Cases reported "Psoriasis"

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11/40. arthritis in patients with psoriasis treated with gamma-interferon.

    We observed 3 patients with psoriasis who developed arthritis during treatment of psoriatic skin disease with intramuscular recombinant human gamma-interferon (IFN-gamma). Symptoms primarily involved the hands, feet, shoulders, and neck. One patient had acute plantar fasciitis. Routine laboratory studies were unrevealing. patients presented with symptoms initially between the 10th and 12th weeks of treatment and the arthritis resolved after cessation of IFN-gamma. One patient was subsequently retreated with IFN-gamma for 4 weeks and had a temporary recurrence of arthritis with an associated rise and fall of his articular index.
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keywords = skin disease
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12/40. Bullous pemphigoid in a patient with psoriasis and possible drug reaction: a case report.

    Bullous pemphigoid, first described in 1953 by Lever, is the most common autoimmune blistering skin disease. As such,this disorder may be encountered relatively frequently in the dermatologist's office, though it is a rarity on the inpatient medicine wards. Lesions develop when autoantibodies are directed against glycoproteins BPAG1 and BPAG2, hemidesmosomes that are embedded in the epidermal basement membrane. The immune complex triggers a complement cascade that activates neutrophils and eosinophils, resulting in the release of proteolytic enzymes. As a result, subepidermal bullae develop; the diagnosis is confirmed by histological examination of skin biopsy. The case of bullous pemphigoid described here presented the treating team with some diagnostic challenges because of the patient's concomitant history of psoriasis and apparent dermatologic reaction to cephalexin. Though the patient's skin lesions resolved rapidly with appropriate treatment, the case generated many questions about the diagnosis and most effective management of bullous pemphigoid.
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keywords = skin disease
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13/40. Pustular psoriasis and the Kobner phenomenon caused by allergic contact dermatitis from zinc pyrithione-containing shampoo.

    zinc pyrithione is a shampoo ingredient that has been shown to be safe and effective for dandruff and scalp psoriasis. It is thought to decrease the cell turnover rate in hyperproliferative dermatoses such as psoriasis, and also has fungistatic and antimicrobial activity, although its exact mode of action is unknown. In psoriasis, external factors, such as trauma, infection and drugs, may provoke aggravated manifestations of psoriatic skin lesions. Rarely, irritant or allergic mechanisms are likely causes of psoriatic flare and Kobnerization. A patient had had stable psoriasis for 25 years and no any other skin disease. Within 20 days, she developed an aggravated scaly erythematous patch on the scalp, where a shampoo had been applied, and simultaneously developed pustular psoriasis on both forearms. Patch testing showed a relevant sensitization to zinc pyrithione, and we observed symptomatic aggravation by provocation testing with zinc pyrithione shampoo. We report a rare case of psoriasis aggravated by the induction of allergic contact dermatitis from zinc pyrithione after using antidandruff shampoo.
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keywords = skin disease
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14/40. psoriasis of the dorsal surface of the tongue.

    psoriasis is primarily an inherited inflammatory skin disease, it is characterized by erythemato-squamous lesions that usually involve elbows, knees and the scalp. oral manifestations are rare in psoriasis, infact, oral psoriasis involves 2% of psoriatic patients and usually it is observed with the onset of cutaneous lesions and progresses with them. Differential diagnosis should be done for Reiter's syndrome, leukoplakia and geographic tongue. The authors describe a case of tongue psoriasis without cutaneous lesions.
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keywords = skin disease
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15/40. Sustained effects of low dose infliximab in combination with methotrexate in the management of chronic recalcitrant psoriasis.

    psoriasis is a chronic inflammatory skin disease whose pathogenesis is modulated by numerous genetic and immunologic factors. During the last decade, our understanding of the pathophysiology of psoriasis has significantly improved, and the disease is now accepted as a T-cell mediated process. This concept has dramatically altered the approach to the treatment of psoriasis. tumor necrosis factor-alpha (TNF-alpha) is one of the key chemokines in the pathophysiology of psoriasis and its expression is notably increased in psoriatic plaques. Infliximab is a chimeric anti-TNF-alpha monoclonal antibody that binds to both transmembrane and soluble TNF-alpha with high affinity, specificity, and avidity. Presented here is a severe recalcitrant case of psoriasis with sustained benefit from low-dose infliximab in combination with methotrexate.
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keywords = skin disease
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16/40. Remission of psoriasis after open gastric bypass.

    psoriasis is a frequent skin disease, affecting 2% of the world's population. Stress, alcohol, smoking and obesity may be associated with psoriasis. A 56-year-old man with BMI 46.9 kg/m(2), hypertension and gastroesophageal reflux, had severe psoriasis for the last 39 years, without any remission on multiple treatments. Psoriatic papules and plaques were noted on his face, dorsum of hands, buttocks, knees, and elbows. He underwent open Roux-en-Y gastric bypass. At 4-month follow-up, the patient had lost 23 kg or 34.8% of excess weight, and presented complete remission of the psoriasis without medications. bariatric surgery for positive metabolic, psychological and lifestyle consequences should be considered a treatment of psoriasis. Long-term observation is necessary.
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keywords = skin disease
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17/40. Lymphocytapheresis in the treatment of psoriasis vulgaris.

    psoriasis is a common autoimmune chronic inflammatory skin disease that affects approximately 2% of the world's population; fundamental for its immunopathogenic mechanism is secretion of type 1 (Th1) cytokines by T cells and their activation. Since cytapheresis has been widely applied to autoimmune disorders, emphasizing the recently reported results of granulocyte and monocyte adsorption apheresis in psoriasis, a small series of psoriasis vulgaris (PV) patients underwent lymphocytapheresis (LCA) with the aim to remove lymphocytes. Five patients were submitted to weekly LCA. The severity of the disease had been evaluated through psoriasis area and severity index (PASI) score before LCA and one week after the last apheresis. PASI score before: patient A: 66; patient B: 33; patient C: 50; patient D: 56; patient E: 29. All the patients showed improvement of skin lesions. PASI score after LCA: patient A: 24; patient B: 8; patient C: 5; patient D: 36; patient E: 2.1. No side effects linked to apheresis were reported. LCA seems to produce interesting results in PV, and PASI improvement related to apheresis is clinically significant. Further studies to address its mechanism of action and potential long-term side effects are needed. It could become a valuable therapeutic alternative or a complementary tool, which might even be used to reduce the dosages of conventional pharmacological therapies adopted for this chronic disease.
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keywords = skin disease
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18/40. Cutaneous psoriasis in a military flight surgeon.

    Cutaneous psoriasis is a common, non-infectious, hyperproliferative, papulosquamous, inflammatory skin disease whose pathogenesis is unknown. The course of psoriasis is typically chronic and unpredictable. psoriasis can range from a small, local pathological area of skin to widespread dermatologic disease, such as generalized pustular psoriasis and erythroderma. Symptoms can range from mildly symptomatic to life threatening. Complications can range from psychological problems to systemic medical disease, such as psoriatic arthritis and inflammatory bowel disease. Treatment options can have adverse side effects which negatively affect multiple organ systems such as the hematological, neurological, and immunological systems. Therefore, psoriasis is a dermatologic disease that should be taken seriously in military aviation. The disease, its complications, and its therapies can interfere with concentration, mission accomplishment, the ability to operate aircraft safely, and compliance with safety equipment use. In this case report, we present the case of a naval flight surgeon who presented with inverse psoriasis and plaque psoriasis, which ultimately became well controlled with topical medications. The flight surgeon was recommended for military aeromedical waivers for psoriasis and chronic medication use. We also review the medical literature on cutaneous psoriasis, discuss its complications, and review its aeromedical implications in military aviation.
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keywords = skin disease
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19/40. vitamin d-mediated hypercalcemia in slack skin disease: evidence for involvement of extrarenal 25-hydroxyvitamin D 1alpha-hydroxylase.

    A case of granulomatous slack skin disease is presented in which we studied the possible involvement of extrarenal 1,25(OH)2D in the pathogenesis of the patient's hypercalcemia. Immunolocalization of 1alpha-OH in skin showed simultaneous dysregulation in epithelial and granulomatous cells. INTRODUCTION: granuloma-forming diseases such as sarcoidosis are associated with extrarenal synthesis of active 1,25-dihydroxyvitamin D [1,25(OH)2D]. Here we describe a case of granulomatous slack skin disease in which we have studied the possible involvement of extrarenal synthesis of 1,25(OH)2D in the pathogenesis of the patient's hypercalcemia. The aim of the study was to clarify the etiology of hypercalcemia in this patient. MATERIALS AND methods: This was a case study of a 19-year-old man with a T-cell lymphoproliferative disorder diagnosed as granulomatous slack skin disease who presented with hypercalcemia and raised serum 1,25(OH)2D. Analysis of expression of the enzyme 25-hydroxyvitamin D 1alpha-hydroxylase (1alpha-hydroxylase), which catalyzes synthesis of 1,25(OH)2D, was carried out by immunohistochemical analysis of involved and uninvolved skin. Approval was granted by the Mayo Foundation Institutional review Board and Biospecimens Subcommittee. RESULTS: In uninvolved skin, expression of 1alpha-hydroxylase was confined to the basal layer of the epidermis, whereas slack skin showed overexpression of the enzyme in dermal granulomata and basal cells of the epidermis. CONCLUSIONS: hypercalcemia associated with granulomatous slack skin syndrome seems to be caused by dysregulation of 1alpha-hydroxylase expression in both epidermal and dermal granulomatous cells. This contrasts with psoriasis and sarcoidosis of the skin, in which overexpression of the enzyme is restricted to keratinocytes and granulomata, respectively.
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ranking = 7
keywords = skin disease
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20/40. Successful treatment of pediatric psoriasis with Indigo naturalis composite ointment.

    The treatment of psoriasis in children is still an intractable problem and demands a long-term therapy with prolonged efficacy that is free from serious adverse events. Many modes of therapy are currently in use but the disease is often resistant to treatment owing to the unacceptable toxicity that leads to poor compliance. Therefore, to develop an alternative treatment is indispensable. Traditional Chinese medicine has been documented for over 1000 years to provide various effective treatments for inflammatory skin diseases. Herein, we report an 8-year-old boy with recalcitrant pediatric psoriasis who, after multiple treatment failures with conventional antipsoriatic medications, showed remarkable clinical improvement with 8 weeks of topical treatment with Indigo naturalis composite ointment. Remission has lasted for over 2 years until now. Our patient's response suggests that topical Indigo naturalis composite ointment may provide a safe and effective alternative treatment for pediatric psoriasis.
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keywords = skin disease
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