scholarly journals PSORIASIS VULGARIS PADA BAYI

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Shienty Gaspersz ◽  
Herry E. J. Pandaleke
Keyword(s):  
Vitamin D3 ◽  
Psoriasis Vulgaris ◽  
Age Of Onset ◽  
Severity Index ◽  
Psoriasis Area Severity Index ◽  
Normal Limits ◽  
Severity Index Score ◽  
Pasi Score ◽  
Erythematous Plaques ◽  
Topical Emollient

Abstract: Psoriasis may begin at any age but most often after puberty and only about 2% occurs in less than 2 years of age. The age of onset plays an important role because early onset psoriasis accompanied by a psoriasis family history is more severe and has a tendency to relapse. The treatment for mild psoriasis is topical and phototherapy. The first-line treatment is topical emollient, glucocorticoids, and vitamin D3 analog. We reported a case of a 3-month-old female infant presenting erythematous plaques with scales on scalp, face, neck, chest, tummy, armpit, back, buttock, and groin accompanied with irritability that had occured for a week. The Psoriasis Area Severity Index score (PASI) was 7% and laboratory examinations were within normal limits. Treatment with topical desonide 0.05% for 1 week did not result in any improvement. The treatment was changed to topical mometason furoat 0.1%. After 7 weeks of therapy, the plaques became flattened and less pigmented, and the PASI score decreased to 0.9%.Keywords: psoriasis vulgaris, infant  Abstrak: Usia awitan psoriasis bervariasi dari bayi hingga usia lanjut, namun sebagian besar timbul setelah pubertas dan hanya sekitar 2% terjadi pada usia kurang dari 2 tahun. Usia awitan perlu diketahui karena semakin dini usia awitan disertai adanya riwayat keluarga dengan psoriasis, perjalanan penyakit akan makin berat dan makin sering kambuh. Pilihan pengobatan pada psoriasis ringan (< 10%) ialah pengobatan topikal dan fototerapi. Pengobatan topikal lini pertama ialah emolien, glukokortikoid, dan analog vitamin D3. Kami melaporkan seorang bayi perempuan berusia 3 bulan yang datang dengan plak eritematosa, berbatas tegas, ukuran bervariasi, dengan skuama pada kepala, wajah, leher, dada, perut, ketiak, punggung, bokong, dan selangkangan, disertai rewel sejak 1 minggu lalu. Perhitungan Psoriasis Area Severity Index (PASI) 7%. Pemeriksan laboratorium masih dalam batas normal. Pasien diterapi dengan krim desonide 0,05%, namun setelah 1 minggu tidak terdapat perbaikan yang memuaskan, sehingga diganti dengan krim mometason furoat 0,1%. Setelah 7 minggu menggunakan mometason furoat, bercak merah yang awalnya meninggi menjadi hipopigmentasi dan mendatar serta perhitungan PASI menjadi 0,9%.Kata kunci: psoriasis vulgaris, bayi

scholarly journals Successful Certolizumab Pegol Treatment of Chronic Anterior Uveitis Associated with Psoriasis Vulgaris

2018 ◽  
Vol 9 (3) ◽  
pp. 499-503 ◽  
Author(s):  
Keiko Yamaguchi ◽  
Takaaki Hayashi ◽  
Genichiro Takahashi ◽  
Mami Momose ◽  
Akihiko Asahina ◽  
...  
Keyword(s):  
Anterior Uveitis ◽  
Psoriasis Vulgaris ◽  
Certolizumab Pegol ◽  
Severity Index ◽  
The Body ◽  
Psoriasis Area Severity Index ◽  
Necrosis Factor Alpha ◽  
Pasi Score ◽  
Factor Alpha ◽  
Grade 3

This report presents details on a 45-year-old male Japanese patient with chronic and refractory anterior uveitis associated with psoriasis vulgaris who was administered certolizumab pegol (CZP), which is an anti-tumor necrosis factor alpha (TNF-α) monoclonal antibody. Although CZP has only been formally approved for rheumatoid arthritis treatment in Japan, a clinical trial allowed us to assess CZP effectiveness in this patient. The grade 3+ anterior chamber inflammation (for both the cells and flare) observed at baseline improved to grade 0 at 3 months post-treatment. Dermatologically, the psoriasis area severity index (PASI) score was 25.4, while the body surface area (BSA) was 88% at baseline. At 3 months after treatment, the scores improved to 2.8 for PASI and less than 1% for BSA. After the treatment, remission has lasted for at least 9 months. No adverse events were seen during the CZP treatment. These findings suggest that CZP could be an effective therapeutic alternative in some refractory anterior uveitis patients with psoriasis vulgaris.

Management of Psoriasis Vulgaris with Methotrexate 0.25% in a Hydrophilic Gel: A Placebo-Controlled, Double-Blind Study

2001 ◽  
Vol 5 (4) ◽  
pp. 299-302 ◽  
Author(s):  
Tanweer A. Syed ◽  
Suhail M. Hadi ◽  
Zulfiqar A. Qureshi ◽  
Christine G. Nordstrom ◽  
Shahida M. Ali
Keyword(s):  
Psoriasis Vulgaris ◽  
Topical Therapy ◽  
Severity Index ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Plaque Type ◽  
Normal Limits ◽  
Pasi Score ◽  
Hydrophilic Gel

Background: Methotrexate has been used as one of the first and systemic therapies for psoriasis. In general, 70% of patients with psoriasis prefer topical therapy as the treatment of choice. Objective: The purpose of this placebo-controlled double-blind study was to evaluate the clinical efficacy and tolerability of methotrexate 0.25% incorporated in a hydrophilic gel (hydroxyethylcellulose 1%) to treat patients afflicted with psoriasis vulgaris. Methods: Sixty patients (37M/23F) ranging between 18 and 70 years of age, with slight to moderate chronic plaque-type psoriasis and PASI (Psoriasis Area and Severity Index) scores between 5.3 and 17.5 joined the study. The mean duration of the disease at entry was 9.6 years (range 1–24 years). The diagnosis of psoriasis was established by clinical and histopathologic methods. Patients were sequentially randomized into two parallel groups. Each patient was allocated a precoded 100-g tube (active or placebo) with instructions on how to self-administer the trial medication topically (without occlusion) to their lesions two times daily for 5 consecutive days per week. The study lasted for 12 weeks with 4 weeks of active treatment. Patients were examined on a weekly basis and those showing total clearing or remission of lesions were considered effectively treated. Results: By the end of the treatment, breaking the code disclosed that methotrexate 0.25% gel had significantly treated more patients than placebo (83.3% vs. 6.7%; p < 0.0001), reduced the PASI score to a mean of 2.2, and cleared more plaques (82.2% vs. 4.3%; p < 0.0001). Laboratory evaluations, including CBC with differential and platelet count, renal function, liver chemistry [SGOT (aspartate transaminase) and SGPT (alanine transaminase)], and serum creatinine, were within the normal limits. The treatment was well-tolerated by all the patients, with no adverse drug-related symptoms and no dropouts. The study was followed up for 12 months from the first day of the treatment; two cured patients had relapsed after 8 months. Conclusion: The findings of this study demonstrate that methotrexate 0.25% in a hydrophilic gel is well tolerated and significantly more effective than placebo as a patient-applied topical medication to treat psoriasis vulgaris.

Identifying Top Predictors of Change in Noncalcified Coronary Burden in Psoriasis by Machine Learning Over 1-Year

2021 ◽  
pp. 247553032110007
Author(s):  
Eric Munger ◽  
Amit K. Dey ◽  
Justin Rodante ◽  
Martin P. Playford ◽  
Alexander V. Sorokin ◽  
...  
Keyword(s):  
Machine Learning ◽  
Blood Pressure ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Severity Index ◽  
Blood Cell Count ◽  
Psoriasis Area Severity Index ◽  
Severity Index Score

Background: Psoriasis is associated with accelerated non-calcified coronary plaque burden (NCB) by coronary computed tomography angiography (CCTA). Machine learning (ML) algorithms have been shown to effectively identify cardiometabolic variables with NCB in cross-sectional analysis. Objective: To use ML methods to characterize important predictors of change in NCB by CCTA in psoriasis over 1-year of observation. Methods: The analysis included 182 consecutive patients with 80 available variables from the Psoriasis Atherosclerosis Cardiometabolic Initiative, a prospective, observational cohort study at baseline and 1-year using the random forest regression algorithm. NCB was assessed at baseline and 1-year from CCTA. Results: Using ML, we identified variables of high importance in the context of predicting changes in NCB. For the cohort that worsened NCB (n = 102), top baseline variables were cholesterol (total and HDL), white blood cell count, psoriasis area severity index score, and diastolic blood pressure. Top predictors of 1-year change were change in visceral adiposity, white blood cell count, total cholesterol, c-reactive protein, and absolute lymphocyte count. For the cohort that improved NCB (n = 80), the top baseline variables were HDL cholesterol related including apolipoprotein A1, basophil count, and psoriasis area severity index score, and top predictors of 1-year change were change in apoA, apoB, and systolic blood pressure. Conclusion: ML methods ranked predictors of progression and regression of NCB in psoriasis over 1 year providing strong evidence to focus on treating LDL, blood pressure, and obesity; as well as the importance of controlling cutaneous disease in psoriasis.

scholarly journals The Effect of Systemic Methotrexate and Cyclosporine Combination Therapy inPsoriasis Vulgaris Patients in Bandung, Indonesia

2021 ◽  
Vol 33 (3) ◽  
pp. 200
Author(s):  
Oki Suwarsa ◽  
Fatima Aulia Khairani ◽  
Syawalika Ulya Isneny ◽  
Erda Avriyanti ◽  
Hartati Purbo Dharmadji ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Adverse Effects ◽  
Combination Therapy ◽  
Combination Treatment ◽  
Psoriasis Vulgaris ◽  
Severity Index ◽  
Dermatology Clinic ◽  
Significant Difference ◽  
Pasi Score

Background: Methotrexate (MTX) and cyclosporine have been used as effective systemic mono-therapy for psoriasis. Several factors are considered to switch monotherapy to combination therapy because monotherapy is no longer effective and has higher side effects. Hence,clinicians have avoided systemic therapy combinations due to its toxicity. However, some studies showed that this combination therapy could be usedeffectively for psoriasis patients. Purpose: This study aimed to analyze the efficacy and adverse effects of systemic MTX and cyclosporine combination therapy in Indonesian psoriasis vulgaris patients. Methods: The retrospective study assessed the effectiveness of 3 monthsmono-therapyand combination therapy of systemic MTX and cyclosporine in psoriasisvulgaris patients from 2016–2017 in Dermatology Clinic, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia. Result: Psoriasis area and severity index (PASI) score 90 were achieved in the group MTX (50%) and cyclosporine group (50%), while none in the combination group.However, eight patients (50%) in group MTX and cyclosporine reached the primary endpoint of PASI 50. One patient in cyclosporine group had adverse effects on kidney profiles. Nonetheless, other patients had no biochemical changes. But, there was no significant difference in the change of PASI between each group (p=0.102). Conclusion: We propose that combination therapy of MTX and cyclosporine is relatively safe and efficacious in treating Indonesian psoriasis vulgaris patients. This combination treatment isas effective as MTX or cyclosporinemono-therapy.

scholarly journals Treatment of moderate to severe psoriasis with apremilast over 2 years in the context of long-term treated HIV infection: A case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984519 ◽  
Author(s):  
Misha Zarbafian ◽  
Benoit Cote ◽  
Vincent Richer
Keyword(s):  
Hiv Infection ◽  
Opportunistic Infections ◽  
Total Body Surface Area ◽  
Undetectable Viral Load ◽  
Severity Index ◽  
Severe Psoriasis ◽  
Psoriasis Area Severity Index ◽  
Quality Of Life Index ◽  
Pasi Score ◽  
Total Body

Treatment of moderate-to-severe psoriasis in patients with HIV infection is a clinical challenge. We present the case of a patient with a longstanding history of well-controlled HIV. He had failed topical management, and his hypertriglyceridemia made use of acitretin potentially unsafe. He was unable to regularly attend a phototherapy unit. Physical examination revealed 12% total body surface area involvement with a Psoriasis Area Severity Index (PASI) of 10.2. His Dermatology Quality of Life Index (DLQI) was 20. After 3 months of apremilast treatment, his PASI decreased to 4.1. After 7 months, his PASI decreased to 2.7 and his DLQI to 1. Two years later, his PASI score was 2.4, with a stable CD4 count of 1200 cells/mm3 and an undetectable viral load. There were no serious opportunistic infections or laboratory abnormalities. To our knowledge, this represents the second reported case of psoriasis treatment with apremilast in a patient with HIV.

Psoriasis: Moderne Versorgung braucht einen ganzheitlichen Ansatz

2019 ◽  
pp. 196-197
Author(s):  
Natalia Kirsten
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Mass ◽  
Body Surface ◽  
Vitamin D3 ◽  
Severity Index ◽  
Serum Concentrations ◽  
Depression Severity ◽  
Interleukin 18 ◽  
Psoriasis Area Severity Index

Objective: Psoriasis and depression may have common mechanisms, such as systemic inflammation, dysfunction of the hypothalamic-pituitary-adrenal axis, and vitamin D3 deficiency. Among men with psoriasis, this study examined whether depression severity was associated with serum concentrations of different metabolic and inflammatory markers.Methods: The study included 85 men with psoriasis (mean age ±standard deviation [SD], 47 ±14 years) and 65 men without psoriasis (mean age ±SD, 44 ±13 years). In both groups, we measured the body mass index; blood pressure; and serum concentrations of lipids, uric acid, lipase, interleukins 6 and 18, cortisol, and 25-hydroxyvitamin D3. All participants completed the Beck Depression Inventory. Other variables analyzed included psoriasis duration, the Psoriasis Area Severity Index, and the percentage of body surface area affected by psoriatic lesions.Results: Compared with controls, patients with psoriasis had significantly greater depression severity, higher body mass indices, and higher serum concentrations of total cholesterol and interleukins 6 and 18; moreover, they had significantly lower serum 25-hydroxyvitamin D3 concentrations. In patients with psoriasis, depression severity correlated positively with psoriasis duration, the Psoriasis Area Severity Index, the percentage of body surface area affected by psoriatic lesions, and interleukin-18 concentration. In patients with psoriasis, depression severity correlated negatively with 25-hydroxyvitamin D3 concentration, but it did not correlate significantly with the serum concentrations of interleukin 6 and cortisol. Conclusion: High concentrations of interleukin 18 and low concentrations of 25-hydroxyvitamin D3 may be associated with depression severity in men with psoriasis. Thus, further studies should examine whether effective anti-inflammatory treatments or vitamin D3 supplementation can improve depression outcomes in these patients.

scholarly journals A Nonimmunosuppressant Approach on Asia Psoriasis Subjects: 5-Year Followup and 11-Year Data Analysis

2012 ◽  
Vol 2012 ◽  
pp. 1-11
Author(s):  
Tony Yuqi Tang
Keyword(s):  
Severity Index ◽  
Adverse Event Reporting ◽  
Efficacy And Safety ◽  
Psoriasis Area Severity Index ◽  
Telephone Interviews ◽  
Liver Function Testing ◽  
Pasi Score ◽  
Psoriasis Lesion ◽  
Function Testing ◽  
Monthly Visit

Mono- or combine immunosuppressants are commonly used for psoriasis; however the side effect caused by potent systemic immunosuppressants frequently incurred; moreover the inflammation flares up shortly after immunosuppressants are discontinued. An alternative nonimmunosuppressive therapy was introduced to psoriasis subjects. A retrospective observational study consisted of 1583 psoriasis patients who were treated with Herose Psoria capsule 1440 mg three times daily at two clinical centres, one in China, the other in Singapore, from 1 January 2000 to 1 January 2011. Psoriasis lesion evolution was photographed at monthly visit, and efficacy and safety were assessed using psoriasis area severity index PASI score grading, renal and liver function testing, and adverse event reporting and supplemented by information obtained during targeted telephone interviews. The effectiveness of Herose on psoriasis was inversely associated to prior immunosuppressants exposure (r=0.9154), significant improvements occurred in non-immunosuppressants subjects, and complete clearance was achieved in 8 months (87.5%, 14 of 16); the wavelike evolution of psoriatic lesion appeared in prior immunosuppressants subjects.

scholarly journals Physician-reported Clinical Unmet Needs, Burden and Treatment Patterns of Paediatric Psoriasis Patients: a US and EU Real-world Evidence Study

2021 ◽  
Author(s):  
Marieke M.B. Seyger ◽  
Matthias Augustin ◽  
Michael Sticherling ◽  
Teresa Bachhuber ◽  
Juanzhi Fang ◽  
...  
Keyword(s):  
Severe Disease ◽  
Topical Therapy ◽  
Significant Proportion ◽  
Unmet Need ◽  
Severity Index ◽  
Paediatric Population ◽  
Cross Sectional Survey ◽  
Psoriasis Area Severity Index ◽  
Cross Sectional ◽  
Pasi Score

This study is a retrospective analysis using data collected from the Adelphi Paediatric Psoriasis Disease-Specific Programme cross-sectional survey. Despite being treated for their psoriasis, a substantial proportion of paediatric patients presented with moderate (18.3%) or severe (1.3%) disease at sampling; 42.9% and 92.0% had a body surface area (BSA) of >10%, and 38.8% and 100.0% had a Psoriasis Area Severity Index (PASI) score >10, respectively. Overall, 69.9% of patients had only ever been treated with a topical therapy for their psoriasis. For patients with moderate or severe disease at sampling, 16.3% and 14.4% were currently receiving conventional systemics or biologic therapy, respectively. There is a clinical unmet need in this paediatric population; a considerable percentage of patients still experienced moderate or severe disease and persistent psoriasis symptoms, with numerous body areas affected. A significant proportion of patients were undertreated, which may explain the high burden of disease observed.

Psoriasis: Wechsel der Medikamentenklasse bei Nichtansprechen?

2020 ◽  
Vol 8 (1) ◽  
pp. 16-18 ◽  
Author(s):  
Sandra Philipp
Keyword(s):  
Quality Of Life ◽  
Severity Index ◽  
Biologic Agents ◽  
Efficacy And Safety ◽  
Serious Adverse Events ◽  
Psoriasis Area Severity Index ◽  
Drug Survival ◽  
Quality Of Life Index ◽  
Pasi Score

Background: Switching between biologics is commonly performed for the management of plaque psoriasis. However, no evidence about switching from secukinumab to ustekinumab has been reported. Methods: This retrospective observational multicenter study aimed to describe efficacy and safety of ustekinumab in secukinumab nonresponder patients. Results: A total of 21 patients unresponsive to secukinumab were treated with ustekinumab for a mean period of 53.3 weeks. Ustekinumab was effective in reducing disease severity, with significant improvements of both psoriasis area severity index (PASI) and dermatology quality of life index (DLQI) scores. PASI score improvements of 31.8, 44, 77.8, 80.3, 80.5, and 89.6%, at week 4, 12, 24, 36, 48, and above 60 weeks, respectively, were detected (p<0.05), achieving PASI 50, 75, and >90 responses in 93.8, 87.5, and 50% of patients at week 48. Four patients withdrew from ustekinumab treatment because of inefficacy, and failure of multiple biologic agents (>2) seemed to affect ustekinumab drug survival. No serious adverse events (AEs) were reported while 38.1% of patients experienced mild AEs. Conclusion: Ustekinumab was safe and effective in treating patients unresponsive to secukinumab.

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