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Background Goeckerman's therapy (GT) of psoriasis is based on daily application of pharmacy grade coal tar on affected skin with subsequent exposure to UV light. Pentraxin 3 (PTX3) is a newly identified acute phase reactant with non redundant functions in innate immunity. PTX3 has been shown to be a reliable prognostic marker in patients with various inflammatory disorders including rheumatoid arthritis, vasculitis, and psoriasis. Methods The aim of this study was to evaluate the influence of Goeckerman's therapy of psoriasis on levels of two pentraxins: long pentraxin PTX3 and C reactive protein in 49 patients with chronic plaque psoriasis. CRP was assessed by immunonephelometry on IMMAGE 800 (Beckman, USA). PTX3 was detected using sandwich ELISA detection set (Alexis Biochemicals, Switzerland). Results The serum levels of both parameters (expressed as average ± 1 SD) were significantly diminished after GT. The level of PTX3 dropped from 1.92 ± 0.72 ng/ml before GT to 1.66 ± 0.58 ng/ml after GT ( P= 0.0396) and the level of CRP fell from 4.64 ± 3.93 mg/l to 1.66 ± 0.58 mg/l ( P < 0.0001).Comparing to healthy controls, the serum levels of both parameters before GT were significantly higher than those found in healthy blood donors and remained significantly increased after GT. Conclusion Increased serum concentrations of pentraxin 3 and CRP are alleviated by GT in patients with psoriasis. [ABSTRACT FROM AUTHOR]

Background This study investigates four measures of disease severity in patients with psoriasis, both before and after therapy. Methods Data records were analyzed from 33 patients with moderate-to-severe chronic plaque psoriasis who were treated with efalizumab, 1 mg/kg/week subcutaneously, for 12 weeks. Four measures of disease severity were used: body surface area (BSA), psoriasis area and severity index (PASI), psoriasis log-based area and severity index (PLASI) and self-administered PASI (SAPASI). Results At the end of the 12-week therapy, the mean percent improvement shown by each measure varied considerably, ranging from 48.6% (PASI) to 70.6% (SAPASI). PASI and PLASI were the most comparable (67.3% and 66.5%). These differences were smaller when a dermatologist's opinion about the improvement was taken into account, for example “very good improvement” ranged from mean percent improvement of 63.8% (BSA) to 83.8% (PASI). The correlation between all measures revealed a high level of significance ( P≤ 10−5). Conclusions Comparing the slopes and intercepts of the regression lines revealed PLASI as the most reliable measure for the severity and therapeutic improvement in patients with moderate-to-severe chronic plaque psoriasis. PLASI proved to be a marginally more accurate than PASI, and much more accurate than SAPASI and BSA. The superiority of PLASI may be a result of the logarithmic scale of the affected skin surface. [ABSTRACT FROM AUTHOR]

Background The Goeckerman regimen (GR) involves the dermal application of a crude coal tar (polycyclic aromatic hydrocarbon, PAH) and exposure to ultraviolet (UV) radiation. Both PAH and UV radiation exhibit immunosuppressive activity. This study describes the changes in the serum levels of the pro-inflammatory cytokine interleukin-12 (IL-12) and the anti-inflammatory cytokine IL-10 in patients with psoriasis ( n = 55) treated with GR. Methods The serum levels of IL-12 and IL-10 were compared before and after GR. In addition, the IL-12 and IL-10 levels in psoriatic patients were compared with those in a control group of healthy blood donors ( n = 47). The Psoriasis Area and Severity Index (PASI) was used to evaluate the efficacy of GR. Results When compared with the control group, both IL-12 and IL-10 were significantly higher in psoriatic patients in all cases ( P < 0.001). When compared before and after GR, the IL-12 and IL-10 levels ( P < 0.01) and PASI value ( P < 0.001) were significantly lower after GR. The decrease in the serum level of IL-12 and IL-10 after GR was related to the entry value before GR (IL-12, r = 0.60, P < 0.001; IL-10, r = 0.36, P < 0.01). There was a significant correlation between the IL-10 level before GR and the PASI value after GR ( r = –0.39; P < 0.01). Conclusions The results indicate a strong pro-inflammatory effect of IL-12 in the immunopathogenesis of psoriasis, and confirm the immunosuppressive and anti-inflammatory effect of GR. IL-10 seems to be a promising individual marker for a positive effect of GR therapy. [ABSTRACT FROM AUTHOR]

Background The clinical usefulness of cyclosporine in patients with psoriasis has generally been established; however, modification of the dosage on the basis of therapeutic drug monitoring is needed to prevent potential adverse reactions. The area under the drug concentration–time curve from 0 to 4 h after treatment (AUC0−4), used to assess the pharmacokinetics of cyclosporine microemulsion, correlates with clinical symptoms and adverse reactions. Methods In order to evaluate the blood collection times after oral treatment that are most relevant to pharmacokinetics, we examined the pharmacokinetics of cyclosporine up to 4 h after treatment in 24 patients with psoriasis vulgaris who received an oral dose of 3.0 mg/kg of cyclosporine microemulsion (Neoral®) daily in two divided doses. Results Our results showed that the blood concentration of cyclosporine 2 h after treatment ( C2) correlated with AUC0−4 ( r = 0.89, P < 0.001). Conclusions C2 should be monitored in patients treated with cyclosporine microemulsion instead of the blood trough level immediately before treatment, which has conventionally been used to monitor cyclosporine concentrations in blood. [ABSTRACT FROM AUTHOR]

No cure for psoriasis exists for the 1–3% of the American population who suffer from it; however, anecdotal reports from patients with psoriasis visiting Hawaii who purchased kukui nut oil, claim it helped reduce the severity of their lesions. This pilot study was a double-blind, placebo-controlled clinical trial to determine the effectiveness of kukui nut oil as a topical treatment for psoriasis. Thirty adult subjects (18–78 year) were recruited from the community for a 12-week randomized, double-blind, placebo-controlled pilot study. Subjects were previously diagnosed with mild, stable plaque psoriasis (less than 15% of total body surface area [TBSA]) and agreed to abstain from other treatments during the course of the study. Following a 4-week washout period the subjects were randomized into a treatment group (15 subjects applying kukui nut oil) or a control group (15 applying the mineral oil placebo). Patients were seen every 2 weeks (seven visits at 0, 2, 4, 6, 8, 10, and 12 weeks) by a dermatological nurse practitioner under the general supervision of a board certified dermatologist. Measurable outcomes included evaluation of one targeted lesion and of the overall severity of their psoriasis using clinical evaluation, Psoriasis Area and Sensitivity Index (PASI), Global Severity of Psoriasis Scale, and photographs. Each patient also evaluated their own lesions daily using the Global Severity of Psoriasis Scale, and noted any side-effects or other treatments used. Although both groups improved, we found no significant difference between the treatment (kukui nut oil) and the placebo (mineral oil) among the 24 out of 30 subjects (80%) who completed the study. No side-effects or adverse events were reported. Kukui nut oil did not significantly reduce symptoms of psoriasis; however, this was a small pilot study, and the use of this oil cannot be dismissed without using a larger study population of patients with psoriasis. [ABSTRACT FROM AUTHOR]

The topical application of mechlorethamine is associated with a high incidence of irritant contact dermatitis. An attempt was made to avoid this complication by the use of a topical tolerogenic schedule. Seven of ten patients developed contact dermatitis to the medication after they had completed the schedule. The use of this medication in its present form is unlikely to be of practical value in the treatment of psoriasis. [ABSTRACT FROM AUTHOR]

This article focuses on calagualine, a hydrophilic fraction of polypodium leucotomos, for the management of psoriasis. As the cutaneous lesion in psoriasis is characterized by an augmented generative activity of the epidermis, it is reasonable enough to use drugs for treatment which depress epithelial reproduction. Study suggests that calagualine is a useful agent in the management of psoriasis. Its effect consists in inhibiting epithelial proliferation. Although the pharmacological effect of this agent still needs precise study and clinical experience is also needed in a more complete way, there is evidence of its therapeutic value.

Background Coal tar has been a very popular traditional treatment for various types of psoriasis for over a century. It is the first-line treatment for scalp, hand, and foot psoriasis. However, the application of coal tar on hair invariably causes staining, which results in a high degree of patient non-compliance, especially in patients with non-black hair. Thus, the treatment of scalp psoriasis with a topical coal tar formulation requires that special concern be paid to product esthetics. Objective This study aimed to evaluate the hair-staining characteristics of a novel lecithinized coal tar (LCT) formulation on different types of mammalian hair. Methods Samples of hair from different mammals, including human, sheep, rabbit, and goat, were repeatedly exposed to the LCT formulation over 14 days. The color of hair samples treated with LCT was compared with that of untreated control hair samples. Results The study revealed the distinct non-staining potential of the LCT formulation. Conclusions This LCT formulation lacks the propensity to stain hair and thus has excellent potential to be exploited in the treatment of scalp psoriasis. [ABSTRACT FROM AUTHOR]

Compares the clinical effectiveness of between clobetasol propionate cream and halcinonide in the treatment of psoriasis. Approval of the use of clobetasol propionate in the U.S.; Number of patients included in the comparative trial between the two treatments; Demonstration of a superior pharmacologic efficiency of clobetasol in psoriasis as measured by degree, rate, and duration of healing.

The article presents a case study of male patients with an average age of 25 years with the diagnosis of psoriasis associated with psoriatic arthritis for 16 years and nail disease after treatment of biologics available for the treatment of psoriasis. Patients showed pitting, onycholysis, and oil patches which are signs of psoriasis of the nail. Patients were given ustekinumab to treat nail psoriasis. The article discusses nail psoriasis, and the use of the drug ustekinumab.

Presents a letter to the editor on the treatment of early psoriasis lesions with oral amphotericin B or nystatin.