Cases reported "Psoriasis"

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1/5. Systemic toxicity following administration of sirolimus (formerly rapamycin) for psoriasis: association of capillary leak syndrome with apoptosis of lesional lymphocytes.

    BACKGROUND: sirolimus (formerly rapamycin) is an immunosuppressive agent that interferes with T-cell activation. After 2 individuals with psoriasis developed a capillary leak syndrome following treatment with oral sirolimus lesional skin cells and activated peripheral blood cells were analyzed for induction of apoptosis. OBSERVATIONS: A keratome skin specimen from 1 patient with sirolimus-induced capillary leak syndrome had a 2.3-fold increase in percentage of apoptotic cells (to 48%) compared with an unaffected sirolimus-treated patient with psoriasis (21%). Activated peripheral blood T cells from patients with psoriasis tended to exhibit greater spontaneous or dexamethasone-induced apoptosis than did normal T cells, particularly in the presence of sirolimus. CONCLUSIONS: Severe adverse effects of sirolimus include fever, anemia, and capillary leak syndrome. These symptoms may be the result of drug-induced apoptosis of lesional leukocytes, especially activated T lymphocytes, and possibly release of inflammatory mediators. Because patients with severe psoriasis may develop capillary leak from various systemic therapies, clinical monitoring is advisable for patients with inflammatory diseases who are treated with immune modulators.
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ranking = 1
keywords = apoptosis
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2/5. Histopathology of psoriasis treated with zinc pyrithione.

    psoriasis is still a relatively poorly understood inflammatory dermatosis that is resistant to many therapies. Because the pathogenesis is poorly understood, rational treatment is elusive. Until recently, the North American public was able to achieve successful resolution with an over-the-counter topical preparation marketed for dandruff and seborrheic dermatitis called SkinCap, which has now been withdrawn from the market. The purpose of this study was to examine the histologic changes induced by this preparation in a well-developed psoriatic plaque. Serial punch biopsies were taken over a 2-week period during which time SkinCap was applied topically twice daily. The biopsies were examined histologically, and features were evaluated semiquantitatively. The classic histologic features of psoriasis resolved completely over 2 weeks, with the reversal beginning with disappearance of neutrophils and the most striking finding being prominent apoptosis at 48 hours. The mechanism of this normalization is unknown. Hypotheses include blockage of cytokine and growth factor effect at some level and induction of apoptosis.
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ranking = 0.28571428571429
keywords = apoptosis
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3/5. Treatment of palmoplantar psoriasis with intramuscular alefacept.

    Alefacept is a dimeric fusion protein that consists of the extracellular CD2-binding portion of human lymphocyte function-associated antigen-3, which is linked to the Fc segment of human IgG1. Alefacept inhibits T-cell activation and proliferation, and induces apoptosis of memory-effector (CD45RO ) T cells in vitro, limiting the inflammatory and uncontrolled keratinocyte proliferation seen in psoriatic lesions. Alefacept is the first biologic approved in the united states for the treatment of moderate to severe chronic plaque psoriasis. This report describes the use of alefacept in 2 patients with extensive and recalcitrant palmoplantar psoriasis who achieved significant improvements on alefacept therapy.
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ranking = 0.14285714285714
keywords = apoptosis
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4/5. Induction of lesional and circulating leukocyte apoptosis by infliximab in a patient with moderate to severe psoriasis.

    Infliximab demonstrates high efficacy in treating psoriasis in a high proportion of patients. In this report we demonstrate induction of plaque (T cells, dendritic cells) and peripheral blood (T cells, monocytes) leukocyte apoptosis following a single infliximab infusion in a psoriasis patient.
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ranking = 0.71428571428571
keywords = apoptosis
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5/5. Cutaneous pathobiology mediated by chemotherapy.

    A histopathologic study of side effects of chemotherapy on normal skin was made by light microscopy and radioautography after incorporation of tritiated thymidine. Two psoriatic patients were studied after methotrexate treatment and one after polychemotherapy for an osteosarcoma 2--5 days after administration of methotrexate. Four biological effects can occur: cellular death, recruitment of cells from a resting phase into the cell cycle of proliferation, synchronization of cells in that cycle and blockage of cells in specific phases. Sub-lethal signs and necrosis were recognized in the epidermis as vacuolar alterations, cytoplasmic inclusions, swelling of keratinocytes, apoptosis and dyskeratosis. Bullae resulted from epidermal necrolysis. The labelling index of normal looking keratinocytes was very high. Within capillaries, plump and hyperchromatic endothelial cells were increased in number, as was their labelling index. fibroblasts and cells of the eccrine glands were also labelled in number. The number of labelled nuclei within these cell lines reflects the recruitment and synchronization in the cell cycle and the blockage in s phase.
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ranking = 0.14285714285714
keywords = apoptosis
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