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Psoriasis

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15401. A study examining inter- and intrarater reliability of three scales for measuring severity of psoriasis: Psoriasis Area and Severity Index, Physician's Global Assessment and Lattice System Physician's Global Assessment. (Abstract)

A study examining inter- and intrarater reliability of three scales for measuring severity of psoriasis: Psoriasis Area and Severity Index, Physician's Global Assessment and Lattice System Physician's Global Assessment. There is a lack of consensus as to the best way of monitoring psoriasis severity in clinical trials. The Psoriasis Area and Severity Index (PASI) is the most frequently used system and the Physician's Global Assessment (PGA) is also often used. However, both instruments have (...) some drawbacks and neither has been fully evaluated in terms of 'validity' and 'reliability' as a psoriasis rating scale. The Lattice System Physician's Global Assessment (LS-PGA) scale has recently been developed to address some disadvantages of the PASI and PGA.To evaluate the inter-rater and intrarater reliability of the PASI, PGA and LS-PGA.On the day before the study, 14 dermatologists (raters), with varied experience of assessing psoriasis, received detailed training (2.5 h) on use

2006 The British journal of dermatology Controlled trial quality: uncertain

15402. National Psoriasis Foundation consensus statement on screening for latent tuberculosis infection in patients with psoriasis treated with systemic and biologic agents. (Abstract)

National Psoriasis Foundation consensus statement on screening for latent tuberculosis infection in patients with psoriasis treated with systemic and biologic agents. Chronic immunosuppression is a known risk factor for allowing latent tuberculosis (TB) infection to transform into active TB. Immunosuppressive/immunomodulatory therapies, while highly efficacious in the treatment of psoriasis and psoriatic arthritis, may be associated with an increased rate of active TB in patients receiving some (...) of these therapies.Our aim was to arrive at a consensus on screening for latent TB infection in psoriasis patient treated with systemic and biologic agents.Reports in the literature were reviewed regarding immunosuppressive therapies and risk of TB.Screening patients for latent TB infection before commencement of treatment is of utmost importance when beginning treatment with the tumor necrosis factor-alpha inhibitors, T-cell blockers, cyclosporine, or methotrexate. The currently recommended method for screening

2008 Journal of American Academy of Dermatology

15403. FR255734, a Humanized, Fc-Silent, Anti-CD28 Antibody, Improves Psoriasis in the SCID Mouse-Psoriasis Xenograft Model. Full Text available with Trip Pro

FR255734, a Humanized, Fc-Silent, Anti-CD28 Antibody, Improves Psoriasis in the SCID Mouse-Psoriasis Xenograft Model. In psoriasis, CD28/B7 costimulatory molecules are well characterized. Here, using the severe combined immunodeficient (SCID) mouse-psoriasis xenograft model, we report therapeutic efficacy of a humanized anti-CD28 monoclonal antibody (FR255734; Astellas Pharmaceuticals Inc., Tokyo, Japan). Transplanted psoriasis plaques on the SCID mouse were treated weekly for 4 weeks

2008 Journal of Investigative Dermatology

15404. National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening. Full Text available with Trip Pro

National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening. There have been several articles and reports in recent months about comorbidities and risks that affect psoriasis patients in addition to their underlying disease. This piece reviews the current literature and begins to address what should be done with this new information by updating the clinician about what health screening tests, preventative exams, and referrals should

2008 Journal of American Academy of Dermatology

15405. Demographic and clinical correlates of extent of psoriasis during stable disease and during flares in chronic plaque psoriasis. (Abstract)

Demographic and clinical correlates of extent of psoriasis during stable disease and during flares in chronic plaque psoriasis. Following a previous population-based study, we define a common psoriatic phenotype (A) with a limited area of involvement of stable disease but extensive flares and a less common phenotype (B) with consistently widespread disease.To define these phenotypes quantitatively and to investigate any biological significance through correlations with clinical disease (...) characteristics. Psoriatic plaque thickness was also included in the analyses.Two hundred and ninety-four patients who had had chronic plaque psoriasis for at least 5 years were recruited. Area of involvement during stable disease (A(basal)) and during the most severe flare (A(max)) were derived from current area of involvement and patient history. Mean plaque thickness (T) was calculated from a current Psoriasis Area and Severity Index score.Multivariate regression of each variable on A(basal), A(max) and T

2008 British Journal of Dermatology

15406. From the Medical Board of the National Psoriasis Foundation: Monitoring and vaccinations in patients treated with biologics for psoriasis. (Abstract)

From the Medical Board of the National Psoriasis Foundation: Monitoring and vaccinations in patients treated with biologics for psoriasis. Biologics are widely used in the treatment of psoriasis and psoriatic arthritis.Our aim was to arrive at a consensus on the kind of monitoring and the vaccinations that should be performed before and during biologic therapy.Medical literature and data presented at meetings were reviewed and a consensus conference was held by members of the Medical Board (...) of the National Psoriasis Foundation.Consensus was established on monitoring and vaccination practices that included discussion and recognition of variations in those practices. History, physical examination, chemistry screen with liver function tests, complete blood cell count, and platelet count and tuberculosis testing are widely obtained at baseline and with variable frequencies thereafter. Patients treated with efalizumab have platelet counts checked more often; liver function tests are repeated more

2007 Journal of American Academy of Dermatology

15407. Observations of psoriasis in the absence of therapeutic intervention identifies two unappreciated morphologic variants, thin-plaque and thick-plaque psoriasis, and their associated phenotypes. Full Text available with Trip Pro

Observations of psoriasis in the absence of therapeutic intervention identifies two unappreciated morphologic variants, thin-plaque and thick-plaque psoriasis, and their associated phenotypes. Psoriatic plaque thickness is a clinical measure of psoriasis severity. We have observed that patients tend to revert to a baseline thickness of psoriatic plaques when in an untreated state, and hypothesized that other features of psoriasis could associate with this trait. Data prospectively collected (...) on 500 participants in the Utah Psoriasis Initiative were used for the study. In response to a question assessing plaque thickness when disease was at its worst, 144 (28.8%) reported thick plaques, 123 (24.6%) reported thin plaques, and 233 (46.6%) reported intermediate thickness. For patients with "worst-ever" disease at enrollment (n=122), there was significant correlation of thickness between assessment by the patient and the physician (r=0.448, P-value 0.01). Thick plaques associated with male

2006 Journal of Investigative Dermatology

15408. The major psoriasis susceptibility locus PSORS1 is not a risk factor for late-onset psoriasis. Full Text available with Trip Pro

The major psoriasis susceptibility locus PSORS1 is not a risk factor for late-onset psoriasis. PSORS1 is the major susceptibility locus for psoriasis vulgaris (PV) and lies within an approximately 200 kb segment of the major histocompatibility complex on chromosome 6p21.3. Alleles of candidate genes in this region including human leukocyte antigen (HLA)-C, alpha-helical coiled coil rod (HCR), and corneodesmosin (CDSN) show association with early-onset PV. Late-onset psoriasis (LOP) is defined (...) =0.013), and HCR SNP +325 (p=0.038). Patients with age of onset for psoriasis of 50 y or above provided no evidence of association with any of these alleles. These data suggest that the study cohort may include a number of subjects who harbor PSORS1 predisposition to early-onset psoriasis and yet do not present with disease by the age of 40 y. Thus this study demonstrates that PSORS1 is not a major inherited risk factor in the pathogenesis of LOP. These data suggest that the exclusion of LOP subjects

2005 Journal of Investigative Dermatology

15409. Are patients with psoriasis undertreated? Results of National Psoriasis Foundation survey. (Abstract)

Are patients with psoriasis undertreated? Results of National Psoriasis Foundation survey. We sought to assess whether patients with psoriasis with moderate or severe disease are being treated with systemic therapy.Participants were identified from a random sample of the National Psoriasis Foundation contact database who were 18 years and older, with severe psoriasis (>10% body surface area) and moderate psoriasis (3%-10% body surface area); respondents with psoriatic arthritis were excluded.In (...) all, 1657 respondents with psoriasis completed the survey (28% severe, 41% moderate). A total of 39% of respondents with severe psoriasis and 37% with moderate psoriasis were not currently receiving any treatment. Among respondents currently receiving therapy, only 43% of respondents with severe psoriasis received either traditional systemic therapy, biologic therapy, or phototherapy.Respondents were from the National Psoriasis Foundation contact database and reported their current severity, which

2007 Journal of American Academy of Dermatology

15410. Giant verrucous porokeratosis of Mibelli mimicking psoriasis in a patient with psoriasis. (Abstract)

Giant verrucous porokeratosis of Mibelli mimicking psoriasis in a patient with psoriasis. Porokeratosis of Mibelli is a disorder of epidermal keratinization characterized by annular plaques with an atrophic center surrounded by a keratotic wall. We report a case of a giant verrucous porokeratosis of Mibelli mimicking psoriasis that developed in a patient with psoriasis and therefore went unrecognized for a long time. Histologically the lesion combined features of porokeratosis at the periphery (...) and of psoriasis at its center, a picture recently described as "psoriasis encircled by porokeratosis." The possible pathogenetic relationship between psoriasis and the development of porokeratosis is also discussed.

2007 Journal of American Academy of Dermatology

15411. Elevated plasma osteopontin level is associated with occurrence of psoriasis and is an unfavorable cardiovascular risk factor in patients with psoriasis. (Abstract)

Elevated plasma osteopontin level is associated with occurrence of psoriasis and is an unfavorable cardiovascular risk factor in patients with psoriasis. The association between psoriasis and cardiovascular diseases is well documented yet the underlying mechanisms remain elusive.We sought to study the role of circulating osteopontin (OPN) in the pathogenesis of cardiovascular diseases in patients with psoriasis.Plasma samples from 40 patients with psoriasis and 37 control subjects were (...) collected for enzyme-linked immunosorbent assays. The clinical significance of OPN levels in patients with psoriasis versus control subjects was analyzed using the Mann-Whitney U test and logistic regression. DNA samples from 268 patients with psoriasis and 146 control subjects were collected for genotyping of the OPN gene.Higher body mass index values (P = .047) and hypertension (odds ratio [OR] 2.68, P = .05) were observed in patients with psoriasis. Increased plasma OPN levels (>or=62.95 ng/mL) were

2008 Journal of American Academy of Dermatology

15412. A multicenter, open-label study of repeat courses of intramuscular alefacept in combination with other psoriasis therapies in patients with chronic plaque psoriasis. (Abstract)

A multicenter, open-label study of repeat courses of intramuscular alefacept in combination with other psoriasis therapies in patients with chronic plaque psoriasis. To evaluate the safety and efficacy of multiple courses of alefacept in combination with traditional psoriasis therapy for the treatment of chronic plaque psoriasis (CPP).Patients with CPP requiring systemic therapy were eligible for this study. Patients received up to three courses of intramuscular alefacept 15 mg once weekly (...) for 12 weeks. One concomitant psoriasis therapy (topical agents, methotrexate, cyclosporine, systemic retinoids, or ultraviolet B [UVB]) per course was allowed. The extent of disease was determined using the 7-point Physician Global Assessment (PGA; scale ranging from 0 = clear to 6 = severe).More than 73% of patients improved by > or = one PGA category and > or = 44% of patients improved by > or = two PGA categories across all concomitant treatments. Clinical responses tended to be greatest

2008 Journal of Dermatological Treatment

15413. A study examining inter-rater and intrarater reliability of a novel instrument for assessment of psoriasis: the Copenhagen Psoriasis Severity Index. (Abstract)

A study examining inter-rater and intrarater reliability of a novel instrument for assessment of psoriasis: the Copenhagen Psoriasis Severity Index. There is a perceived need for a better method for clinical assessment of the severity of psoriasis vulgaris. The most frequently used system is the Psoriasis Area and Severity Index (PASI), which has significant disadvantages, including the requirement for assessment of the percentage of skin affected, an inability to separate milder cases (...) , and a lack of linearity. The Copenhagen Psoriasis Severity Index (CoPSI) is a novel approach which comprises assessment of three signs: erythema, plaque thickness and scaling, each on a four-point scale (0, none; 1, mild; 2, moderate; 3, severe), at each of 10 sites: face, scalp, upper limbs (excluding hands and wrists), hands and wrists, chest and abdomen, back, buttocks and sacral area, genitalia, lower limbs (excluding feet and ankles), feet and ankles.To evaluate the inter-rater and intrarater

2008 British Journal of Dermatology

15414. Effectiveness of climatotherapy at the Dead Sea for psoriasis vulgaris: A community-oriented study introducing the 'Beer Sheva Psoriasis Severity Score'. (Abstract)

Effectiveness of climatotherapy at the Dead Sea for psoriasis vulgaris: A community-oriented study introducing the 'Beer Sheva Psoriasis Severity Score'. Climatotherapy at the Dead Sea (CDS) is a therapeutic modality for moderate to severe psoriasis vulgaris.To evaluate the effectiveness of CDS in patients with psoriasis, using the PASI score and a novel simplified tool for the assessment of psoriasis - the Beer Sheva Psoriasis Severity Score (BPSS).A total of 70 patients with psoriasis (...) vulgaris were treated by CDS. In all patients, the severity of psoriasis was assessed before and after CDS using PASI score and BPSS. BPSS includes eight items that are recorded by the physician (total severity of the disease, and seven items relating to the physical distribution of the disease) and eight items that are recorded by the patient (total severity, physical and psychological severity, pruritus and assessment of involvement in the face, nails, palms and soles and genital regions).The study

2005 Journal of Dermatological Treatment

15415. Psoriasis herpeticum: three cases of Kaposi's varicelliform eruption in psoriasis. (Abstract)

Psoriasis herpeticum: three cases of Kaposi's varicelliform eruption in psoriasis. Kaposi's varicelliform eruption (KVE), first described in 1887 by Moritz Kaposi, refers to a disseminated cutaneous infection with herpesvirus type 1 or 2, vaccinia virus, or coxsackievirus A16 in a patient with another underlying dermatosis. When herpesvirus type 1 or 2 is the pathogenic virus, the term "eczema herpeticum" is used, independent of the underlying dermatologic diagnosis that preceded the eruption (...) with psoriasis. Erythroderma, systemic sepsis, therapy with immunosuppressant drugs, such as methotrexate and systemic steroids, and therapy with systemic retinoids may possibly increase susceptibility to KVE.

2005 Journal of American Academy of Dermatology

15416. Three retinoid X receptor gene polymorphisms in plaque psoriasis and psoriasis guttata. (Abstract)

Three retinoid X receptor gene polymorphisms in plaque psoriasis and psoriasis guttata. Polymorphisms in retinoid X receptors (RXRs) are very interesting from the point of view of a possible association of their variability with psoriasis.A total of 293 patients with plaque psoriasis, 82 patients with psoriasis guttata and 202 control subjects were enrolled in this study focused on 3 polymorphisms in RXRA and RXRB gene associations.A marginally significant increase in AA allelic frequency (...) of the RXRA A39526AA polymorphism in plaque psoriatic men compared to healthy men was proved. In women with psoriasis guttata, the higher risk for genotypes AA and TT in the RXRB 3'+140A/T polymorphism compared to healthy women was identified (p(corr) = 0.01). The genotypes A/A and AA/AA are more frequent in plaque psoriasis patients with a positive family history of psoriasis compared to the patients with a negative family history of psoriasis (p(corr) = 0.02). The A/A genotype is more frequent

2007 Dermatology

15417. A 50% reduction in the Psoriasis Area and Severity Index (PASI 50) is a clinically significant endpoint in the assessment of psoriasis. (Abstract)

A 50% reduction in the Psoriasis Area and Severity Index (PASI 50) is a clinically significant endpoint in the assessment of psoriasis. A 75% reduction in the Psoriasis Area and Severity Index (PASI) score (PASI 75) is the current benchmark of primary endpoints for most clinical trials of psoriasis. Many consider this endpoint to be too stringent as it places potentially useful therapies at risk of failing to demonstrate efficacy. We hypothesized that a 50% reduction in the PASI score (PASI 50 (...) ) represents a meaningful change in a person's life and thus is a better primary endpoint. To test this hypothesis, we analyzed PASI scores, quality of life (QoL) data, and desired re-treatment scores from a number of clinical trials in addition to studying individual elements that make up the PASI. This analysis shows (1). the PASI score is not linearly reflective of psoriasis severity (eg, a reduction in area of 95% without a change in redness, scaliness, and induration translates to only a 66% reduction

2004 Journal of American Academy of Dermatology

15418. Why is psoriasis uncommon in Africans? The influence of dietary factors on the expression of psoriasis. (Abstract)

Why is psoriasis uncommon in Africans? The influence of dietary factors on the expression of psoriasis. Psoriasis is uncommonly seen in Africans, probably partly due to genetic factors. However, the dietary habits of Africans may provide another explanation, which is explored in this paper. Maize, the staple diet in most parts of Africa, is high in linoleic acid but low in other polyunstaturated fatty acids and riboflavin. Linoleic acid is a precursor of prostaglandin E2 (PGE2) and its high (...) intake, especially in the absence of other polyunsaturated fatty acids (PUFAs) and riboflavin, results in high tissue production of PGE2. PGE2 is known to suppress cellular immunity, resulting in decreased expression of psoriasis.

2004 International Journal of Dermatology

15419. Developing a quality of life instrument in patients with psoriasis: the Psoriasis Quality of Life Questionnaire (PQLQ). (Abstract)

Developing a quality of life instrument in patients with psoriasis: the Psoriasis Quality of Life Questionnaire (PQLQ). Psoriasis is a chronic skin disease which causes psychological, social and physical problems and affects quality of life. The aim of this study was to develop a quality of life instrument for patients with psoriasis which is suitable for Islamic populations.The psychosocial and daily life problems defined by 75 patients with psoriasis, their relatives and physicians were used (...) . For convergent validity, all patients' self-ratings and Psoriasis Area and Severity Index (PASI) were correlated with the questionnaire score (P < 0.001).The questionnaire consisting of 17 items was found to be suitable for both epidemiologic and clinical trials.

2006 International Journal of Dermatology

15420. The psoriasis area and severity index is the adequate criterion to define severity in chronic plaque-type psoriasis. Full Text available with Trip Pro

The psoriasis area and severity index is the adequate criterion to define severity in chronic plaque-type psoriasis. Chronic plaque-type psoriasis is a major dermatosis, but a significant question is still unanswered: What defines severity in chronic plaque-type psoriasis? While objective assessments like the Psoriasis Area and Severity Index (PASI) have frequently been used in clinical trials, quality of life (QOL) questionnaires are currently becoming more and more popular.This article (...) summarizes the most important objective and subjective measurements of severity in psoriasis. For every dermatologist it is critically important to distinguish between severe psoriasis and psoriasis that severely affects QOL. Even if the PASI also has disadvantages, it is the most adequate instrument available to evaluate severity in plaque-type psoriasis.We provide reasons why PASI >12 defines severe, PASI 7-12 moderate and PASI <7 mild chronic plaque-type psoriasis.

2005 Dermatology

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