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Since the introduction of biologic therapies for tuberculosis ( TB), screening for latent TB infection has increased in importance, especially in countries in which TB is endemic. The aim of this study was to evaluate the effect of psoriasis on tuberculin skin test ( TST) results and to compare two TB screening tests, the TST and Quanti FERON®- TB Gold In-Tube ( QFT- GIT) test, in psoriasis and psoriatic arthritis ( PA) patients living in a TB-endemic country (Turkey). This prospective study included 61 psoriasis and 40 PA patients, and 58 healthy controls. Demographic data, medical history, human immunodeficiency virus ( HIV) status, level of education, smoking status, exposure to TB, personal and family histories of TB, and bacillus Calmette-Guérin ( BCG) vaccination status were recorded for all participants. The TST and QFT- GIT were performed in all participants. The mean ± standard deviation TST indurations in the patient and control groups were 12.6 ± 6.4 mm and 10.2 ± 6.5 mm, respectively ( P = 0.051). The TST positivity rate was higher in patients than in controls (86.1% vs. 37.9%; P < 0.001), whereas QFT- GIT positivity did not differ significantly (patients: 20.8%; controls: 17.2%; P = 0.737). False positive results can lead to unnecessary prophylactic TB treatment; therefore, the cut-off point for TST positivity in psoriasis and PA patients should be re-evaluated, or other tests, such as the QFT- GIT, should be used. [ABSTRACT FROM AUTHOR]

Background: Because antigen presenting is necessary for T-cell activation, antigen-presenting cells should be involved in the pathogenesis of psoriasis. In this study, our purpose was to evaluate and compare effects of PUVA, cyclosporine A and narrow-band UVB on dendritic cells and activated lymphocytes in the psoriatic lesions. Methods: Forty-five volunteered patients (15 patients in each treatment group as PUVA, cyclosporin A and narrow-band UVB) were enrolled in this study. Lesional skin biopsies were taken from each patient before and after treatments. Fresh frozen biopsies were studied for the expressions of CD1a, CD68, CD86, CD4, CD8 and HLA-DR proteins by immunohistochemistry. Results: There was no correlation between severity of the lesions and expressions of the antigens. Only PUVA significantly decreased CD1a+ epidermal Langerhans cells' (LCs) counts. Treatment modalities decreased expression of costimulator CD86, and most of them decrease antigen-presenting capacity of skin by decreasing HLA class-II expression. Conclusions: All treatment modalities equally reduce lymphocytes, macrophages and dendritic cells. PUVA is the only treatment that decreases epidermal LCs. All treatments effectively diminish expression of CD86 and inhibit this step of inflammation. [ABSTRACT FROM AUTHOR]

Background Narrow-band (311 nm) UVB is an effective treatment modality for moderate to severe psoriasis. The effect of maintenance narrow-band UVB on the duration of remission is unknown. Aim To determine whether maintenance narrow-band UVB affects the duration of remission. Methods After clinically significant improvement [defined as 75% reduction in the initial Psoriasis Area and Severity Index (PASI) = “PASI 75”], patients were randomly assigned to one of two groups, namely maintenance and no maintenance. The first group received 2 months of maintenance therapy; the second group received no further treatment. Both groups were followed up for 1 year. Results At the end of 12 weeks, 46 of 50 patients (92%) achieved “PASI 75”. Of these 46 patients, 32 had plaque-type psoriasis and 14 had guttate-type psoriasis. The numbers of patients assigned to the maintenance and no maintenance groups were 22 and 24, respectively. At the end of the study, 12 of the 22 patients (55%) in the maintenance group and, by contrast, eight of the 24 patients (33%) in the no maintenance group were still in remission. When the patients in both groups were categorized according to the type of psoriasis, eight of 14 (57%) patients with plaque-type psoriasis in the maintenance group and, by contrast, three of 18 (17%) in the no maintenance group were still in remission. Although numerically significant, life-table analysis indicated no statistically significant difference for the probability of remaining in remission between maintenance and no maintenance groups. Conclusions The results provide some evidence that maintenance narrow-band UVB may achieve longer remission durations for patients with plaque-type psoriasis. [ABSTRACT FROM AUTHOR]

Generalized pustular psoriasis (GPP) is a rare type of psoriasis and is considered the most severe variant. Infantile pustular psoriasis (IPP) is a very rare form of GPP. Severe IPP may be difficult to control and is complicated by bacterial superinfection, dehydration, and sepsis. Herein, a 2.5-month-old infant with IPP is presented, who was successfully treated with systemic retinoid therapy, which appears to be a safe and effective option for this challenging pustular eruption of childhood. [ABSTRACT FROM AUTHOR]

Objectives: Our aim was to compare 20% with 10% to 5% incremental regimens in narrowband UVB phototherapy. Study patients: The study included patients with psoriasis (N = 191) with Fitzpatrick skin phototypes II and III. Results: Occurrence of erythema as well as maximum and cumulative doses were higher with 20% escalations, whereas response rates and time to response did not significantly differ. Limitations: The study was limited by its retrospective nature. Conclusion: A 5% or 10% incremental regimen may have similar therapeutic efficacy. [Copyright &y& Elsevier]