中西医结合治疗红皮病型银屑病的疗效观察

目的观察中药与小剂量阿维A治疗红皮病型银屑病的临床疗效。方法33例红皮病型银屑病患者随机分为两组,治疗组采用本院中药清热活血方(150mL,2次/d,早晚饭后半小时口服)配合小剂量阿维A(20mg,1次/d)治疗,对照组采用口服阿维A胶囊治疗(20mg,1次/d),4周为1个疗程,治疗1个疗程后进行疗效判定,观察有效率、PASI积分及不良反应情况。结果治疗组有效率为94.12%,对照组为81.25%,两组有效率差异有显著性(P<0.01),治疗组有效率明显高于对照组,其不良反应也低于对照组。结论中药与小剂量阿维A治疗红皮病型银屑病疗效较好,不良反应少。     

中西医结合治疗红皮病型银屑病113例分析

红皮病型银屑病顽固难愈且病情凶险,我科经过多年探讨,初步总结出了中医、中西医结合治疗本病的方案,现报道如下。一、临床资料1979～1995年收住院的诊断明确的红皮病型银屑病113例。男91例,女22例;年龄13～84岁,平均46.06岁。病程25天至26年,其中复发者69例,既往有皮质类固醇激素(简称激素)或免疫抑制剂用药史者82例。二、治疗方案1.中药煎剂:为首选方案,主要分为两个证型。1毒热炽盛证:主证为发病急,全身弥漫性潮红、浸润及水肿,伴大量脱屑或有渗出;可伴发热、心烦、便干、溲赤,舌质红绛、苔薄白或黄腻,脉弦数。辨证为毒热挟湿,郁于营血。…     

红皮病型银屑病的中医、中西医结合治疗进展

综述近6年来中医、中西医结合治疗红皮病型银屑病的临床研究，并做出总结。     

中西医结合治疗红皮病性银屑病32例疗效观察

我科于2005年1月—2006年7月,采用中西医结合治疗32例红皮病性银屑病,取得了较好的临床疗效,并与同期单纯应用西药治疗的36例红皮病性银屑病进行比较,现报告如下。[第一段]     

Tigason治疗老年性红皮病型银屑病5例临床观察

近年来，Ｔｉｇａｓｏｎ治疗红皮病型银屑病取得满意疗效，但由于其严重的副作用，临床应用仍很谨慎，我们对５例老年性红皮病型银屑病用Ｔｉｇａｓｏｎ治疗，现报告如下：１临床资料：５例均为住院病人，男性，年龄５９—７４岁，平均年龄６６岁，有银屑病史３—５０年...     

Tigason治疗11例红皮病型银屑病疗效观察

Ｔｉｇａｓｏｎ治疗１１例红皮病型银屑病疗效观察白玫，宋智琦，高明阳Ｔｉｇａｓｏｎ（依曲替酯）治疗红皮病型银屑病的效果已被证实。但对其剂量、治疗方案、不良反应等国内尚报告不多，需要经验积累。现将我们治疗１１例红皮病型银屑病的初步结果报告如下。１病例和方...     

中西医结合治疗红皮病性银屑病27例临床观察

红皮病性银屑病在银屑病分型中属较重的一型,表现为全身皮肤发红、肿胀、脱屑,部分患者伴有发热,治疗较为困难.我们于1998年9月-2004年5月采用中西医结合辨证论治的方法,对该病进行了临床观察,取得了较好的效果,现报告如下.     

中西医结合治疗银屑病性红皮病21例

由银屑病引起的红皮病症状严重，若不及时处理往往出现较多并发症，甚至危及生命，现将笔者1999～2005年所遇到的21例报告如下。     

红皮病型银屑病16例治疗初探

红皮病型银屑病是银屑病的一种特殊的炎症类型，病情严重，病程迂延顽固，容易复发，治疗十分困难。现将我院1989—1998年共收治的16例红皮病型银屑病分析报告如下：     

红皮病型银屑病120例临床分析

目的分析红皮病型银屑病的诱发因素、实验室检查特点及治疗效果。方法对120例红皮病型银屑病患者的临床资料进行回顾性分析。结果多种因素可诱发或加重红皮病型银屑病,不规则应用糖皮质激素及中药、外用刺激性较大的药物、感染是其主要诱因,占75.83%。实验室检查显示患者有感染、低蛋白血症及电解质代谢紊乱等特征。结论加强对红皮病型银屑病的规范治疗可降低其发生率,药物联合应用治疗红皮病型银屑病可取得较为确切的疗效。     

红皮病型银屑病治疗进展

红皮病型银屑病是银屑病少见且严重的类型,其特点是并发症的发生率高,电解质异常导致的死亡率高,营养状况受损、体温调节异常和潜在的机会感染.随着临床研究不断发展,传统疗法、替代疗法、生物制剂,对于治疗红皮病型银屑病有效.本文就红皮病型银屑病的治疗进展进行综述.     

复方苦参注射液治疗红皮病型银屑病50例疗效评价

目的:评价复方苦参注射液治疗红皮病型银屑病的疗效和安全性。方法:106例患者随机分为观察组(53例)和对照组(53例),两组均给予胸腺五肽、美能注射液,另观察组加用复方苦参注射液,用药3周后比较疗效。结果:观察组总显效率92.5%,对照组总显效率52.9%,两组间差异有统计学意义(P0.05)。结论:复方苦参注射液治疗红皮病型银屑病安全有效。     

红皮病性银屑病52例临床分析

目的：探讨红皮病性银屑病的诱发因素,临床表现及治疗效果。方法：对52例红皮病性银屑病患者进行临床回顾分析。结果：男女发病率之比为4：1,多种因素可诱发或加重红皮病性银屑病,滥用糖皮质激素,中药的不合理治疗以及感染是其主要诱因。结论：合理规范的治疗是影响红皮病性银屑病预后的重要因素。甲氨蝶呤仍是治疗红皮病性银屑病的一线药物、阿维A联合复方甘草甜素（商品名：美能）治疗红皮病烂银屑病也有确切疗效。美能作为治疗红皮病性银屑病的联合用药效果良好,值得临床推广应用。     

Treatment of erythrodermic psoriasis in HCV+ patient with adalimumab

Erythrodermic psoriasis is a severe and disabling variant of psoriasis. The authors present the case of a 48-year-old man with psoriasis and hemophilia presented with a history of hepatitis C virus (HCV) infection treated with pegylated interferon alpha-2a and ribavirin therapy. At the end of antiviral therapy, skin manifestation progressively worsened, becoming erythrodermic, with lack of efficacy of steroid therapy. The authors decided to start biological therapy with induction dose of adalimumab (Humira, Abbott Laboratories, Abbott Park, Chicago, IL) 80 mg at Week 0 and 40 mg weekly. In our case, this resulted in a highly effective and safe treatment.     

A case of erythrodermic psoriasis successfully treated with ixekizumab

Erythrodermic psoriasis (EP) is the most severe form of psoriasis, resulting in significant morbidity and mortality. International guidelines on EP treatment are lacking, with most of the biologic drugs being used basing on case reports or small case series. Ixekizumab, a fully human anti‐interleukin (IL)‐17A monoclonal antibody, is approved for moderate to severe plaque psoriasis while its use in EP is off label. However, two studies conducted on eight Japanese EP patients have showed ixekizumab as an efficacious and well tolerated therapy up to 24 and 52 weeks, respectively. To date, no case reports on Caucasian patients have been described. We report the case of a 66‐year‐old Caucasian female with EP successfully treated with ixekizumab, reaching PASI 100 after only 6 weeks of therapy and still maintaining this response at week 24. Our case report suggests ixekizumab as a highly efficacious treatment in EP, presenting also a very rapid action which leads to complete resolution of the disease after 6 weeks. Further studies are warrant to confirm our data, with controlled trials specifically dedicated to EP being strictly needed in order to verify the role and efficacy of the new biologics in EP.     

司库奇尤单抗治疗红皮病型银屑病一例并文献复习

报道一例司库奇尤单抗治疗红皮病型银屑病治疗效果并复习相关文献.41岁红皮病型银屑病男性患者,在排除肝炎、结核的基础上,经知情同意后,给予司库奇尤单抗标准方案:0～4周每周皮下注射300 mg,随后每4周注射300 mg.在第4周达到PASI 75,第8周达到PASI 100.随访32周未见明显复发及不良反应.     

Efficacy and safety of ixekizumab treatment for Japanese patients with moderate to severe plaque psoriasis,erythrodermic psoriasis and generalized pustular psoriasis: Results from a 52‐week,open‐label,phase 3 study (UNCOVER‐J)

Psoriasis, a chronic, immune‐mediated skin disease characterized by red, scaly plaques, affects approximately 0.3% of the population in Japan. The aim of this open‐label study was to evaluate the long‐term efficacy and safety of ixekizumab, a humanized, anti‐interleukin‐17A monoclonal antibody, in Japanese patients with plaque psoriasis (n = 78, including 11 psoriatic arthritis), erythrodermic psoriasis (n = 8) and generalized pustular psoriasis (n = 5). Ixekizumab was administrated s.c. at baseline (week 0, 160 mg), from weeks 2 to 12 (80 mg every 2 weeks), and from weeks 16 to 52 (80 mg every 4 weeks). At week 52, 92.3% of patients with plaque psoriasis achieved Psoriasis Area and Severity Index (PASI) 75, 80.8% achieved PASI 90, 48.7% achieved PASI 100, and 52.6% had remission of plaques (by static Physician Global Assessment, sPGA [0]). Difficult to treat areas of psoriasis (nail or scalp) also responded to ixekizumab. All patients with psoriatic arthritis who were assessed (5/5) achieved an American College of Rheumatology 20 response. Most patients with erythrodermic psoriasis or generalized pustular psoriasis responded to ixekizumab and the clinical outcome was maintained over 52 weeks (75% and 60% of patients achieved sPGA [0, 1] at week 52, respectively). Mostly mild or moderate treatment‐emergent adverse events were reported by 79 of 91 patients; the most common were nasopharyngitis, eczema, seborrheic dermatitis, urticaria and injection site reactions. In conclusion, 52‐week ixekizumab treatment was efficacious and well tolerated in Japanese patients with plaque psoriasis. Efficacy was also observed in patients with erythrodermic psoriasis, generalized pustular psoriasis and psoriatic arthritis.     

Erythrodermic psoriasis in a dialyzed patient successfully treated with Secukinumab

Erythrodermic psoriasis is a severe, life‐threatening condition with additional complications, when occurring in hemodialyzed patients, as the majority of treatments are contraindicated. A 44‐years‐old man, of Philippine origins, with a 15‐years‐history of psoriasis treated with cyclosporine developed progressive hypertension and renal insufficiency. Despite drug dismission, renal function worsen to end‐stage, and hemodialysis was necessary three times a week. Phototherapy was not able to control the skin condition, progressing to erythroderma, and after nephrology consultation, the patient consent to the off‐label secukinumab treatment, at the standard regimen (300 mg subcutaneously once weekly at weeks 0‐4 followed by 300 mg every 4 weeks). Seven days after the first injection, a rapid improvement was noted, with the psoriasis area severity index (PASI) score passing from 31.5 to 17.6. At the 52‐week‐follow‐up visit, the patient was completely clarified, without any side effects. The case supports secukinumab effectiveness and safety in difficult patients, including erythrodermic psoriasis with end‐stage renal failure, as drug plasma levels seem not to be affected by hemodialysis. Results are rapidly achieved, and long term maintained, with the additional advantage of a very comfortable monthly administration.     

Practical compendium for psoriasis management

Psoriasis management is complex and challenging. It should be tailored for each patient. Treatment strategy differs according to patient's age, sex, disease type, disease severity, burden on patient's quality of life, comorbidities, involvement of specific sites, and pregnancy. The choice of the appropriate therapeutic must take into consideration the availability, the price, and the patient's preferences. It is very important that the chosen treatment is not more unpleasant, intolerable, or dangerous than the disease itself. According to the disease type, severity, and effect on patient's quality of life, dermatologist chooses whether to start with topical therapy, phototherapy or systemic therapy, or a combination of two or more of them. Under each category, there are different types of therapies that can be the first line therapeutics, second line, or even contraindicated. In this compendium, we provide dermatologists with different treatment plans considering all the mentioned variables so that a dermatologist can choose the optimum plan for the patient.     

Ustekinumab in severe complicated erythrodermic psoriasis: rapid clearing,safety, and sustained remission

Erythrodermic psoriasis is a severe type of psoriasis associated with comorbidities and high mortality. Patients with erythrodermic psoriasis need hospitalization and systemic treatment. Conventional drugs and biologic agents may not manage to control refractory and complicated erythrodermic psoriasis resulting from treatment failure. Ustekinumab, a human monoclonal antibody against interleukin‐12 and 23, seems to be an effective therapeutic option in erythrodermic psoriasis whenever other therapies have failed.