1/40. Troglitazone improves psoriasis and normalizes models of proliferative skin disease: ligands for peroxisome proliferator-activated receptor-gamma inhibit keratinocyte proliferation.BACKGROUND: psoriasis is often treated with agents that activate nuclear hormone receptors for glucocorticoids, retinoids, and vitamin d. The peroxisome proliferator-activated receptor-gamma (PPARgamma) is a related nuclear hormone receptor that can be activated by its ligands, including the thiazolidinediones. OBJECTIVE: To assess whether treatment with troglitazone, a currently available thiazolidinedione used to treat diabetes mellitus, has an effect on psoriasis in normoglycemic patients and whether ligands for PPARgamma have an effect on models of psoriasis. DESIGN: Open-label administration of troglitazone in patients with psoriasis and evaluation of drug actions in cellular, organ, and transplant models of psoriasis. SETTING: University and community hospital outpatient departments and university laboratories. patients: patients with chronic, stable plaque psoriasis and control subjects. Five patients with psoriasis received troglitazone (none withdrew); 10 different untreated patients and 10 controls provided tissue samples. INTERVENTIONS: Oral troglitazone therapy at various dosages in patients with psoriasis; also, use of troglitazone, ciglitazone, and 15-deoxy-delta-12,14-prostaglandinJ2 in psoriasis models. MAIN OUTCOME MEASURES: Investigator-determined clinical results in patients and cell counts and histological evidence in models. RESULTS: All patients' psoriasis improved substantially during troglitazone therapy. Peroxisome proliferator-activated receptor-gamma was expressed in human keratinocytes; ligands for PPARgamma inhibited the proliferation of normal and psoriatic human keratinocytes in culture. Troglitazone treatment normalized the histological features of psoriatic skin in organ culture and reduced the epidermal hyperplasia of psoriasis in the severe combined immunodeficient mouse and human skin transplant model of psoriasis (P<.05 compared with untreated controls). CONCLUSIONS: Peroxisome proliferator-activated receptor-gamma might be a useful intracellular target for the treatment of psoriasis; further study is needed to assess the clinical value of ligands for PPARgamma, including troglitazone.- - - - - - - - - - ranking = 1keywords = skin disease (Clic here for more details about this article) |
2/40. Oral lesions in patients with psoriasis: clinical presentation and management.psoriasis is a chronic inflammatory skin disease that rarely involves the oral cavity. In this report we describe 2 cases, initially diagnosed with cutaneous psoriasis, that present with oral lesions on the attached gingiva. The clinical appearance and differential diagnosis are presented and discussed. Case 1 describes the non-surgical management of intraoral psoriasiform lesions and the use of a free gingival graft to restore an area of gingival recession resulting from an oral lesion. The second case outlines the use of topical corticosteroid therapy as an adjunct to non-surgical periodontal therapy. Although patients with cutaneous psoriasis rarely present with oral involvement, the clinician should be aware that oral lesions may occur. Accurate diagnosis is dependent on a thorough clinical examination, a biopsy of the oral lesions, and a history of cutaneous psoriasis.- - - - - - - - - - ranking = 0.25keywords = skin disease (Clic here for more details about this article) |
3/40. Improvement of pyoderma gangrenosum and psoriasis associated with crohn disease with anti-tumor necrosis factor alpha monoclonal antibody.BACKGROUND: Infliximab is an anti-tumor necrosis factor alpha monoclonal antibody IgG effective in the treatment and maintenance of remission of active refractory crohn disease and associated draining enterocutaneous fistulae. Multiple infusions of infliximab show promising results in patients with rheumatoid arthritis. Currently, there is limited clinical experience with infliximab, and no published reports exist on its use in cutaneous disorders. OBSERVATIONS: We describe 2 patients with crohn disease and pyoderma gangrenosum and 1 patient with crohn disease and psoriasis who were treated with infliximab for recalcitrant Crohn fistulae, with concurrent improvement in their skin diseases. CONCLUSIONS: These cases suggest that infliximab, a promising therapeutic agent for refractory crohn disease and fistulae, may also be effective in the treatment of pyoderma gangrenosum and psoriasis associated with crohn disease.- - - - - - - - - - ranking = 0.25keywords = skin disease (Clic here for more details about this article) |
4/40. skin diseases in ghana and the UK.BACKGROUND: Although diseases of the skin have been studied in some African countries, the provision of dermatology services is as yet a relatively underdeveloped aspect of medicine in sub-Saharan africa. OBJECTIVE: To determine the pattern of skin diseases seen in a sub-Saharan community and to compare it with that seen in a European community. methods: The diagnoses of the principal presenting complaint of 2254 consecutive new patients seen at the dermatology clinic of Komfo Anokye teaching Hospital (KATH), Kumasi, ghana, are presented and compared with those of 3383 consecutive new patients seen at the dermatology clinic of The William Harvey Hospital (WHH), Ashford, Kent, UK. RESULTS: The most common conditions in ghana were infections (46.3%; UK, 12%). In the UK, the most common conditions were malignant and premalignant diseases of the skin (22.2%; ghana, 0.5%) and benign tumors (16.8%; ghana, 0.5%). dermatitis was common in both countries (ghana, 18.4%; UK, 16.0%). psoriasis was more common in the UK (6.2%) than in ghana (0.4%). In ghana, fixed drug eruption, mainly due to cotrimoxazole (Septrin), was not rare (27 cases), and complications from cosmetic skin lightening creams were a frequent problem among women (86 cases). No cases of rosacea were found in ghana, but it was not uncommon in the UK (1.6%). CONCLUSIONS: The patterns of skin diseases are different in the two countries. It is hoped that this study may help to catalyze the further development of dermatology services in ghana.- - - - - - - - - - ranking = 0.5keywords = skin disease (Clic here for more details about this article) |
5/40. Turner's syndrome associated with psoriasis and alopecia areata.Turner's syndrome is a sex chromosomal abnormality characterized by gonadal failure, short stature, skeletal and medical anomalies due to structural defects or monosomy of the x chromosome. The association between this syndrome and autoimmune diseases has been reported in the literature. This case report highlights the finding of two immunological skin diseases, alopecia areata and psoriasis, in an 18-year-old girl with Turner's syndrome. By the time of her referral to the Department of dermatology, Verona University (italy) the girl had suffered from psoriasis on the scalp for 5 years and alopecia for 6 months; the diagnoses were confirmed by histological evaluation. Topical therapy was useful for the treatment of the psoriatic lesions but not for the alopecia areata. alopecia areata and psoriasis occurring together in Turner's syndrome may indicate some genetic relationship and could support the concept that these patients have the tendency to develop autoimmune or immunological diseases. anxiety, depression and unsatisfactory relationships could have been important trigger factors in our patient. Multidisciplinary management, including psychological, educational and behavioural techniques, in addition to other therapies, could be useful in treating these conditions.- - - - - - - - - - ranking = 0.25keywords = skin disease (Clic here for more details about this article) |
6/40. Hazards of steroid therapy in hepatic failure.Three patients with extensive skin disease and liver failure are described. Two were treated with large amounts of topical corticosteroids and one with a small oral dose of betamethasone. The former two patients developed Addisonian crises when they failed to apply the topical steroids and all three patients developed aseptic necrosis of bone. This report emphasizes that the hazards of steroid therapy may be increased in patients with hepatic failure.- - - - - - - - - - ranking = 0.25keywords = skin disease (Clic here for more details about this article) |
7/40. Treatment of pustular psoriasis with granulocyte and monocyte adsorption apheresis.We studied the efficacy of granulocyte and monocyte adsorption apheresis in 2 patients with pustular psoriasis, one localized, the other generalized. Treatment with granulocyte and monocyte adsorption apheresis resulted in remarkable clearing of the skin lesions, suggesting that this therapy is a valuable tool for treating patients with intractable skin diseases attributable to activated granulocytes. We present detailed descriptions of these patients and this novel therapy.- - - - - - - - - - ranking = 0.25keywords = skin disease (Clic here for more details about this article) |
8/40. psoriasis-associated periodontitis: a case report.psoriasis with oral manifestations is rarely seen. It has been reported in the past either as an oral manifestation of this skin disease or lichen planus accompanying psoriasis. Very few periodontal lesions associated with dermatologic psoriasis have been reported in the literature. This report describes a case of psoriasis in which exacerbation of the cutaneous disease was accompanied by gingival epithelial changes and periodontal bursts, together with a report on the light microscopy of biopsies from periodontal lesions.- - - - - - - - - - ranking = 0.25keywords = skin disease (Clic here for more details about this article) |
9/40. Iatrogenic hypercalcemia due to vitamin D3 ointment (1,24(OH)2D3) combined with thiazide diuretics in a case of psoriasis.Tacalcitol is a synthetic vitamin D3 analogue developed for topical treatment of inflammatory skin diseases such as psoriasis. hypercalcemia has not been previously reported during treatment with topical tacalcitol. We experienced a male patient with psoriasis and hypertension whose conditions were treated with tacalcitol ointment and thiazide, respectively, resulting in hypercalciuria and hypercalcemia. After initiation of topical vitamin D3 ointment (20 micro g/g of tacalcitol) 10 g/day for the skin lesions, both the serum level of calcium and urinary excretion of calcium increased gradually. On day 28 of the treatment, his serum calcium levels had reached 3.55 mmol/l, and his urinary calcium excretion had also increased from 0.008 g/day to 0.475 g/day. The tacalcitol treatment was terminated, seven days later, the serum calcium level had returned to the reference range without any specific treatment. The present case is the first report of hypercalcemia induced by vitamin D3 ointment and thiazide simultaneously.- - - - - - - - - - ranking = 0.25keywords = skin disease (Clic here for more details about this article) |
10/40. psoriasis remission after laparoscopic Roux-en-Y gastric bypass for morbid obesity.BACKGROUND: psoriasis is a chronic skin disease characterized by epithelial hyperplasia and an accelerated rate of epithelial turnover affecting approximately 1-3% of the population. Exogenous and endogenous factors including morbid obesity can increase the morbidity of psoriasis. CASE REPORT: A 55-year-old male, who weighed 131 kg with BMI 41 kg/m2, underwent laparoscopic Roux-en-Y gastric bypass (LRYGBP). He had a 15-year duration of severe psoriasis and was being medically treated. At 12 months after LRYGBP, he had lost 39 kg (68% EWL), and had complete resolution of the psoriasis and had discontinued all preoperative medications related to the disease. At 2 years after LRYGBP, psoriasis has not recurred. CONCLUSION: weight loss after LRYGBP should be considered as a strategy in the treatment of severe psoriasis in morbidly obese patients.- - - - - - - - - - ranking = 0.25keywords = skin disease (Clic here for more details about this article) |
| | Next -> |