EFFECT OF RETINOIC ACID IN PSORIASIS, II

Summary.— Clinical and histological features and mitotic counts have been studied in the lesions of 11 patients with psoriasis who were treated with topically applied retinoic acid ointment for a period of 3 months.
Serial biopsies were taken at monthly intervals from treated lesions in all 11 patients and from lesions treated with the unmedicated ointment base in 9.
There was no significant difference between treated and placebo groups regarding any of the parameters studied. Irritant effects of the retinoic acid were prominent in 7 patients.
The significance of these results is discussed in the light of the known mechanism of action of retinoic acid.     

TOPICAL RETINOIC ACID IN THE TREATMENT OF ACNE VULGARIS

Summary.— Twenty-two patients with facial acne vulgaris received local treatment with 0·1% retinoic acid lotion. Although a slight to moderate improvement occurred in 13 patients, the irritant effect of the lotion was a major problem producing an unacceptable degree of erythema and peeling. If the frequency of application of the lotion was reduced sufficiently to minimize the side effects of treatment, any obvious beneficial effect on the acne was often lost.     

HYDROXYUREA IN THE TREATMENT OF PUSTULAR PSORIASIS

SUMMARY.— Four patients with generalized pustular psoriasis of von Zumbusch were treated with hydroxyurea in an oral dosage of 1–2 g daily. In each instance the pustular, the febrile, the leucocytic and toxic responses were significantly suppressed.
It is suggested that the effectiveness of this new treatment reflects the known selective suppressant effect of hydroxyurea on the polymorphonuclear leucocytes, which apparently play a central role in this disease.     

A DIETARY REGIMEN IN THE TREATMENT OF PSORIASIS

SUMMARY.— A dietary regimen employing turkey meat as the major protein source has been evaluated in patients with severe psoriasis. These patients had been selected for failure to remit spontaneously and failure to respond to other methods of therapy. Of 12 patients studied, 7 exhibited excellent response, 3 moderate response, and 2 no response to the dietary regimen. Two patients, who responded initially, were studied further. Upon resumption of a normal diet, their disease exacerbated. Reinstitution of the study diet again resulted in complete clearing of their psoriasis. Addition of turkey to a normal diet, however, did not prevent re-exacerbation.
These results suggest that turkey meat may lack a substance potentially harmful to patients with psoriasis.     

DITHRANOL IN A CREAM BASE IN THE TREATMENT OF PSORIASIS

In this study, twenty patients with mild or moderately severe psoriasis were divided into two groups. In one group the combination of PUVA therapy and dithranol cream was compared with PUVA therapy alone. In the other group dithranol 0.2% in Lassar's paste was compared with dithranol cream. On an overall assessment, patients improved after treatment for a period of four weeks. In the group comparing dithranol cream with 0.2% dithranol in Lassar's paste, seven of the eight patients preferred dithranol cream. Both preparations caused staining of the skin and clothes but irritation of the normal skin was more prevalent in those areas treated with dithranol 0.2% in Lassar's paste. The dithranol cream formulation (Di-Cream) was shown to be a stable, effective formulation that was more acceptable to patients than dithranol in Lassar's paste.     

THE USE OF RETINOIC ACID IN CONGENITAL ICHTHYOSIFORM ERYTHRODERMA *

SUMMARY. . A patient with congenital ichthyosiform erythroderma was treated with retinoic acid, topically and orally. By both methods a considerable improvement in the condition was achieved. The background to the use of this agent and some hypotheses as to how it may influence keratin are discussed.     

NAEVES COMEDONICUS TREATMENT WITH RETINOIC ACID

Summary.— Two patients are described with naevus comedonicus. Both patients were successfully treated with topical retinoic acid with a minimum of irritation. Continued periodic application of retinoic acid is necessary to prevent reaccumulation of horny material in the involved follicles.     

EFFECT OF EETINOIC ACID IN PSORIASIS

The effect of topical retinoic acid on the clinical and histological features and mitotic counts of lesions in 12 patients with psoriasis have been studied for a 2-week period. Serial biopsies were performed on lesions treated with retinoic acid in all 12 patients; control lesions treated with unmedicated ointment base were similarly biopsied in 7. There was a significant clinical improvement in 11 of the 12 patients treated with retinoic acid, and in all these patients it was greater than that achieved in the control lesions. Reformation of the granular layer, which was previously absent or only partially formed, occurred in 6 of the 12 psoriatic lesions treated with retinoic acid, but in none of the controls. Mitotic counts for the treated group fell after the 2-week period, but not in the controls. Topical retinoic acid would seem to be of therapeutic value in the treatment of psoriasis. The possible mechanisms of action are discussed.     

HYDROXYUREA: A NEW ANTIMETABOLITE IN THE TREATMENT OF PSORIASIS

SUMMARY.— A short term study of the treatment of 12 cases of refractory psoriasis with hydroxyurea is reported. Before commencing treatment, each patient's Hb., W.B.C. and platelets were determined and liver and renal function tests were performed. The dose of hydroxyurea varied from 1.5 to 2.0 g daily and treatment was continued until a maximal therapeutic response was obtained. All cases were evaluated at weekly intervals and weekly determinations of W.B.C, Hb. and platelets were made. Six of the patients were favourably affected, 2 showed no change after 8 weeks of treatment and 4 discontinued treatment because of side effects.     

DOUBLE-BLIND COMPARISON OF TOPICAL HALCINONIDE AND FLUOCINONIDE IN THE TREATMENT OE PSORIASIS

ABSTRACT: In a short-term, double-blind paired-comparison study involving 50 patients with mild to severe psoriasis, halcinonide cream, 0.1% was superior to fluocinonide cream, 0.05%. The superiority of halcinonide was evident after 2 weeks of treatment.