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Psoriasis

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15301. Family-based analysis using a dense single-nucleotide polymorphism-based map defines genetic variation at PSORS1, the major psoriasis-susceptibility locus. Full Text available with Trip Pro

Family-based analysis using a dense single-nucleotide polymorphism-based map defines genetic variation at PSORS1, the major psoriasis-susceptibility locus. Psoriasis is a common skin disorder of multifactorial origin. Genomewide scans for disease susceptibility have repeatedly demonstrated the existence of a major locus, PSORS1 (psoriasis susceptibility 1), contained within the major histocompatibility complex (MHC), on chromosome 6p21. Subsequent refinement studies have highlighted linkage (...) disequilibrium (LD) with psoriasis, along a 150-kb segment that includes at least three candidate genes (encoding human leukocyte antigen-C [HLA-C], alpha-helix-coiled-coil-rod homologue, and corneodesmosin), each of which has been shown to harbor disease-associated alleles. However, the boundaries of the minimal PSORS1 region remain poorly defined. Moreover, interpretations of allelic association with psoriasis are compounded by limited insight of LD conservation within MHC class I interval. To address

2002 American Journal of Human Genetics

15302. The International Psoriasis Genetics Study: assessing linkage to 14 candidate susceptibility loci in a cohort of 942 affected sib pairs. Full Text available with Trip Pro

The International Psoriasis Genetics Study: assessing linkage to 14 candidate susceptibility loci in a cohort of 942 affected sib pairs. In an effort to confirm previously reported linkages to psoriasis, we analyzed 942 affected sibling pairs (ASPs) from 710 pedigrees for 53 polymorphic microsatellites spanning 14 psoriasis candidate regions at an intermarker spacing of approximately 5 cM. Maximum LOD score (MLS) analysis of ASPs yielded allele sharing of 60% for markers within the major (...) histocompatibility complex (MHC) (P=2 x 10(-14)), which yielded a gene-specific lambda(s) of 1.6. Across the remainder of the genome, the strongest evidence of allele sharing was obtained on chromosomes 16q (D16S3032; MLS=1.3; P=.007) and 10q22-q23 (D10S2327; MLS=1.1; P=.012). None of the remaining loci exceeded MLS=0.9, the value expected to occur by chance once in this study. In agreement with previous studies, strong linkage disequilibrium was also observed between psoriasis and the MHC (pedigree

2003 American Journal of Human Genetics

15303. Increased serum cutaneous T cell-attracting chemokine (CCL27) levels in patients with atopic dermatitis and psoriasis vulgaris. (Abstract)

Increased serum cutaneous T cell-attracting chemokine (CCL27) levels in patients with atopic dermatitis and psoriasis vulgaris. Both atopic dermatitis (AD) and psoriasis vulgaris (PsV) are characterized as chronic and relapsing inflammatory skin diseases associated with various immunologic abnormalities. Cutaneous T cell-attracting chemokine (CTACK; CCL27) is a member of the CC chemokine family and a functional ligand for CC chemokine receptor 10. It is selectively expressed in skin (...) significantly higher than those in healthy control subjects. The serum CTACK levels in patients with AD significantly correlated with scoring atopic dermatitis (SCORAD) scores, serum soluble IL-2 receptor levels, serum soluble E-selectin levels, serum thymus and activation-regulated chemokine levels, and serum macrophage-derived chemokine levels. Serum CTACK levels in patients with PsV significantly correlated with the serum IP-10 levels but not with the Psoriasis Area and Severity Index score

2003 Journal of Allergy and Clinical Immunology

15304. Distinct patterns of gene expression in the skin lesions of atopic dermatitis and psoriasis: a gene microarray analysis. (Abstract)

Distinct patterns of gene expression in the skin lesions of atopic dermatitis and psoriasis: a gene microarray analysis. Atopic dermatitis (AD) and psoriasis are the two most common chronic inflammatory skin diseases. Both of these diseases have distinct clinical findings and specific inflammatory cell infiltrates. Previous reports have focused individually on one or two genes or gene products in the lesions of both skin diseases. However, they have not captured the complex gene expression (...) that must occur to induce specific cellular infiltrates in the skin lesions of these two diseases. DNA microarray studies allow the simultaneous comparison of thousands of messenger RNAs that may identify the disease-specific pattern of tissue inflammatory responses.To compare the complex gene expression pattern of AD versus psoriasis skin lesions.RNA was extracted from skin biopsy specimens of 6 patients with AD and 7 patients with psoriasis and analyzed with the use of Hu-U95Av.GeneChip microarrays

2003 Journal of Allergy and Clinical Immunology

15305. Systemic therapies for psoriasis: understanding current and newly emerging therapies. (Abstract)

Systemic therapies for psoriasis: understanding current and newly emerging therapies. The treatment of moderate to severe psoriasis is a rapidly expanding area. Recent insights into the pathogenesis of this disease as a T-cell mediated process has led to a greater understanding of the mechanisms of action of conventional FDA-approved systemic therapies such as methotrexate, cyclosporine, acitretin, and psoralen with ultraviolet A phototherapy. It has also led to the development of rationally

2003 Seminars in Cutaneous Medicine and Surgery

15306. Spontaneous clearance of psoriasis during the course of Kikuchi-Fujimoto disease. (Abstract)

Spontaneous clearance of psoriasis during the course of Kikuchi-Fujimoto disease. A 23-year-old woman had psoriasis vulgaris since childhood. She noted painless enlargement of several lymph nodes in the cervical region accompanied by fever and malaise. A biopsy specimen from a cervical lymph node revealed histiocytic necrotizing lymphadenitis without granulocyte infiltration (Kikuchi-Fujimoto disease), a rare and benign lymphadenopathy of unknown cause. During the course of the Kikuchi-Fujimoto

2002 Journal of American Academy of Dermatology

15307. Clinical and histologic response to single-dose treatment of moderate to severe psoriasis with an anti-CD80 monoclonal antibody. (Abstract)

Clinical and histologic response to single-dose treatment of moderate to severe psoriasis with an anti-CD80 monoclonal antibody. Pathologic T-cell activation is implicated in psoriasis progression. CD80, a costimulatory molecule involved in T-cell activation, likely plays a key role. IDEC-114, an IgG(1) anti-CD80 antibody, was evaluated for safety, pharmacokinetics, and preliminary clinical activity in this open-label, single-dose, dose-escalating study in patients with moderate to severe (...) chronic plaque psoriasis. Twenty-four patients received IDEC-114 (0.05 mg/kg, 0.25 mg/kg, 1 mg/kg, 5 mg/kg, 10 mg/kg, or 15 mg/kg). Psoriasis Area and Severity Index, Physician's Global Psoriasis Assessment, and Psoriasis Severity Scale scores improved in the highest-dose groups. Average plaque thickness and plaque CD3+ and CD8+ T-cell counts decreased in the 10 mg/kg dose group. Adverse events were primarily mild, transient, constitutional symptoms; the most common related events were mild asthenia

2002 Journal of American Academy of Dermatology

15308. Medium-dose 308-nm excimer laser for the treatment of psoriasis. (Abstract)

Medium-dose 308-nm excimer laser for the treatment of psoriasis. The excimer laser delivers targeted ultraviolet B 308-nm radiation.This investigation evaluated the efficacy of multiple, medium-dose excimer 308-nm laser treatments for psoriasis.Twenty volunteers with plaque psoriasis were enrolled. Six plaques received treatment 3 times per week for up to 8 weeks; another plaque served as a control. As in standard phototherapy, a flexible dose escalation scheme was implemented during the course (...) of treatment. Modified Psoriasis Area and Severity Index scores were rendered throughout the study with follow-ups at 1, 2, 4, and 6 months.Fifteen subjects completed the study without complications. The mean number of treatments to achieve >95% clearance was 10.6. The mean cumulative UV radiation dose was 6.1 J/cm(2), and the mean remission time was 3.5 months.A thrice-weekly, medium-dose irradiation schedule with the 308-nm laser can effectively clear localized plaque-type psoriasis in fewer treatments

2002 Journal of American Academy of Dermatology

15309. Quantifying the harmful effect of psoriasis on health-related quality of life. (Abstract)

Quantifying the harmful effect of psoriasis on health-related quality of life. Psoriasis affects 7 million people in the United States, causing substantial cost, social stigma, and disability.The purpose of this study was to evaluate the health effects of skin disease by comparing psoriasis to other primary medical disorders using 3 different scales of health-related quality of life.A self-administered questionnaire consisting of 3 health-related quality of life measures was given sequentially (...) to 35 eligible patients with psoriasis presenting to the Dermatology Branch of the National Cancer Institute (NCI) for an investigational therapeutic protocol.All patients (100%) agreed to participate. The median Psoriasis Area and Severity Index (PASI) score was 13.0. Overall, 82.9% at least often felt the need to hide their psoriasis, and 74.3% claimed their self-confidence was at least often affected by their psoriasis. The median EQ-5D health state utility score was 13.0% less than healthy

2002 Journal of American Academy of Dermatology

15310. Transition from methotrexate and cyclosporine to other therapies including retinoids, ultraviolet light and biologic agents in the management of patients with psoriasis. (Abstract)

Transition from methotrexate and cyclosporine to other therapies including retinoids, ultraviolet light and biologic agents in the management of patients with psoriasis. Patients with psoriasis typically face longterm therapy for their chronic disease. Often, the therapeutic agents that physicians use to treat them may become less effective or may cause safety or toxicity issues. The clinician must then decide the next therapy for his/her patient and assess benefit/risk of the next therapeutic (...) agent or combination. In moving the patient from one therapy to the next, specific characteristics of the transition must be assessed, and how to stop the existing therapy, and introduce the new agent(s). The decision making process must take into account the longterm risks to the patient. This article focuses on the transition for patients with psoriasis being managed with methotrexate and cyclosporine to retinoids, phototherapy, and newer agents.

2003 Journal of Dermatological Treatment

15311. Retrospective analysis of the treatment of psoriasis of the palms and soles. (Abstract)

Retrospective analysis of the treatment of psoriasis of the palms and soles. In this retrospective analysis, the effect of currently used treatments in 26 patients with psoriasis of the palms and soles were analyzed. In general, patients are treated initially with topical medications including superpotent topical corticosteroids in combination with calcipotriene ointment or tazarotene gel or both. If satisfactory improvement is not achieved in 4-8 weeks, systemic retinoids are added, formerly

2003 Journal of Dermatological Treatment

15312. Case studies in severe psoriasis: A clinical strategy. (Abstract)

Case studies in severe psoriasis: A clinical strategy. Individuals with moderate-to-severe psoriasis perceive that the disease exerts profound emotional, social and physical effects on their lives, and a significant percentage report that they do not consider their treatment sufficiently aggressive. A survey of individuals with a variety of chronic diseases reveals that those with psoriasis have the lowest estimation of their health-related quality of life, lower than that of patients (...) with arthritis, congestive heart failure, chronic lung disease or depression. Although psoriasis can be treated effectively, many treatments are associated with long-term risks. Toxicity-sparing treatment strategies that include combination, rotational and sequential regimens can help to control moderate-to-severe psoriasis while reducing risk. Algorithms for the treatment of moderate-to-severe psoriasis detail possible options for specific types of psoriasis and for patients with specific needs. The purpose

2003 Journal of Dermatological Treatment

15313. Erythrodermic, recalcitrant psoriasis: clinical resolution with infliximab. (Abstract)

Erythrodermic, recalcitrant psoriasis: clinical resolution with infliximab. This report describes the case of a patient with erythrodermic psoriasis who had failed all previous therapies and been hospitalized numerous times over a 12-year period that responded dramatically to treatment with infliximab. The potential utility of infliximab as a therapeutic alternative for erythrodermic psoriasis is discussed.

2003 Journal of Dermatological Treatment

15314. Successful treatment of recalcitrant psoriasis with a combination of infliximab and hydroxyurea. (Abstract)

Successful treatment of recalcitrant psoriasis with a combination of infliximab and hydroxyurea. We report the use of a combination of the tumour necrosis factor alpha (TNF alpha) inhibitor infliximab and hydroxyurea to achieve control of disabling psoriasis and psoriatic arthritis. Our patient had psoriasis that proved resistant to conventional therapy including vitamin D analogues, topical steroids, dithranol, crude coal tar, narrow band UVB, bath PUVA and acitretin. She subsequently (...) responded to hydroxyurea 1 g daily combined with infliximab infusions repeated at three monthly intervals which led to satisfactory control of her psoriasis and psoriatic arthritis. She has not reported any side-effects from this treatment regimen and her full blood count has remained normal.

2003 Journal of Dermatological Treatment

15315. Clinical course of psoriasis during pregnancy. (Abstract)

Clinical course of psoriasis during pregnancy. Since the landmark study on rheumatoid arthritis, many reports have suggested that physiological changes during pregnancy often induce remission of systemic and cutaneous inflammatory diseases. In this study we investigated the clinical course of psoriasis during pregnancy.In this retrospective study information was collected from Psoriasis Life History Questionnaires. The data obtained from 736 questionnaires were entered into a computerized (...) database. Information relevant to the clinical course of psoriasis during pregnancy was evaluated in respect to improvement/worsening, number of pregnancies, severity of the disease, and certain other clinical parameters.In a majority of the patients psoriasis improved during pregnancy. Data available from 91 pregnancies revealed: psoriasis improved in 51 (56%), worsened in 24 (26.4%), and remained unchanged in 16 (17.6%). Also, appearance of psoriasis new lesions was found to be frequent during

2003 International Journal of Dermatology

15316. Frequent use of tobacco and alcohol in Chinese psoriasis patients. (Abstract)

Frequent use of tobacco and alcohol in Chinese psoriasis patients. This study aimed to explore smoking and drinking as risk factors in psoriasis.Data collected from 789 psoriasis patients and 789 healthy controls were analyzed to determine whether there was an association between smoking/drinking and psoriasis.The proportion of male psoriasis patients using tobacco and alcohol was much higher than that of the control group (P < 10(-6)), whereas no statistical differences were found between (...) female smokers and the control group. In general, heavy smokers were more likely to have severe psoriasis.Tobacco use in patients is correlated with psoriasis.

2002 International Journal of Dermatology

15317. The genetic epidemiology of psoriasis vulgaris in Chinese Han. (Abstract)

The genetic epidemiology of psoriasis vulgaris in Chinese Han. The aim of this study was to explore the effects of genetic factors on the onset of psoriasis vulgaris and to develop a possible genetic model of psoriasis in Chinese Han.Data for 1043 patients with psoriasis vulgaris were obtained by questionnaire. Complex segregation analysis and heritability were performed using Penrose's method, Falconer's method, and the EPI INFO 6.0 and SAGE-REGTL programs.(1) For male and female patients (...) , the peak ages of initial onset were 30-39 and 10-19 years, respectively, with the mean age of initial onset being 27.69 +/- 12.32 years in males and 23.26 +/- 12.56 years in females. (2) Of 1043 patients with psoriasis, 326 (31.26%) were reported to have a family history of psoriasis. The onset for males with a family history of psoriasis was earlier than that for those without a family history (P < 0.01). The morbidities of first-degree relatives were 7.67% in patients with type I psoriasis and 5.27

2002 International Journal of Dermatology

15318. Atypical pityriasis rosea or psoriasis guttata? Early examination is the key to a correct diagnosis. (Abstract)

Atypical pityriasis rosea or psoriasis guttata? Early examination is the key to a correct diagnosis. Pityriasis rosea is a self-limited, mild, inflammatory skin disease characterized by scaly lesions, possibly due to an unidentified infectious agent. It may occur at any age, but is seen most frequently in young adults. This paper reports a patient who presented with a skin condition which was initially diagnosed as pityriasis rosea; however, due to the persistence and change in appearance (...) of the lesions, the diagnosis was later altered to psoriasis guttata. Changes in pityriasis rosea lesions over the course of the disease may make a correct diagnosis difficult, unless the patient is seen during the early stages of lesion formation. The final diagnosis in this case was of the rare variant known as pityriasis rosea irritata. This case highlights the importance of an excellent patient history in order to correctly diagnose the disease.

2002 International Journal of Dermatology

15319. Advances in the management of psoriasis: monoclonal antibody therapies. (Abstract)

Advances in the management of psoriasis: monoclonal antibody therapies. Psoriasis is a common skin disorder characterized by erythematous, scaling plaques. Until recently, therapies for this disease have been aimed at reducing keratinocyte proliferation. We have learned that psoriasis is not primarily a disorder of keratinocyte hyperproliferation, but is an inflammatory disease. This knowledge, especially our current understanding of the role of activated T cells in psoriasis, has led to new (...) therapeutic options and new areas of research. Immunosuppressive agents such as cyclosporine have proven very useful in the treatment of psoriasis, but their use is limited by toxicity. Monoclonal antibodies directed against key components of the inflammatory process have been studied in an attempt to produce safer, more selective immunosuppressive agents. This review summarizes much of the available literature describing the use of monoclonal antibodies in the treatment of psoriasis.

2002 International Journal of Dermatology

15320. Repeat courses of intravenous alefacept in patients with chronic plaque psoriasis provide consistent safety and efficacy. (Abstract)

Repeat courses of intravenous alefacept in patients with chronic plaque psoriasis provide consistent safety and efficacy. Psoriasis is a chronic, relapsing skin disease that may require multiple treatment courses. Alefacept targets the memory T cells implicated in psoriasis pathogenesis. This open-label study evaluated the safety and tolerability, efficacy, and pharmacodynamics of repeat courses of alefacept in men and women with chronic plaque psoriasis. This article reports the interim (...) regardless of the retreatment course. No opportunistic infections, rebound of disease, or flares were reported. Low titers of anti-alefacept antibodies occurred in a few patients without related safety issues. Sixty-six per cent of patients achieved a >/= 50% reduction in the Psoriasis Area and Severity Index (PASI) at any time after the first dose of retreatment course 1. Patients who received two retreatment courses (n = 50) had consistent or improved responses after the second course; 64% and 68

2003 International Journal of Dermatology

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