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PubMedDate not supplied

[Heredity of psoriasis].

INTRODUCTION: Epidemiological studies of twins show that there is a genetic predisposition to psoriasis. Researches conducted so far show that psoriasis is a multifactorial polygenetic disease with reduced gene penetration. They also show that heredity is more significant than the "trigger" factor whose influence is limited to the exchange of phenotypes. Researches in USA, Canada and Europe identified four most important loci (psoriasis susceptibility--1-4). At least one is in MHC (major histocompatibility complex) due to the connection between psoriasis and alleles of human leukocyte antigen (HLA). OBJECTIVE: Our study included 117 patients and examined the indicators of genetic predisposition to psoriasis: frequency of psoriasis among relatives of psoriatic probands; frequency of psoriasis among relatives (I and II degree) of psoriatic patients; age of probands and other relatives at the onset of illness. MATERIAL AND METHODS: We have used a structured questionnaire for collection of data about existence of psoriasis in relatives of I and II degree of psoriatic probands and about the age of probands and relatives at the time of onset. RESULTS AND DISCUSSION: Twenty six (21.85%) probands have at least one ill relative. The examined patients who have diseased relatives get ill much earlier than those who do not. Probands with two or more diseased relatives get ill much earlier than those who have just one diseased relative. Analysis of our sample shows a significant statistical difference regarding the onset of illness of diseased parents and their children. Children get ill earlier. CONCLUSIONS: We have concluded that in our sample there is a hereditary component which is related to frequency and onset of psoriasis.

Adolescent↗

PubMed1998

T-lymphocyte chemotaxis to IL-8 in patients with psoriasis in vitro.

OBJECTIVE: The critical role of infiltrating T cells in the pathogenesis of psoriasis is now well established. In order to determine whether circulating T cells from patients with psoriasis were also involved in the disease process, the authors investigated the biological behavior as studied by chemotactic activity of T cells in patients with psoriasis. METHODS: A 48 microchemotaxis chamber was employed to determine T-cell chemotaxis activity. In addition, the expression of T cell activation markers such as HLA-DR and interleukin 2 receptor were analysed with fluorescence activated cell sorting technique and serum IL-8 level was measured with ELISA methods. Forty-five patients with psoriasis (23 patients with severe psoriasis and 22 with mild psoriasis) and 21 patients with atopic dermatitis were investigated. For comparison, T-lymphocytes from 20 healthy controls were tested equally. RESULTS: T-cell chemotactic responses were significantly decreased in patients with severe psoriasis and atopic dermatitis as compared to healthy controls. Increased expression of activation markers such as HLA-DR and interleukin 2 receptor were demonstrated in circulating T cells from psoriatic patients and atopic dermatitis patients in comparison to healthy controls. Serum IL-8 level was significantly increased in patients with psoriasis and atopic dermatitis. CONCLUSIONS: Circulating T cells in patients with severe psoriasis show abnormal in vitro chemotactic response to IL-8. Furthermore, the in vivo activation state of T lymphocytes in these patients and increased level of serum IL-8 seemed to be associated to their decreased in vitro T-cell chemotactic responses.

Chemotaxis, Leukocyte↗

PubMedDate not supplied

Long-term treatment of psoriasis with calcipotriol scalp solution and cream.

The efficacy and safety of long-term concurrent twice-daily treatment of scalp and body psoriasis with calcipotriol scalp solution (50 mcg/ml) and calcipotriol cream (50 mcg/g) were evaluated in a prospective, multi-centre, open-label, non-controlled evaluation over 52 weeks in 202 patients. Safety and efficacy as measured by total sign score (scalp psoriasis), modified PASI (body psoriasis) and patient self-assessment were assessed at week 2, 6 and 10 and thereafter every six weeks. By week 28, mean total sign score for scalp psoriasis had reduced from 5.9 to 2.5 (p<0.001). No further reduction was seen. By week 34, mean PASI for body psoriasis had reduced from 6.8 to 2.6 (p<0.001). No further reduction was seen. At week 52, the percentage of patients assessing their psoriasis as moderate or severe had decreased from 72 to 21% for scalp psoriasis and from 62 to 19% for body psoriasis. Facial irritation was the most frequent adverse event (91/276 events) with the highest incidence occurring at week 2 and few new reports at subsequent visits. There were no significant changes in mean serum calcium, parathormone or urinary calcium/creatinine ratio. Combined treatment with calcipotriol scalp solution and cream was effective and safe for long-term treatment of scalp and body psoriasis.

Administration, Topical↗

PubMed2000

[Oral terbinafine-induced plantar pustular psoriasis].

BACKGROUND: Cutaneous reactions may occur in patients receiving terbinafine therapy, mainly rash and urticaria. More exceptionally, development of psoriasis has been described. We describe the development of plantar pustular psoriasis in a patient who took oral terbinafine. CASE REPORT: A 70-year-old man, without previously known history of psoriasis, was treated with terbinafine, 250 mg/day, for onychomycosis. Ten days later, a plantar pustular psoriasis appeared. The psoriasis cleared up after discontinuation of terbinafine and institution of antipsoriatic therapy. DISCUSSION: Terbinafine is an antifungal agent widely use in the treatment of onychomycosis. A skin reaction occurs in 3 p. 100 of patients. Only 24 cases of flare-up of previous psoriasis or psoriasis de novo after terbinafine have been described. The psoriasis generally clears after discontinuation of terbinafine. So, terbinafine is perhaps not the best first line therapy for onychomycosis in patients with psoriasis.

Administration, Oral↗

PubMed2002

Itching in patients suffering from psoriasis.

Some psoriatic patients suffer from intensive itching, however, literature data on its prevalence and especially on clinical manifestation are very limited. This study was undertaken to evaluate the frequency and clinical characteristics of itching in patients with psoriasis and to correlate the presence and intensity of pruritus with clinical severity of psoriasis. One hundred psoriatic individuals (psoriasis vulgaris in 77% and arthropatic psoriasis in 23%) were included in the study. The severity of psoriasis was assessed according to PASI score. Itching was evaluated using two methods: visual analog scale (VAS) and a specially designed questionnaire method. Itching was found in 80% of psoriatic patients. The severity of psoriasis in pruritic patients was significantly (p<0.004) higher as compared to non-pruritic subjects. Significant correlations were found between PASI scores and intensity of itching, as assessed by both scales: VAS and the questionnaire method (r=0.29, p<0.01 for both analyses). The presence and intensity of itching did not depend on age and gender of patients, type of psoriasis, duration of disease, and last outbreak of psoriasis. Generalized itching was reported by 28.7% of pruritic patients. The most common sites of itching were lower limbs (50%), trunk (48.7%), upper limbs (48.7%) and scalp (35%). Face appeared to be the least commonly affected skin area by itching (only 1.2%). We conclude that itching is a common symptom in patients with psoriasis, and its intensity correlates with clinical severity of the disease.

Adolescent↗

PubMedDate not supplied

Flexural versus plaque lesions in psoriasis: an immunohistochemical differentiation.

Clinical presentation, therapeutic options, micro-environment and HLA-typing have been reported to be different in flexural psoriasis as compared to plaque psoriasis. We were interested in any difference concerning the pathogenesis of both conditions. By analysing T-cell subsets, NK-T cells and proliferation and differentiation markers, insight into the pathogenesis of both subtypes was obtained. Quantitative studies of T-cell subsets, cells expressing NK-receptors and markers of proliferation and differentiation in flexural and plaque psoriasis were investigated. Biopsies from 6 patients with both flexural and plaque lesions were obtained and processed for immunohistochemistry. Several T-cell subsets were stained: CD4+, CD8+, CD2+, CD25+, CD45RO+ and CD45RA+ T-cells. In addition cells expressing NK receptors were stained: CD94+ cells and CD161+ cells. T-cell subsets and cells expressing NK-receptors were analysed by immunohistochemical scoring. The proliferation marker Ki-67 and differentiation marker keratin-10 were revealed immunohistochemically by MIB-1 and RKSE60 respectively. Both markers were analysed using quantitative image analyses. The number of Ki-67 positive nuclei and the percentage of keratin-10 positive epidermal cells in flexural and plaque psoriasis were comparable. There is no difference between flexural and plaque psoriasis concerning other T-cell subsets. However a highly significant reduction is seen in flexural psoriasis with respect to CD161+ cells in the dermis. The similarity of chronic plaque psoriasis compared to flexural psoriasis with respect to T-cell subsets, epidermal proliferation and keratinization suggests that both conditions are pathogenetically identical. We propose the decreased quantity of lesional CD161+ cells in the dermis of flexural psoriatic lesions may result from chronic microbial challenge in flexural psoriasis.

Adult↗

PubMed2006

Cutaneous psoriasis in a military flight surgeon.

Cutaneous psoriasis is a common, non-infectious, hyperproliferative, papulosquamous, inflammatory skin disease whose pathogenesis is unknown. The course of psoriasis is typically chronic and unpredictable. Psoriasis can range from a small, local pathological area of skin to widespread dermatologic disease, such as generalized pustular psoriasis and erythroderma. Symptoms can range from mildly symptomatic to life threatening. Complications can range from psychological problems to systemic medical disease, such as psoriatic arthritis and inflammatory bowel disease. Treatment options can have adverse side effects which negatively affect multiple organ systems such as the hematological, neurological, and immunological systems. Therefore, psoriasis is a dermatologic disease that should be taken seriously in military aviation. The disease, its complications, and its therapies can interfere with concentration, mission accomplishment, the ability to operate aircraft safely, and compliance with safety equipment use. In this case report, we present the case of a naval flight surgeon who presented with inverse psoriasis and plaque psoriasis, which ultimately became well controlled with topical medications. The flight surgeon was recommended for military aeromedical waivers for psoriasis and chronic medication use. We also review the medical literature on cutaneous psoriasis, discuss its complications, and review its aeromedical implications in military aviation.

Adult↗

PubMed2006

Increased endocytic activity in monocyte-derived dendritic cells in patients with psoriasis vulgaris.

BACKGROUND & OBJECTIVE: The understanding of the pathogenesis of psoriasis vulgaris has focused on T cell mediated immune disorder for many years. Recent studies provide evidence that dendritic cells may be of major importance as regulatory cells driving the psoriasis tissue reaction, and they are one of the therapeutic targets. In order to further characterize the role of dendritic cells in psoriasis, this study was designed to assess the differentiation of dendritic cells from monocytes (MoDC), the expression of phagocytosis related receptors by MoDC, their endocytic activity for fluorescent beads and lucifer yellow as well as their superoxide generation in patients with psoriasis. METHODS: Twenty eight patients with psoriasis vulgaris and 12 healthy controls were included in the study. MoDC were obtained by culturing monocytes with granulocyte macrophage-colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) for 5 days. Cell surface expression of CD1a, CD14, CD40, CD80, CD83, CD86, HLA-DR, mannose receptor (MR) and Fcg receptors by MoDC and their endocytosis of dextran and lucifer yellow were analyzed by flow cytometry. Zymosan ingestion was measured to access the phagocytosis of MoDC. RESULTS: Differentiation of monocytes to dendritic cells was upregulated in patients manifested as significantly increased expression of CD40, CD80, CD86 and HLA-DR compared with that in healthy controls (P<0.01). Expression of MR and Fcg receptor II (CD32) by MoDC was significantly increased in patients with psoriasis as well (P<0.01). Endocytosis of dextran but not lucifer yellow in patients was significantly higher than controls (P<0.01), and significantly enhanced phagocytosis by increasing zymosan ingestion was also observed (P<0.01) in patients. Taken together, endocytic and phagocytic activity of MoDC in psoriasis was increased than normal persons. INTERPRETATION & CONCLUSION: Enhanced activity of dendritic cells binding and capturing foreign antigens for subsequent antigen presentation and the initiation of immune responses in psoriasis may contribute to the pathogenesis of the disease. The upregulated expression of MR and the enhanced endocytic activity of DC might be an explanation for the absence of skin infection observed in psoriasis.

Adolescent↗

PubMed1991

Psychological stress and psoriasis: experimental and prospective correlational studies.

Using a dismantled time-series design, 18 subjects with psoriasis symptoms on the scalp were randomly assigned to four groups and six dropped out: meditation (N = 5); meditation and imagery (N = 4); waiting list (N = 5); and no treatment control group (N = 4). Treatment lasted 12 weeks, with 4 weeks pre- and post-baseline periods. An assessment control group was also used during baseline periods (N = 4). The severity of psoriasis symptoms was reliably rated by dermatologists. A time-series multivariate regression analysis controlling for extraneous factors influencing psoriasis symptoms, revealed a significant difference between the mean psoriasis ratings of treatment and control groups after treatment (partial r = 0.30, p less than 0.01). No additional impact was associated with the use of the imagery technique (partial r = 0.06, p less than 0.05). Four subjects in the treatment groups, two in each condition, succeeded in clinically improving their psoriasis symptoms and none deteriorated. The practice of meditation may be clinically effective for some patients in reducing their psoriasis symptoms. For one of the control groups, the relation between psychological stress and psoriasis was examined prospectively over a period of 20 weeks using standardized measures. A time-series multivariate statistical method indicated an average positive correlation between the severity of psoriasis symptoms and psychological distress (partial r = 0.31, p less than 0.01) and the impact of adverse life events (partial r = 0.23, p less than 0.05); there were, however, important individual differences. Stress reduction techniques can thus be regarded as part of the treatment offered to some patients suffering from psoriasis.

Adult↗

PubMed1985

Angiogenic capability of peripheral blood mononuclear cells in psoriasis.

The angiogenic capability of peripheral blood mononuclear cells (MNCs) from patients with psoriasis was tested by lymphocyte-induced angiogenesis assay. The study was performed in 36 patients with psoriasis vulgaris, six with generalized pustular psoriasis of the von Zumbusch type, and five with palmo-plantar pustular psoriasis. When patients with psoriasis vulgaris were considered as a whole, no significant differences in the angiogenic capability of their MNCs could be detected, as compared with controls. However, when cases of psoriasis were classified into various types, the differences in angiogenic capability of MNCs became evident. This capability was found to be markedly increased in the active form of psoriasis vulgaris and decreased in the stationary stage of the disease. It was increased in palmo-plantar pustular psoriasis but markedly decreased in generalized pustular psoriasis of the von Zumbusch type.

Adolescent↗

PubMed1989

Tissue-type plasminogen activator concentrations in plasma from patients with psoriasis.

An ELISA for tissue-type plasminogen activator (t-PA) was developed and used to measure the concentration of t-PA in plasma from 15 healthy donors and 23 psoriasis patients. The mean value for the healthy donors was 2.4 +/- 1.3 ng/ml (SD) of t-PA in plasma. The mean value for the psoriasis patients was 4.4 +/- 3.2 ng/ml of t-PA. The psoriasis patients were divided into two groups: patients with mild psoriasis, i.e. less than 20% of the skin affected; and patients with severe psoriasis, i.e. more than 20% of the skin affected. Patients with mild psoriasis had t-PA concentrations of 2.8 +/- 2.3 ng/ml, while patients with severe psoriasis had 5.4 +/- 3.3 ng/ml. t-PA concentrations were higher in the psoriasis patients than in the normal controls (at the 5% level). The patients with severe psoriasis had t-PA concentrations significantly higher than the normal controls (at the 1% level).

Enzyme-Linked Immunosorbent Assay↗

PubMed1995

A questionnaire-based survey of patients' knowledge of psoriasis at the National Skin Centre.

Psoriasis is a chronic disease, which while potentially controllable, cannot be cured. Treatment is long term and requires continuous effort by the patient. Patient education is important for a chronic disease like psoriasis and this involves acquiring knowledge about the disease. With knowledge gained, the patient will be better able to cope, improve decision-making and comply with treatment. The aim was to determine the level of knowledge of psoriasis among four groups of patients attending the National Skin Centre. The study population consisted of 120 patients divided into four groups with 30 patients each from the general clinic, psoriasis clinic, private clinic and phototherapy clinic. The patients were asked to fill up a questionnaire. For those who were Chinese educated, a Mandarin translation of the questionnaire was made. The patients' age ranged from 13 to 83 years with a mean of 39 years. The mean duration of psoriasis was 9 years. Patients from the phototherapy clinic scored significantly higher than patients from the other clinics. There were, however, gaps in the knowledge of psoriasis among the various groups. No correlation was noted between age, sex, duration of psoriasis, number of consultations or phototherapy session with correct scores to the questionnaire. The most common treatment prescribed for the general and private clinics was a combination of topical steroids and tar (67% and 44% respectively). For the psoriasis clinic, the most common treatment prescribed was methotrexate (60%). For the phototherapy clinic, the most common modality used was ultraviolet B light (60%). Education is important in the overall treatment of psoriasis patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

[Proportion of psoriasis in cases treated at the dermatology service at the Sibenik Medical Center over a 5-year period].

The paper reviews medical record data on psoriasis at the Sibenik Medical Center, Department of Skin Diseases, over a five-year period (1986-1990). Separate analysis was performed for hospital and outpatient departments. Various parameters were analysed, the most important being sex, age, type of disease and occupation. The outpatient department recorded 539 psoriasis patients, 302 (56.0%) males and 237 (44.0%) females. Psoriasis vulgaris was found in 478 (88.7%), arthropathic in 39 (7.2%), pustular in 9 (1.7%) and erythrodermic in 13 (2.4%) patients. Out of a total of 54,129 visits to the outpatient department, 2281 (4.2%) were due to psoriasis. A total of 1598 patients were hospitalized over the same study period, of whom 131 (8.2%) due to psoriasis, i.e. 81 (61.8%) males and 50 (38.2%) females. Psoriasis vulgaris was reported in 92 (70.2%), arthropathic psoriasis in 19 (14.5%), pustular in 9 (6.9%) and erythrodermic in 11 (8.4%) patients. A total of 46,368 hospital days were realized, with an average of 18 inpatient days. Out of those, 4710 (10.2%) were due to psoriasis, the average treatment lasting 16.7 days. In relation to the incidence and nature of this disease, as well as to health care costs, it can be concluded that psoriasis represents not only a serious medicosocial but also an economic and public problem.

Adult↗

PubMed1997

Is psoriasis induced by streptococcal superantigens and maintained by M-protein-specific T cells that cross-react with keratin?

The evidence that T lymphocytes play a key role in the pathogenesis of psoriasis is now compelling. Eruption of psoriatic skin lesions coincides with epidermal infiltration and activation of T cells, and spontaneous or treatment-induced resolution of the lesions is preceded by the reduction or disappearance of epidermal T cells. An upregulation has also been demonstrated for various molecules associated with T-cell mediated inflammation, and treatments selectively directed against T cells have proved very effective. Infections with group A beta-haemolytic streptococci have been associated with onset of acute psoriasis and exacerbation of chronic psoriasis. Such infections are also frequently accompanied by erythematous skin rashes. Also, recent reports indicate that streptococcal superantigens can induce expression of cutaneous lymphocyte antigens (CLA), believed to play a major role in enabling T cells to migrate to the skin. Furthermore, T-cell lines isolated from psoriatic lesions may show strong reactivity to streptococcal antigens. We have postulated that psoriasis is an autoimmune disease mediated by T cells reacting to epitopes that are common to streptococcal M-proteins and keratins. To investigate this possibility, circulating T cells from 12 patients with active psoriasis, paired controls, and six patients with atopic dermatitis were challenged in vitro with five synthetic 20aa (amino acid) M-peptides: production of IFN-gamma and IL-4 was analysed by ELISPOT and RT-PCR techniques. Four of these peptides shared five to six aa sequences with several type I keratins and one did not. In 10 of the 12 psoriasis patients, measurable IFN-gamma production could be induced by one or more of the four peptides that share sequences with keratins. A borderline response was observed in only four of the 18 controls: the dermatitis patients were all negative. The only peptide that shared 6aa with keratins was the one that induced a response in the psoriatic patients most frequently, and four of them showed the strongest response to this peptide while none of the controls reacted to it. In all instances negligible responses were observed to the control peptide that did not share sequences with keratins. Except for PHA-stimulated controls, IL-4 responses could not be detected by either ELISPOT or RT-PCR and there was generally good agreement between the two techniques. A marked reduction in the M-peptide-induced IFN-gamma responses was observed in the psoriasis patients during remission induced by UVB treatment, while their responses to streptokinase-streptodornase were not affected. Thus, active psoriasis is associated with a Th1 type response to short peptides with epitopes shared by streptococcal M-protein and keratin. This is consistent with the hypothesis that psoriasis may be induced and exacerbated in susceptible individuals by M-protein-specific Th1-like cells that cross-react with human epidermal keratin.

Animals↗

PubMed1998

[Management of psoriasis in family practice is now in closer agreement with the guidelines of the Netherlands Society of Family Physicians].

OBJECTIVE: To assess changes in incidence of psoriasis and to study changes in the management of psoriasis in general practice after the sending of guidelines on management of psoriasis to general practitioners (GPs) by the NHG. DESIGN: Secondary data analysis. SETTING: Netherlands Institute for Health Care Research (NIVEL), Utrecht, the Netherlands. METHOD: Data on the incidence of psoriasis and its management by general practitioners were collected from a file predating the publication of the NHG guideline 'Psoriasis' in 1994, namely the 'Dutch National Survey of General Practice' (NS; 1987/'88), and from a subsequent file, the 'Registration Network Groningen' (RNG; 1995). RESULTS: In the NS there were 106 new patients with psoriasis (incidence: 1.3/1000/year; 95% confidence interval (95% CI): 1.2-1.4) while in the RNG there were 24 (incidence: 1.2/1000/year; 95% CI: 0.7-1.9). In all, there were 466 psoriasis patients in the NS and 125 in the RNG. The number of referrals to dermatologists was halved in 1995 (7.2%) compared with 1987/'88 (14.4%; p < 0.05). The most frequently prescribed dermatologica in psoriasis was in 1995 corticosteroid group 3 (32.8%; in 1987/'88: 28.5%), but the rise was stronger in corticosteroid group 2 (29.6%; in 1987/'88: 16.0%; p < 0.001) and group 4 (16.0%; in 1987/'88: 8.8%; p < 0.05). CONCLUSION: The incidence of psoriasis in general practice had not changed between 1987/'88 en 1995. Referral pattern and prescription shifted towards the guidelines issued by the NHG.

Adrenal Cortex Hormones↗

PubMed2004

Measures of clinical severity, quality of life, and psychological distress in patients with psoriasis: a cluster analysis.

The impact of psoriasis on patients' quality of life may be quite destructive, and measures of disease status alone seem to have questionable validity in describing the true burden of illness. Our aim was to study, in patients with psoriasis, the relationship between classical measures of clinical status (i.e., PASI and SAPASI) and quality-of-life indexes (i.e., Skindex-29, Dermatology Life Quality Index, Psoriasis Disability Index, Impact of Psoriasis Questionnaire). In addition, two psychological distress indexes (i.e., Psoriasis Life Stress Inventory, 12-item General Health Questionnaire) were assessed. Data were collected between February 2000 and July 2001 at the inpatient wards of the Dermatological Institute IDI-IRCCS, Rome, Italy, in the framework of a large project on clinical, epidemiologic, emotional, and quality-of-life aspects of psoriasis. A cluster analysis of all the above-mentioned instruments was conducted on 786 eligible patients hospitalized with a diagnosis of psoriasis. Correlations between instruments were also analyzed in subsets of patients based on the main variables of interest. The instruments clustered in two distinct groups, one formed by clinical severity measurements and the other grouping all the quality-of-life and psychological indexes. The correlations between instruments observed in the subgroups determined by different sociodemographic and clinical variables showed the same pattern. In conclusion, the dissimilarity between clinical severity assessment and patient-centered measures stresses the need for a more comprehensive assessment of severity of psoriasis.

Adult↗

PubMed2026

Predictors of Efficacy Maintenance After Vunakizumab Discontinuation in Patients With Moderate-to-Severe Plaque Psoriasis: A Post Hoc Analysis of a Randomized Controlled Trial.

BACKGROUND: Efficacy cannot be maintained in some psoriasis patients after biological discontinuation. This study aimed to explore predictors of efficacy maintenance after vunakizumab discontinuation in patients with moderate-to-severe plaque psoriasis. METHODS: This post hoc analysis used data from a phase III trial (NCT04839016); 291 patients with moderate-to-severe plaque psoriasis who achieved 100% improvement in Psoriasis Area and Severity Index (PASI) score at Week 52 were enrolled. Efficacy maintenance was defined as patients who maintained PASI 90 or PASI 100 after 20 weeks of vunakizumab discontinuation. RESULTS: There were 44.7% and 72.5% of patients with PASI 100 and PASI 90 maintenance, respectively. In the multivariate logistic regression model, body mass index (BMI) (odds ratio [OR] = 0.922, p = 0.024) and treatment interruption (OR = 0.550, p = 0.020) were independently associated with a lower possibility of PASI 100 maintenance; however, the association of family history of psoriasis and the first time of PASI 100 achievement with PASI 100 maintenance did not achieve statistical significance. Duration of psoriasis (OR = 0.972, p = 0.049) and treatment interruption (OR = 0.257, p < 0.001) were independently associated with a lower possibility of PASI 90 maintenance. Two nomograms for predicting PASI 90 and PASI 100 maintenance were constructed based on the multivariate models, which disclosed good calibration performance. CONCLUSIONS: PASI 90 and PASI 100 maintenance rates are 72.5% and 44.7% after 20 weeks of vunakizumab discontinuation in patients with moderate-to-severe plaque psoriasis. BMI, treatment interruption, and duration of psoriasis predict a lower possibility of efficacy maintenance after vunakizumab discontinuation.

Humans↗

PubMed2004

Prevalence of symptoms experienced by patients with different clinical types of psoriasis.

BACKGROUND: The main dermatology textbooks describe only in passing pruritus in psoriasis and rarely mention other symptoms. A quantification of the presence of symptoms is not available for clinical subgroups of psoriasis. OBJECTIVES: To investigate the prevalence of symptoms experienced by patients with different clinical types of psoriasis. METHODS: The study was carried out in patients hospitalized for psoriasis between February 2000 and February 2002 at the inpatient wards of the Istituto Dermopatico dell'Immacolata, Rome, Italy. Symptoms were evaluated using the symptoms scale of Skindex-29. Clinical severity was assessed by the dermatologists using the Psoriasis Area and Severity Index (PASI), and by the patients completing the self-administered PASI. Psychiatric morbidity was evaluated using the 12-item General Health Questionnaire. RESULTS: In total, 936 eligible patients were analysed. The proportions of patients experiencing symptoms often or always in the 4 weeks before hospitalization were: 63.8% itching, 59.7% irritation, 46.1% burning/stinging, 39% sensitivity, 26% pain (from 10% in guttate psoriasis to 50% in arthropathic), 25.4% bleeding (17% pustular, 19% localized plaque, 36% palmoplantar), and 23.9% bothered by water (from 8.5% in the guttate form to 68% in palmoplantar). The prevalence of all symptoms was significantly higher in women and tended to increase with clinical severity. CONCLUSIONS: Our study provides evidence of the high frequency of a number of symptoms in different subgroups of psoriasis patients determined by their sociodemographic characteristics, clinical type and disease severity. Symptoms represent a serious disabling factor in patients affected by psoriasis, including those with low levels of psychological distress. Dermatologists should include symptoms in the evaluation of disease severity both in clinical practice and in clinical trials.

Adult↗