F; Beylot-Barry, M; Richard, M-A

    2017-01-01

    Limited information is available regarding factors associated with long-term drug survival of infliximab for psoriasis in real life. The main aim pf this study was to identify predictors of long-term (>12 months) drug survival among patients treated with infliximab for psoriasis in a real-world clinical setting. Retrospectively collected data, relating to disease, patient characteristics and treatment procedures, in a multicentre observational cohort of patients with moderate-to-severe plaque psoriasis treated with infliximab at eight university hospitals, 120 of whom maintained a response to infliximab for more than 12 months, were compared with prospectively collected data in the same centres from 54 patients who experienced secondary loss of response within a 12-month period. Mean duration of drug survival of infliximab in patients with long-term drug survival was 41.12 months ± 20.64 SD vs. 8.5 months ± 2.43 SD in patients with a secondary loss of response. Multivariate analysis identified greater disease severity at treatment onset (PASI score >12) (OR = 5.18, 95% CI: 1.60-16.77, P = 0.006), high levels of initial psoriasis clearance (PASI-90 reduction or equivalent) (OR = 18.50, 95% CI: 4.56-74.45, P = 0.0001) and combination with methotrexate (OR = 13.15, 95% CI: 1.46-118.79, P = 0.022) as independent predictors of long-term drug survival and sustained efficacy of infliximab. Positive predictors for long-term drug survival of infliximab in real life were identified. Their impact on treatment management should be addressed in further prospective trials. © 2016 European Academy of Dermatology and Venereology.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Bimatoprost for the treatment of eyelash, eyebrow and scalp alopecia.

    Science.gov (United States)

    Barrón-Hernández, Yevher Lorena; Tosti, Antonella

    2017-04-01

    Alopecia is a common condition observed among people of all ages. It is a disorder that can involve only the scalp as observed in androgenetic alopecia or scalp and body as in alopecia areata or patients under chemotherapy treatment. There are several treatment options with different safety and efficacy outcomes. Bimatoprost, a synthetic prostamide F2α analog originally approved for the treatment of ocular hypertension and open-angle glaucoma, is now FDA approved as a 0.03%, solution to be applied once daily to increase eyelashes growth. Areas covered: In this review, the authors evaluate the role of bimatoprost in idiopathic hypotrichosis of the eyelashes, in hypotrichosis of the eyelashes associated to chemotherapy, in alopecia areata of the eyelashes and eyebrows and in androgenetic alopecia. In addition, pharmacokinetics, pharmacodynamics, safety and tolerability of bimatoprost are discussed. Expert opinion: Bimatoprost will likely be the third FDA approved weapon in the fight against hair loss. Prostaglandin analogs are the only possible treatment for hypotrichosis and alopecia of the eyelashes regardless of its etiology. Eyebrow hypotrichosis due to alopecia areata or frontal fibrosis alopecia can also possibly benefit of these medications.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. Hair Whorl Patterns On The Posterior Apsect Of The Scalp Among ...

    African Journals Online (AJOL)

    The types and incidence of hair whorl patterns on the posterior aspect of the scalp amongst Nigerians was studied using a population sample with ages ranging between 15 and 40 years. The age range chosen was so because the scalp hair apparently deteriorates with aging as seen in senile alopecia. Five hundred ...

  16. The role of oxidative damage in poor scalp health: ramifications to causality and associated hair growth.

    Science.gov (United States)

    Schwartz, J R; Henry, J P; Kerr, K M; Mizoguchi, H; Li, L

    2015-12-01

    The oxidative stress element of unhealthy scalp leads to compromised pre-emergent hair formation and poorly formed hair as it grows. Only cosmetic solutions can minimize the impact of unhealthy hair and to achieve healthy looking and feeling hair, the scalp health must be normalized first. The objectives of this research were to both investigate whether oxidative stress was a relevant aetiological element in scalp dandruff and seborrhoeic dermatitis and whether scalp condition affects the quality of hair that grows from it. Further, this research was designed to determine whether an effective anti-dandruff shampoo would repair and protect the scalp and pre-emergent hair from oxidative stress. This study demonstrated that oxidative stress is an aetiological element relevant to the dandruff condition and that a potentiated ZPT shampoo effectively improves scalp condition, including a reduction in oxidative stress. The compromised hair condition associated with dandruff is concomitantly improved when the scalp condition is improved. It appears that there is a direct link between hair quality and scalp health. © 2015 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

  17. Domestic donkey (Equus africanus asinus bites: An unusual aetiology of severe scalp injuries in Morocco

    Directory of Open Access Journals (Sweden)

    Hatim Droussi

    2014-12-01

    Discussion: The bite of a donkey is rare aetiology of scalp injuries. Special features of these injuries, including a literature review, are discussed focusing on the care of these patients in the emergency centre, describing the surgical procedures required and antibiotic choice. Recommendations for the management of donkey bite scalp injuries are provided.

  18. Recurrent squamous cell carcinoma of the scalp treated with serial free flaps

    DEFF Research Database (Denmark)

    Ikander, Peder; Sørensen, Jens Ahm

    2015-01-01

    Reconstruction of large full thickness scalp defects is always a challenge. Many different techniques can be used, but larger defects often call for a free tissue transfer. The purpose of this report is to present one successful way of treating multiple large scalp defects. A 61-year-old man was ...

  19. Ivermectin treatment for massive orbital myiasis in an empty socket with concomitant scalp pediculosis

    Directory of Open Access Journals (Sweden)

    Neelam Puthran

    2012-01-01

    Full Text Available We report a rare case of massive orbital myiasis following recent lid injury, occurring in the empty socket of an elderly lady, who had concurrent scalp pediculosis. The orbital myiasis was effectively treated with the broad-spectrum antiparasitic agent, ivermectin, thus precluding the need for an exploratory surgery. Ivermectin was also effective in managing the concurrent scalp pediculosis.

  20. Heterotopic epithelialization presenting as a non-healing scalp wound after surgery

    DEFF Research Database (Denmark)

    Askaner, Gustav; Rasmussen, Rune; Schmidt, Grethe

    2017-01-01

    Patients undergoing cerebral revascularization surgery have a relatively high incidence of wound complications. We report a case of heterotopic epithelialization of the dura presenting as a non-healing scalp wound after an extracranial-intracranial (EC-IC) arterial bypass. The scalp wound was rev...

  1. Cost-effectiveness analysis of scalp cooling to reduce chemotherapy-induced alopecia

    NARCIS (Netherlands)

    van den Hurk, C.J.; van den Akker-van Marle, E.M.; Breed, W.P.M.; van de Poll-Franse, L.V.; Nortier, J.; Coebergh, J.W.W.

    2014-01-01

    Background. Alopecia is a frequently occurring side effect of chemotherapy that often can be prevented by cooling the scalp during the infusion. This study compared effects and costs of scalp cooling with usual general oncological care, i.e. purchasing a wig or head cover. Material and methods.

  2. 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.

  3. Incidental Syringomas of the Scalp in a Patient with Scarring Alopecia

    Directory of Open Access Journals (Sweden)

    Kristyn Deen

    2015-07-01

    Full Text Available Syringomas are benign adnexal neoplasms of eccrine lineage, which occur most commonly in the periorbital region in middle-aged females. These cutaneous lesions rarely occur on the scalp, are typically asymptomatic and are predominantly of cosmetic significance. Involvement of the scalp may be indistinguishable from that of scarring alopecia. We present an unusual case of clinically inapparent syringomas occurring on the scalp of a 56-year-old female with alopecia who was subsequently diagnosed with lichen planopilaris after repeated scalp biopsy. In patients with unexplained hair loss, or in cases that are refractive to treatment, clinicians should perform scalp biopsy to exclude the diagnosis of rare neoplastic lesions like syringomas and to diagnose associated conditions.

  4. Interference of scalp and skull with dynamic isotope studies of brain

    International Nuclear Information System (INIS)

    Oldendorf, W.H.

    1972-01-01

    The overlying scalp and skull create artifacts in external brain counting measurements in which isotope appears in these tissues. It is much less of a problem in dynamic studies since high levels of superficial isotope are not found in the first few seconds after introduction into the blood by any anatomic route. Diffusible tracers concentrate somewhat less in the scalp and skull than in the brain immediately after injection by any route. Nondiffusible tracers of low molecular weight attain a much higher concentration in the scalp than the brain only after about the first minute because of passage from plasma to scalp extracellular fluid. This equilibration does not occur in brain because of the blood-brain barrier. Scalp and skull thus create much less of a problem with brief dynamic studies than with chronic long-term studies. Some physical considerations of external collimation are discussed, and means are suggested to minimize superficial isotope contributions to brain counts. (U.S.)

  5. 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...

  6. 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].

  7. 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

  8. 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.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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 ...

  16. 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...

  17. 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....

  18. 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.

  19. 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...

  20. Spiritual and religious aspects of torture and scalping among the Indian cultures in Eastern North America, from ancient to colonial times

    Directory of Open Access Journals (Sweden)

    Juha Hiltunen

    2011-01-01

    Full Text Available Only a few decades ago a common perception prevailed that the historic­al Native Americans were very prone to violence and warfare. Scalping and torture were seen as a specific custom attached into their ideology and sociocultural ethos. However in the 1960s a completely reversed picture started to emerge, following the course of other worldwide movements, such as ethnic rights, pan-Indianism, ecological conscience, revisionist historiography and so on. Immediately the Native American people came to be seen as the victims of the European colonialism and the Whites were the bad guys who massacred innocent women and children, either at Sand Creek or in Vietnam. Books were written in which the historians pointed out that the practice of scalping was actually not present in the Americas before the whites came. This theory drew sustenance from some early colonial accounts, especially from the Dutch and New England colonies, where it was documented that a special bounty was offered for Indian scalps. According to this idea, the practice of scalping among the Indians escalated only after this. On the other hand, the blame fell on the Iroquois tribesmen, whose cruel fighting spread terror throughout the seventeenth century, when they expanded an empire in the north eastern wilderness. This accords with those theorists who wanted to maintain a more balanced view of the diffusion of scalping and torture, agreeing that these traits were indeed present in Pre-Columbian America, but limited only to the Iroquoians of the east. Colonial American history has been rewritten every now and then. In the 1980s, and in the field of archaeology especially, a completely new set of insights have arisen. There has been a secondary burial of the myth of Noble Savage and a return of the old Wild Indian idea, but this time stripped of its cartoon stereo­typical attachments. The Indians are now seen as being like any other human beings, with their usual mixture of vices

  1. Hemangioma rubi no couro cabeludo Cherry hemangioma in the scalp

    Directory of Open Access Journals (Sweden)

    José Marcos Pereira

    2004-02-01

    Full Text Available O hemangioma rubi (HR é dermatose de origem vascular extremamente freqüente, acometendo mais de 75% da população acima de 70 anos de idade. Em geral compõe-se de lesões múltiplas,localizadas predominantemente no alto do tronco e braços. Clinicamente é caracterizado por lesões que variam desde máculas puntiformes até lesões papulosas com cinco milímetros de diâmetro. As mais novas são vermelhas, em tons vivos, e as mais antigas podem ser azuladas. O HR é de etiologia desconhecida. Histologicamente chama atenção uma neoformação de vasos capilares, que se tornam dilatados e com fenestrações em suas paredes. A membrana basal está muito espessada e existe abundante estroma de colágeno entre os vasos. O presente trabalho demonstra a alta incidência do HR no couro cabeludo Em amostra de 171 pacientes, sendo 85 homens e 86 mulheres, o autor observou que 123 deles (72% tinham HR no couro cabeludo, localização em que o HR nunca foi descrito na literatura.Cherry hemangioma (CH is an extremely frequent dermatosis with vascular origin involving more than 75% of the population over 70 years of age. Normally they are multiplex spots and focus predominantly on the upper trunk and arms. Clinically they are characterized by pinpoint maculae and papules with up to 5 millimeters in diameter. The most recent lesions can be a strong red color while the older ones are bluish. The etiology of CH is still unknown. From the histologic standpoint, the neoformation of the capillary tube draws attention: they are very dilated and with fenestration along the wall. The basement membranes are thickened and there is abundant collagen stroma between the veins. This work demonstrates the high frequency of CH in the scalp. In a sample of 171 patients (85 men and 86 women the author noted that 123 (72% had CH in the scalp. However, according to the literature, CH in the scalp has never been described.

  2. 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.

  3. 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.

  4. [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.

  5. 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...

  6. 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...

  7. Scalp involvement by Sarcoptes scabiei var hominis resembling seborrhoeic dermatitis in two immunocompromised patients with systemic lupus erythematosus.

    Science.gov (United States)

    Birry, Antonia; Jarrett, Paul

    2013-08-16

    Scabies is a common condition in New Zealand but scalp infestation by the mite is not often considered. Topical treatments traditionally do not involve the scalp. We report two cases of immunocompromised patients with systemic lupus erythematosus (SLE) who had scalp infestation clinically mimicking seborrhoeic dermatitis.

  8. Rare and Common Variants in CARD14, Encoding an Epidermal Regulator of NF-kappaB, in Psoriasis

    Science.gov (United States)

    Jordan, Catherine T.; Cao, Li; Roberson, Elisha D.O.; Duan, Shenghui; Helms, Cynthia A.; Nair, Rajan P.; Duffin, Kristina Callis; Stuart, Philip E.; Goldgar, David; Hayashi, Genki; Olfson, Emily H.; Feng, Bing-Jian; Pullinger, Clive R.; Kane, John P.; Wise, Carol A.; Goldbach-Mansky, Raphaela; Lowes, Michelle A.; Peddle, Lynette; Chandran, Vinod; Liao, Wilson; Rahman, Proton; Krueger, Gerald G.; Gladman, Dafna; Elder, James T.; Menter, Alan; Bowcock, Anne M.

    2012-01-01

    Psoriasis is a common inflammatory disorder of the skin and other organs. We have determined that mutations in CARD14, encoding a nuclear factor of kappa light chain enhancer in B cells (NF-kB) activator within skin epidermis, account for PSORS2. Here, we describe fifteen additional rare missense variants in CARD14, their distribution in seven psoriasis cohorts (>6,000 cases and >4,000 controls), and their effects on NF-kB activation and the transcriptome of keratinocytes. There were more CARD14 rare variants in cases than in controls (burden test p value = 0.0015). Some variants were only seen in a single case, and these included putative pathogenic mutations (c.424G>A [p.Glu142Lys] and c.425A>G [p.Glu142Gly]) and the generalized-pustular-psoriasis mutation, c.413A>C (p.Glu138Ala); these three mutations lie within the coiled-coil domain of CARD14. The c.349G>A (p.Gly117Ser) familial-psoriasis mutation was present at a frequency of 0.0005 in cases of European ancestry. CARD14 variants led to a range of NF-kB activities; in particular, putative pathogenic variants led to levels >2.5× higher than did wild-type CARD14. Two variants (c.511C>A [p.His171Asn] and c.536G>A [p.Arg179His]) required stimulation with tumor necrosis factor alpha (TNF-α) to achieve significant increases in NF-kB levels. Transcriptome profiling of wild-type and variant CARD14 transfectants in keratinocytes differentiated probably pathogenic mutations from neutral variants such as polymorphisms. Over 20 CARD14 polymorphisms were also genotyped, and meta-analysis revealed an association between psoriasis and rs11652075 (c.2458C>T [p.Arg820Trp]; p value = 2.1 × 10−6). In the two largest psoriasis cohorts, evidence for association increased when rs11652075 was conditioned on HLA-Cw∗0602 (PSORS1). These studies contribute to our understanding of the genetic basis of psoriasis and illustrate the challenges faced in identifying pathogenic variants in common disease. PMID:22521419

  9. 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...

  10. Chondrosarcomatous Differentiation in a Large Malignant Melanoma of the Scalp

    Directory of Open Access Journals (Sweden)

    Colin S. Alderson

    2016-01-01

    Full Text Available Background. Divergent differentiation in malignant melanoma is a rare phenomenon, which can lead to delayed diagnosis or misdiagnosis, impacting upon patient treatment and outcome, as well as the understanding of tumour behaviour. Case. We present the case of a large long-standing tumour on the scalp of a 72-year-old female patient, which when excised and examined histologically was revealed to be a nodular malignant melanoma displaying chondrosarcomatous differentiation. Foci suggestive of lentigo maligna were also present. Rapid metastatic spread of the tumour was observed shortly after the primary resection. Discussion. To our knowledge, this is the first reported case in the literature of chondrosarcomatous differentiation in a lentigo maligna melanoma. The clinical and histopathological details and images of this case are presented alongside a discussion regarding such tumours and patterns of similar tumour behaviour.

  11. Serial cultivation of human scalp hair follicle keratinocytes.

    Science.gov (United States)

    Weterings, P J; Roelofs, H M; Vermorken, A J; Bloemendal, H

    1983-01-01

    A method is described for the serial cultivation of adult human hair follicle keratinocytes. Plucked scalp hair follicles, placed on bovine eye lens capsules as a growth substrate, give rise to quickly expanding colonies within a few days. After trypsinization, the cells are replated with irradiated 3T3 cells as 'feeders'. Using this combination of techniques the keratinocytes can be subcultured up to four times. In this way about 10(7) keratinocytes can be generated from one single hair follicle. Moreover, the technique enables cryogenic storage of the cells, allowing for instance, convenient transportation. Subcultured hair follicle keratinocytes can be plated on glass coverslips. This allows immunofluorescence studies. The keratin cytoskeletons visualized using an antiserum against human keratin.

  12. Differentiation of human scalp hair follicle keratinocytes in culture.

    Science.gov (United States)

    Weterings, P J; Verhagen, H; Wirtz, P; Vermorken, A J

    1984-01-01

    The morphology of human scalp hair follicle keratinocytes, cultured on the bovine eye lens capsule, is studied by light and electron microscopy. The hair follicle keratinocytes in the stratified cultures are characterized by the presence of numerous tonofilaments, desmosomes and lysosomes and by the presence of glycogen accumulations. The cells in the upper layers develop a cornified envelope. Moreover, an incomplete basal lamina is found between the capsule and the basal cells. However, some features of epidermal keratinocytes in vivo, such as keratohyalin granules and stratum corneum formation, are absent. Analysis of the polypeptides by sodium dodecylsulfate polyacrylamide gel electrophoresis also reveals differences between the cultured hair follicle cells and epidermis, whilst the patterns of cultured cells and hair follicle sheaths are similar. The morphological and protein biosynthetic aspects of terminal differentiation of the keratinocytes in vitro are correlated. These results are discussed in the light of the findings with cultured epidermal keratinocytes, reported in the literature.

  13. 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.

  14. 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.

  15. Efficacy of dexmedetomidine as an adjuvant to local anesthetic agent in scalp block and scalp infiltration to control postcraniotomy pain: A double-blind randomized trial

    Directory of Open Access Journals (Sweden)

    Shankar Vallapu

    2018-01-01

    Full Text Available Context: Scalp infiltration and scalp block are being used to manage postcraniotomy pain. Dexmedetomidine has been successfully used as an adjuvant in regional anesthesia. The study was intended to compare whether addition of dexmedetomidine prolonged the duration of analgesia as well as to compare the two techniques. Aims: The primary objective was to assess whether addition of dexmedetomidine to bupivacaine prolonged the duration of analgesia. The secondary objective was to compare between scalp nerve block and scalp infiltration as techniques for pain relief. Settings and Design: The randomized control study was conducted in a tertiary care center from November 2013 to October 2014. Materials and Methods: A total of 150 American Society of Anesthesiologists Physical Status I–II patients, aged 18–70 years undergoing elective craniotomy were included. Patients were randomized into three groups of 50 patients, i.e., Group BI (bupivacaine infiltration, Group BDI (bupivacaine and dexmedetomidine infiltration, and Group BDNB (bupivacaine and dexmedetomidine scalp nerve block. Patient's pain score, pain-free interval, rescue analgesic requirement, and hemodynamic and respiratory parameters were noted for 48 h. Patients were followed up at 1 and 3 months to assess postcraniotomy pain. Results: Pain-free period was significantly longer in Group BDNB than Groups BDI and BI (P < 0.0001 and pain control was better in dexmedetomidine containing groups than in bupivacaine group (BI (P < 0.0001. The rescue analgesic requirement was significantly lower in Group BDNB and Group BDI compared to Group BI. Conclusion: The addition of dexmedetomidine (1 μg/kg to bupivacaine prolonged the pain-free period. Scalp nerve block is a superior technique than scalp infiltration.

  16. 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.

  17. 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.

  18. Analysis of genetic variants of class II cytokine and their receptor genes in psoriasis patients of two ethnic groups from the Volga-Ural region of Russia.

    Science.gov (United States)

    Galimova, Elvira; Akhmetova, Vita; Latipov, Boris; Kingo, Külli; Rätsep, Ranno; Traks, Tanel; Kõks, Sulev; Khusnutdinova, Elza

    2012-10-01

    The molecular basis of pathogenesis of psoriasis remains unclear, but one unifying hypothesis of disease aetiology is the cytokine network model. The class II cytokines (CF2) and their receptors (CRF2) are all involved in the inflammatory processes and single nucleotide polymorphisms (SNPs) in respective genes have been associated with psoriasis in a previous study of the Estonian population. We performed a replication study of 47 SNPs in CF2 and CRF2 genes in independent cohorts of psoriasis patients of two ethnic groups (Russians and Bashkirs) from the Volga-Ural region of Russia. DNA was obtained from 395 psoriasis patients of two ethnic groups from the Volga-Ural region of Russia and 476 ethnically matched controls. 47 SNPs in the loci of the genes encoding Class II cytokines and their receptors were selected by SNPbrowser version 3.5. Genotyping was performed using the SNPlex™ (Applied Biosystems) platform. The genetic variant rs30461 previously associated in original case-control study in Estonians, was also associated in Russians (corrected P-value (Pc=0.008, OR=0.44), but did not reach statistical significance in the Bashkir population. Additionally, the haplotype analysis provided that CC haplotype formed by the SNPs rs30461 and rs955155 had a protective effect in Russians (Pc=0.0024, OR=0.44), supporting the involvement of this locus in the protection against psoriasis. Combined meta-analysis of three populations, including 943 psoriasis patients and 812 healthy controls, showed that the IL29 rs30461 C-allele was not associated with decreased risk of psoriasis (P=0.165, OR=0.68). Moreover, stratification of studies by ethnicity revealed a significant association in the European cohort (P=9.506E-006, OR=0.53). Therefore, there is no overall evidence of association between psoriasis and SNP rs30461 of the IL29 gene, but there is some evidence to suggest that an association exists in Europeans. However, this current concept should be considered as

  19. 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.

  20. 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...

  1. Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthetic Agent in Scalp Block and Scalp Infiltration to Control Postcraniotomy Pain: A Double-Blind Randomized Trial.

    Science.gov (United States)

    Vallapu, Shankar; Panda, Nidhi Bidyut; Samagh, Navneh; Bharti, Neerja

    2018-01-01

    Scalp infiltration and scalp block are being used to manage postcraniotomy pain. Dexmedetomidine has been successfully used as an adjuvant in regional anesthesia. The study was intended to compare whether addition of dexmedetomidine prolonged the duration of analgesia as well as to compare the two techniques. The primary objective was to assess whether addition of dexmedetomidine to bupivacaine prolonged the duration of analgesia. The secondary objective was to compare between scalp nerve block and scalp infiltration as techniques for pain relief. The randomized control study was conducted in a tertiary care center from November 2013 to October 2014. A total of 150 American Society of Anesthesiologists Physical Status I-II patients, aged 18-70 years undergoing elective craniotomy were included. Patients were randomized into three groups of 50 patients, i.e., Group BI (bupivacaine infiltration), Group BDI (bupivacaine and dexmedetomidine infiltration), and Group BDNB (bupivacaine and dexmedetomidine scalp nerve block). Patient's pain score, pain-free interval, rescue analgesic requirement, and hemodynamic and respiratory parameters were noted for 48 h. Patients were followed up at 1 and 3 months to assess postcraniotomy pain. Pain-free period was significantly longer in Group BDNB than Groups BDI and BI ( P infiltration.

  2. 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.

  3. 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...

  4. 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.

  5. 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.

  6. 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.

  7. [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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.)

  13. 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...

  14. 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.

  15. 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.

  16. 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,

  17. 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.

  18. Brooke-Spiegler Syndrome with Multiple Scalp Cylindromas and Bilateral Parotid Gland Adenomas

    Directory of Open Access Journals (Sweden)

    Peter Kalina

    2012-01-01

    Full Text Available A 62-year-old female presented with numerous soft tissue lesions of her scalp and bilateral preauricular region. Several of these have been biopsied or removed with a diagnosis of cylindromas. Cylindromas are benign tumors with a differentiation towards apocrine sweat glands that increase in number and size throughout life. Multiple scalp cylindromas may coalesce and cover the entire scalp, resulting in the “turban tumor.” These are often associated with the autosomal dominant Brooke-Spiegler syndrome with coexistent facial trichoepitheliomas and spiradenomas. There is a very rare association between cylindromas and basal cell adenoma and adenocarcinoma of the parotid gland, with only 17 reported cases. Ours is the first CT demonstration of both the scalp and parotid gland findings in this uncommon situation.

  19. Heditary hypotrichosis simplex of the scalp: a report of 2 additional ...

    African Journals Online (AJOL)

    Abstract. Hereditary Hypotrichosis Simplex of the Scalp (HHSS) is a relatively rare form of hereditary alopecia. Herein, we report 2 additional families affected with this disorder. Sudanese Journal of Dermatology Vol. 3(3) 2005: 128-131 ...

  20. 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

  1. Improvement in scalp hair growth in androgen-deficient women treated with testosterone: a questionnaire study

    OpenAIRE

    Glaser, RL; Dimitrakakis, C; Messenger, AG

    2012-01-01

    Background Androgens are thought to have an adverse effect on female scalp hair growth. However, our clinical experience of androgen replacement therapy in women with androgen deficiency, in which hair loss was seldom reported, led us to question this concept. Objectives To evaluate the effect of subcutaneous testosterone therapy on scalp hair growth in female patients. Methods A total of 285 women, treated for a minimum of 1 year with subcutaneous testosterone implants for symptoms of androg...

  2. Scalp Seeding Post Craniotomy and Radiosurgery for Solitary Brain Metastasis: A Case Report and Systematic Review

    OpenAIRE

    Sharieff, Waseem; Mulroy, Liam; Weeks, Adrienne; Mansoor, Samina; Pahil, Rajbir; Islam, Muhammad U

    2017-01-01

    Background?? Radiosurgery is being increasingly used post craniotomy for brain metastasis, instead of whole-brain radiation. We report a case of scalp metastasis following craniotomy and radiosurgery, along with a systematic review of the literature. Methods???????? Our patient was a 70-year-old male who presented with a scalp metastasis, two years after craniotomy and radiosurgery, for a solitary brain metastasis from esophageal carcinoma. Using Medline? (United States National Library of Me...

  3. High density scalp EEG in frontal lobe epilepsy.

    Science.gov (United States)

    Feyissa, Anteneh M; Britton, Jeffrey W; Van Gompel, Jamie; Lagerlund, Terrance L; So, Elson; Wong-Kisiel, Lilly C; Cascino, Gregory C; Brinkman, Benjamin H; Nelson, Cindy L; Watson, Robert; Worrell, Gregory A

    2017-01-01

    Localization of seizures in frontal lobe epilepsy using the 10-20 system scalp EEG is often challenging because neocortical seizure can spread rapidly, significant muscle artifact, and the suboptimal spatial resolution for seizure generators involving mesial frontal lobe cortex. Our aim in this study was to determine the value of visual interpretation of 76 channel high density EEG (hdEEG) monitoring (10-10 system) in patients with suspected frontal lobe epilepsy, and to evaluate concordance with MRI, subtraction ictal SPECT co-registered to MRI (SISCOM), conventional EEG, and intracranial EEG (iEEG). We performed a retrospective cohort study of 14 consecutive patients who underwent hdEEG monitoring for suspected frontal lobe seizures. The gold standard for localization was considered to be iEEG. Concordance of hdEEG findings with MRI, subtraction ictal SPECT co-registered to MRI (SISCOM), conventional 10-20 EEG, and iEEG as well as correlation of hdEEG localization with surgical outcome were examined. hdEEG localization was concordant with iEEG in 12/14 and was superior to conventional EEG 3/14 (pfrontal epilepsy requiring localization of epileptogenic brain. hdEEG may assist in developing a hypothesis for iEEG monitoring and could potentially augment EEG source localization. Published by Elsevier B.V.

  4. Diagnosis and treatment of clear cell hidradenocarcinoma of the scalp.

    Science.gov (United States)

    Shu, Kai; Xiao, Qungen; Büchele, Fabian; Zhang, Suojun; Jiang, Wei; Lei, Ting

    2012-12-01

    Clear cell hidradenocarcinoma (CCH) is an exceedingly rare and highly malignant tumor of the eccrine sweat glands. Its treatment is extremely difficult due to the characteristically aggressive clinical course including repeated local recurrence and uncontrollable distal metastasis coming along with a very poor prognosis. Most published case studies recommend a wide surgical excision followed by adjuvant conservative therapy, which is generally considered to be the standard treatment. Two cases of nodular CCH of the scalp either presenting as a singular primary lesion or at an already metastatic stage were analyzed retrospectively. Wide local excision of the tumor couldn't prevent the primary carcinoma from recurring and metastasizing. Both cases received various therapies but the results were unsatisfactory. Although most authors have recommended that early wide surgical excision of the tumor is a feasible therapeutic measurement, our results raise doubts on the efficacy of this treatment strategy. As alternative approaches (i.e. chemotherapy, radiotherapy) are similarly controversial, further studies and a wide exchange of clinical experiences are crucial.

  5. Cutaneous fungal microbiome:Malasseziayeasts in seborrheic dermatitis scalp in a randomized, comparative and therapeutic trial.

    Science.gov (United States)

    Kamamoto, C S L; Nishikaku, A S; Gompertz, O F; Melo, A S; Hassun, K M; Bagatin, E

    2017-01-01

    Malassezia spp in skin microbiome scalp has been implicated in seborrheic dermatitis pathogenesis. Thus, treatment based in antifungal combined to topical keratolitic agents have been indicated as well as oral isotretinoin as it reduces the sebum production, glandular's size and possesses anti-inflammatory properties. This randomized, comparative and therapeutic trial aimed toper form the genotypic identification of Malassezia species before and after low-dose oral isotretinoin or topical antifungal treatments for moderate to severe seborrhea and/or seborrheic dermatitis on scalp. Scales and sebum of the scalp were seeded in the middle of modified Dixon and incubated at 32°C. For genotypic identification polymerase chain reaction primers for the ITS and D1/D2 ribossomal DNA were used and followed by samples sequencing. The procedure was conducted before and after therapeutic and randomized intervention for moderate to severe seborrhea/seborrheic dermatitis on the scalp, including oral isotretinoin, 10 mg, every other day and anti-seborrheic shampoo (piroctone olamine), over six months. The M. globosa and M. restricta were the most frequent species isolated on the scalp before and after both treatments. Other non- Malassezia species were also identified. The Malassezia spp. were maintained in the scalp after both treatments that were equally effective for the control of seborrhea/seborrheic dermatitis clinical signs.

  6. Lipoedematous scalp: is there an association with fatty infiltration of the parotid?

    Science.gov (United States)

    Law, Sarah; Jayarajan, Rajshree

    2017-10-09

    Lipoedematous scalp (LS) is an extremely rare condition characterised by a soft and boggy consistency in the scalp due to an increased layer of subcutaneous tissue.In this report, we present a case of LS in a 64-year-old Indian woman. Clinical examination revealed only vague boggy lumpiness involving the whole of occipital scalp extending to parietal scalp. MRI scalp showed diffuse fatty infiltration of the scalp, particularly at the posterior parietal and occipital convexity extending to both lateral aspects of the cranium, with homogeneous signal in keeping with fat. Incidentally MRI also found diffuse fatty infiltration of the parotids.The aethiopathogenesis of LS is still unknown, however it is believed that the hormone leptin could be the key hormone in the dysregulation of fat deposition and distribution. This case report highlights the subtle features with which these cases can present and explores the literature on reported cases of LS. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. 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.

  8. 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.

  9. 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.

  10. 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...

  11. 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

  12. 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.

  13. 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.

  14. 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...

  15. 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...

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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)

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. [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.

  7. 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.

  8. 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.

  9. 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.

  10. [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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. [Interactive dynamic scalp acupuncture combined with occupational therapy for upper limb motor impairment in stroke: a randomized controlled trial].

    Science.gov (United States)

    Wang, Jun; Pei, Jian; Cui, Xiao; Sun, Kexing; Ni, Huanhuan; Zhou, Cuixia; Wu, Ji; Huang, Mei; Ji, Li

    2015-10-01

    To compare the clinical efficacy on upper limb motor impairment in stroke between the interactive dynamic scalp acupuncture therapy and the traditional scalp acupuncture therapy. The randomized controlled trial and MINIMIZE layering randomization software were adopted. Seventy patients of upper limb with III to V grade in Brunnstrom scale after stroke were randomized into an interactive dynamic scalp acupuncture group and a traditional scalp acupuncture group, 35 cases in each one. In the interactive dynamic scalp acupuncture group, the middle 2/5 of Dingnieqianxiexian (anterior oblique line of vertex-temporal), the middle 2/5 of Dingniehouxiexian (posterior oblique line of vertex-temporal) and Dingpangerxian (lateral line 2 of vertex) on the affected side were selected as the stimulation areas. Additionally, the rehabilitation training was applied during scalp acupuncture treatment. In the traditional scalp acupuncture group, the scalp stimulation areas were same as the interactive dynamic scalp acupuncture group. But the rehabilitation training was applied separately. The rehabilitation training was applied in the morning and the scalp acupuncture was done in the afternoon. The results in Fugl-Meyer for the upper limb motor function (U-FMA), the Wolf motor function measure scale (WM- FT) and the modified Barthel index in the two groups were compared between the two groups before treatment and in 1 and 2 months of treatment, respectively. After treatment, the U-FMA score, WMFT score and the score of the modified Barthel index were all apparently improved as compared with those before treatment (all P acupuncture group was better than that in the traditional scalp acupuncture group (P acupuncture group were improved apparently as compared with those in the traditional scalp acupuncture group (P acupuncture group were not different significantly as compared with those in the traditional scalp acupuncture group (both P > 0.05). For the patients of IV to V grade in

  19. 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.

  20. The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization.

    Science.gov (United States)

    Noda, Shinji; Suárez-Fariñas, Mayte; Ungar, Benjamin; Kim, Soo Jung; de Guzman Strong, Cristina; Xu, Hui; Peng, Xiangyu; Estrada, Yeriel D; Nakajima, Saeko; Honda, Tetsuya; Shin, Jung U; Lee, Hemin; Krueger, James G; Lee, Kwang-Hoon; Kabashima, Kenji; Guttman-Yassky, Emma

    2015-11-01

    Atopic dermatitis (AD) shows very high prevalence in Asia, with a large unmet need for effective therapeutics. Direct comparisons between European American (EA) and Asian patients with AD are unavailable, but earlier blood studies detected increased IL-17(+)-producing cell counts in Asian patients with AD. We sought to characterize the Asian AD skin phenotype and compare it with the EA AD skin phenotype. We performed genomic profiling (real-time PCR) and immunohistochemistry on lesional and nonlesional biopsy specimens from 52 patients with AD (25 EAs and 27 Asians), 10 patients with psoriasis (all EAs), and 27 healthy subjects (12 EAs and 15 Asians). Although disease severity/SCORAD scores were similar between the AD groups (58.0 vs 56.7, P = .77), greater acanthosis, higher Ki67 counts, and frequent parakeratosis were characteristics of lesional epidermis from Asian patients with AD (P Asian patients had high IgE levels. A principal component analysis using real-time PCR data clustered the Asian AD phenotype between the EA AD and psoriasis phenotypes. TH2 skewing characterized both Asian and EA patients with AD but not patients with psoriasis. Significantly higher TH17 and TH22 (IL17A, IL19, and S100A12 in lesional and IL-22 in nonlesional skin; P Asian patients. The Asian AD phenotype presents (even in the presence of increased IgE levels) a blended phenotype between that of EA patients with AD and those with psoriasis, including increased hyperplasia, parakeratosis, higher TH17 activation, and a strong TH2 component. The relative pathogenic contributions of the TH17 and TH2 axes in creating the Asian AD phenotype need to be tested in future clinical trials with appropriate targeted therapeutics. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.