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Introduction: Tumor necrosis factor (TNF)-α inhibitors are widely used for the treatment of inflammatory diseases. One of the side effects of TNF-inhibitors is the development of a psoriatiform eruption, also known as paradoxical psoriasis. In this case report, we describe a patient with this side effect after treatment with adalimumab and etanercept. Case Report: A 45-year-old female was treated with adalimumab 40 mg once every 2 weeks for pustulosis palmoplantaris and psoriatic arthritis. After 2 injections, the patient developed a psoriatiform eruption on her body, which improved after discontinuation of adalimumab but worsened after treatment with etanercept 50 mg twice weekly. Eventually, the patient was treated with topical corticosteroids and ustekinumab 45 mg once every 3 months with a complete remission of the psoriatiform eruption. Discussion: Several case reports and reviews have been published in recent years which describe patients with a psoriatiform eruption after treatment with TNF-α inhibitors. The pathogenesis that causes this psoriatic eruption is unclear. In conclusion, we describe a patient with a psoriatiform eruption after treatment with adalimumab and etanercept. This patient had to discontinue the treatment and eventually had a complete response after treatment with topical corticosteroids and treatment with ustekinumab. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic, relapsing, immune-mediated disease that can have a profound negative impact on patients' quality of life. Five different types of psoriasis have been characterised according to their clinical features. A working group sanctioned by the Dermatology Society of South Africa engaged in discussions which resulted in the development of guidelines for the diagnosis and management of psoriasis in the South African context. Healthcare professionals can use these recommended guidelines to promote a strategic evidence-based approach when treating patients with psoriasis to ensure optimal treatment outcomes. Topical agents are the mainstay of treatment in mild psoriasis, and phototherapy and systemic agents should be considered if the treatment is ineffective or the severity of the psoriasis heightened. [ABSTRACT FROM AUTHOR]

Introduction: Psoriasis is a chronic, inflammatory papulosquamous disease clinically characterized by erythematous, sharply demarcated, indurated papules and rounded plaques covered by silvery, micaceous scales. Psoriasis is characterized by hyperproliferation and abnormal differentiation of epidermal keratinocytes, infiltration of mostly T lymphocytes and various endothelial vascular changes in the dermal layer, such as angiogenesis, dilatation and high endothelial venule (HEV) formation. Material and Methods: The study was conducted on 70 patients of psoriasis attending the outpatient department. Patients who fulfilled the selection criterion were alternately assigned into two groups, 35 patients in each group. The assessment of effectiveness was done with the help of PASI. Follow up of patients were done after 1st, 2nd, 4th and 6th week of initiation of treatment. Results: We observed 70 patients and both the group showed statistically significant reduction in the disease severity. Conclusion: The calcipotriol and mometasone furoate ointment were found to be equally effective in clearance of the disease. [ABSTRACT FROM AUTHOR]

Objectives Dithranol, one of the most successful topical agents for the treatment of psoriasis, has been shown to exert its therapeutic effect by inducing keratinocyte apoptosis. To gain further insights into dithranol-induced apoptotic events in vitro, a detailed investigation of its time- and dose-dependent effects has been performed through the evaluation of selected apoptotic markers, using a human keratinocyte cell line ( HaCaT) as a model. Methods The time- and dose-dependent effects of dithranol on a human keratinocyte cell line ( HaCaT) were investigated through the evaluation of a series of apoptotic markers; morphological changes (electron microscopy), phosphatidylserine externalisation (flow cytometry), and caspase-3/7 activation. Key findings The dithranol-induced apoptotic cascade was found to follow a well-defined dose and time-course, with the concentration and the period of exposure to the drug acting as the two major factors influencing the events and nature of cell death. The earliest apoptotic event detected was caspase activation (after 6 h), followed by the occurrence of phosphatidylserine externalisation (after 9 h) and subsequently the morphological characteristics associated with early and late stage apoptosis/necrosis (after 12 h). Conclusions This study has elucidated the dose- and time-response effects of dithranol-induced apoptosis in human keratinocytes in vitro. [ABSTRACT FROM AUTHOR]

Summary Background An unmet need remains for safe and effective long-term treatments of psoriasis. Objectives To evaluate ustekinumab efficacy and safety for up to 3 years in the PHOENIX 1 trial. Methods Patients ( n = 766) with moderate-to-severe psoriasis were randomized to ustekinumab 45 mg or 90 mg at weeks 0 and 4, and then every 12 weeks, or placebo at weeks 0 and 4, with crossover to ustekinumab at week 12. Ustekinumab responders [≥ 75% improvement from baseline in the Psoriasis Area and Severity Index (PASI 75) at weeks 28 and 40] were re-randomized at week 40 to continue or withdraw from treatment until psoriasis recurrence. Partial responders (week 28: PASI 50-74; week 40: < PASI 75) switched to dosing every 8 weeks. Clinical efficacy was assessed by PASI, the Physician's Global Assessment (PGA), and the Dermatology Life Quality Index (DLQI) measures. Results Overall, 79·8% of the ustekinumab-treated patients remained in the study for 3 years. PASI 75 response rates (45 mg: 61·2%; 90 mg: 72·4%) at week 76 were maintained through year 3 (45 mg: 62·7%; 90 mg: 72·2%); PGA response was similarly durable. At year 3, 80·9% (45 mg) and 82·7% (90 mg) of week 40 responders continuing treatment every 12 weeks achieved a PASI 75 response, while 42·6% (45 mg) and 58·0% (90 mg) achieved a PASI 90 response. Among partial responders adjusted to dosing every 8 weeks, 50·9% (45 mg) and 52·0% (90 mg) had a PASI 75 response at year 3. DLQI responses paralleled the PASI responses. Through year 3, no dose response was observed in rates of adverse events (AEs), overall infections, serious AEs, or AEs leading to discontinuation; nor was there evidence of cumulative organ toxicity. Conclusions Continuous, stable, maintenance dosing with ustekinumab was generally well tolerated and sustained durable efficacy for up to 3 years of treatment. [ABSTRACT FROM AUTHOR]

Summary [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic, disabling disease in which adherence to treatment is often poor. The aim of this article is to highlight the problem of adherence to long-term treatment in psoriasis and the factors that contribute to it, and to discuss how adherence, and thus outcomes, can be improved. This article 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. Adherence to topical medication is a major problem in psoriasis. Not only are prescriptions not being filled by patients (primary adherence) but topical medications are not being used as recommended (secondary adherence). The issue is complex due to the many factors which affect adherence, including efficacy, ease of use and convenience of application, and the healthcare professional-patient relationship. Due to the nature of the disease, patients suffer poor self-image and feel stigmatized, particularly when psoriasis is present on a visible part of the body. Consequently, the negative impact of psoriasis on patient quality of life underlies many adherence issues. It is therefore important for treatment to address the psychological aspects as well as the physical symptoms of psoriasis. Improvements in several areas of disease management may lead to benefits in medication adherence and hence clinical benefit. Prescribing therapy in line with patient preference for treatment vehicle and improving the healthcare professional-patient relationship may be key factors. Nurses have an important role in educating patients and delivering long-term care. This individualized, personal, approach may help improve treatment adherence, outcomes, and the quality of life for patients with psoriasis. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Adherence to treatment is an indicator of treatment success. Long-term data on adherence to biologic treatment in psoriasis are lacking. To compare the tumour necrosis factor (TNF)-α inhibitors regarding drug survival rate and safety in patients with psoriasis. This study is based on data from the Danish nationwide database DERMBIO covering patients with psoriasis treated with a biologic agent. All patients who received anti-TNF-α treatment in academic referral centres were included. Baseline data, adverse events, time on treatment and reason for stopping treatment were recorded. Hazard ratios (HRs) for factors determining drug survival were calculated by logistic regression. In total, 882 treatment series with etanercept ( n = 311), adalimumab ( n = 427) or infliximab ( n = 144) were administered to 747 patients. Significant predictors of drug survival were: sex, the anti-TNF-α agent and the previous response to an anti-TNF-α agent. In the group of anti-TNF-α-naïve patients the longest drug survival was observed for infliximab, followed by adalimumab [HR vs. infliximab 3·70, 95% confidence interval (CI) 1·99-6·89] and etanercept (HR vs. infliximab 3·18, 95% CI 1·72-5·86). The 4-year drug survival is in the range of 40% for etanercept or adalimumab vs. 70% for infliximab. There was no difference in number of adverse events. The overall efficacy of anti-TNF-α drugs diminishes with time, as envisaged by the progressive loss of patient adherence to treatment. The major reasons for stopping treatment were loss of efficacy, followed by adverse events. Infliximab had the best patient retention ability, with 70% of patients still being on the drug after 4 years of treatment. [ABSTRACT FROM AUTHOR]

Methotrexate and fumarates are effective systemic therapies for moderate to severe psoriasis according to the European S3 guidelines. We conducted a randomized controlled trial comparing the effectiveness and the adverse events of methotrexate and fumarates. Sixty patients with moderate to severe psoriasis vulgaris were randomly assigned to treatment for 16 weeks with either methotrexate (30 patients; 15 mg per week) or fumarates (30 patients; 30 mg, followed by 120 mg according to a standard progressive dosage regimen) and were followed up for 4 weeks. The primary endpoint with respect to the efficacy was the difference in mean change from baseline in Psoriasis Area and Severity Index (PASI) after 12 weeks of treatment. The study was powered to detect a difference of five points. Analyses were by intention to treat. Six patients were excluded because five were not eligible and one withdrew consent. Two patients in the methotrexate group and one in the fumarate group dropped out during the 12 weeks of treatment because of nonappearance at the outpatient clinic. In total, 25 patients in the methotrexate group and 26 in the fumarate group were evaluated in the primary analysis. After 12 weeks of treatment, the mean ± SD PASI decreased from 14·5 ± 3·0 at baseline to 6·7 ± 4·5 in the 25 patients treated with methotrexate, whereas it decreased from 18·1 ± 7·0 to 10·5 ± 6·7 in the 26 patients treated with fumarates. After adjustment for baseline values, the absolute difference (fumarates minus methotrexate) in the mean values at 12 weeks was 1·4 (95% confidence interval −2·0 to 4·7; P = 0·417). In this randomized trial methotrexate and fumarates were found to be equally effective in the treatment of patients with moderate to severe psoriasis. No serious or irreversible adverse events were observed in any of the patients. [ABSTRACT FROM AUTHOR]

Psoriasis is a dermatosis in which a multiplicity of ethio-pathogenic factors are involved, in a complex way. In the second part of this article the so called biological agents and non-traditional drugs, used for the treatment of this entity, will be reviewed. [ABSTRACT FROM AUTHOR]

A part of the book "Monthly Prescribing Reference" for February 2011 is presented. It offers an overview of pharmacological treatments for dermatological disorders including acne, psoriasis and skin infections. The drugs include Aczone from Allergan, Neoral from Novartis and Abreva from GlaxoSmithKline. Information on pharmacologic class, generic name, adverse reactions, and required doses for children and adults are also offered.

Nail involvement in psoriasis is common and can be distressing. It can be treated with a range of treatment options, including topical medications, intralesional corticosteroids, phototherapy, radiation therapy, systemic therapies and biological agents. However, evidence for their efficacy in this setting is generally limited and additional research is needed. [ABSTRACT FROM AUTHOR]

The article offers information on biologic therapies. These refer to new therapies that involve the use of biologic interventions for blocking the molecular steps in psoriasis' pathogenesis and are classified into two types, one targeting tumor necrosis factor-α and interleukin-IL 12/23. Several products are featured, including he Sterlara monoclonal antibody from Jannsen-Cliag Ltd. and Enbrel TNF-inhibitor from Wyeth Pharmaceuticals.

The article discusses the case of a psoriasis patient who became pregnant while undergoing treatment with ustekinumab. Topics discussed include the discontinuation of ustekinumab treatment during the patient's first pregnancy, the re-start of ustekinumab after pregnancy which resulted to the remission of psoriasis and impetigo herpetiformis, and unintended second pregnancy following the third injection of ustekinumab.

Ustekinumab is a novel investigational human monoclonal antibody (mAb) that is pending approval for the treatment of plaque psoriasis. As a chronic inflammatory skin disorder, psoriasis can be effectively treated with biologic agents, which target immune pathways. Current approved biologic agents for psoriasis include agents that inhibit tumor necrosis factor (TNF)-alpha (eg, etanercept, infliximab, adalimumab) or T-ceil activation (eg, alefacept, efalizumab), Ustekinumab works through the inhibition of interleukin (IL)42 and IL-23, Subcutaneous administration of ustekinumab has demonstrated efficacy in both phase 2 and 3 trials, with larger proportions of ustekinumab-treated patients (>50%) achieving 75% reduction in Psoriasis Area and Severity Index (PASI) scores compared with placebo-treated patients. Ustekinumab-treated patients also experienced greater improvements in health-related quality of life. Ustekinumab is generally well tolerated; the most commonly reported adverse events include cough, arthralgia, injection-site reaction, and headache. INSET: I Formulary considerations. [ABSTRACT FROM AUTHOR]

The article discusses the impact of biologic agents used in treating plaque psoriasis. It refers to psoriasis refers as a chronic inflammatory skin disorder that is characterized by thickened, erythematous and scaling plaques. The etiology, the use of the Psoriasis Area and Severity Index (PASI) in determining the severity of psoriasis and various treatment approaches are detailed. The agents tackled include etanercept, a soluble tumor necrosis factor (TNF)α receptor, and the monoclonal antibodies infliximab and adalimumab.

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: Psoriasis and atopic eczema are reportedly as common among women as among men and are not known to differ in severity between sexes. Research has shown that men get more treatment with ultraviolet (UV) light for longer periods than women. This fact, together with ongoing efforts to improve patient satisfaction with care and treatment at our department, prompted us to gather information from our patients. Objective: The aim of this study was to explore patients' views of dermatological care and treatment methods. Method: A questionnaire-based survey was carried out, complemented with qualitative interviews. Results: The main findings fall under three areas of clinical relevance: information to patients must be individually designed with a gender perspective; men and women have different attitudes towards greasing which must be kept in mind in clinical practice; and women often appear to be under-prescribed UV treatment. Conclusion: The information from our study can form a basis for new therapeutic strategies, taking a gender perspective into account. [ABSTRACT FROM AUTHOR]

Background In 2003, the Dutch psoriasis guidelines were among the first evidence-based medicine guidelines in dermatology. Although pivotal, the implementation of dermatological guidelines has not been assessed. Objectives To evaluate various aspects that affect implementation of clinical guidelines such as knowledge, attitudes and practices among dermatologists. Methods A cross-sectional anonymous postal survey was conducted among all Dutch dermatologists. In addition to questions about knowledge and practices, 24 items assessed guidelines attitudes. Factor analysis was applied to merge these items into attitudinal scales and multiple linear regression was used to identify predictors for these scales. Results Of the 353 dermatologists, 161 (46%) completed the questionnaire. Almost all respondents were aware of the guidelines and 60% reported to have a decent knowledge of their content. Factor analysis retained 22 items divided into three scales: usefulness and content, barriers, and reliability. Apart from some disagreement on the user-friendliness and communication facilitating properties, the dermatologists’ attitudes were generally positive. A larger volume of patients with psoriasis was associated with more frequent use of the guidelines [adjusted odds ratio (OR) = 2·42; 95% confidence interval (CI) 1·02–5·72]. Good familiarity predicted a more positive attitude towards the guidelines’ usefulness and content ( P < 0·001), perceived barriers ( P < 0·001), and more frequent use in practice (adjusted OR = 8·38; 95% CI 3·08–22·81). Conclusions Dutch dermatologists seem to know and appreciate their psoriasis guidelines and use them more often when they have a larger psoriasis population. Enhancing the familiarity of the guidelines among users may result in a more positive attitude towards them and a higher frequency of use. [ABSTRACT FROM AUTHOR]

The article cites a study that describes the basic characteristics of psoriatic disease, a dermatologic disorder that affects residents in the U.S. It discusses the need for appropriate management for early and aggressive intervention of this condition. It highlights the principles that maximizes treatment outcomes by giving tumor necrosis factor-alpha antagonist therapy.

Abstract: Spa (thermal) tourism is gaining increasing importance in health tourism. Turkey has numerous thermal sources that have been used to cure a number of common diseases. Among these thermal sources, Kangal Fish Spring has a unique nature with its doctor fish known to cure psoriasis. To date, a number of studies analyzed Kangal Fish Spring as a thermal source with its water and fish characteristics but no research to the authors’ knowledge has been conducted to analyze the spring''s demand and destination characteristics. In Turkey, research about thermal health centers and their visitors, is fairly limited from a tourism experience point of view. The current paper reports a case study of psoriasis treatment by doctor fish in Kangal Fish Spring as part of health tourism in Turkey. The paper describes Kangal Fish Spring as a health tourism destination and investigates socio-economic and visitor characteristics of the people visiting Kangal Fish Spring. As part of the study, 104 visitors to the destination were surveyed and visitor perceptions about the destination and visitor characteristics were reported. The paper concludes with a discussion about the future of the destination and health tourism in Turkey. [Copyright &y& Elsevier]

Background: No controlled data is available till date comparing topical tazarotene and clobetasol in Indian psoriatic patients. Objective: The aim was to compare the clinical efficacy of 12 weeks of once-daily tazarotene 0.1% cream with that of once-daily clobetasol propionate 0.05% cream in the treatment of patients with chronic plaque psoriasis. Methods: About 36 patients with bilaterally symmetrical lesions were enrolled in this double-blind randomized controlled study. A left-right randomized study was conducted. Results: Clobetasol cream was better than tazarotene cream in reducing the erythema throughout the treatment period with statistically significant differences favoring clobetasol at weeks 2, 4, 6 and 8 (P<0.05). Tazarotene was better in reducing the induration at weeks 2 (P<0.05), 4, 10 and 12. Clobetasol cream was better in reducing the scaling throughout the treatment period with statistically significant differences favoring clobetasol over the entire treatment period. Treatment success rate was 100% with clobetasol and 88% with tazarotene at the end of week 12 with clobetasol achieving 100% success rate at the end of week 6. Treatment with tazarotene resulted in uniform reduction of plaque elevation and was not associated with the development of hot spots. Conclusion: Topical tazarotene 0.1% cream is less effective than topical clobetasol propionate 0.05% cream in the treatment of plaque psoriasis. It has more effect on induration than on erythema and scaling of psoriatic lesions. [ABSTRACT FROM AUTHOR]

Background: A two-compound product containing calcipotriol and betamethasone dipropionate (Daivobet®/Dovobet®) has been evaluated in a large clinical trial programme, providing a wealth of data on the treatment of psoriasis vulgaris. Objective: To determine the effectiveness of the two-compound product in patients with mild, moderate and severe psoriasis vulgaris. Methods: Data from over 1,534 patients with psoriasis vulgaris who received the two-compound product once daily for at least 4 weeks in four randomised, double-blind studies were pooled. A meta-analysis of the pooled data is presented. Severity of psoriasis at baseline was determined by investigator assessment and Psoriasis Area and Severity Index (PASI) score. Results: For patients with severe disease defined by PASI score (PASI baseline ≥17), the mean reduction in PASI after up to 4 weeks of treatment was 71.6% compared with 68.9 and 67.2% for those with moderate (PASI baseline 5.1–16.0) and mild disease (PASI baseline ≤5). Corresponding reductions for investigator-assessed severity were 72.6, 69.1 and 68.7%, respectively. Conclusion: Although the meta-analysis of the data from these four studies was performed post hoc, we may conclude that the two-compound product provided highly effective treatment of psoriasis, regardless of the category of baseline disease severity. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

On the scalp, dithranol has been studied in only a few trials. The dithranol molecule that contains both hydrophilic and lipophilic centers can be incorporated into detergents and allows easy removal from hair. This property has led to the incorporation of dithranol in an emulsifying oil base (bio-wash-oil). The formulation has been used routinely for more than two decades in East Germany. We reexamined the efficacy and safety of dithranol in bio-wash-oil and compared it to dithranol embedded in crystalline monoglycerides (Micanol®) in patients with psoriasis of the scalp. In a prospective, parallel group study, 64 patients attending a day-care clinic were randomly allocated to 3 treatment groups: (1) dithranol in bio-wash-oil; (2) Micanol® cream, and (3) Micanol® cream in bio-wash-oil. Treatment was carried out for 3 weeks and results assessed using a modified Psoriasis Area and Severity Index score. Dithranol in bio-wash-oil resulted in a reduction in the score of 34% on day 7 and 57% on day 14. This was significantly better than in groups 2 and 3, as were the overall response and patients’ assessment at the end of treatment (p < 0.05). Dithranol in a bio-wash-oil is an effective, well-tolerated and low-priced treatment in psoriasis of the scalp.Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Presents information on calcipotriene, a synthetic analog of vitamin D3 which is a safe and effective option in the treatment of plaque psoriasis. Explanation that vitamin D plays a critical role in maintaining adequate levels of serum calcium and phosphorous that are both essential for adequate mineralization of bone; Vitamin D synthesis; Discussion on the treatment of psoriasis.

The author discusses various approved systemic treatments for psoriasis, a chronic skin condition that causes skin cells to grow quickly. Topic discussed include theoretical risk of malignancy and infection for using oral tofacitinib, association between psoriasis and cardiovascular comorbidities, and use of several medication such as ustekinumab and methotrexate in psoriasis.

Features the drug efalizumab, a recombinant monoclonal immunoglobulin G-1 antibody. Application of efalizumab in plaque psoriasis; Effect of the drug on CD1a lymphocyte and its ligand intercellular adhesion molecule-1; Administration of efalizumab.

The article describes the case of a 44-year-old male patient with a history of psoriasis vulgaris and who developed generalized pustular psoriasis (GPP) which was treated with secukinumab. The patient previously took other medications such as cyclosporine, prednisolone, etanercept, anakinra and ustekinumab that exacerbated his condition. A discussion on the possibility of using secukinumab in other neutrophilic dermatosis is offered.

The article discusses the cases of patients with severe psoriasis who underwent treatment with biosimilar infliximab (Remsima). Topics discussed include the treatment of the patients via biosimilar infliximab monotherapy and in combination with methotrexate or leflunomide, remissions achieved by the patients, and the effectiveness and safety of the biosimilar.

The article discusses the development of biosimilars for the treatment for psoriasis. Topics discussed include the European Medicines Agency's (EMA) approval of CT-P13 biosimilar monoclonal antibody for psoriasis, the clinical trials of biosimilars of etanercept and adalimumab, and the role of dermatologists in the prescription of biosimilar substitutions for psoriasis.

The article reflects on the significance of biologics in the long-term safe treatment of patients with psoriasis. The author outlines that many dermatologists were restrictive in their use of systemic treatment. He notes that the number of patients treated with a biologic was low during the past years. He points out that there is a major improvement in the eligibility criteria for treatment with a biologic due to the guidelines for its interventions.

The article offers information on the more effective biologic agents in treating psoriasis. Trial results which have been presented at the American Academy of Dermatology's 65th Annual Meeting in February 2007 reveal adalimumab and efalizumab as treatment options in managing psoriasis. Both drugs were found to show significant effect in curing moderate-to-severe plaque psoriasis.

The article presents abstracts on medical topics related to dermatology including the determinants of skin ageing in the skin area lateral to the right eye, the increased risk of acute myocardial infarction (MI) in patients undergoing psoriasis treatment, and the effectiveness of and safety of the drug infliximab in severe plaque psoriasis treatment as compared with methotrexate (MTX).

The article discusses the growing role of alefacept in managing dermatologic diseases. It is said that alefacept is no longer only used for managing palmoplantar pustular psoriasis. It can also be used to manage other variants of psoriasis, including nail psoriasis and scalp psoriasis. Moreover, studies indicate the effectiveness of alefacept in treating pyoderma gangrenosum, chronic graft versus host disease and erosive lichen planus.

The article reports that using Raptiva in psoriasis patients revealed a favorable long-term safety profile. It states that the drug is an appropriate long-term treatment option for sufferers of a moderate-to-severe chronic plaque psoriasis. In connection, Raptiva is a humanized anti-CD11a monoclonal antibody that binds to and blocks the activity of CD11 on the surface of T cells.