1,720,982 research outputs found
Efficacy and safety of guselkumab in two psoriatic patients with hepatitis B and C virus infection
No full textChronische Graft-versus-Host-Erkrankung am männlichen Genitale: eine unterschätzte Manifestation
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Survey of bullous pemphigoid in an Italian University hospital: clinical-epidemiological characteristics and follow-up
No full textThe clinical-epidemiological characteristics and course of bullous pemphigoid in the general population is not clear. Few studies have been performed to date, and only one in the Italian population more than ten years ago. We decided to evaluate the characteristics and outcome of patients admitted for a bullous pemphigoid at our Hospital in the last 4 years
Combining secukinumab with dimethyl fumarate for treatment of a patient with psoriasis and recent diagnosis of multiple sclerosis
Full text linkResults
We report the case of a 44-year-old male patient referred to our department in 2006 for evaluation and management of psoriasis and psoriatic arthritis not responding to previous topical therapies and to conventional systemic treatments. On initial evaluation, his Psoriasis Area and Severity Index (PASI) was 23 so it was decided to start a biological therapy. Etanercept was firstly introduced with partial control of both cutaneous and articular manifestations and stopped after 2 years due to a loss of efficacy. Then, other different biological drugs were administered but discontinued for loss of efficacy or no clinical response. In 2017, we started a treatment with secukinumab with significant clinical improvement. These results were still maintained after 2 years. In January 2019, due to several episodes of hypoesthesia and paraesthesia, the patient performed a neurological examination and a brain magnetic resonance imaging (MRI) with gadolinium revealing multiple encephalic and spinal hyperintense lesions compatible with focal demyelinated areas. A diagnosis of relapsing-remitting multiple sclerosis was made and therapy with dimethyl fumarate (240 bid) started. Secukinumab therapy was maintained but decreasing the dose to 150 mg/month in order to reduce the immunosuppressive risks. After 12 months of follow-up, the patient tolerates the association of the two therapies and presents good control of both diseases.
To the best of our knowledge, this is the first case of a combination of two immunosuppressive drugs, secukinumab and dimethyl fumarate, for the treatment of a patient with concomitant psoriasis and multiple sclerosis. Among the widely different conventional therapies available to treat these two diseases, only dimethyl fumarate has been approved for both conditions. Moreover, interleukin 17 (IL-17) appears to play a key role in the pathogenesis of both diseases; it is produced by lymphocytes Th17, but also by CD8+ cells, Tγδ lymphocytes and some cells of the central nervous system, such as astrocytes and oligodendrocytes, in the context of active lesions of multiple sclerosis. Currently, the efficacy of anti IL-17 has been described only in few cases of multiple sclerosis. In conclusion, our case emphasizes the potential efficacy and safety of combination therapy of secukinumab and dimethyl fumarate, which may be a therapeutic option for such challenging patients
Dietary habits of psoriatic patients treated with dimethyl fumarate and drug-related side effects: results from an observational study
No full textBackground: Despite its favorable long-term safety profile, side effects during dimethyl fumarate (DMF) treatment for psoriasis are not uncommon and may lead to treatment suspension. The association between side effects, especially gastrointestinal, and dietary habits has not yet been specifically addressed. Methods: This observational, cross-sectional study aimed to assess the dietary habits of patients with moderate-to-severe plaque psoriasis in treatment with DMF who attended three Italian psoriasis clinics. Demographic and clinical data, including any side effects, were collected from the patients' medical records. A self-administered questionnaire recorded and scored: 1) if meals are eaten regularly or not; 2) daily intake at meals of fatty foods, milk and dairy products, alcohol, fruit and vegetables; and 3) in the case of side effects, the time between eating and their onset. Results: We included 53 patients in treatment with DMF at a daily dose of 232.4±194.1 mg for 38±29.8 weeks. Thirty-eight (71.7%) reported side effects, namely flushing (60.5%), diarrhea (44.7%), gastralgia (29%) and nausea (15.8%). Overweight seemed associated with the occurrence of side effects. In 47.4% of subjects, side effects appeared within 2 hours of having a meal. Daily fat intake appeared to protect against side effects, albeit without statistical significance; skipping meals was correlated with their onset in subjects complaining of diarrhea. Conclusions: Finding some correlation between dietary habits and occurrence of side effects during DMF treatment requires further investigation with the aim of developing possible strategies to improve its tolerability and retention rate
Radiation-induced angiosarcoma of the breast: an uncommon polymorphic disorder
No full textBreast conservative surgery combined with whole-breast radiotherapy has become the gold standard for the treatment of breast cancer, leading to the risk of subsequent occurrence of a secondary breast angiosarcoma in the irradiated area. We describe a case series
Helicobacter Pylori infection in psoriatic patients during biological therapy
No full textPsoriasis is a relapsing inflammatory disease exacerbated by many triggers. Helicobacter Pylori (H. Pylori) is a Gram-negative bacterium causing the liberation of many cytokines and having a role in systemic inflammation. We assessed over a period of 12 months the presence of H. Pylori in psoriatic patients undergoing biologic therapy and how PASI improved after its eradication
The rope sign: a case of interstitial granulomatous dermatitis with arthritis
No full textInterstitial granulomatous dermatitis with arthritis (IGDA), also known as Ackerman's syndrome, is a rare cutaneous disease classically characterized by the triad of cutaneous cords, a typical histologic infiltrate mainly constituted by histiocytes and arthritis/connective tissue disease. Here we report the case of IGDA with the typical clinical and histological features in a patient affected by lupus erythematosus. In this article we underline that IGDA may have a variety of different clinical and histological features. The rope sign is typical but infrequent, while histology is usually characteristic and shows a dermal inflammatory infiltrate, with a predominance of histiocytes, localized interstitially and in a palisaded array between collagen fibres, that show signs of degeneration. Clinical and histological differential diagnoses are discussed
Combination treatment with secukinumab and dimethyl fumarate in a patient with psoriasis and recent diagnosis of multiple sclerosis
No full textThe therapeutic approach to patients with psoriasis and concomitant multiple sclerosis is challenging. We report the clinical case of a 44-year-old man affected by psoriasis and psoriatic arthritis treated with secukinumab for 2 years, who received also dimethyl fumarate because of a recent diagnosis of relapsing remitting multiple sclerosis. Moreover, a mini-review of the available literature regarding the use of secukinumab in patients with psoriasis or ankylosing spondylitis and coexisting central nervous system demyelinating diseases was performed. To the best of our knowledge, this is the first case of successfully combining secukinumab and dimethyl fumarate for the treatment of two different immune mediated inflammatory diseases with good response and safety outcomes. Our case emphasizes the potential efficacy of this combination therapy, which may represent an effective synergistic strategy to manage such challenging patients
Cross-Switch from Etanercept Originator to Biosimilar SB4 and to GP2015 in Patients with Chronic Plaque Psoriasis
Full text linkBiosimilars of anti-TNF-α inhibitors have become a valid and usually less expensive alternative to their originator drugs [1]. Therefore, switching from originator to biosimilar drugs is an increasingly widespread approach because of the potential cost savings. As more biosimilars become available, switching between biosimilars of the same originator will be likely
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