吡硫翁锌气雾剂联合迪银片治疗寻常性银屑病疗效观察

目的观察吡硫翁锌气雾剂联合迪银片治疗寻常性银屑病的临床疗效。方法采用随机(1:1)单盲法将92例寻常性进行期银屑病患者随机分为治疗组、对照组各46例,治疗组给予迪银片口服,5片/次,3次/d;同时外用吡硫翁锌气雾剂2次/d。对照组单服迪银片,用法同上。两组疗程均为4周。治疗前后分别评定PASI积分,观察两组患者临床疗效及不良反应。结果①两组治疗后PASI积分均降低,治疗前后积分差异有显著性(P<0.001)。②治疗组治愈率69.57%,有效率86.96%。对照组分别为15.22%和50.00%。两组治愈率及有效率差异均具有显著性(P<0.005)。两组均无明显不良反应。结论吡硫翁锌气雾剂联合迪银片治疗寻常型银屑病,疗效优于单用迪银片组。     

火把花根治疗寻常型银屑病50例临床疗效观察

评价火把花根治疗寻常型银屑病的近期疗效和安全性。50例寻常型银屑病患者口服火把花根片,每次4片,每日3次,连续服用60天。结果基本痊愈率38.0%,总显效率30.0%,总有效率68.8%,与雷公藤对照组总有效率63.4%相比,无显著性差异(P>0.05)。观察表明此药主要不良反应为轻度胃肠道不适,对血液系统、生殖系统、肝功能的影响明显<对照组。     

迪银片联合火把花根片治疗寻常型银屑病

我站从2000年1月～2003年1月应用迪银片联合火把花根片治疗寻常型银屑病168例，取得满意疗效。现报道如下。     

308nm准分子激光联合复方甘草酸苷片治疗寻常型银屑病118例临床疗效观察

目的观察308nm准分子激光联合复方甘草酸苷片治疗寻常型银屑病临床疗效。方法将入选的118例银屑病患者随机分为两组,治疗组62例,对照组56例,治疗组给予308nm准分子激光联合复方甘草酸苷片治疗;对照组仅口服复方甘草酸苷片。8周后评定疗效。结果治疗组:62例,痊愈23例(37.1%)、显效30例(48.4%)、有效8例(12.9%)、无效1例(1.6%),有效率85.5%;对照组:56例,痊愈16例(28.6%)、显效20例(35.7%)、有效18例(32.1%)、无效2例(3.6%),有效率64.3%。治疗组疗效明显高于对照组,差异有统计学意义。(P0.01)。结论 308nm准分子激光联合复方甘草酸苷片治疗寻常型银屑病临床疗效显著,未发现明显不良反应。     

复方甘草单胺联合复方氨肽素治疗寻常性银屑病疗效观察

目的观察复方甘草单胺注射液联合复方氨肽素片治疗寻常性银屑病的疗效。方法197例寻常性银屑病患者随机分成两组，试验组给予复方甘草单胺注射液15ml静脉滴注，每日1次，同时给予复方氨肽素片5片，每日3次口服，对照组给予复方氨肽素片5片，每日3次口服。20d为1个疗程，治疗后1个月判定疗效。结果试验组107例患者中痊愈54例，显效43例，好转7例，无效3例，有效率90．7％。对照组90例中痊愈32例，显效28例，好转5例，无效25例，治疗有效率66．7％。两组相比，差异有统计学意义（P〈0．01）。结论复方甘草单胺注射液联合复方氨肽素片治疗寻常性银屑病，无明显不良反应，安全性较高，有一定的临床应用价值。     

银屑平丸联合阿维A胶囊治疗寻常型银屑病的疗效观察

目的观察银屑平丸联合阿维A胶囊治疗寻常型银屑病的临床疗效。方法将80例寻常型银屑病的患者随机分为治疗组和对照组各40例,治疗组予以中成药银屑平丸及阿维A胶囊口服,对照组予以阿维A胶囊口服。结果治疗组痊愈15例,显效17例,好转5例,无效3例,总有效率92.50%;对照组痊愈7例,显效11例,好转13例,无效9例,总有效率77.50%,2组PASI评分比较差异有统计学意义(P=0.01),治疗组疗效优于对照组疗效。结论银屑平丸联合阿维A胶囊治疗寻常型银屑病的疗效满意。     

复方三草汤联合迪银片治疗寻常性银屑病

目的 探讨寻常性银屑病的有效治疗方法。方法 治疗组用复方三草汤加味联合迪银片口服。对照组单纯口服迪银片。结果 治疗组有效率为84.62％,对照组为58.33％。两组有效率有显著性差异(X~2=10.69,P<0.01)。结论 复方三草汤联合迪银片治疗银屑病疗效高,副作用少。     

迪银片治疗前后寻常性银屑病血清白介素8、白介素10、泌乳素和雌二醇含量的变化

目的观察迪银片治疗48例寻常性银屑病临床疗效,探讨治疗前后患者血清中IL-8、IL-10和PRL、E2含量的变化.方法48例寻常性银屑病患者接受迪银片治疗前及治疗后第12周分别检测IL-8、IL-10和PRL、E2.结果①治疗前银屑病患者与正常对照组相比,IL-8、PRL的水平均明显升高(P＜0.01,P＜0.01);IL-10水平明显降低(P＜0.01);女性银屑病患者雌二醇含量明显高于正常对照组(P＜0.01).②经迪银片治疗后,IL-8、PRL水平较治疗前明显降低(P＜0.01),IL-10水平明显升高(P＜0.01),女性银屑病患者雌二醇水平明显降低(P＜0.01).结论银屑病患者IL-8、IL-10和PRL含量异常,提示其免疫-内分泌功能紊乱,治疗前后三种激素的变化,提示迪银片可以改善银屑病患者免疫-内分泌紊乱.     

中西药联合治疗寻常性银屑病临床疗效观察

目的观察黄芪注射液联合穿琥宁注射液与迪银片对治疗寻常性银屑病的疗效。方法将62例寻常性银屑病患者分为治疗组和对照组,两组均用迪银片,治疗组用黄芪联合穿琥宁注射液,对照组用黄芪注射液,比较治疗前后的评分情况和治疗后疗效。结果同组治疗前后相比PASI评分均差异有显著性(P<0.001),两组治疗前PASI评分相比差异无显著性(P>0.05),而治疗后PASI评分相比差异有显著性(P<0.05),治疗组总有效率77.42%,对照组70.97%,两组总有效率相比差异有显著性(P<0.05)。结论黄芪、穿琥宁注射液与迪银片中西药综合治疗对寻常性银屑病具有较好的效果。     

迪银片治疗银屑病临床疗效观察

我科自 1997年 2月～ 1999年 2月 ,使用重庆华邦制药有限公司生产的迪银片治疗寻常性银屑病 44例 ,获得满意效果。现报告如下。临床资料病例选择　治疗组 44例寻常性银屑病患者均来自聊城市人民医院皮肤科门诊 ,男 3 4例 ,女 10例 ,年龄 10～ 64岁 ,平均41岁 ,病期 1个月～ 2 0年 ,平均 3 .5年 ;进行期 3 5例 ,稳定期 9例 ;皮损形态 :点滴状 3 0例 ,斑块状 14例。对照组 40例 ,基本情况与治疗组相似 ,两组治疗前后肝肾功能及血尿常规检查均正常。治疗方法　治疗组采用迪银片 ,成人每次 5片 ,2次 /ｄ ,儿童酌减 ;对照组服用复方青黛丸 ,每次 …     

Plasma trough levels of mycophenolic acid do not correlate with efficacy and safety of mycophenolate mofetil in psoriasis

BACKGROUND: Mycophenolate mofetil (MMF) has been shown to be effective for systemic treatment of psoriasis. MMF is the prodrug of mycophenolic acid (MPA), the pharmacologically active compound. The measurement of plasma MPA levels could be useful for optimizing therapeutic management using MMF. OBJECTIVES: To investigate whether plasma trough levels of MPA correlate with the efficacy and safety of oral MMF in the treatment of patients with psoriasis. METHODS: Six patients (four women and two men, mean age 58 years) with severe chronic plaque-type psoriasis were treated with oral MMF 1 g twice daily. The Psoriasis Area and Severity Index (PASI), routine laboratory examinations and plasma MPA trough levels, measured by an enzyme-multiplied immunoassay (EMIT), were determined at 2 weeks and 1, 3, 5 and 7 months. RESULTS: All the patients experienced a marked improvement within the first 15 days and continued to do so for 5-7 months. Two patients achieved complete remission. MMF was well tolerated. MPA levels showed a wide intra- and interindividual variability. There was no significant correlation between MPA trough levels and the reduction of the PASI or the presence of adverse effects, but a good correlation with therapeutic compliance. CONCLUSIONS: The monitoring of MPA trough levels with EMIT appears to be a poor predictor of efficacy or toxicity. In contrast, it is a useful tool to evaluate the degree of therapeutic compliance.     

复方甘草酸苷联合甲氨喋呤治疗中重度银屑病疗效观察

目的:观察复方甘草酸苷(StrongerNeo-MinophagenC;SNMC)联合甲氨喋呤(methotrexate,MTX)治疗中、重度银屑病的临床疗效和安全性。方法:将56例银屑病患者分为治疗组及对照组,治疗组予静滴SNMC60mg,每日1次,共6周,同时静滴MTX5-15mg,每周1次,共8周。对照组单纯静滴MTX5-15mg,每周1次,共8周。结果:治疗组总有效率为84.2%,对照组总有效率为55.6%。组间差异有统计学意义(P<0.05)。结论:复方甘草酸苷联合甲氨喋呤治疗中、重度银屑病起效快,不良反应少,安全有效。     

Psoriasis vulgaris treated successfully with mycophenolate mofetil

Mycophenolate mofetil (MMF) is a new immunosuppressive drug which non-competitively and reversibly blocks the de novo synthesis of guanine nucleotides required for DNA and RNA synthesis during T- and B-cell proliferation. This induces a selective inhibition of lymphocyte proliferation. Thus MMF is currently used to prolong graft survival in renal transplant patients. In this communication we describe the first case of a man with severe psoriasis treated successfully with oral MMF without short-term side-effects. The psoriasis area and severity index score decreased during therapy (5 weeks) from 22.0 to 11.4. Thus MMF appears to be an effective therapeutic alternative in the treatment of severe psoriasis.     

Mycophenolate mofetil as a systemic antipsoriatic agent: positive experience in 11 patients

BACKGROUND: Mycophenolate mofetil (MMF) is a novel immunosuppressive drug. Several case reports have suggested that MMF has a beneficial effect in patients with psoriasis and autoimmune dermatoses. OBJECTIVES: To investigate the efficacy and safety of oral MMF in severe psoriasis. METHODS: Eleven patients with severe stable plaque-type psoriasis and a Psoriasis Area and Severity Index (PASI) between 12 and 53 (mean 30.5) were included in the study. They received oral MMF 1 g twice daily for 3 weeks and then 0.5 g twice daily for 3 weeks. The PASI were determined at baseline (week 0) and after 1, 2, 3 and 6 weeks of treatment. RESULTS: Within 3 weeks of this therapy there was a reduction in PASI of between 40% and 70% in seven of 11 patients, and only one patient achieved a reduction in PASI of < 25% from baseline (mean PASI 15.6). Reducing MMF from 2 g daily to 1 g daily led to further, although only slight, improvement in six of 11 patients during the following 3 weeks. In four of 11 patients, the PASI increased at this lower dosage, and in one patient the drug was withdrawn because of muscle pain, which was possibly drug induced. This side-effect reversed within a few days after stopping the drug. Other side-effects, especially gastrointestinal and haematological toxicity, were not observed in any of the 11 patients treated. Overall, the mean PASI was 16.1 after 6 weeks. CONCLUSIONS: We conclude that the immunosuppressant MMF 2 g daily is effective and safe in the treatment of severe psoriasis.     

Efficacy and safety of mycophenolate mofetil vs. methotrexate for the treatment of chronic plaque psoriasis

Background Methotrexate (MTX) is a well‐known systemic drug for moderate to severe chronic plaque psoriasis. Recently, mycophenolate mofetil (MMF) has been recommended for psoriasis. Objective To compare the efficacy and safety of MMF vs. MTX for the treatment of chronic plaque psoriasis. Methods Thirty‐eight consecutive patients with Psoriasis Area and Severity Index (PASI) >10 were randomly assigned for 12 weeks of treatment with either MTX (18 patients; initial dose, 7.5 mg/week) or MMF (20 patients; dose; 2 g/day) and were followed for 12 weeks after discontinuing the treatment. The differences between the two groups were analysed at the end of treatment and follow‐up comparing with baseline values. Results After 12 weeks of treatment, the mean ± SD score for the PASI decreased from 16.46 ± 5.29 at baseline to 3.17 ± 2.35 among 15 patients treated with MTX, whereas the score decreased from 17.43 ± 7.42 to 3.97 ± 5.95 among 17 patients treated with MMF (P > 0.05). Twelve weeks after discontinuing the treatment, the scores were 4.77 ± 3.52 and 5.94 ± 4.27, respectively (P > 0.05). PASI ‐75 were achieved in 58.8% of patients in MMF group and 73.3% in MTX group (P > 0.05). Three months after discontinuing the treatment, PASI‐75 remained in 33.3% of patients in MMF and 53.3% of MTX group (P > 0.05). Both drugs were well tolerated and side‐effects were minor and transient. Conclusions No significant differences in efficacy were found between MTX and MMF groups. MMF may represent a good alternative for the treatment of psoriasis in patients who are unable to take MTX or other available drugs due to contraindication or toxicity.     

Long-term maintenance treatment of moderate-to-severe plaque psoriasis with infliximab in combination with methotrexate or azathioprine in a retrospective cohort

Background  Effective, fast-acting and safe therapies are needed for long-term maintenance treatment of psoriasis. In October 2005, infliximab was approved for the treatment of moderate-to-severe plaque psoriasis, but long-term data are limited.
Objective  To evaluate the effectiveness of infliximab, used in combination with methotrexate or azathioprine, in maintaining clinical benefit in patients with moderate-to-severe psoriasis.
Methods  The medical charts of 23 patients treated with infliximab from August 2001 to February 2007 were retrospectively reviewed. Most patients received either infliximab 3 mg/kg (17 of 23) or 5 mg/kg (1 of 23) in combination with methotrexate, while 5 of 23 patients received infliximab 5 mg/kg in combination with azathioprine. Psoriasis Area Severity Index (PASI) score and adverse events were recorded at every infliximab infusion visit at the hospital.
Results  Patient data were available for a minimum of 4 weeks and up to 5 years and 5 months. At week 14, 91.3% achieved PASI 50, 69.6% achieved PASI 75, and 39.1% achieved PASI 90. Only two patients discontinued therapy due to loss of response: one after 15 months and one after 3 years. All other patients displayed a good clinical response (≥ PASI 50) and were still receiving this regimen at last observation. Combination regimens of infliximab with methotrexate or azathioprine were well tolerated, and only one patient discontinued therapy because of an adverse event (lung embolism) after two infusions with infliximab.
Conclusions  Long-term (> 1 year) maintenance therapy of infliximab combined with methotrexate or azathioprine is effective and well tolerated for moderate-to-severe plaque-type psoriasis.

Conflicts of interest

None declared     

白芍总苷联合阿维A治疗中、重度银屑病32例临床观察

目的观察白芍总苷联合阿维A治疗中、重度银屑病的临床疗效和安全性。方法 62例中、重度银屑病患者随机分为2组,治疗组32例,予口服白芍总苷600mg3次/d,阿维A0.5mg/(kg.d)治疗,对照组30例仅予口服阿维A0.5mg/(kg.d)治疗,疗程8周。以银屑病皮损面积和严重程度(PASI)评分评价疗效并记录不良反应。结果治疗8周后,治疗组PASI评分(4.36±3.12)低于对照组(6.38±2.81),差异有统计学意义(P<0.05);治疗组有效率(90.62%)高于对照组(76.67%)。差异有统计学意义(P<0.05)。两组未见明显不良反应。结论白芍总苷联合阿维A治疗中、重度银屑病的患者疗效好,安全性高。     

Treatment of psoriatic nails with topical cyclosporin: a prospective,randomized placebo-controlled study

BACKGROUND: Nail involvement is a frequent event in the course of psoriasis causing severe distress. While systemic cyclosporin (CsA) represents a well-established therapy of psoriasis, its topical use is limited by the difficult penetration of the molecule through the skin and the nail because of its highly lipophilic nature. OBJECTIVES: We carried out a prospective randomized placebo-controlled study in order to analyze the effectiveness and tolerability of topical oil-dissolved 70% CsA solution in nail psoriasis. METHODS: Sixteen adult patients with nail psoriasis, divided randomly into two groups of 8 patients (group A and group B), were treated respectively with a 70% maize-oil-dissolved oral CsA solution and maize oil alone. To compare the therapeutic effectiveness, all patients were evaluated, before starting the treatment and after 12 weeks of therapy, by the same dermatologists. The patients were also asked to assess the severity of their nail involvement at baseline and at the end of the treatment. RESULTS: In group A, 3 patients came to a complete resolution of nail lesions and 5 showed a substantial improvement of the overall severity score. In group B, a slight improvement was noted in only 1 patient. All the patients of group A judged positively the results of the therapy, while in group B only 1 patient reported a moderate improvement. CONCLUSION: Our results show that topical therapy with oral CsA solution is a safe, effective and cosmetically highly acceptable treatment modality for nail psoriasis. The ability of CsA to influence keratinocyte proliferation and T-cell lymphokine release, reducing the cornification of the upper layers of the epidermis, may prevent the typical alterations observed in nail psoriasis.     

Tratamiento de la dermatitis atópica grave del adulto con mofetil micofenolato en 8 pacientes

BackgroundAtopic dermatitis (AD) includes severe forms that can be refractory to various systemic treatments. Mycophenolate mofetil (MMF) has been found to be useful in patients with severe forms of AD and to have fewer side effects than long-term treatment with oral corticosteroids or cyclosporine.ObjectivesTo evaluate the efficacy and adverse effects of MMF in patients seen in our skin allergy unit with severe adult AD refractory to other systemic treatments.MethodsWe performed a retrospective study of 8 patients with severe adult AD treated with MMF, analyzing the baseline characteristics, previous treatments used by the patients, and the outcome and adverse effects of treatment with MMF.ResultsFive patients treated with MMF showed improvement in the fourth week of treatment. In addition, 5 of the 8 patients presented a clear, long-term improvement in their disease. Remission of AD occurred in 1 patient, making it possible to discontinue MMF; this patient remains stable with no relapses after 4 months without treatment. The other 4 patients continue on maintenance therapy. Three patients continued to have frequent acute outbreaks of AD despite treatment with MMF for 16 to 72 weeks. All patients tolerated the treatment and there were few adverse effects.ConclusionsMMF can be an effective option in selected patients with severe forms of atopic dermatitis. Although the response is not as rapid as with oral corticosteroids or cyclosporine, it can be used for maintenance treatment with good clinical control and few adverse effects.     

Mycophenolate mofetil: A new therapeutic option in the treatment of blistering autoimmune diseases

Background: Mycophenolate mofetil (MMF), an ester of mycophenolic acid (MPA), was approved by the Food and Drug Administration in 1995 and is currently primarily indicated for the prophylaxis of rejection in renal transplant patients. The drug seems also to be of value in the treatment of psoriasis and rheumatic arthritis. Recently there have been 6 reported cases of successful treatment of blistering autoimmune diseases with MMF in combination with high dose prednisone therapy. Objective: On the basis of these reports we administered this new treatment regimen to several patients with blistering autoimmune diseases. Besides using a combination of MMF and high-dose prednisone we wanted to evaluate whether MMF monotherapy is also effective in the treatment of blistering autoimmune diseases. Methods: We administered MMF to 5 patients who had severe pemphigus vulgaris or bullous pemphigoid. Two patients received MMF in combination with high-dose prednisone therapy and 3 patients received MMF monotherapy. To our knowledge, this is the first report of successful treatment of pemphigus vulgaris and bullous pemphigoid with MMF monotherapy. Results: All patients were completely free of symptoms within 8 to 11 weeks of therapy. Patients who had received MMF monotherapy responded as well to treatment as those who received a combination of MMF and high-dose prednisone. Conclusion: Our experiences strongly suggest that MMF monotherapy may be effective for patients even with severe pemphigus vulgaris and bullous pemphigoid. In addition, MMF monotherapy, at least over the short term, offers the advantage of fewer side effects in comparison to immunosuppressive combination therapy and was well tolerated by our patients. (J Am Acad Dermatol 1999;40:957-60.)