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 667 records · Page 37Linked to original sources

PubMed2004

Infliximab induction therapy for patients with severe plaque-type psoriasis: a randomized, double-blind, placebo-controlled trial.

BACKGROUND: Tumor necrosis factor-alpha is a key mediator in the pathogenesis of psoriasis. Infliximab is a monoclonal antibody that specifically binds to tumor necrosis factor-alpha, blocking its biologic activity. OBJECTIVE: The purpose of this study was to access the efficacy and safety of infliximab induction therapy for patients with severe plaque psoriasis. METHODS: In this multicenter, double-blind, placebo-controlled trial, 249 patients with severe plaque psoriasis were randomly assigned to receive intravenous infusions of either 3 or 5 mg/kg of infliximab or placebo given at weeks 0, 2, and 6. The primary end point was the proportion of patients who achieved at least 75% improvement in Psoriasis Area and Severity Index score from baseline at week 10. At week 26, patients whose Physician Global Assessment indicated moderate or severe disease were eligible for a single intravenous infusion of their assigned treatment to assess the safety of retreatment after a 20-week, treatment-free interval. RESULTS: At week 10, 72% of patients treated with infliximab (3 mg/kg) and 88% of patients treated with infliximab (5 mg/kg) achieved a 75% or greater improvement from baseline in Psoriasis Area and Severity Index score compared with 6% of patients treated with placebo (P <.001). Improvement was observed in both infliximab groups as early as 2 weeks. Overall, 63%, 78%, and 79% of patients in the placebo, 3-, and 5-mg/kg groups, respectively, reported one or more adverse events. CONCLUSIONS: Infliximab treatment resulted in a rapid and significant improvement in the signs and symptoms of psoriasis. Infliximab was generally well tolerated.

Adult↗

PubMed2004

Determinants of quality of life in patients with psoriasis: a study from the US population.

BACKGROUND: Psoriasis is a common disease with substantial effects on quality of life. Few quality of life studies have been performed in psoriasis patients from the general US population. OBJECTIVE: To describe the determinants of quality of life in psoriasis patients from the US population. METHODS: Patients were randomly selected from the US population. Patients who identified themselves as having been diagnosed with psoriasis by a physician were invited to complete a more detailed survey about quality of life. RESULTS: Two hundred sixty-six psoriasis patients from the US population completed the detailed survey. Body surface area showed the strongest association with decrements in quality of life (Spearman 0.50, P < .0001). Younger patients and female patients also had statistically significant reductions in quality of life. Increasing psoriasis severity was associated with seeking care from multiple physicians and having decrements in income. CONCLUSION: Patients with more extensive skin involvement have greater reductions in quality of life. Female patients and young patients are affected to a greater extent.

Age Factors↗

PubMed2004

Tacrolimus ointment is effective for facial and intertriginous psoriasis.

BACKGROUND: Intertriginous and facial involvement are manifestations of psoriasis that require a different approach than is used for typical plaque psoriasis on other skin areas. Topical corticosteroids are the primary treatment for psoriasis; however, the side effects of corticosteroids are magnified on intertriginous and facial skin. Topical tacrolimus offers the potential for anti-inflammatory effect without the atrophy or other local side effects associated with the use of topical corticosteroids. OBJECTIVE: To determine the efficacy and tolerability of 0.1% tacrolimus ointment for the treatment of facial or intertriginous psoriasis. METHODS: One hundred sixty-seven patients 16 years or older were evaluated in an 8-week, randomized, double-blind, vehicle-controlled, multi-center study. Upon entry into the study, patients were randomized 2:1 to apply the tacrolimus ointment 0.1% or vehicle twice daily to all psoriatic lesions of the face or intertriginous areas for 8 weeks. The physician's global assessment was used to assess improvement from baseline. The inverse psoriasis severity for patients was measured using a 6-point scale from clear to very severe. RESULTS: As early as day 8, more patients ( P = .004) had cleared or achieved excellent improvement in the 0.1% tacrolimus ointment group compared to the vehicle group (24.8% vs 5.8%). At the end of the 8-week treatment period 65.2% of the tacrolimus ointment group and 31.5% of the vehicle were clear or almost clear ( P < .0001) based on a Static Severity Score. Adverse events were similar in the 0.1% tacrolimus ointment and vehicle groups. Conclusion Tacrolimus ointment is an effective treatment for psoriasis of the face or intertriginous areas.

Adolescent↗

PubMed2005

Psoriasis--recent advances in understanding its pathogenesis and treatment.

Although not completely understood, there is clearly a genetic component in the development of psoriasis. Twin studies show a 67% concordance for monozygotic twins versus 18% for dizygotic twins. This lack of complete concordance in monozygotic twins suggests multifactorial inheritance and interaction between genetic predisposition and the environment. At present, 8 different psoriasis susceptibility loci have been identified in genome-wide linkage scans, including locations on 15 different chromosomes. Genetic connections have been made between psoriasis and other diseases, including atopic dermatitis, rheumatoid arthritis, and Crohn's disease. A variety of approaches are available for the treatment of psoriasis, ranging from topical agents for milder forms of the disease to phototherapy and systemic agents for severe psoriasis. Despite the importance of systemic therapies and recent advances represented by biologic agents, topical treatments will probably remain the mainstay of psoriasis therapy for most patients. The advent of new, cosmetically attractive vehicles may enhance compliance, add to the use of topical agents, and potentially improve patient outcomes.

Anti-Inflammatory Agents↗

PubMed2006

Development and reliability testing of a standardized questionnaire to assess psoriasis phenotype.

BACKGROUND: Psoriasis genetics researchers have utilized separate and widely differing survey instruments to capture clinical data to be utilized in genotype-phenotype studies, which make comparison and collaboration studies among these researchers difficult. OBJECTIVE: The purpose of this study was to develop and validate a clinical survey instrument to facilitate future collaborative genotype-phenotype studies among psoriasis genetics researchers. METHODS: The Delphi method was employed to obtain international consensus on components of the novel survey instrument. The survey was pretested for acceptability purposes, and then formally tested for reliability using 3 independent raters interviewing 48 subjects with psoriasis. RESULTS: Data showed high or moderately high agreement for questions relating to place of birth (85% to 100% in agreement), family origin (kappa = 0.48 -1.0), psoriasis history (kappa = 0.66-1.0), patient medical history (kappa = 0.76-1.0), distribution of lesions (kappa = 0.73-1.0), precipitating factors (kappa = 0.79-1.0), joint involvement (kappa = 0.74-.91), and treatment history, including use of oral retinoids, methotrexate, and etanercept (kappa = 0.73-1.0). Other parameters had lower degrees of agreement. LIMITATIONS: The time involved and the need for the rater to be a clinician with knowledge of psoriasis may preclude widespread use of this survey instrument. CONCLUSION: We developed a novel, reliable survey instrument that can be used to gather clinical information in a standardized manner from psoriasis patients participating in clinical and genetics research studies.

Humans↗

PubMed2004

Gene expression of enzymes for tryptophan degradation pathway is upregulated in the skin lesions of patients with atopic dermatitis or psoriasis.

BACKGROUND: Atopic dermatitis (AD) and psoriasis are common inflammatory skin diseases. Although many reports implicate Th2 cytokines in the pathophysiology of AD and Th1 cytokines in psoriasis, the precise etiology of these diseases remains elusive. OBJECTIVE: We investigated novel AD- or psoriasis-related genes to further understand the pathogenesis of these diseases. METHODS: We performed a comprehensive analysis of mRNA expression in skin biopsies from AD or psoriasis patients using DNA microarrays. Quantitative PCR was then used to monitor the expression of novel disease-related genes in human keratinocytes or pinnae from NC/Nga mice. RESULTS: Levels of mRNA for IDO (indoleamine 2,3-dioxygenase) and kynureninase, enzymes constituting the tryptophan degradation pathway, were found to be upregulated in the skin lesions as compared to the uninvolved skin of patients with AD or psoriasis. Expression of these two genes was induced in human epidermal keratinocytes stimulated with IFN-gamma in vitro. Moreover, in NC/Nga mice, the expression of kynureninase mRNA in the ear skin was induced following development of AD-like skin lesions. CONCLUSION: The tryptophan degradation pathway may play an important role in the pathophysiology of AD and psoriasis.

Adult↗

PubMed2004

Perceived stress, stress attributions and psychological distress in psoriasis.

OBJECTIVE: The objective of this study was to measure causal beliefs in individuals with psoriasis and to explore their relationship with perceived stress, quality of life, psychological well-being and psoriasis severity. METHODS: This study was cross-sectional in design, and patients were required to complete validated questionnaires assessing perceptions of illness, quality of life, psoriasis severity, perceived stress and psychological mood. A total of 141 individuals were recruited from two settings: an outpatient skin clinic at King's College Hospital and the Psoriasis Association. RESULTS: A strong belief in stress/psychological attributes as a causal factor was found in 61% of the sample. This belief was significantly associated with higher levels of anxiety, depression and perceived stress (r > or = .38; P < or = .0001). Perceived stress in this sample was significantly associated with a poorer level of quality of life, higher levels of anxiety and depression (r > or = .27; P < or = .002) but not with psoriasis severity. CONCLUSIONS: The belief that stress is causal was associated with lower levels of psychological well-being. However, there was no association between perceived stress and more objective measures of psoriasis severity.

Adult↗

PubMed2006

Possible association of psoriasis and reduced bone mineral density due to increased TNF-alpha and IL-6 concentrations.

Psoriasis is a chronic erythematosquamous disease affecting about 2-3% of the population. It is generally considered to be a T cell-mediated disorder. Psoriasis is characterized by Th1-type cytokine pattern with the predominant secretion of IL-2, IL-6, IFN-gamma and TNF-alpha. Such cytokine pattern is sufficient in inducing keratinocyte hyperproliferation, a hallmark of psoriasis. It seems that development of psoriatic lesions is mediated by TNF-alpha and proliferation of local T cells is dependent on local TNF-alpha production. IL-6 enhances activation, proliferation and chemotaxis of T cells into psoriatic lesions. It is also a direct keratinocyte mitogen that could directly stimulate keratinocyte proliferation. Data of possible association between psoriasis and reduced bone mineral density (BMD) are limited and therefore, not fully conclusive. The major limitation of two studies reported so far was small sample size. Based on increased concentrations of TNF-alpha and IL-6 in psoriasis we hypothesized that these patients are more prone to osteoporosis than healthy subjects. TNF-alpha enhances bone resorption via stimulating osteoclast development and activity as well as bone formation. On the other hand, IL-6 is also a potent stimulator of bone resorption. Moreover, increased production of TNF-alpha and IL-6 has been found in postmenopausal women with osteoporosis. Several lines of evidence support our hypothesis; higher value of IL-6 was recorded in children with idiopathic osteoporosis than in healthy controls; TNF-alpha knock-out mice do not lose bone after ovariectomy; polymorphism of TNFRSF1B gene which encodes 75 Kd TNF receptor is associated with BMD; treatment with anti-TNF-alpha antibody exert beneficial effect on bone metabolism in patients with rheumatoid arthritis and finally, raloxifene inhibit osteoclast activity by reducing TNF-alpha and IL-6 synthesis. However, our hypothesis raised number of questions. Are increased serum concentrations of TNF-alpha and IL-6 mirrored by increased concentrations of these cytokines on the local level? Furthermore, could other cytokines relevant in the pathogenesis of the psoriasis, first of all IFN-gamma, modulate the risk of osteoporosis? Thus, a large prospective, case-control study with the data on BMD, biochemical parameters of bone turnover and fractures have to be done to test our hypothesis.

Bone Density↗

PubMed2005

Analysis of T cell receptor alpha-chain variable region (Valpha) usage and CDR3alpha of T cells infiltrated into lesions of psoriasis patients.

Psoriasis is a common inflammatory skin disease and is considered as T cell-mediated immune response. In this study, we analyzed T cell receptor alpha-chain variable region (TCR Valpha) usage in the lesions of psoriasis patients using 5'-RACE. As the results, Valpha1, -2, -7, -8, -10, -11, -12, and -23 were commonly detected in psoriatic lesions and comparison of expressions of these Valpha types between psoriasis patients and healthy individuals showed that Valpha1, -7, -11, and -12 were highly increased in psoriasis patients than in healthy individuals. Compared with atopy dermatitis patients, the expressions of Valpha1 and Valpha7 were increased in psoriasis patients. Then, to identify CDR3alpha of T cells infiltrated in psoriatic lesions, we examined which type of J gene segment was rearranged with Valpha1 or Valpha7, which the expressions was specifically increased in psoriatic lesions. The result showed that the V-J rearrangements between the examined patients were not equivalent and their frequencies were diverse, however, several common rearrangements such as Valpha1-Jalpha13, -23, -27, or -34 and Valpha7-Jalpha12, -33 were detected. The results in this study might provide the clue to define the characteristics of T cells associated with the pathogenesis of psoriasis.

Amino Acid Sequence↗

PubMed2005

Psoriatic arthritis and psoriasis: need for a multidisciplinary approach.

Psoriatic arthritis is a progressive and often destructive form of seronegative inflammatory arthritis that is associated with psoriasis. It can be difficult to diagnose because it can present in a number of different ways, often indistinguishable from noninflammatory arthropathies such as osteoarthritis as well as inflammatory arthritis such as gout. Severe arthritis may be observed in the absence of psoriasis, or mild arthritis may be seen in the presence of moderate-to-severe psoriasis. A high index of suspicion, screening of psoriasis patients, and close follow-up and evaluation with rheumatology often is needed to make the diagnosis. Early recognition of the disorder and timely therapy can prevent long-term complications, such as permanent joint destruction and disability. With the advent of biologic agents, we are better equipped to manage psoriatic arthritis today. Because dermatologists are on the front-line of psoriasis management, we are perfectly poised to identify and help improve care for patients who suffer from both psoriasis and psoriatic arthritis.

Arthritis, Psoriatic↗

PubMed2002

Antioxidant potential of propylthiouracil in patients with psoriasis.

OBJECTIVE: There is growing evidence supporting the reactive oxygen species (ROS) in the pathogenesis of psoriasis. Propylthiouracil(PTU), an antithyroid drug, has been shown to have beneficial effects on psoriasis. The aim of this study was to investigate both disturbances in oxidant/antioxidant system in psoriasis and whether PTU, shown to have immunomodulatory effects and antioxidant potential, has effects on oxidant/antioxidant system and clinical improvement in psoriatics. DESIGN AND METHODS: Malondialdehyde (MDA), end product of lipid peroxidation, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and antioxidant enzymes were measured in plasma, erythrocytes and skin biopsies of psoriatics who were resistant to conventional therapy before and after 8 weeks of oral treatment with PTU (300 mg/day) or PTU/thyroxine (25 microg/day- to prevent possible hypothyroidism). The same parameters were also studied in healthy controls. Psoriasis Area and Severity Index (PASI) scores were used to evaluate the severity of the disease, and routine analyses and thyroid function tests were measured during the study. RESULTS: Increased baseline MDA in all samples were found to be lower. In addition baseline SOD and GSH-Px in skin and erythrocytes were also lower. The increased plasma SOD levels in skin and erythrocytes of the study groups was found to be higher and lower,respectively in all patients after the treatment. No tissue parameters or erythrocyte GSH-Px were different from control levels at the end of the study. Significant clinical improvement and decreased PASI scores were observed in all patients. Post treatment TSH levels were higher in all patients, but these levels were within the reference range and none had clinical hypothyroidism. CONCLUSION: These findings may provide some evidence for a potential role of increased lipid peroxidation and decreased antioxidant activity in psoriasis. PTU may be considered as treatment model in psoriasis, in particular for resistant cases, because of its antioxidant potential, and also antiproliferative and immunomodulatory effects.

Adolescent↗

PubMed2004

Linear psoriasis with porokeratotic eccrine ostial and dermal duct nevus.

Linear psoriasis is an uncommon form of psoriasis characterized by the linear distribution of the psoriatic lesions. It usually follows the lines of Blaschko with unilateral involvement. Poro keratotic eccrine ostial and dermal duct (PEODD) nevus is another rare dermatosis that follows Blaschko's line. The pathogenesis of linear psoriasis and PEODD nevus is unclear, but both could be best explained by a specific somatic mutation. Hence, it has been suggested that the mutation responsible for PEODD nevus would constitute a rare but critical psoriasis gene. In the literature, 1 case of linear psoriasis with PEODD nevus was reported, which may support this suggestion. This article describes another case of linear psoriasis and PEODD nevus. A 7-year-old boy had a 4-month history of multiple psoriasiform plaques, arranged in linear distribution, and had congenital linear hyperkeratotic papules and pits on the right side of his trunk and right arm.

Child↗

PubMed1985

Psoriasis and susceptibility to nonmelanoma skin cancer.

Using data from a national skin cancer survey, we assessed the risk of basal cell and squamous cell carcinoma among patients with psoriasis compared with the general population. For both male and female psoriatic patients, the risk of basal cell carcinoma was significantly elevated (relative risk = 2.2 and 1.7; p less than 0.05, both comparisons). The risk of squamous cell carcinoma was not significantly or substantially different for persons with a history of psoriasis compared with other persons (relative risk = 1.3; p greater than 0.05). The relative risk of basal cell skin cancer among patients with psoriasis was significantly higher even after stratification for factors associated with both psoriasis and cutaneous malignancy, which include fair complexion, exposure to coal tar or pitch, and exposure to radiation. Contrary to long-standing beliefs, our findings support the hypothesis that even after allowing for possible greater exposures to cutaneous carcinogens, the risk of nonmelanoma skin cancer in patients with psoriasis is at least as great as in the general population. Thus persons with psoriasis who are treated with potential carcinogens such as ultraviolet radiation, tar, and oral methoxsalen photochemotherapy merit careful, long-term monitoring.

Adult↗

PubMed1987

Treatment of resistant severe psoriasis with systemic cyclosporine.

Four patients with severe psoriasis have been treated with oral cyclosporine for 6 months. Two had generalized erythroderma and two had extensive plaque-type psoriasis; all had either become unresponsive to or were unable to use other accepted treatments. All four patients responded rapidly and were completely clear of psoriasis within 3 weeks of beginning therapy. Initial doses ranged from 7.5 to 8.5 mg/kg/day. Mild reversible nephrotoxicity occurred in the one patient whose cyclosporine trough level briefly exceeded 200 ng/ml. Cyclosporine may offer an alternative therapeutic modality in the management of erythrodermic or severe resistant plaque-type psoriasis. The effectiveness of cyclosporine in psoriasis underscores the putative role of cell-mediated immune factors in the pathogenesis of psoriasis.

Administration, Oral↗

PubMed1996

Effects of psychologic intervention on psoriasis: a preliminary report.

BACKGROUND: Case reports have indicated that psychologic treatments may have a beneficial effect on psoriasis activity. OBJECTIVE: Our purpose was to further investigate the hypothesis that psychologic intervention has a beneficial effect on psoriasis activity in a blinded, controlled manner. METHODS: Fifty-one patients with psoriasis vulgaris were randomly assigned to a treatment or a control group. Patients in the treatment group participated in seven individual psychotherapy sessions in 12 weeks. Intervention techniques included stress management, guided imagery, and relaxation. The Psoriasis Area Severity Index (PASI), Total Sign Score (TSS), and Laser Doppler Skin Blood Flow (LDBF) of a selected reference plaque was measured in a blinded fashion at baseline (week 0), week 4, week 8, and after treatment (week 12). RESULTS: Slight, but significant, changes in TSS and LDBF were found in the treatment group but not in the control group. When analyses were performed for both groups separately, the treatment group displayed significant reductions for all three psoriasis activity measures, whereas no changes were seen in the control group. CONCLUSION: Our preliminary results suggest that psychologic intervention may have a moderate beneficial effect on psoriasis activity.

Adult↗

PubMed1997

Ranitidine does not affect psoriasis: a multicenter, double-blind, placebo-controlled study.

BACKGROUND: Data from open studies suggest that ranitidine has a beneficial effect on psoriasis and is well tolerated. OBJECTIVE: Our purpose was to determine the effectiveness of ranitidine in a 24-week, multicenter, double-blind, placebo-controlled, dose-comparing study of 201 patients with psoriasis. METHODS: Patients with moderate to severe psoriasis who had stopped systemic antipsoriatic therapy, including PUVA and UVB, for at least 10 weeks were included. After a washout period of 2 weeks, patients were randomly allocated to use either ranitidine, 150 mg twice a day; ranitidine, 300 mg twice a day; or placebo for up to 24 weeks. Assessment with the Psoriasis Area and Severity Index was performed at weeks 3, 6, 9, 12, 18, and 24 after randomization. Reduction of the Psoriasis Area and Severity Index score by 70% at the completion of the study was considered a treatment success. RESULTS: The success rates at week 24 in the 300 mg, 600 mg, and placebo groups were 11%, 5%, and 12%, respectively. No significant differences were observed between the three treatment groups at any stage of the study. CONCLUSION: This study provides strong evidence that ranitidine does not affect the skin disease in patients with psoriasis.

Adult↗

PubMed1999

A randomized comparison of narrow-band TL-01 phototherapy and PUVA photochemotherapy for psoriasis.

BACKGROUND: Although PUVA treatment of psoriasis is more effective than conventional or broad-band UVB phototherapy, two small studies have suggested that narrow-band or TL-01 phototherapy may have a therapeutic effect equal to PUVA. If confirmed, this would be of considerable importance as TL-01 therapy is likely to be considerably safer in the long term than PUVA. OBJECTIVE: The purpose of this study was to compare PUVA with narrow-band (TL-01) phototherapy in psoriasis. METHODS: We studied 100 patients with plaque-type psoriasis who were randomly allocated to twice-weekly treatment with PUVA or narrow-band UVB. RESULTS: Clearance of psoriasis was achieved in a significantly greater proportion of patients treated with PUVA (84%) than with TL-01 (63%) (P =.018), and with significantly fewer treatments (median number of treatments for clearance with PUVA, 16.7; with TL-01, 25.3; P =.001). Only 12% of those treated with TL-01 were clear of psoriasis 6 months after finishing treatment compared with 35% for PUVA (P =.002). CONCLUSION: When given twice weekly, PUVA is more effective for psoriasis than narrow-band UVB phototherapy.

Adult↗

PubMed2003

Selenium status in psoriasis and its relations to the duration and severity of the disease.

OBJECTIVE: We examined the role of selenium (Se) status in psoriasis and its relation to the severity and duration of the disease. METHODS: The study was conducted among 30 patients with psoriasis of less than 10 mo duration (study group 1, sg 1) and 30 with psoriasis of more than 3 y duration (study group 2, sg 2). Control groups (cg) consisted of 30 patients with short periods of skin disorders other than psoriasis and 24 healthy volunteers (cg 1 and cg 2, respectively). Plasma Se concentration and glutathione peroxidase (GSH-Px) activity in plasma and erythrocytes were measured to determine Se status. RESULTS: Plasma Se (microg/L) levels were 47.11 +/- 11.61 in sg 1, 38.69 +/- 13.22 in sg 2, 43.53 +/- 11.73 in cg 1, and 48.71 +/- 9.39 in cg 2; plasma GSH-Px (U/mL) levels, were 0.15 +/- 0.04, 0.14 +/- 0.04, 0.16 +/- 0.04, and 0.18 +/- 0.03, respectively; and erythrocyte GSH-Px (U/g of hemoglobin) levels were 13.97 +/- 4.27, 13.16 +/- 3.85, 14.25 +/- 3.84, and 14.35 +/- 3.35, respectively. Erythrocyte GSH-Px correlated inversely to severity of psoriasis in sg 2 (r = -0.37, P < 0.05). CONCLUSION: Se status is depressed and related to the severity of the disease only in patients with psoriasis lasting more than 3 y.

Adolescent↗