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The data on long-term efficacy, safety and drug survival rates of conventional systemic therapeutics in pediatric psoriasis is lacking. The primary aim of this study is to investigate acitretin, methotrexate, cyclosporin efficacy, safety and drug survival rates in pediatric patients as well as predictors of drug survival. This is a multicenter study including 289 pediatric cases being treated with acitretin, methotrexate and cyclosporin in four academic referral centers. Efficacy, adverse events, reasons for discontinuation, 1, 2- and 3-year drug survival rates, and determinants of drug survival were analyzed. A 75% reduction of Psoriasis Area and Severity Index score or better response rate was obtained in 47.5%, 34.1% and 40% of the patients who were treated with acitretin, methotrexate and cyclosporin, respectively. One-year drug survival rates for acitretin, methotrexate and cyclosporin were 36.3%, 21.1% and 15.1%, respectively. The most significant determinant of drug survival, which diminished over time, was treatment response whereas arthritis, body mass index and sex had no influence. Although all three medications are effective and relatively safe in children, drug survival rates are low due to safety concerns at this age group. Effective disease control through their rational use can be expected to improve survival rates. Pfizer Novartis Merck & Company - Schering Plough Corporation AbbVie Merck & Company Johnson & Johnson - Johnson & Johnson USA - Janssen Biotech Inc

The present study determines the relative developmental toxicity potencies of retinoids in the embryonic stem (ES)-D3 cell differentiation assay of the embryonic stem cell test, and compares the outcomes with their relative potencies in in vivo and two other in vitro assays for developmental toxicity. The results reveal that the potency ranking obtained in the ES-D3 cell differentiation assay is similar to the reported potency rankings in the two other in vitro assays for developmental toxicity. TTNPB ((E)-4[2-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl)-1-propenyl]benzoic acid) was the most potent retinoid, whereas etretinate and retinol had the lowest potency. All- trans-retinoic acid, 13- cis-retinoic acid, 9- cis-retinoic acid and acitretin showed an intermediate potency. In vivo potency rankings of the developmental toxicity of retinoids appear to be dependent on the species and/or exposure regimens used. The obtained in vitro potency ranking does not completely correspond with the in vivo potency rankings, although TTNPB is correctly predicted to be the most potent and retinol the least potent congener. The lack of in vivo kinetic processes in the ES-D3 cell differentiation assay might explain the deviating potency predictions of some retinoids. Therefore, knowledge on the species-dependent in vivo kinetics is essential when using in vitro toxicity data for the estimation of in vivo developmental toxicity potencies within series of related compounds. © 2011 Elsevier Ireland Ltd.

Bazal hücreli karsinom (BHK), insanlarda en sık görülen deri kanseri tipidir. BHK'ların tedavisinde cerrahi, halen altın standart olarak yerini korumaktadır. Buna rağmen, cerrahiye uygun olmayan ve kozmetik kaygıları olan bireylerde imikimod krem ve intralezyonel interferon (IFN) alfa2b gibi, daha az invaziv, cerrahi olmayan seçenekler de bulunmaktadır. Yalnız başına imikimod ya da imikimod ile kombine olarak interferon alfa-2b ile başarılı bir şekilde tedavi ettiğimiz değişik alt tiplerde 11 BHK vakasını sunduk. 2005-2010 yılları arasında polikliniğimizde histopatolojik olarak BHK oldukları kanıtlanmış, tek başına ya da IFN alfa-2b ile kombine olarak imikimod ile tedavi edilmiş çeşitli alt tiplerdeki hastalar bu rapora dahil edildi. Sunduğumuz 11 hastadan sadece 4 'ü (3 infiltratif, 1 solid tipler) topikal imikimoda ek olarak haftada 3 gün intralezyonel interferon alfa2b 3 milyon IU tedavisi de almıştı. Geri kalan 7 hasta sadece imikimod %5 krem kullanmıştı. Tüm hastalarda bu tedavi seçenekleri ile tam iyileşme sağlandığı görüldü. Bu olgulardaki gözlemlerimiz, İmikimodun sadece yüzeyel değil; infiltratif, solid, nodüler tip BHK'larda da etkili olduğunu düşündürmektedir. İmikimod, sadece yüzeyel değil, aynı zamanda, infiltratif, solid ve nodüler tip BHK'larda da etkili olduğunu düşündürmektedir. İntralezyonel interferon alfa-2b'nin de BHK'larda etkili olduğu ve imikimod ile kombine edildiğinde sinerjistik etki gösterdiği bilinmektedir. Basal cell carcinoma (BCC) is the most common type of skin cancer in humans. Surgery is still the gold standard for treating BCCs. However, there are also less-invasive, nonsurgical therapies such as imiquimod cream and intralesional interferon (IFN) alpha-2b for patients who are poor surgical candidates and who care about cosmetic outcomes. We report 11 patients with various subtypes of. BCC successfully treated with either imiquimod alone or in combination with interferon alfa-2b. In this paper, we present 11 patients with various subtypes of histopathologically proven BCCs, who were treated with imiquimod or combination of imiquimod and IFN alpha-2b, in our outpatient clinic between 2005 and 2010. Of 11 patients, only 4 patients (3 infiltrative, 1 solid types) had received intralesional interferon alpha-2b at a dose of 3 million IU, 3 times a week combined with topical imiquimod while 7 patients had received only 5% imiquimod cream. All patients were cured with these regimens. Imiquimod is found to be effective not only in superficial, but also in infiltrative, solid, and nodular types. Intralesional interferon alpha-2b is also known to be effective in BCCs and it has a synergistic effect when combined with imiquimod.

Psoriasis is a common chronic inflammatory skin condition in which patients suffer from mild to chronic plaque skin plaques. The disease manifests through an excessive inflammatory response in the skin due to complex interactions between different genetic and environmental factors. Psoriasis can affect the physical, emotional, and psychosocial well-being of patients, and currently there is no cure with treatments focusing primarily on the use of anti-inflammatory agents to control disease symptoms. Traditional anti-inflammatory agents can cause immunosuppression and adverse systemic effects. Further understanding of the disease has led to current areas of research aiming at the development of selective molecular targets to suppress the pathogenic immune responses. Refereed/Peer-reviewed