1/16. Successful treatment of severe psoriasis with basiliximab, an interleukin-2 receptor monoclonal antibody.T-cell mediated inflammation plays an important role in the aetiology of psoriasis. We describe a case of severe recalcitrant psoriasis responding well to combined cyclosporin and basiliximab (Simulect(R) Novartis Pharmaceuticals UK Ltd), an interleukin-2 receptor (IL-2R; CD25) chimeric monoclonal antibody.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/16. Etanercept for the treatment of human immunodeficiency virus-associated psoriatic arthritis.Etanercept may play an important role in modulating the inflammatory activity and progression of human immunodeficiency virus (hiv)-associated psoriasis and psoriatic arthritis. We report the case of a 45-year-old homosexual man with a CD4 cell count of less than 0.05 x 10(9)/L and an hiv viral load of 4200 copies/mL (while receiving highly active antiretroviral therapy) who developed extensive psoriatic plaques, 4.5-kg weight loss, onychodystrophy, and psoriatic arthropathy with severe periarticular bone demineralization. The arthritis progressed despite the use of several disease-modifying medications, including corticosteroids, hydroxychloroquine, and minocycline. Because of uncontrolled, progressive, and disabling arthritis and resulting profound disability, he was treated with etanercept. Within 3 weeks, his psoriasis had improved dramatically and his joint inflammation had stabilized. For the next 4 months, immunologic and viral parameters remained stable, but his clinical course was complicated by frequent polymicrobial infections. Etanercept was thus discontinued despite continued improvements in his psoriasis, psoriatic arthritis, and functional status. While both cutaneous and joint manifestations of psoriasis improved dramatically, the experience with this patient dictates that caution and careful follow-up must be exercised when prescribing etanercept in the setting of hiv infection.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
3/16. psoriasis in infancy: therapy with calcipotriene ointment.psoriasis in infancy is often more therapeutically challenging than atopic and seborrheic dermatitis. The generalized nature of psoriasis and the intensity of inflammation often reduce the efficacy of topical corticosteroids. Furthermore, involvement of intertriginous skin and the presence of scalp disease limit the potency of the topical steroids that can be prescribed. We report on an infant treated with topical calcipotriene for infantile psoriasis who experienced greater benefit than he had with standard corticosteroid medications. Laboratory testing for calcium metabolism was normal during the course of therapy. We conclude that calcipotriene can be a safe and effective therapy for psoriasis in early infancy.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
4/16. Pachydermoperiostosis and psoriatic onychopathy: an unusual association.A 33-year-old man, suffering from cutaneous psoriasis since the age of 16, in the last 6 years experienced slow and painless enlargement at his fingertips and later at his big toes, which resulted in digital clubbing. Since the age of 31, the patient also presented psoriatic nail changes involving all his fingernails, without joint pain or inflammation. The patient's family history was negative for psoriasis, however, his brother, a 29-year-old healthy man, also presented digital clubbing. The diagnosis of pachydermoperiostosis coexistent with ungual and cutaneous manifestations of psoriasis vulgaris was made. The differential diagnosis with psoriatic onycho-pachydermo-periostitis, as well as other clinical conditions that involve the distal interphalangeal joints is discussed.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
5/16. Cyclosporin A-induced gingival hyperplasia in psoriasis: review of the literature and case reports.Cyslosporin A (CyA) treatment of psoriasis is warranted in severe cases where other, conventional antipsoriatic approaches have failed. gingival hyperplasia is a rare side effect of cyclosporin A treatment in psoriasis patients. Previous studies in cyclosporin A-treated patients (mostly transplant recipients) have demonstrated correlation between cyclosporin A serum levels and oral hygiene status on the one hand, and the prevalence and severity of this overgrowth on the other hand. Severe cases of gingival overgrowth may call for radical treatments such as periodontal surgery. Our aim was to present a severe form of cyclosporin A-induced hyperplasia in two female patients and to give an overview of the current literature on the issue. High serum levels of cyclosporin A were observed in both patients. Moreover, high initial plaque accumulation was noted in both patients. Upon cessation of drug administration and a combined periodontal treatment, virtually complete reduction of the gingival enlargement and inflammation was observed. Consequently, early diagnosis and an all-inclusive treatment of cyclosporin A-induced hyperplasia can result in virtually complete remission of the symptoms and eliminate the need of aggressive treatments such as periodontal surgery.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
6/16. Inflammatory linear verrucous epidermal naevus (ILVEN) versus linear psoriasis. A clinical, histological and immunohistochemical study.Inflammatory Linear Verrucous Epidermal nevus (ILVEN) has been suggested to be a separate disease entity. However, the distinction from linear psoriasis has been discussed in the literature over recent decades. The aim of the present study was to investigate, in addition to the clinical and histological criteria, the immunohistochemical aspects of inflammation, epidermal proliferation and keratinization. From a clinical and histological point of view, ILVEN and psoriasis, according to the established criteria, have been proved to overlap. The immunohistochemical study suggests that the following procedures have an additional diagnostic impact: assessment of elastase-positive cells, assessment of keratin 16 and of keratin 10.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
7/16. Multiple pregnancy-induced remissions of psoriatic arthritis: case report.A patient experienced remission of the pain and inflammation of psoriatic arthritis during her first and second pregnancies. She achieved full remission during her third pregnancy and remained asymptomatic 15 months post partum. patients with autoimmune arthritis who become pregnant provide an in vivo model in which the role of sex hormones on immune responses can be studied.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
8/16. psoriasis and intraocular inflammation.Presented in this series were seven men and three women. Ages when seen, ranged from 32 to 68 years (average 54). psoriasis had begun in childhood in the women and in the late 20's and 30's in the men. arthritis (ankylosing spondylitis) was present in only one. Their ocular inflammations began from ages 26 to 62 (average 41). The onset of the inflammation was acute iritis in four and in indolent iridocylcitis in six. All but one were bilateral and chronic. The vitreous had heavy debris in nine of the ten patients. The retina was normal in only three. Boggy congestion was present in two with cystoid edema. Patches of edema. fluorescein leaking, depigmentation of both maculae, pars plana exudate, and retinal vessel obliteration to grey-white, shaggy cords was present in at least one of the remaining five patients. Systemic corticosteroid therapy has been used in eight of the ten patients described in this report. Doses no higher than 30 mg of prednisone per day were used to initiate reversal of the inflammatory response. In case 10, knowledge of the sensitivity of the process to steroids led to the successful rapid reversal of a recalcitrant iritis with only 20 mg of prednisone as a first dose and 20 mg per day for less than three weeks. maintenance corticosteroid therapy ranged from 40 mg of prednisone every other day in case 9, prednisone 12.5 mg one day and 5 mg the next in case 8, to 8 mg of Aristocort or methylprednisolone acetate (M-edrol) daily in cases 1 and 2. In summary, these patients are older, have an indolent onset bilateral uveitis with dense vitreous debris, retinal abnormalites, and are extremely sensitive to systemic corticosteroids. Many of these patients had undergone the series of clinical evaluations known as a "uveitis survey." Many different systemic abnormalities were found and merited treatment which rarely made a difference in their ocular disease, though two improved after infected teeth were treated. Assuming that these ocular diseases were related to psoriasis, one can then challenge the value of anything found by a "uveitis survey." The author uses information gained from such studies to insure that the patient is in the best possible heatlh and then makes clinical correlations such as presented in this paper. The rarity of this combination of ocular inflammations in patients with psoriasis makes it risky to propose that this is a significant association. Arguments that this is a disease entity began with the clinical similarities: older age, indolent onset, vitreous and retinal involvement, and the extreme sensitivity to systemic corticosteroids. None of these patients had psoriatic arthritis and only one had ankylosing spondylitis. The best explanation for the fact that this disorder has not been emphasized in the past would be an attitude of ophthalmologists and physicians that the eye and skin disease were coincident.- - - - - - - - - - ranking = 7keywords = inflammation (Clic here for more details about this article) |
9/16. pressure inhibition of the Koebner reaction by capillary occlusion.A 38-year-old male with extensive psoriasis received a linear experimental abrasion. Immediate pressure was applied for 24 hours to the central portion of the traumatized site. During a psoriatic relapse 5 weeks later, Koebnerization occurred in the abraded areas but spared the site where pressure had been previously applied. The mechanism is not known but may be due to a local suppressive effect of pressure on inflammation.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
10/16. Reactivation of phototoxicity test for psoralens plus ultraviolet A by low-dose methotrexate.Reactivation of a solar burn has been reported after administration of methotrexate for cancer and psoriasis patients. We report a case of psoriasis with a similar but delayed elicitation of phototoxic reaction by administration of low-dose methotrexate one month after psoralen and long-wave ultraviolet light (PUVA) treatment. The reactivation was seen in an already receding phototoxicity test area but not in a less phototoxic, noninterval PUVA treated area, suggesting that the reactivation by methotrexate is related with the severity of light-induced skin inflammation.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
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