Dead sea bath salt for the treatment of psoriasis vulgaris: a double-blind controlled study

Back-ground The beneficial effect of the Dead Sea (DS) area in psoriasis is attributed in part to the DS water, which has a high content of minerals, Aim The aim of the study was 10 evaluate the sole therapeutic effect of DS salt in psoriasis. Patients and Methods Thirty patients wild psoriasis vulgaris, involving >15% body area, were included in the study, which was conducted in a double-blind controlled manner. Treatment consisted of once daily baths, heated lo 35°C, of 20 min duration, for 3 weeks, of cither DS bath salt (group I) or common salt (group II). Clinical evaluation was based on Psoriasis Area and Severity Index (PASI) score determination before and after treatment Results Twenty-five patients 113 in group 1 and I 2 in group II) terminated the treatment protocol. In both groups, treated by US hath salt and common salt, respectively, the mean PASI score before treatment (18.6, ± 9.4 and 15.7 ± 7.1. respectively) decreased significantly al the end of the treatment (11.4 ± 6.1 and 11.4± 6.6, respectively). The mean percentage reduction of PASI score at the end of the treatment regimen, was higher in patients treated with IDS bath salt (34.8%) compared to patients treated with common salt (27.5%) (P > 0.05). The mean percentage reduction a month after termination of the treatment protocol was higher in patients treated with DS hath salt (43.6%) than in those treated with common salt (24%) (P > 0.05). Conclusions The present study implies a beneficial effect to bathing wish either DS hath salt or common salt as a sole therapy for psoriasis vulgaris. However, we observed an enhanced beneficial effect of DS hath salt compared to common salt.     

Effects of maxacalcitol ointment on skin lesions in patients with psoriasis receiving treatment with adalimumab

Adalimumab is a biologic that is very effective for treatment of psoriasis. However, recalcitrant or recurrent lesions sometimes occur during treatment. Maxacalcitol is an active vitamin D3 ointment that is effective in treatment of psoriasis. Topical therapy may be beneficial in treatment of recalcitrant or recurrent lesions during treatment with systemic therapy, but there is little evidence on this topic. We investigated the effect of maxacalcitol on skin lesions during treatment with adalimumab in patients with psoriasis. Twelve patients with psoriasis were randomly assigned to two groups after informed consent – treatment with adalimumab only (n = 6), and treatment with adalimumab and maxacalcitol (n = 6) – and they were evaluated every 4 weeks for 44 weeks. Exacerbation was defined as an increase of the Psoriasis Area and Severity Index (PASI) score. The interval between adalimumab treatments was elongated to 3–4 weeks from 2 weeks according to the individual patient's condition. The PASI score was evaluated every 4 weeks, and the frequency of exacerbations was counted. The overall improvement in PASI score was not statistically different between the two groups, but the frequency of exacerbations was significantly less in the maxacalcitol combination group compared with the adalimumab monotherapy group (Mann–Whitney U‐test, P < 0.05). The better control of skin lesions in patients who elongated the interval of adalimumab administration was achieved in the maxacalcitol combination group compared with the adalimumab monotherapy group. Topical maxacalcitol treatment is effective and useful in controlling skin lesions in patients with psoriasis when used in combination with adalimumab.     

Saline spa water or combined water and UV-B for psoriasis vs conventional UV-B: lessons from the Salies de Béarn randomized study

OBJECTIVE: To study the effects of UV-B therapy and saline spa water given alone or in combination for the treatment of psoriasis. DESIGN: Randomized, controlled, comparative study with blinded observers. SETTING: Salies de Béarn, saline spa water center located in the southwest of France. PARTICIPANTS: Seventy-one adult patients with psoriasis with a Psoriasis Area and Severity Index (PASI) score greater than 10. INTERVENTION: Patients were randomly assigned to 1 of 3 treatments: spa water alone (group A); UV-B 311-nm phototherapy alone (group B); and a combination of the 2 therapies (group C). The 3 groups were treated on a daily basis 5 days a week for a total of 21 days. MAIN OUTCOME MEASURES: Change in PASI score from baseline as determined by an investigator blinded to randomization; variation in quality of life, adverse effects, and long-term effects (1 year after treatment). RESULTS: Four patients dropped out because of secondary effects. Efficacy was similar in groups B and C, with changes in PASI of -64% and -55%, respectively at 3 weeks. For group A, change in PASI was -29%, thus showing a minor therapeutic effect of saline spa water alone and poor efficacy compared with groups B and C (P<.001). More adverse effects were reported in groups A and C but did not reach significance. Combined saline spa water and UV-B therapy had no sparing effect on UV-B dosages. One year after treatment, no long-term benefit could be attributed specifically to a given regimen, but the patients had overall significantly better PASI scores than at baseline. CONCLUSIONS: Saline spa water alone had a minor therapeutic effect in psoriasis, and the beneficial effect of bathing to enhance phototherapy was not demonstrated.     

银屑病患者生活质量调查

目的:研究银屑病对患者生活质量的影响及皮肤病生活质量指数(DLQI)作为判断银屑病病情及疗效新指标的可信性。方法:采用DLQI研究银屑病患者治疗前、后的生活质量及其影响因素,并与传统的银屑病皮损面积和严重度指数(PASI)进行比较。结果:女性患者的DLQI评分明显高于男性,未婚者的DLQI评分高于已婚者,面部受累者的DLQI评分高于面部未受累者(P<0.05)。DLQI和PASI评分呈显著正相关(r=0.633,P<0.001)。治疗后随着临床病情的改善,PASI和DLQI评分均显著下降,且DLQI改善率和PASI改善率呈显著正相关(r=0.722,P<0.001)。结论:银屑病对患者生活质量的影响较大,DLQI可作为判断银屑病病情及疗效的新指标。     

银屑病患者性功能障碍的调查

目的了解银屑病患者的性功能障碍,分析银屑病严重度和面积评价指数(PASI)与性功能障碍相关性。方法用IIEF对90例男性(银屑病患者中PASI≤10者37例,PASI>10者23例,健康志愿者30名)性功能进行评价。用FSFI对90例女性(银屑病患者中PASI≤10者35例,PASI>10者25例,健康志愿者30名)性功能进行评价。结果女性银屑病患者组FSFI总评分较健康对照组明显下降(P=0.000);同时女性银屑病PASI≤10者和PASI>10者FSFI总评分差异有显著性(P<0.05)。男性银屑病患者组IIEF总评分较健康对照组明显下降(P=0.000);并且男性银屑病PASI≤10者和PASI>10者IIEF总评分差异有显著性(P<0.05)。结论银屑病对男性和女性的性功能均有影响,并与银屑病病情相关。     

A prospective,randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis

Background Topical aloe vera (AV) has been used to treat various skin conditions, including psoriasis, with good results. Objectives This study aims to compare the efficacy of AV and 0.1% triamcinolone acetonide (TA) in mild to moderate plaque psoriasis. Methods A randomized, comparative, double‐blind, 8‐week study was designed. Eighty patients randomly received AV or 0.1% TA cream and their clinical response were evaluated using the Psoriasis Area Severity Index (PASI) and the Dermatology Life Quality Index (DLQI). Results After 8 weeks of treatment, the mean PASI score decreased from 11.6 to 3.9 (–7.7) in the AV group and from 10.9 to 4.3 (–6.6) in the TA group. Between‐group difference was 1.1 (95% confidence interval –2.13, –0.16, P = 0.0237). The mean DLQI score decreased from 8.6 to 2.5 (–6.1) in the AV group and from 8.1 to 2.3 (–5.8) in the TA group. Between‐group difference was 0.3 (95% confidence interval –1.18, –0.64, P = 0.5497). There was no follow‐up period after the 8‐week treatment. Conclusions AV cream may be more effective than 0.1% TA cream in reducing the clinical symptoms of psoriasis; however, both treatments have similar efficacy in improving the quality of life of patients with mild to moderate psoriasis.     

Plasma YKL‐40: a potential biomarker for psoriatic arthritis?

Background Plasma YKL‐40 is an inflammatory biomarker. No useful biomarker exists in patients with psoriasis or psoriatic arthritis. Objective To measure YKL‐40 and high‐sensitivity C‐reactive protein (hs‐CRP) in patients with psoriasis or psoriatic arthritis before and during treatment. Methods In 48 patients with psoriasis, we measured YKL‐40, hs‐CRP and Psoriasis Area and Severity Index (PASI) at inclusion and in a subgroup of 14 patients, we repeated the measurements after four to six weeks of methotrexate treatment. In 42 patients with psoriatic arthritis, we measured YKL‐40 and hs‐CRP at inclusion and during 48 weeks of adalimumab treatment. The patients with psoriatic arthritis were divided into responders and non‐responders. Results In patients with psoriasis, the baseline median PASI score was 10.8 and baseline YKL‐40 was 45 μg/L. Seventeen per cent had elevated plasma YKL‐40 compared with healthy subjects. Baseline PASI and YKL‐40 were not correlated (rho = 0.14, P = 0.347) and YKL‐40 and hs‐CRP remained unchanged after treatment. In patients with psoriatic arthritis, the median pretreatment YKL‐40 was 112 μg/L and 43% had elevated YKL‐40. YKL‐40 decreased in 33 patients who responded to adalimumab (from 112 μg/L to 68 at 48 weeks, P = 0.007). Hs‐CRP decreased (from 4.65 mg/L to 0.91, P = 0.013) in the responders. In the non‐responders (n = 9), YKL‐40 and hs‐CRP remained unchanged. Conclusions YKL‐40 is elevated in many patients with psoriatic arthritis, but not in patients with psoriasis. YKL‐40 decreased in patients with psoriatic arthritis who responded to treatment. YKL‐40 may be a useful biomarker to monitor the effect of treatment with tumour necrosis factor‐α inhibitors in patients with psoriatic arthritis.     

Treatment of plaque‐type psoriasis with oral CF101: data from an exploratory randomized phase 2 clinical trial

Aims CF101 demonstrated a marked anti‐inflammatory effect in Phase 2 studies conducted in patients with rheumatoid arthritis and dry eye syndrome. The aim of this study was to evaluate the safety and efficacy of CF101 for the treatment of patients with moderate to severe plaque‐type psoriasis. Materials and methods This was a phase 2, multicentre, randomized, double‐blind, dose‐ranging, placebo‐controlled study. Seventy five patients with moderate to severe plaque‐type psoriasis were enrolled, randomized and treated with CF101 (1, 2, or 4 mg) or placebo administered orally twice daily for 12 weeks. Safety and change from base line of Psoriasis Area and Severity Index (PASI) score and physician’s global assessment (PGA) score over 12 weeks. Results In the 2 mg CF101‐treated group, a progressive improvement in the mean change from baseline in the PASI score vs. placebo throughout the study period was observed, with a statistically significant difference on weeks 8 and 12 (P = 0.047; P = 0.031, respectively). In this group, 35.3% of the patients achieved PASI ≥50 response, and 23.5% of the patients achieved a PGA score of 0 or 1. CF101 was safe and well tolerated. Conclusions CF101 was well tolerated and demonstrated clear evidence of efficacy in patients with moderate to severe plaque psoriasis.     

Treatment of erythrodermic psoriasis with etanercept

BACKGROUND: Severe variants of psoriasis, such as erythrodermic psoriasis, may be associated with serious morbidity and mortality. Current treatment options for erythrodermic psoriasis are limited, unsatisfactory and potentially associated with organ-specific toxicity. Recently, a new class of agents, targeted biological therapies, has emerged. Etanercept is a recombinant human fusion protein acting as a competitive inhibitor of tumour necrosis factor-alpha. The safety and efficacy of etanercept have been widely demonstrated in psoriatic arthritis and moderate to severe plaque-type psoriasis. OBJECTIVES: To assess the efficacy and tolerability of etanercept in the treatment of erythrodermic psoriasis over a period of 24 weeks. METHODS: Ten patients, eight men and two women, were selected to receive etanercept 25 mg subcutaneously twice weekly. The Psoriasis Area and Severity Index (PASI) score, ranging from 0 to 72, was used to assess the severity of disease. RESULTS: Etanercept was well tolerated and led to a significant reduction in the severity of disease over the period of treatment. After 24 weeks, the mean PASI score decreased from 39.1 (baseline) to 5.1. At week 12, five of 10 (50%) patients achieved an improvement of PASI score from baseline exceeding 75%. At week 24, six of 10 patients (60%) achieved or maintained an improvement of PASI score from baseline exceeding 75% while two patients (20%) maintained an improvement of between 50% and 75%. CONCLUSIONS: In this study, etanercept has been demonstrated to be an effective treatment for erythrodermic psoriasis, providing a safe and convenient alternative to current therapies.     

窄谱中波紫外线对寻常性银屑病患者血清和皮损中IFN-γ,IL-4的影响

目的研究311nm窄谱中波紫外线(NB-UVB)对寻常性银屑病患者血清和皮损中IFN-γ和IL-4的影响。方法40例寻常性银屑病患者随机分为NB-UVB和对照两组,每组20例,NB-UVB组每周光疗3次,共4周,对照组不予光疗。治疗前后分别以银屑病严重程度PASI评分标准评分,以ELISA法测定血清中IFN-γ和IL-4含量,以免疫组化方法和图像分析系统分析IFN-γ和IL-4在银屑病皮损中的表达,结果以积分光密度值(IOD值)表示。结果两组患者治疗后PASI评分均显著下降(P<0.05),且NB-UVB组低于对照组(P<0.05);血清IFN-γ水平均下降(P<0.05),而IL-4水平无明显变化;皮损中IFN-γ表达明显下降(P<0.05),且NB-UVB组低于对照组(P<0.05);IL-4水平增高(P<0.05),且NB-UVB组高于对照组(P<0.05)。结论NB-UVB可以调节寻常性银屑病血清IFN-γ水平和皮损中IFN-γ,IL-4的表达,改善患者体内Th1,Th2失衡状态达到治疗效果。     

Systemic high-dose ranitidine in the treatment of psoriasis: an open prospective clinical trial

We report the results of an open, prospective study on the efficacy of systemic ranitidine in the treatment of psoriasis. Twenty patients suffering from moderate to severe psoriasis were included in the study. The median pretreatment PASI score was 15·7 (range 6·0-24·7). The patients were treated with oral ranitidine 300 mg twice a day for 6 months; no other medication was allowed during the study period. Eighteen patients completed the study. The median PASI score was reduced from 15·7 to 14·5. 9·1 and 5·7. after 1, 3 and 6 months of treatment, respectively (P<0·00001). A significant reduction in PASI score was evident at 3 months of treatment. A mild to moderate deterioration occurred in 15 patients within the first month of treatment, but this was followed by improvement during prolonged treatment in most patients. No other clinical and/or biochemical side-effects were observed. Eight patients continued therapy with ranitidine after the study was completed, and none of these patients relapsed during a follow-up period of 12–18 months. The results of the present study suggest that ranitidine may be a beneficial and safe treatment for psoriasis. In addition, high-dose, long-term ranitidine treatment appears to be free from severe adverse effects.     

The efficacy of methotrexate plus pioglitazone vs. methotrexate alone in the management of patients with plaque‐type psoriasis: a single‐blinded randomized controlled trial

Recently, thiazolidinediones have shown to be efficacious with a favorable safety profile when used in the treatment of chronic plaque‐type psoriasis. The aim of this study was to evaluate and compare the efficacy and safety of a combination of methotrexate plus pioglitazone and methotrexate alone in plaque‐type psoriasis. A total of 44 adult patients with plaque‐type psoriasis were included in the study. Patients were randomized to treatment with methotrexate alone (group A) or methotrexate plus pioglitazone (group B) for 16 weeks. The primary efficacy outcome measure was psoriasis area and severity index (PASI) score change between the study groups at week 16 relative to baseline. The secondary efficacy outcome measure was dermatology life quality index (DLQI) score change between the two groups at week 16 relative to baseline. The PASI 75 score was also measured. After 16 weeks of therapy, the percentage of reduction in the mean PASI score was 70.3% in group B and 60.2% in group A. PASI 75 was achieved in 14 patients (63.6%) in group B compared with two patients (9.1%) in group A within 16 weeks, which was significant (P < 0.001). At 16 weeks from the baseline, a 63.6% decrease in the mean DLQI score of group B was seen, while the decrease for group A was 56.9%. Pioglitazone enhances the therapeutic effect of methotrexate in plaque‐type psoriasis, as demonstrated by a reduction in the mean PASI scores. In terms of DLQI, there was no extra benefit by the addition of pioglitazone to methotrexate therapy.     

Optical coherence tomography imaging of psoriasis vulgaris: correlation with histology and disease severity

Epidermal thickness (ET) has been suggested as a surrogate measure of psoriasis severity. Optical coherence tomography (OCT) is a recent imaging technology that provides real-time skin images to a depth of 1.8 mm with a micrometre resolution. OCT may provide an accurate in vivo measure of ET. It is, therefore, speculated that OCT may be used in the assessment of psoriasis vulgaris. A total of 23 patients with psoriasis vulgaris were systematically evaluated by OCT imaging and skin biopsy during treatment. Biopsies were graded for disease severity, and additional evaluation was done by the physician via psoriasis area and severity index (PASI) score, and by the patient through measures such as self-administered PASI, psoriasis life stress inventory index and dermatology life quality index. ET was calculated from OCT images. In comparison to normal skin, psoriasis appeared with a more irregular surface with a stronger entrance signal, a serrated dermo-epidermal junction was found and a less signal intensity in the dermis as shown in OCT images. ET measured in untreated plaques was thicker reflecting epidermal hyperproliferation and inflammation. The changes were significantly correlated with the biopsy grading (r ² = 0.41, p = 0.001) and ET significantly decreased with treatment (p = 0.0001). ET correlated significantly with self-reported measures of disease severity, but not with physician-assessed global PASI. The data suggest that OCT may be used to measure ET in psoriasis and the measurements correlate with several other parameters of disease severity. This implies that OCT assessment of psoriatic plaques may provide a useful method for non-invasive in vivo method to follow the evolution of psoriasis lesions.     

Algorithm to select optimal systemic anti‐psoriatic drugs in relation with patients' Psoriasis Area and Severity Index score for plaque psoriasis

This study sought to develop a therapeutic algorithm for selecting the optimal systemic drugs to treat moderate to severe psoriasis, based on the patient's Psoriasis Area Severity Index (PASI) score. Data from 191 patients undergoing treatment for plaque psoriasis were retrospectively analyzed. Pre‐ and post‐treatment PASI scores were compared across patients treated with acitretin of retinoic acid (RA; n = 95), methotrexate (MTX; n = 41) or cyclosporin A (CsA; n = 55). The PASI score improvement was examined at weeks 4 (primary end‐point) and 12 (secondary end‐point). MTX and CsA had a higher global therapeutic efficacy, with more patients exhibiting a marked improvement (≥75% improvement in PASI [PASI 75]) at week 12 with MTX (56.1%, P = 0.028) and CsA (54.5%, P = 0.025) than RA (35.8%). Multivariate analysis adjusting for confounders produced consistent results (P = 0.026). For patients with severe psoriasis (PASI >12), the PASI 75 response was higher with CsA (55.6%) than RA (31.5%) (P = 0.023) at week 4 and higher with MTX (57.1%, P = 0.029) and CsA (61.5%, P = 0.017) than RA (21.7%) at week 12. Because RA is a standard systemic drug, the RA group was divided into two subgroups based on the PASI 50 response at week 12. Marked or moderate improvement (PASI ≥50) with RA was observed in patients with a pretreatment PASI score less than 14. Thus, oral RA is recommended as a first‐line drug for patients with PASI of less than 14, and MTX or CsA are recommended for patients with PASI of 14 or more.     

两种不同治疗方案对缩短寻常性银屑病疗程的比较

目的比较两种不同治疗方案对治疗寻常型银屑病疗程的影响。方法选用两组不同的治疗方案,应用PASI评分法对寻常性银屑病患者的疗效进行观察。结果两组患者治疗前PASI评分差异无显著性(P>0.05),而治疗后传统治疗组PASI评分低于阿维A组(P<0.05)。传统治疗组平均治疗周期短于阿维A组(P<0.05)。结论应用PASI能够比较客观的掌握银屑病患者的病情,传统治疗方案仍不失为治疗寻常性银屑病的一种良策。     

Secukinumab improves psoriasis symptoms in patients with inadequate response to cyclosporine A: A prospective study to evaluate direct switch

There are limited data on the safety and efficacy of switching to secukinumab from cyclosporine A (CyA) in patients with psoriasis. The purpose of the present study was to assess the efficacy and safety of secukinumab for 16 weeks after direct switching from CyA in patients with moderate‐to‐severe psoriasis. In this multicenter, open‐label, phase IV study, 34 patients with moderate‐to‐severe psoriasis and inadequate response to CyA received secukinumab 300 mg s.c. at baseline and weeks 1, 2, 3, 4, 8 and 12. The primary end‐point was ≥75% improvement from baseline in Psoriasis Area and Severity Index score (PASI 75) at week 16. The efficacy of secukinumab treatment was evaluated up to week 16, and adverse events (AE) were monitored during the study. The primary end‐point of the PASI 75 response at week 16 was achieved by 82.4% (n = 28) of patients receiving secukinumab. Early improvements were observed with secukinumab, with PASI 50 response of 41.2% at week 2 and PASI 75 response of 44.1% at week 4. AE were observed in 70.6% (n = 24) of patients, and there were no serious AE or deaths reported in the entire study period. Secukinumab showed a favorable safety profile consistent with previous data with no new or unexpected safety signals. The results of the present study show that secukinumab is effective in patients with psoriasis enabling a smooth and safe direct switch from CyA to biological therapy.     

Effect of climate therapy at Gran Canaria on vitamin D production, blood glucose and lipids in patients with psoriasis

Background Climate therapy (heliotherapy) of psoriasis is an effective and natural treatment. Ultraviolet radiation (UVB) from the sun improves psoriasis and induces vitamin D₃ synthesis. Objective The aim of the study was to investigate the effect of climate therapy on vitamin D₃ synthesis, blood glucose, lipids and vitamin B12 in psoriasis patients. Methods Twenty Caucasian patients (6 women and 14 men; mean age, 47.2 years; range, 24–65) with moderate to severe psoriasis [mean Psoriasis Area and Severity Index (PASI) score 9.8; range, 3.8–18.8] received climate therapy at the Gran Canarias for 3 weeks. Blood samples were drawn before and after 15 days of sun exposure. In addition, the patients’ individual skin UV doses based on UV measurements were estimated. Results Sun exposure for 15 days lead to a 72.8% (± 18.0 SD) reduction in the PASI score in psoriasis patients. Although no direct correlation was observed between PASI score improvement and UVB dose, the sun exposure improved the vitamin D, lipid and carbohydrate status of the patients. The serum concentrations of 25‐hydroxyvitamin D [25(OH)D] increased from 57.2 ± 14.9 nmol/L before therapy to 104.5 ± 15.8 nmol/L (P < 0.0001) after 15 days of sun exposure; the serum levels of 1,25‐dihydroxyvitamin D [1,25(OH)₂D] increased from 146.5 ± 42.0 to 182.7 ± 59.1 pmol/L (P = 0.01); the ratio of low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol decreased from 2.4 to 1.9 (P < 0.001); and the haemoglobin A₁c (HbA₁c) levels decreased from 5.6 ± 1.7% to 5.1 ± 0.3% (P < 0.0001). Conclusion Climate therapy with sun exposure had a positive effect on psoriasis, vitamin D production, lipid and carbohydrate status.     

Optimizing acitretin use in patients with plaque psoriasis

Acitretin is one of the systemic agents used for the treatment of psoriasis. Because different acitretin dosages resulted therapeutically successful, there is no general agreement on the optimal dose regimen. To report acitretin efficacy and safety in a real‐life setting, wherein patient‐tailored dose regimen is usually prescribed, a retrospective analysis evaluating charts of all plaque‐type psoriasis patients treated with acitretin from the clinic database was performed. PASI score improvement, as well as PASI 50, 75, 90, and 100 responses were assessed throughout the observational period. Overall, 52% PASI score reduction and a satisfactory safety profile were detected. PASI 50, 75, 90, and 100 response was achieved by 53%, 48%, 28%, and 14%, respectively. Treatment consisted on a mean daily acitretin dose of 25.01 mg. The initial dose was increased (51.2% of cases) or decreased (48.8%) prescribing a mean daily dose of 29.8 mg and 20.02 mg, respectively. This study proposed a dose regimen customized on clinical response and patient's needs, to optimized acitretin benefit.     

Efficacy and tolerability of topical tacrolimus ointment for the treatment of male genital psoriasis

BACKGROUND: Genital psoriasis is difficult to treat and has a significant psychological impact on affected patients. OBJECTIVE: To study the safety and efficacy of topical tacrolimus ointment in male patients with genital psoriasis. METHODS: This was an open-label study in 12 male patients with genital psoriasis. Patients received topical tacrolimus 0.1% ointment twice daily for 8 weeks followed by a 4-week observational period. Efficacy was assessed by a modification of the Psoriasis Area and Severity Index (PASI) scale adapted for genital psoriasis (male genital PASI). Severity was also evaluated individually for the glans, shaft of the penis, and scrotum. RESULTS: Male genital PASI decreased from a mean score of 15.8 at baseline to 1.2 at week 8 (p < .001). Psoriasis severity also improved significantly for the glans, shaft of the penis, and scrotum evaluated individually. Tacrolimus 0.1% ointment was very well tolerated, with only mild pruritus or burning sensation of limited duration reported. CONCLUSIONS: Topical tacrolimus ointment appears very efficacious and well tolerated in male patients with genital psoriasis.     

NB-UVB联合阿维A治疗寻常型银屑病及其对红细胞天然免疫功能的影响

目的观察窄谱中波紫外线(NB-UVB)联合阿维A治疗寻常型银屑病的疗效及安全性,了解治疗前后患者红细胞天然免疫功能的变化。方法对30例中重度寻常型银屑病患者采用NB-UVB3次/W照射配合阿维A10mg2次/d,疗程8周,用PASI积分评价疗效,同时应用流式细胞仪检测治疗前后患者血浆红细胞CD35(CR1,补体Ⅰ型受体)的表达变化。结果 30例银屑病患者治愈率40%;治疗前红细胞CD35分子定量(70.04±27.05),治疗后CD35分子定量(59.00±17.24),治疗前后差异有统计学意义(t=2.097,P<0.05),且治疗前后红细胞CD35定量与PASI评分呈明显正相关(γ=0.924,P<0.001)。结论 NB-UVB联合阿维A治疗寻常型银屑病有疗效确切,同时测定患者红细胞天然免疫功能可作辅助性观察和评价治疗效果。