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Forty-four patients with severe psoriasis have been treated with cyclosporin A (CyA) for 2–50 months (mean 17 months). During the study, 31 (70%) of these patients achieved a > 70% reduction in PASI score, 39 (88%) achieved a > 60% reduction and 42 (95%) a > 50% reduction. The mean initial dose of CyA was 3 mg/kg/day and the mean dose was 3·3 mg/kg/day throughout the study. Twenty-five (57%) patients were maintained on ≤ 3 mg and six (14%) required > 5 mg/kg/day for limited periods to obtain significant improvement. In three of these patients, this was achieved with 6 mg/kg/day but, of the remainder, one required 7 mg and two required 10 mg/kg/day. Of the 44 patients, 32 (73%) are still taking CyA. Patients were discontinued because of: side-effects directly attributable to treatment (n = 4); remission of psoriasis (n = 4); death (n = I); defaulting (n = I); infrequent attendance (n = I); high doses of NSAID were necessary for arthritis (n = I). Before starting CyA, 39 patients were normotensive; 21 (54%) developed mild hypertension. In 28 patients where the GFRs were estimated before and during treatment, there was a 16% reduction (P < 0.0001) during a mean period of 8 months. Two patients developed malignancies. The incidence of hypertension and percentage decrease in GFR were strongly correlated with the dose required to control the psoriasis. [ABSTRACT FROM AUTHOR]

Cyclosporin A (CyA) is the forerunner of a new generation of immunosuppressive drugs. It is highly effective in both antibody- and cell-mediated immunity and in inhibiting chronic inflammatory reactions. Cyclosporin A is, therefore, widely used to prevent rejection in clinical organ transplantation and appears to be very promising in the treatment of several autoimmune diseases, in particular psoriasis. Cyclosporin A is not only effective when given at the time of sensitization (prevention of rejection), but also when administered therapeutically during an immune response, such as during the active course of an autoimmune disease. The most important aspect of its immunosuppressive mechanism is the inhibition of lymphokine production secreted by activated T cells. The pharmacological effects of CyA are rapid in onset, dose-dependent and often quickly reversible when treatment is stopped. [ABSTRACT FROM AUTHOR]

Several open studies with active forms of vitamin D3 have been reported to be effective in the treatment of psoriasis. We report a double-blind study of Iα,25-dihydroxycholecalciferol in psoriasis using 0.5 μg of active substance applied topically twice daily. In contrast to previous studies, the present investigation does not provide evidence of clinical efficacy for the drug at that dosage and with the vehicle that was used. [ABSTRACT FROM AUTHOR]

To investigate the effect of Grenz ray therapy alone compared with Grenz rays combined with a topical corticosteroid (betamethasone dipropionate) in psoriasis of the scalp, 40 patients were randomized into two groups. One group received 4 Gy of Grenz rays administered on six occasions at intervals of I week and the other group was given the same Grenz ray treatment plus topical corticosteroid. The patients were assessed before and after Grenz ray therapy and were followed-up for 6 months. Of the 37 patients who completed the trial 16 out of I9 (84%) of the patients in the Grenz ray group, and 13 out of 18 (72%) of the patients in the combination group healed. The remission time did not differ significantly between the two groups. Of the patients who healed, 5 of 16 patients in the Grenz ray only group and 4 of 13 patients in the combination group remained healed at 6 months. We conclude that Grenz ray therapy is a useful treatment modality for scalp psoriasis, but that the addition of a topical corticosteroid has only a minor effect. [ABSTRACT FROM AUTHOR]

Twenty patients with palmoplantar pustular psoriasis were treated initially for 4 weeks with 70 mg etretinate daily. This led to clinical improvement and a significant fall in pustule count. The patients were then allocated randomly to 30 mg etretinate daily or placebo for a further 12 weeks. There was a rapid deterioration in the clinical condition and a rise in pustule count in the placebo group. The etretinate-treated group still showed clinical improvement and a significantly lower pustule count after 12 weeks. Clinical side-effects were few and adverse effects on liver function and serum lipids were not found. [ABSTRACT FROM AUTHOR]

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]

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 presents the findings of a medical research study into the use of advanced glycation end products (RAGE) as a biomarker for determining the severity of Psoriasis in patients. Topics include the objective of the conducted medical study along with the methods used and the results of the medical study.

Two double-blind studies comparing the effectiveness of the cyclic nucleotide-attering agent (4-[3-butoxy-4- methoxybenzyl]-2-imidazolidinone) (Ro 20-1724) vs vehicle have demonstrated that this compound can improve psoriatic lesions. Although Ro 20-1724 was not as effective as intensive occlusive treatment of psoriatic lesions with 0.025% triameinolone acetonide, Ro 20-1724 had no adverse systemic or cutaneous effects. Ro 20-1724 and other cyclic nucleotide-altering agents may have therapeutic potential in the future treatment of psoriasis. [ABSTRACT FROM AUTHOR]

Ten patients with extensive plaque psoriasis were treated with calcipotriol ointment (50 μg/g) for 2 weeks (200 g for 1 week, followed by 300 g during the second week). Mean improvement in psoriasis area and severity index (PASI) was 71%. Mean 24 h urine calcium rose from 4.79 mmol/24 h to 7.27 mmol/24 h (P<0.001). Urine calcium returned towards baseline after stopping calcipotriol. Mean serum calcium also rose slightly, but significantly, from 2.26 mmol/l to 2.32 mmol/l (P<0.005), and fell again in the washout phase. Individual serum calcium values remained within the normal range throughout the study. Topical calcipotriol is an effective, rapidly acting and safe in-patient treatment for extensive plaque psoriasis. [ABSTRACT FROM AUTHOR]

Discusses the application of cyclosporin A therapy for psoriasis. Efficacy and safety of the treatment; Patients who qualified for the treatment; Method on the application of the treatment.

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 discusses a research about the role of p16 protein in psoriasis and chronic spongiotic dermatisis. Topics discussed include the histopathological criteria for psoriasis, differential diagnosis of chronic spongiotic dermatitis, focal expression of p16 protein and the overexpression of p16 in psoriatic lesions as not a consistent finding and can never be used in the assessment of psoriasiform dermatitis.

Two case studies are presented such as a 56 year-old man with a history of psoriasiform lesions and treated with abatacept for his rheumatoid arthritis and a 25 year-old woman with a history of moderate psoriasis and developed erythematous hyperkeratotic plaques on palms while taking abatacept. The male patient was discontinued taking abatacept and achieved complete remission with calcipotriol and steroids. The female patient was treated anti-tumor necrosis factor blocking agents.

[Objective] Discuss the clinical effect of compound Wubeizi hoop ointment on psoriasis vulgaris. [Method] 104 cases definitely diagnosed with psoriasis vulgaris were grouped into two groups randomly, observation group (52 cases) and control group (52 cases). The observation group was treated with compound Wulieizi hoop ointment while the control group was treated with tretinoin (Vitamin A Acid). Then compare the clinical curative effects of the two groups. [Result] After 3 months of treating, the PASI score of the observation group was distinctly lower than that of the control group, and PASI scores of the two groups were significantly different (P <0.05). The total effective rate of the observation group reached 84.6% which was evidently higher than that of the control group, 73.1% (P<0.05). [Conclusion] The clinical effect of compound Wubeizi hoop ointment on alcoholic fatty liver disease is good, so it is worthy of clinical application. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the onset of urticaria as a side effect of the biologic drugs Humira® and Stelara®, which are being used to treat a 28-year-old woman with psoriasis.

Background: Chronic plaque psoriasis is the most common type of psoriasis and is characterized by redness, thickness, and scaling. First-line management of chronic plaque psoriasis is with topical treatments, including vitamin D analogues, topical corticosteroids, tar-based preparations, dithranol, salicylic acid, and topical retinoids. Objectives: To compare the effectiveness, tolerability, and safety of topical treatments for chronic plaque psoriasis with placebo; to compare vitamin D analogues with other topical treatments. Search Strategy: The Cochrane Skin Group's Trials Register was searched (December 2004). To update an unpublished 2002 review, the researchers also searched CENTRAL in the Cochrane Library (2005; Issue 1); Medline (to February 2005); EMBASE (to August 2005); Science Citation Index (to 2005); Biosis (to 2005); Dissertation Abstracts (all publication years); Inside Conferences (all publication years); SIGLE (to 2005); National Research Register (all projects with a start date of 2001 to 2005); and metaRegister of Current Controlled Trials. Selection Criteria: Randomized trials comparing treatments with placebo or with vitamin D analogues in persons with chronic plaque psoriasis. Data Collection and Analysis: One author extracted study data and assessed study quality. A second author checked these data. Researchers routinely contacted trial lists and companies for missing data. They extracted data on withdrawals and adverse effects. Main Results: The review included 131 randomized controlled trials with 21,448 participants. Vitamin D was significantly more effective than placebo, although there was a wide variation in effect size, with the standardized mean difference (SMD) ranging from -0.82 (95% confidence interval [CI], -1.34 to -0.29) to -1.90 (95% CI, -2.09 to -1.71). With one exception, all corticosteroids performed better than placebo, with potent corticosteroids (SMD = -0.95; 95% CI, -1.11 to -0.80; I²[heterogeneity statistic] = 61.1 percent; 17 studies; 2,386 participants) having smaller benefits than very potent corticosteroids (SMD = -1.29; 95% CI, -1.45 to -1.13; I² = 53.2 percent; 11 studies; 1,571 participants). Dithranol and tazarotene performed better than placebo. Head-to-head comparisons of vitamin D against potent or very potent corticosteroids found no significant differences. However, combined treatment with vitamin D/corticosteroid performed significantly better than either vitamin D or corticosteroid alone. Vitamin D performed better than coal tar, but findings relative to dithranol were mixed. Potent corticosteroids were less likely than vitamin D to cause local adverse effects. No comparison of topical agents found a significant difference in systemic adverse effects. Authors' Conclusions: Corticosteroids perform as well as vitamin D analogues and are associated with a lower incidence of local adverse effects. Further research is required to inform long-term maintenance treatment. [ABSTRACT FROM AUTHOR]

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.

Discusses research being done on the effectiveness of tacrolimus ointment in treating facial and intertriginous psoriasis. Reference to a study by M. Lebwohl et al published in a November 2004 issue of the "Journal of the American Academy of Dermatology"; Dosage of tacrolimus applied on the respondents; Adverse effects of the medicine.

Presents a letter to the editor about treatment of Psoriasis by Cyclosporin A.

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.

Focuses on the medication of Isotretinoin-psoralen photochemotherapy (PUVA) in women with psoriasis. Efficacy of the treatment of PUVA to a 30-year-old women with extensive psoriases for 20 years; Impact of Isotretinoin introduced as monotherapy at the dose 0-6 mg/kg per day; Effects of the establishment of RePUVA on the psoriases treatment.

Presents a letter to the editor providing information on the use of vitamin D substitute in the treatment of psoriasis.

Describes a study concerning the treatment of psoriasis with cyclosporin A (CyA). Effectiveness of CyA; Recurrence of psoriasis after withdrawal of the drug; Observations noted from patients treated with CyA.

Severe psoriasis is commonly associated with depression and may be its cause. The hazards of treating such patients with lithium are well known (Lazarus & Gilgor, 1979), but other drugs may also destabilize psoriasis. We report a patient in whom the anti-depressant trazodone hydrochloride (Molipaxin®, Roussel), a serotonin antagonist, provoked generalized pustular psoriasis (GPP). [ABSTRACT FROM AUTHOR]