1,720,961 research outputs found
Videocapillaroscopic study in psoriatic patients treated with tacalcitol
No full textAim. An analysis was made of the modifications of the superficial capillary bed in a psoriatic plaque and the perilesional healthy skin during treatment with tacalcitol by means of video-capillaroscopy (VC). Methods. Twenty-four patients suffering from psoriasis vulgaris over no more than 15% of the body were studied for a period of 3 months during treatment with 4 mg/g tacalcitol ointment Once a psoriatic plaque had been selected, a visual clinical assessment was made and capillaroscopic measurements were taken with VC at the time of recruitment (TO), after 4 weeks (T1), after 8 (T2) and after 12 weeks (T3). Results. The lesions studied gradually improved and at the end of the study the psoriatic plaques had disappeared in 12 patients. Even the diameter of the "basket" type capillaries had reduced significantly (average diameter: 67.64 at the beginning of the study; 34.08 at the end of the study), but only in 4 patients did the surface capillary plexus reappear with altered capillary loops. In the apparently healthy perilesional skin, 14 patients had abnormally elongated capillary loops. At the end of treatment, only 4 patients still had altered capillary loops. Conclusion. Tacalcitol proved to be effective in reducing the clinical and capillaroscopic alterations. Nevertheless, the microcirculatory improvement does not perfectly follow the clinical improvement. We also noted that the tacalcitol action on the microcirculation is not only limited to the area of application, but also extends to the surrounding areas
Response of cutaneous microcirculation to treatment with mometasone furoate in patients with psoriasis
No full textBackground. In patients with psoriasis, videocapillaroscopy has been used to visualize the typical modifications in the microcirculatory architecture. Aim. To evaluate the modifications of the superficial capillary bed in a psoriatic plaque and healthy perilesional skin during treatment with a topical steroid. Methods. In total, 24 patients affected with psoriasis vulgaris were enrolled. Each patient was instructed to apply mometasone furoate cream 0.1% once daily to a selected psoriatic lesion for 12 weeks. At baseline (T0) and after 4 (T1), 8 (T2) and 12 (T3) weeks, clinical and capillaroscopic examination was made of the psoriatic plaque and the surrounding skin. Results. At the end of the study, the diameters of dilated and convoluted capillaries in the psoriatic plaque were significantly reduced (baseline, 69.2 mu m; after 12 weeks, 29.3 mu m; P < 0.0001) in all subjects. A marked clinical improvement was also noted (plaque score: baseline, 7.4; after 12 weeks, 0.5; P < 0.0001). The perilesional skin also showed improvement in capillaroscopic alterations, even if the drug had not been applied to those areas. Of the 24 patients, 12 were clinically healed at the end of the treatment period, although the capillaroscopic picture returned to normal in only 2 of them. Conclusions. Mometasone furoate cream proved to be effective in reducing the clinical and capillaroscopic alterations of the psoriatic plaque, but there was no association between clinical improvement and microcirculatory alterations noted. The action of mometasone furoate action on the microcirculation was not limited only to the area of application, but also extended to the surrounding areas
Morphologic changes in the microcirculation of the psoriatic plaque induced by treatment with tacalcitol or mometason furoate
No full textCUTANEOUS VASCULAR ALTERATIONS IN PSORIATIC PATIENTS TREATED WITH CYCLOSPORINE
No full textVideocapillaroscopy can be used to assess cutaneous microcirculation modifications in vivo, and therefore allows assessment of variations in the microvascular architecture in psoriatic subjects during treatment. The aim of this study was to observe and quantify the modifications of the superficial capillary bed in psoriatic plaques during treatment with cyclosporin A. Twelve patients with psoriasis vulgaris were treated with an initial dose of 4 mg/kg/day cyclosporin A over a period of 3 months with periodic clinical and capillaroscopic assessments. Clinical resolution of the lesions and a reduction in microcirculatory alterations was observed in 70% of patients, although none returned to a normal capillaroscopic pattern
Successful treatment of rare dermatologic diseases with oral cyclosporine
No full textCyclosporine A has been shown to be a very versatile drug able to act on different diseases of immune pathogenesis. We present four cases of different drug-resistant dermatoses that showed no response to any of the previous treatments and that, because of the seriousness and extent of their clinical pictures, prompted us to use cyclosporine A. The dermatoses were the following: ulcerative lichen ruber planus, necrobiosis lipoidica, pyoderma gangrenosum and persistent light reaction. In all of the four cases the average attack dose was 4.5 mg/kg/day, which was gradually reduced. The treatment was then protracted for several months. The result was reepithelization of the ulcers and maintenance of the result after treatment suspension in necrobiosis lipoidica and in pyoderma gangrenosum. In the patients with erosive lichen ruber planus and persistent light reaction, cyclosporine A therapy provided a dramatic, although only temporary, improvement of the lesions. In all four patients, cyclosporine A proved to be an efficacious and manageable drug
Therapeutic efficacy of cyclosporine-A in the treatment of pyoderma gangrenosum, necrobiosis lipoidica, erosive lichen planus and persistent light reaction
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