SEARCH · Search PubMed

Results for “PSORIASIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 613 records · Page 34Linked to original sources

PubMed1979

Psoriasis: odd varieties in the adult.

Occasionally we observe particular varieties of psoriasis and in rare cases transitional features with other diseases, which pose problems concerning the differential diagnosis and the nosological classification. This communication deals with the following clinical and histological aspects of psoriasis: 1) Sebopsoriasis. Relationship of psoriasis to pityriasis rubra pilaris. 2) Erythema annulare centrifugum type of psoriasis. 3) Is subcorneal pustular dermatosis an expression of pustular psoriasis? 4) Salient histopathological criteria for the diagnosis of the different atypical forms of psoriasis. 5) Presentation of an unusal case with striated and retiform verrucous psoriasis-like eruptions, which show a relationship to parakeratosis variegata.

Adult↗

PubMed1979

[Histological differential diagnosis of psoriasis vulgaris and seborrheic eczema of the scalp].

The clinical differential diagnosis between seborrheic dermatitis and psoriasis vulgaris of the scalp can be difficult. We, therefore, tried to elaborate histopathological criteria for a differentiation of the two dermatoses. Forty excisional biopsies were analysed without knowing the clinical diagnosis. The histopathological substrate within the epidermis is characterized in psoriasis by dermatitis-like and in seborrheic dermatitis by psoriasis-like alterations. Therefore, in some cases a definite histopathological diagnosis could not be made. Strong criteria favouring psoriasis are: moderate condensed hyperkeratosis with alternating parakeratosis, PAS-reactive serum inclusions and Munro abscesses within the horny layer, spongiform pustles and neutrophilic leukocytes within the epidermis. Strong criteria for seborrheic dermatitis are: irregular acanthosis with relatively thin condensed orthoor parakeratotic horny layer, spongiosis and spongiotic vesicles, exocytosis of lymphocytes and the lack of any hard criterias for psoriasis. The results may suggest that seborrheic dermatitis of the scalp may transform into psoriasis in patients with a genetical disposition ("psoriatic diathesis", "latent psoriasis") via a Köbner reaction. The existence of the seborrheic dermatitis (Morbus Unna) is not doubted by these investigations.

Biopsy↗

PubMed2005

Limited availability of psoriasis and phototherapy care: an analysis of advertisements.

Because the number of dermatologists remains stable, patients with medical dermatologic conditions such as psoriasis may find it increasingly difficult to access dermatological treatment. Measuring the competition in the marketing of dermatologic care may provide insight into the availability of dermatology services. The purpose of this study was to determine to what extent dermatologists are using the Yellow Pages to advertise to patients with psoriasis. We performed a quantitative and qualitative assessment of dermatologists' Yellow Pages advertisements in small cities and the ten largest metropolitan regions in the country. Per capita, more advertisements were found in smaller markets than larger markets and a higher percentage was descriptive rather than just a name, address and phone number. Cosmetic and surgical advertisements were more common than psoriasis ads in both markets. Cosmetic ads were more prevalent in larger markets. In all regions, psoriasis and psoriasis treatment ads were least common. These findings raise the concern that incentive structures in the United States healthcare system do not adequately support delivery of dermatologic care for psoriasis. Efforts to promote psoriasis care should be encouraged.

Advertising↗

PubMed2005

Biologic therapy for psoriasis: telephone triage.

The past 15 years have been a time of remarkable achievement in the treatment of psoriasis. New topical medications with efficacy and safety have been introduced. At the same time, there has been resurgence in the use of traditional agents such as methotrexate and cyclosporine. An enlightened understanding of psoriasis as an immune-mediated disease has led to the development of unique injectable medications called biologics. All of these developments have occurred in part as we have gained a better understanding of the powerful impact that psoriasis has on patients. The biologics represent a new and exciting class of medications for treating psoriasis. Their novelty is reflected by both excitement and uncertainty. Efficacy rates of the biologics in treating psoriasis are unparalleled and safety data over the short term is promising. However, long-term safety data does not exist. Furthermore, as with any new class of medication, specifically an injectable preparation costing approximately $18,000 to $30,000 annually, concern on the part of patients is expected. Despite any uncertainty, the biologics are drastically altering the arena of psoriasis care. Clinicians have an entirely new class of medications to recommend to patients who have either failed or are not eligible for traditional agents. At the same time, due to the expense of these agents, the relationship between the patient, clinician, and insurer is changing. Certainly the introduction of biologics has created a need for educating clinic staff regarding these therapies. There are barriers to the effective and safe use of the biologics; often, these barriers lie at the level of the patient and depend on his comfort level and understanding of the treatment. This being said, it is the charge of the dermatology community, especially those on the front lines such as nurses, to lead efforts in patient education to ensure the best care for those suffering from psoriasis.

Drug Storage↗

PubMedDate not supplied

[Psoriasis and mud bath therapy: clinical-experimental study].

OBJECTIVE: The psoriasis is chronic disease characterized from an acceleration of the kinetic of the cells of epidermis. To front of the empirical evidence of the benefits of the thermal therapy in the psoriasis, the experimentals-clinics studies is insufficient. The aim of research it has been that of quantify the benefits of the mud-bath therapy with mineral water in the psoriasis. PATIENT AND METHODS: The study has been channel on a champion of 30 subjects of which 19 of male sex and 11 of female sex with middle equal age to 56 years +/- 5.3 affected from psoriasis. The subjects of the examined champion have been divided to random in 2 groups: A and B. The group A has been treated with drugs used for psoriasis for 12 days; the B group has been treated, always for 12 consecutive days, with mud-bath therapy (FBT) with mineral water obtained from the mineral sources (chlorinate-sulphureous-bicarbonate) of the Spa of Stabia in Castellammare (NA). To the beginning and at the end of the advised treatments has been valued the prurient symptomatology and the PASI (Psoriasis and Severity Index). RESULTS: The data highlight an significant (P < 0.05) reduction is of the prurient symptomatology and of the PASI in both the groups considered. CONCLUSIONS: The results of this first step of investigations seems to highlight that the FBT treatment, to the same way of the drugs anti-psoriasis, results useful in the ameliorate the quality of life of these patients.

Anti-Inflammatory Agents↗

PubMed2006

[The pathogenesis of inflammatory dermatoses, especially psoriasis].

The skin contains a variety of cell types and mediators, which together constitute the skin's immune system and play a key role in protecting the human body against dangers from outside. Dysregulation of the skin's immune system, however, frequently occurs and can result in undesirable inflammatory processes in the skin. A typical example of an undesirable inflammation in the skin is the chronic inflammatory skin disease psoriasis. In the pathogenesis of psoriasis, both genetic and environmental factors play a key role. In psoriasis, the complex interactions between T-lymphocytes, antigen-presenting cells, keratinocytes and pro-inflammatory cytokines and chemokines are disturbed. The two most widely accepted hypotheses are: (a) psoriasis is a T-cell mediated autoimmune disease, and (b) psoriasis is the result of a too finely adjusted system for regulating inflammation in the skin. The result of both mechanisms is a chronic inflammatory reaction fuelled by pro-inflammatory type-I cytokines that lead to the psoriasis-skin phenotype. With the development ofbiologicals, it has become feasible to target specific molecules in the immune process, for example type-I cytokines and the molecules present on pathogenic T-cells. This approach has already proved successful in the treatment of rheumatoid arthritis and Crohn's disease, creating novel therapeutic options for psoriasis and other inflammatory dermatoses.

Autoantibodies↗

PubMed2006

The mechanism of lithium and beta-blocking agents in inducing and exacerbating psoriasis.

Documentation of psoriatic eruptions occurring with the initiation of various pharmacotherapy agents has been reported in the literature. Two such agents include lithium and beta-blocking drugs. By understanding the mechanism by which these drugs induce and exacerbate psoriasis, we may gain further understanding of the disease process of psoriasis as well as how to treat this side effect. This paper reviews the literature that has examined the mechanism by which lithium and beta-blockers may induce and exacerbate psoriasis. Mechanisms involving both immunologic and non-immunologic factors have been examined in various studies. No consensus has been reached and further investigation is needed. However, findings such as improvement with inositol supplementation in cases of lithium-induced and -exacerbated psoriasis and disparate histologic presentation of beta-blocker-induced psoriasis provide suggestions that both the origin and treatment of drug-induced psoriasis may be different than psoriasis that is unrelated to medications.

Adrenergic beta-Antagonists↗

PubMed1990

Hemoglobin A2 and F in patients with psoriasis.

HbA2 and HbF were studied in 91 patients with different forms of psoriasis: 29 with psoriasis vulgaris placata (restricted forms); 31 with psoriasis generalisata and erythroderma psoriaticum; 21 with psoriatic arthritis; 10 with psoriasis pustulosa. Statistically significant increase of HbA2 was established in patients with psoriasis vulgaris placata (restricted forms) as well in patients with psoriatic arthritis. HbF is statistically significant increased in all forms of psoriasis. The authors suggest, that there is probably in psoriasis a disturbance in the synthesis of the globine chains, which is genetically dependent.

Adult↗

PubMedDate not supplied

Epstein-Barr virus and human herpesvirus type 6 infection in patients with psoriasis.

The association of psoriasis with latent human herpesvirus infection has not been well described. To better understand the relationship between severe psoriasis and its treatment with latent human herpesvirus infection, we performed a cross-sectional study to determine if patients with severe psoriasis and psoriasis patients treated with immunosuppressive therapies have higher rates of Epstein-Barr virus and human herpesvirus 6 replication compared to healthy controls. The prevalence of Epstein-Barr virus and human herpesvirus 6 replication was measured in white blood cells by quantitative polymerase chain reaction. We found no evidence of active viral replication in white blood cells of healthy controls (0/10; 95% confidence interval 0-0.26), patients with severe psoriasis (0/25; 95% confidence interval 0-0.11) or severe psoriasis patients on immunosuppressive treatment (0/26; 95% confidence interval 0-0.11). The results of this study suggest that neither severe psoriasis alone, nor in combination with immunosuppressive therapy, is associated with an increase in Epstein-Barr virus or human herpesvirus 6 replication in white blood cells.

Adult↗

PubMed1991

Interleukin 1 alpha, tumor necrosis factor alpha, and interferon gamma in psoriasis.

Although recent studies have suggested that a variety of cytokines released by keratinocytes and inflammatory leukocytes could contribute to induction or persistence of the inflammatory processes in psoriasis, it remains unclear how production of these cytokines is regulated in psoriatic patients. To elucidate the biologic relevance of these cytokines to the pathogenesis of psoriasis, we investigated serum levels of interleukin 1 alpha, tumor necrosis factor alpha, and interferon gamma in 21 patients with psoriasis vulgaris, together with 21 healthy controls. The mean serum levels of interleukin 1 alpha and tumor necrosis factor alpha were not significantly different from those in controls, while those of interferon gamma were significantly elevated in the patients with psoriasis. Serum levels of interleukin 1 alpha correlated negatively with clinical disease severity expressed as psoriasis area and severity index score and with duration of psoriasis. In contrast, interferon gamma levels were related, although not significantly, to disease severity. In addition, an inverse correlation was noted between the interleukin 1 alpha levels and interferon gamma levels. These results indicate that interleukin 1 alpha and interferon gamma may be relevant to the induction and perpetuation, respectively, of the inflammatory responses in psoriasis, and that these cytokines, which have similar biologic properties, may strictly regulate one another's production in vivo.

Adult↗

PubMed1990

Efficiency of acitretin in combination with UV-B in the treatment of severe psoriasis.

Compared with the antipsoriatic retinoid etretinate, the new aromatic retinoid acitretin represents an important advance due to its rapid elimination kinetics. Since in psoriasis vulgaris retinoids are used predominantly in combination regimens, we investigated the therapeutic efficacy of acitretin and UV-B compared with placebo and UV-B in a double-blind, randomized multicenter trial in 82 patients with severe psoriasis. They were treated with 35 mg of the study medication during the first 4 weeks of therapy and 25 mg thereafter, concomitantly with UV-B irradiation in increasing energy doses. Forty patients who underwent therapy with acitretin and UV-B and 38 patients who underwent therapy with placebo and UV-B were evaluated for efficacy. The target variables--psoriasis severity index and total UV-B dose--were reported at intervals of 2 weeks over a maximum period of 8 weeks. At the end of treatment, the psoriasis severity index decrease was 79% in the acitretin and UV-B group and 35% in the placebo and UV-B group. The response rate, defined as greater than or equal to a 75% decrease of the psoriasis severity index, was 60% for the combination treatment and only 24% for the control treatment. This treatment response was achieved with markedly lower cumulative UV-B energy. The median cumulative UV-B energy applied to reach 75% clinical improvement was 11.8 J/cm2 vs 6.9 J/cm2. Side effects showed a similar pattern in both groups. Our data show that the acitretin dramatically improves the results of UV-B treatment in patients with severe psoriasis. In addition, it markedly decreases the effective cumulative UV-B dose, thereby reducing the potential long-term hazards of UV irradiation. We conclude that the acitretin plus UV-B combination treatment represents a highly effective therapeutic regimen in severe psoriasis.

Acitretin↗

PubMed1987

[The natural course of psoriasis from infancy to adulthood].

Unraveling questions concerning the etiology of psoriasis is one of the most complex problems facing researchers today. Within the last few decades, significant advances have been made with regard to the biochemical, immunologic, and genetic aspects of many disorders that have a bearing on psoriasis. Recently, we have stressed two concepts concerning the pathogenesis of psoriasis: first, that psoriasis is a disease that involves the total area of the skin and second, that psychoneuro-immunological research may be of fundamental importance to psoriasis. We have related the impact of these two observations to the course of psoriasis from infancy through adulthood. In the latter part of this paper, we emphasized that teaching patients self-help techniques may reduce their psoriasis by preventing a wide range of skin injuries.

Adolescent↗

PubMed1989

Assessment of disease progress in psoriasis.

Effective methods of recording and measuring progress of the signs of psoriasis are essential and central to the accurate assessment of therapy. Currently there is wide variation in assessment methods used, and even well-designed clinical assessment techniques have a wide observer error: objective assessment methods may have advantages. The clinical assessment techniques used in 30 clinical trials of treatment in chronic plaque psoriasis in 1985 and 1986 were reviewed and a detailed analysis is presented. In only 18 trials were individual regions assessed, and widely differing methods of scoring signs were used. Reproducibility of the assessment by clinicians of area of skin involvement by psoriasis was studied. Ten patients with chronic plaque psoriasis had standardized photography, and four clinicians assessed area of involvement from the photographs. The clinicians significantly differed in their rank ordering of the area of psoriatic skin involvement. Area of involvement by psoriasis in the same photographs was assessed objectively using computer-assisted planimetry. Although the clinicians' assessment did not differ randomly from the objective measurement, the accuracy of subjective area assessment is not the same for all clinicians. As even experienced clinical observers show wide variation when attempting to record clinical severity of psoriasis, there is clearly a need for better objective measures of psoriasis severity.

Adolescent↗

PubMed1987

[Psoriasis pustulosa generalisata--classification, clinical aspects and therapy. Review and experiences with 18 patients].

On the basis of clinico-morphological criteria we suggest the following classification of various pustular forms of psoriasis into four subtypes: generalized pustular psoriasis (von Zumbusch) and its atypical forms, erythema anulare centrifugum-like psoriasis with and without pustulation (EACP); psoriasis vulgaris with pustulation; palmo-plantar pustular psoriasis (Königsbeck-Barber) and its acral variant; acrodermatitis continua suppurativa (Hallopeau), and transitional forms. This classification takes into consideration both clinical aspects and response to treatment, and allows a prognosis of the various types of pustular psoriasis. Owing to its mild course and good treatment results, EACP represents a special form of psoriasis pustulosa generalisata. In our group of patients, systemic glucocorticosteroid therapy has proved deleterious, whereas oral photochemotherapy and etretinate have been found to be highly effective modes of therapy with only mild side effects and have been able to induce even permanent remission in EACP.

Adult↗

PubMed1987

Acquired immunodeficiency syndrome-associated psoriasis and Reiter's syndrome.

Human immunodeficiency virus (HIV) causes a spectrum of immunodysfunction, the most severe of which is the acquired immunodeficiency syndrome (AIDS). We have followed the course of psoriasis in 13 patients over 2 1/2 years in a population of more than 1000 HIV-positive individuals. Four patients had a history of mild psoriasis that became severe and uncontrollable as symptoms of immunodeficiency developed. Psoriasis and HIV positivity, AIDS-related complex, or AIDS simultaneously developed in nine patients. In addition to psoriasis, Reiter's syndrome (arthritis, urethritis, and conjunctivitis) developed in one patient in the first group and three patients in the second group. Opportunistic infections, especially candidiasis and Staphylococcus, drugs, and an altered immune system may contribute to the development or flare of psoriasis in these patients. The appearance of severe psoriasis (especially in a patient with other risk factors for HIV) should prompt evaluation for HIV, and may be a poor prognostic indicator in HIV-positive patients, since nine of our 13 patients have died. Immunosuppressive therapy with methotrexate is contraindicated in this group of patients. Newer forms of drug therapy including etretinate show promising results for the management of AIDS-associated psoriasis.

AIDS-Related Complex↗

PubMed1979

[Features of the course of psoriasis in patients with organic diseases of the nervous system].

Of 190 patients suffering from psoriasis in 65 (34.2%) hypothalamic syndrome, sequelae of neuroinfections and craniocerebral injuries, acute and chronic insufficiency of cerebral circulation were noted. These diseases preceded the development of psoriasis in 22.6% of the patients, the fact, that gives one grounds to regard them with a greater probability as a pathogenetic factor of psoriasis. In the patients suffering from psoriasis and the above diseases of the nervous system an inclinication to exudative and pustulous manifestations, arthropathy, and erythroderma, as well as frequent resistance to the therapy and torpid course of the disease were observed. An exacerbation of psoriasis aggravated some neurological disorders, and a deterioration of the neurological state coincided in time in some patients with exacerbation of psoriasis. The interaction between the dermal and the neurological disturbances appeared to be a reason for supplementing the complex of measures for psoriasis treatment with means improving the metabolic processes in the brain, psychotropic and vasocative drugs, and diadynamic currents that produce normalizing effects on the vegetative functions and cerebral hemodynamics.

Adolescent↗

PubMed1975

[The geographic distribution of psoriasis].

On the basis of data published in the literature the geographical distribution of psoriasis vulgaris is described. One of the most interesting results is the increase of the psoriasis frequency in countries such as Japan, Korea, Kazachstan and East Africa. This could be due to the fact, that altered life conditions in connection with an increasing industrialization favour the manifestation of psoriasis genes. How far population differences of the psoriasis frequencies are to be seen exclusively as genetical ones, is hitherto unclear, but rather unlikely. No relations between psoriasis and climatec factors could be seen. Associations between psoriasis and several antigens (HL-A 13 and W 17) of the HL-A-systems seem to be present. These associations could be of considerable importance for the interpretation of the geographical distribution pattern of psoriasis. Further studies in psoriatic families are required, which describe the distribution of the HL-A specifities in the possibly potential psoriatic members of the families, who carry the respective genes.

Africa↗

PubMed1978

[The skin trichophytin reactivity in psoriasis vulgaris. A contribution to the pathogenesis and clinical aspects of psoriatric skin changes].

On the basis of the resultats of four years lasting studies on 330 patients with psoriasis the allergic mechanism of the dermatosis is discussed. In 65 cases it was able to make a clinical diagnosis of the primary psoriasis focus (PPH) and to cultivate from it in 12 cases trichophyton fungi. The possibility to show the relevant mycotic antigen from the PPH is demonstrated, the development of the disease from the initial focus is described by analogy to the clinical development and a difference is made between the acute--subacute psoriasis and the chronic psoriasis with regard to the responsiveness of the competent immunological system. With 330 patients intracutan-tests have been made with trichophytin, and at the same time control tests with tuberculin, toxoplasmin and candida alb. for a period of 12 months up to 24 months. The relative and even absolute blocking of the trichophyton immunological system (TAS) and which is in correlation to the pushes and remittences of the disease constitutes the impressing resultat of the tests. With regard to the working mechanism the opinion is held that the immunological complex which is existant in the psoriatic epidermis participates to a great extent in the release of the epidermopoesis which is typical for the psoriasis. The classification into the stade of PS I (early psoriasis), PS II and PS III (late psoriasis) makes the differentiation of the process possible.

Antibody Formation↗