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Sphingolipids (SLs), are structural components of the skin that contribute to the regulation of the proliferation and differentiation of keratinocytes as well as regulation of the skin epidermal barrier. A prospective cross sectional comparative controlled study was designed to evaluate the serum level of sphingosine 1 phosphate (S1P) and ceramide (CER) before and after narrow band ultraviolet B (NBUVB) in psoriatic patients. The study included 32 patients presented with psoriasis and 32 healthy age and sex matched control volunteers. (S1P and CER) levels were measured before and after NBUVB sessions for psoriatic patients and their levels were correlated to psoriasis area and severity index (PASI) improvements. PASI scores and serum values of the studied sphingolipids demonstrated a significant difference between the baseline and at the end of the 12 weeks NBUVB treatment. A statistically significant positive correlation was established between psoriasis severity and S1P serum levels before and after treatment while no correlation was observed between psoriasis severity and CER serum levels. Decreased total CER and increased S1P serum levels reflect altered sphingolipid metabolism in psoriasis and can be predictors of disease severity., (© 2020 Wiley Periodicals LLC.)

Background: Psoriasis is a chronic common skin condition which alters the skin appearance, causes an inflammation in the outer epidermis, and proliferates the skin epidermal layers. It is influenced by both genomic and other external factors like environmental factors. OBJECTIVES: To know and compare the efficacy and safety of 1. Oral -Methotrexate alone. 2. Combination of both oral -Methotrexate and NBUVB for the treatment of chronic plaque psoriasis. MATERIAL & METHODS: Study Design: Prospective hospital based observational study. Study area: The study was conducted in Department of Department of Dermatology, Narayana Medical College, Nellore, A.P. Study Period: 1 year. Study population: Patients of chronic plaque psoriasis not responding to any other therapeutic modality. Sample size: study consisted a total of 50 subjects. Sampling method: Simple Random sampling method. Study tools and Data collection procedure: Initially a detailed history regarding the age of onset, the duration of illness, past modalities of treatment, family history of the disease, seasonal variation, other triggering factors, occupation were taken. The patients were explained regarding the duration of treatment, the need for regular follow up of therapy, clinic and probable side effects that could be encountered during treatment. Complete haemogram, urine for albumin, sugar and microscopy, skin biopsy, blood sugar, liver function test, renal function test were done in all the patients before initiation of therapy and were done periodically to observe for any systemic involvement and the response to treatment was evaluated every week by PASI Score and also the patients were observed clinically for any cutaneous or systemic side effects. Results: Among all (n=50 including group A and B, 25 of each) participants, relapse of treatment in weeks observed between the range of 6-12, mean was 9 with the standard deviation of 1.6 in group A. For group B relapse of medical regimen in weeks observed between the range 8-12, Mean was 10.5 with the standard deviation of 1.9 which is nearly similar in group A. This results were statistically significant as p= 0.01 where p<0.05. CONCLUSION: From our study it, we concluded that Combination therapy of oral methotrexate and NBUVB is found to be most effective, feasible from the economic point of view as well as the side effects profile and patient compliance. [ABSTRACT FROM AUTHOR]

Purpose: Although the pathogenesis of psoriasis involves the dermis, most previous studies collected samples using the swab technique. A recent study examining the microbiomes obtained via both skin biopsies and swabs revealed a significant difference in normal skin. We hypothesized that the microbiome profile of patients with psoriasis from tape stripping and skin biopsy might be different. This study sought to contribute to microbiome research on psoriasis by investigating the changes in the microbiome during narrowband ultraviolet B (NBUVB) therapy by comparing the results from the different sampling techniques of tape stripping and skin biopsy. Patients and Methods: Twenty-three participants, including 14 patients with chronic plaque psoriasis and nine healthy controls, were recruited, and nine patients with psoriasis completed 20-sessions of NBUVB treatment. Skin microbiota from both techniques was analyzed using the 16S rRNA gene at baseline and after treatment. Results: A clear difference was observed between the results from the two sampling techniques. Alpha diversity of the microbiota obtained from tape stripping was higher than that of the microbiota from skin biopsy, whereas beta diversity was clustered into two groups by sampling technique. The microbiome was altered during NBUVB treatment using both sampling techniques. Conclusion: Different sampling techniques resulted in different microbiome profiles in patients with psoriasis. Tape stripping and swabs are feasible procedures and are mostly used in psoriasis and other skin microbiome studies; however, skin biopsy may also expand our understanding of psoriasis and other skin diseases that pathophysiology involves deeper to the dermis or subcutaneous tissue. [ABSTRACT FROM AUTHOR]

Background: Artificial ultraviolet (UV) radiation is a mainstay in the treatment of a variety of inflammatory skin disorders. Despite existence from a wealth of studies on the impact of narrow-band UVB (NBUVB) on serum levels of nutrients, clinical data on its effect on serum homocysteine (HC) level, which is thought to be a risk factor for cardiovascular disorders, dementia, and depression, are scarce. Objective: To assess serum HC status before and after treatment with at least 30 sessions of NBUVB exposure in patients with various cutaneous disorders. Methods: A prospective cohort study was conducted on 39 patients with psoriasis, vitiligo, atopic dermatitis, and mycosis fungoides who underwent at least 30 sessions of NBUVB phototherapy. Serum HC was measured and compared before and after phototherapy. This study was approved by relevant ethics committee. Results: Levels of HC decreased by 24.8% after 30 sessions of NBUVB phototherapy (10.53 - 3.64 lmol/L vs. 7.92 - 3.26 lmol/L, p-value <0.0001) and this decrease was more prominent in male participants and patients older than 40 years. Conclusions: Based to our findings, NBUVB phototherapy might be a modality of choice especially for older male patients not only as an effective treatment for cutaneous conditions, but also as a modality with potential protective effects against cardio--cerebro--vascular accidents. [ABSTRACT FROM AUTHOR]

Acute phase reactants (APR) are proteins that had been associated with psoriasis severity. We aimed to evaluate the association between psoriasis disease severity and some inflammatory markers as (CRP, ESR, and fibrinogen) before and after narrow band ultraviolet NB (NB‐UVB) therapy. The present study included 38 psoriatic patients and 38 controls of matching age and sex. The 38 included patients were divided according to their pretreatment PASI score into 2 subgroups: moderate 13 (34.2%) and severe 25 (65.8%). CRP, ESR, and fibrinogen levels were measured before and after NBUVB sessions for psoriatic patients and their levels were correlated to psoriasis area and severity index (PASI) improvements. PASI scores and laboratory values of APRs showed a significant difference before and after NBUVB sessions. PASI scores significantly correlated with CRP and FBG levels before and after treatment whereas no significant correlation was demonstrated between PASI and ESR levels before and after treatment. A combination of inflammatory markers and clinical assessment could be used in the formation of a new diagnostic tool to evaluate psoriasis severity and response to treatment. [ABSTRACT FROM AUTHOR]

Conventional, full-body phototherapy equipment is costly and therefore patients are usually treated in dermatology centres. Such office-based therapy is often not feasible for those patients who live far away from a phototherapy centre due to lost time and wages, inability to travel because of extensive skin disease, or prohibitive travel costs. Home phototherapy has emerged as a modality that meets the needs of those patients. Our aim was to review available studies on UV sources, treatment protocols, efficacy, and safety of home phototherapy. A literature review was conducted on PubMed using the terms "home" AND "phototherapy" AND ("guide" OR "approach" OR "review" OR "protocol"). From the data extracted, narrowband UVB (311 nm) offers the best balance between safety and efficacy and is recommended for home phototherapy by most authors. Treatment is safe and possible adverse effects are related to overexposure (erythema, blistering). The usual treatment protocol was administering treatments on alternating days, including weekends, with dosing based on the patient's Fitzpatrick skin type. We also provide information on the available home phototherapy systems in Canada and their reimbursement. Home phototherapy is underused in Canada. Narrowband UVB phototherapy sources equipped with a 3-dimensional panel provides a practical and safe option. [ABSTRACT FROM AUTHOR]

Introduction: Calcipotriol and narrow-band ultraviolet B (NBUVB) phototherapy are widely used to effectively treat psoriasis. To reduce the cumulative NBUVB doses and to enhance clearance of psoriatic plaques, combination therapies have been established. Objectives: To compare the clinical efficacy of NBUVB alone and in combination with topical calcipotriol ointment in psoriasis. Patients and Methods: Fifty five patients with psoriasis vulgaris were included in the study. Patients were randomized into two treatment groups. Group I consisted of 30 patients who received NBUVB phototherapy as monotherapy and group II consisted of 25 patients who were treated with topical calcipotriol ointment combined with NBUVB. The treatment was continued till the patients achieved PASI-75. Results: Twenty patients, in each group, completed the study. At baseline, the mean PASI scores were 15±4 and 16.4±3 in group I and group II respectively, and at the end of treatment, the mean PASI scores were 6.5±3 in group I and 3.4±2 in group II (P=0.000). The total cumulative NBUVB dose and the number of sessions were significantly higher in group I compare to group II. Conclusion: Topical calcipotriol combined with NBUVB reduces the cumulative dose of NBUVB and improves the response of psoriasis vulgaris to phototherapy. [ABSTRACT FROM AUTHOR]