1,720,977 research outputs found
Calcipotriol in psoriasis vulgaris: a controlled trial comparing betamethasone dipropionate + salicylic acid
No full textCyclosporin in psoriasis: pathophysiology and experimental data
No full textCyclosporin has been used efficaciously in recent years for the management of severe psoriasis. The remarkable efficacy of this drug and its known immunosuppressive properties have indicated even more strongly the involvement of the immune system in the induction and maintenance of psoriasis. The present review summarizes the role of cellular immunity in the pathogenesis of psoriasis and possible mechanisms of action of cyclosporin in psoriasis, and describes the laboratory studies performed in our Department under two headings, changes in lesional immune infiltrate (evaluated immunohistologically) and changes in neutrophil chemotaxis during cyclosporin treatment. Our immunohistological study showed that the psoriatic plaques contained an infiltrate composed mainly of activated CD4+ T cells. Cyclosporin treatment significantly decreased T cells and normalized the distribution and antigen expression of intraepidermal Langerhans cells, increasing the number of CD1+ dendritic cells. Our studies on neutrophil chemotaxis showed that cyclosporin reduced the chemotactic activity of neutrophilic polymorphonuclear leukocytes (in vivo but not in vitro), seemingly as a consequence of blocking the production of chemoattracting cytokines by psoriatic monocytes
Cyclosporine A in psoriasis: an immunohistological study
No full textIt is certain that CsA is a very effective drug for the treatment of psoriasis and that CsA acts preferentially on T lymphocytes. It is tempting to speculate that activated T cells play a role in the pathogenesis of psoriasis. The rapid relapse of the disease after discontinuation of CsA treatment supports the idea that activated T lymphocytes are reversibly inactivated by the drug
The cost of hospital-related care of patients with psoriasis in Italy based on the AISP study
No full textThe objective of this study was to assess the cost of caring for patients with psoriasis in Italy according to the AISP study (Associazione Italiana. Studi Psoriasi or Italian Association for Studies on Psoriasis), involving 104 university and hospital centres and 7992 patients in 1994. The mean yearly cost of care for a single patient was calculated at 905 Euros. Hospitalization accounted for more than four-fifths of the costs, therapy for about one-eighth (systemic therapies were the most expensive) and office visits and day hospitals for the remainder. In our study series less than 20% of patients accounted for more than 90% of the total costs
Isotretinoin versus minocycline in cystic acne: a study of lipid metabolism
No full textWe have recently reported that patients with severe nodular cystic acne have much lower levels of HDL-cholesterol, apolipoprotein A and hepatic lipoprotein lipase than healthy controls or subjects with acne vulgaris. Since isotretinoin is very effective in the treatment of the nodular cystic acne but has been shown to increase blood lipid levels, we decided to compare its clinical effectiveness and its effects on lipid metabolism with those of minocycline in patients with nodular cystic acne. After 20 weeks, the number and mean diameter of the cysts were definitely decreased in both groups, but the improvement was more striking in the isotretinoin-treated group. At the end of the treatment, the HDL-C and hepatic lipoprotein lipase levels in this group were increased toward normal, but not in the minocycline-treated group. Our study showed a significant remission in the acne of patients treated with isotretinoin but not in that of the minocycline-treated patients. Furthermore isotretinoin can also correct the altered lipid metabolism in these patients
Nimodipine versus terfenadine in the treatment of physical stimulus-induced urticaria
No full textBasophil and mastocyte degranulation is calcium-dependent. Calcium-antagonists can inhibit synthesis of and release in vitro some mediators in various types of cells. Both immunologically stimulated and non-immunologically stimulated release of material from basophils isolated from normal and allergic subjects can be antagonized by calcium blockers. The present study was aimed at testing the therapeutic effects and side effects of nimodipine therapy, a new dihydropyridine anti-calcium derivative for physical stimulus-induced urticaria, in comparison with a standard H1-antihistamine therapy. The study was done in 32 outpatients who had physical stimulus-induced urticaria: 20 patients received nimodipine three times a day in a daily dose of 180 mg, 12 patients were treated with terfenadine in a dose of 120 mg. In the majority of patients treated with both nimodipine and terfenadine, satisfactory clinical results were obtained after 3 weeks of therapy. There were, however significant (P less than 0.05) differences in responses. Complete clearance after 3 weeks was noted in 50% patients treated with nimodipine, whereas only 16% of patients on terfenadine were completely clear, and some showed only slight improvement. The treatment was easily manageable, and with few side effects
Cyclosporine A inhibits polymorphonuclear leukocyte chemotaxis in vivo
No full textWe have examined the effects of CsA therapy on the ability of serum and neutrophils from psoriatics to stimulate chemotaxis. No statistically significant changes were detected. The discrepancy between the in vivo and the in vitro findings cannot be explained at the moment with this small sample of patients. The depression of neutrophil function observed in vivo during treatment could be a cause or a consequence of the clearing of the psoriasis. The results clearly indicate that CsA can inhibit in vivo migration of neutrophils out of the dermal capillaries. It seems likely that this is an inflammatory effect and not a modification of neutrophil function. This antiinflammatory activity may be one of the mechanisms by which CsA therapy improves psoriasis
[Erosive lichen planus of the glans penis. Treatment with cyclosporin A]
No full textAfter suffering from chronic and steroid-resistant erosive lichen planus of the glans penis for 2 years, a 42-year-old patient presented to our Institute. The clinical picture was of an erythematous and erosive lesion, superficially covered with sero-fibrinous exudations. Lichen planus was diagnosed by clinical and histological examination. Control routine serum analysis and urinalysis gave normal results, and ciclosporin A was given at a dosage of 3 mg/kg daily. After 2 weeks of therapy, significant regression of erythema and infiltration was seen, so that the patient could be circumcised as planned. After leaving our Institute the patient continued the therapy with ciclosporin A and the monthly controls of kidney and liver function had shown no abnormalities during the 6-month follow-up that had elapsed up to the time of writing
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