Topical anthralin for psoriasis vulgaris: evaluation of 70 Japanese patients

In order to determine the usefulness of anthralin in the treatment of psoriasis, we evaluated the effectiveness of topical anthralin therapy in patients with psoriasis vulgaris in our hospital. Seventy patients with plaque-type psoriasis (58 men and 12 women), aged 17-79 years-old (mean; 47.6 years-old), who were treated at the Department of Dermatology, Tokyo Medical and Dental University, between 1992 and 1999, were retrospectively evaluated. Mean psoriasis activity and severity index (PASI) score before therapy was 24.6. Patients were treated with 0.1-2.0% topical anthralin. Responses were determined by clinical examination. The mean PASI score decreased to 8.7 after three months. The most effective anthralin concentration was 0.4-0.5%. The overall response rate was 85.7%, complete remission was obtained in 21.4%, and partial remission in 64.3%. Ten patients (14.3%) were anthralin-resistant. In all patients who entered complete remission, recurrence was noted within six months after stopping anthralin. Minor skin irritation and pigmentation occurred in most of the patients; however, no severe side effects were noted during the treatment. Our study indicated that anthralin is effective for chronic plaque-type psoriasis.     

Obesity in psoriasis: leptin and resistin as mediators of cutaneous inflammation

Background  Obesity is a significant risk factor for psoriasis and body mass index (BMI) correlates with disease severity.
Objectives  To investigate the relationship between obesity and psoriasis, focusing on the role of adipokines such as leptin and resistin.
Patients/methods  Patients with psoriasis ( n  =   30) were recruited and their BMI, waist circumference and disease severity [Psoriasis Area and Severity Index (PASI)] were recorded. Fasting serum samples were obtained on enrolment and after a course of ultraviolet (UV) B treatment. Age-, sex- and BMI-matched healthy controls were also recruited.
Results  On enrolment, serum leptin and soluble leptin receptor levels were not raised compared with the controls. However, resistin, interleukin (IL)-1β, IL-6, and chemokines CCL2, CXCL8 and CXCL9 were all significantly elevated in the patient group and serum resistin correlated with disease severity ( r  =   0·372, P  =   0·043). Improvement after UVB treatment was accompanied by decreased serum CXCL8. In vitro , both leptin and resistin could induce CXCL8 and tumour necrosis factor-α production by blood monocytes, and leptin could additionally induce IL-1β and IL-1 receptor antagonist production. Leptin also dose dependently increased secretion of the growth factor amphiregulin by ex vivo -cultured lesional psoriasis skin.
Conclusions  These data support the view that leptin and resistin may be involved in the pathogenesis of psoriasis in overweight individuals, possibly by augmenting the cytokine expression by the inflammatory infiltrate.     

HLA-G在寻常性银屑病中的表达

以往的研究显示,人类白细胞抗原G(HLA-G)是一种免疫耐受分子,它与许多临床疾病有密切联系[1].我们应用免疫组化标记亲合素生物素-链霉亲合素法(LAB-SA)对寻常性银屑病皮损中HLA-G进行检测,以探讨HLA-G在寻常性银屑病中的表达.     

寻常型银屑病诱因流行病学研究

目的：研究寻常型银屑病的诱因。方法：采用病例对照研究方法,调查了１８２例寻常型银屑病首发患者、６０９例复发患者及同一地区的健康对照６４７例,对建党型银病的诱发因素进行了研究。结果：（１）建党银屑病首发诱因为：服药、感染、精神紧张、受潮、嗜酒、吸烟、食鱼虾、接种疫苗及外伤（Ｐ〈０．０５）;（２）建党银屑病复发诱因为：精神紧张、受潮、嗜酒、吸烟、食鱼虾、服药、接种疫苗、感染（Ｐ〈０．０５）;（３）诱发     

寻常型银屑病患者miR-124与Th17 Treg细胞及相关细胞因子表达的关系

 目的探讨寻常型银屑病患者miR-124与Th17 Treg细胞及相关细胞因子表达的相关性。方法选取寻常型银屑病患者100例作为实验组（进行期47例,稳定期53例）,同时选取50例体检健康者作为对照组,采集外周血样本;用PCR法检测各组miR-124表达水平;用流式细胞仪检测Th17和Treg细胞数量;用双抗体夹心ELISA法检测各组细胞因子TNF-α、IFN-γ、TGF-β、IL-6、IL-17、IL-21、IL-23水平;采用RT-PCR法检测各组ROR-γt mRNA和Foxp3 mRNA转录水平,同时分析miR-124表达与Th17 Treg细胞及相关细胞因子表达的相关性。结果银屑病进行期组和稳定期组miR-124表达水平均低于对照组（均P<0.05）。对照组Th17、Treg和Th17/Treg水平分别为（0.64±0.31）%、（5.11±1.45）%和（0.13±0.05）,均低于银屑病进行期组和稳定期组患者（均P<0.05）。寻常型银屑病进行期和稳定期患者TGF-β的浓度分别为（476.52±34.42）、（471.10±52.39） pg/L,均低于对照组（均P<0.05）;而其他细胞因子TNF-α、IFN-γ、IL-6、IL-17、IL-21和IL-23水平均高于对照组（均P<0.05）。对照组患者ROR-γt mRNA和Foxp3 mRNA值分别为9.14±2.98、2.45±0.97,均高于银屑病进行期组和稳定期组患者（均P<0.05）。对照组miR-124水平与Th17和Treg之间无相关性（r=0.30,P=0.542;r=0.35,P=0.612）,而银屑病进行期组和稳定期组患者miR-124水平与Th17和Treg之间均存在相关性（P<0.05）。IFN-γ、TGF-β、IL-17、IL-21和IL-23与miR-124表达之间均存在相关性（均P<0.05）。结论寻常型银屑病患者Th17和Treg细胞的分化失衡与miR-124表达有关,miR-124表达异常减少可能是寻常型银屑病患者发生发展的因素之一。     

Acceptance of chronic illness in psoriasis vulgaris patients

BACKGROUND: Acceptance of an illness is regarded as a considerable problem in patients with chronic diseases. Lack of acceptance can lead to lower adherence to medical treatment and delayed clinical improvement. Psoriasis, being a chronic skin disease, is known to cause considerable distress to patients. OBJECTIVES: To examine whether selected demographic factors and personal resources have an impact on acceptance of illness in psoriasis vulgaris patients. METHODS: Self-reported data on acceptance of illness, self-efficacy, health locus of control, optimism and coping strategies were collected from 100 psoriasis vulgaris inpatients and PASI was calculated by a dermatologist. The following measures were employed: acceptance of illness scale, generalized self-efficacy scale, multidimensional health locus of control scale, life orientation test and mental adjustment to disease scale. RESULTS: Physical factors such as sex, age, disease duration and severity, and family history of psoriasis had no effect on acceptance of illness. However, based on multiple regression analysis, higher levels of optimism, lower conviction of others' influence on one's health and the less frequently employed coping strategy concentration on emotions, together with more severe disease expressed by PASI, were correlated with higher acceptance of disease in psoriasis patients. CONCLUSIONS: The results obtained seem to confirm that personal resources play an important role in acceptance of chronic illness. Enhancement of optimism, and minimizing one's conviction that one's health depends on others could lead to higher acceptance of illness.     

寻常性银屑病患者血清白细胞介素-26水平与疾病严重度相关性分析

目的:检测寻常性银屑病患者血清中白细胞介素(IL)-26的表达量,并分析其对疾病严重程度的影响.方法:选取2017年12月-2019年1月来山西医科大学第一附属医院就诊的寻常性银屑病患者84例作为观察组,其中进展期患者40例,静止期患者44例;选择同期在该院进行健康体检的志愿者40例作为对照组.采用流式细胞术检测2组患...     

小儿寻常型银屑病伴发皮肌炎1例

患儿男，9岁，头皮、凹肢、躯干部鳞屑性斑块4年。病理报告符合寻常型银屑病，面部水肿性红斑伴肌痛、肌无力2年。肌酶指标升高，肌电图示广泛肌源性损害神经电图示运动神经传导速度在正常范围内。诊断为寻常型银屑病伴发皮肌炎。     

寻常型银屑病患者外周血中微粒子的表达

目的：检测微粒子在寻常型银屑病外周血中的表达。方法：高速离心法分离33例寻常型银屑病患者和33名正常人对照外周血T细胞、B细胞及单核细胞来源的微粒子,分别进行细胞特异性单克隆抗体标记,采用流式细胞仪检测三种细胞来源的微粒子数量。结果：银屑病组患者血浆中T淋巴细胞（CD3+）来源的微粒子、单核细胞（CD14+）来源的微粒子和B淋巴细胞（CD19+）来源的微粒子数量分别为（6.6±0.2）×105,（3.9±0.3）×105和（4.1±0.2）×105高于正常对照组的（2.0±0.3）×105,（1.6±0.3）×105和（1.1±0.2）×105.治疗后银屑病组患者微粒子的总数量较治疗前明显减少（P<0.01）。此外,银屑病患者血浆中微粒子水平与PASI评分具有相关性,尤其是T淋巴细胞源性微粒子。结论：微粒子的数量在寻常型银屑病外周血中明显升高,可能在银屑病的发病中起到重要作用。     

The evaluation of the clinical effect of topical St Johns wort (Hypericum perforatum L.) in plaque type psoriasis vulgaris: a pilot study

In this case series, ten patients with plaque-type psoriasis were treated with Hypericum perforatum ointment. The hypericum ointment was applied to one side of each patient's body and the vehicle to the opposite side twice daily for 4 weeks in a single blinded manner. Modified psoriasis area severity index (PASI) scores were significantly lowered where the formulated ointment had been applied. In determining PASI scores, three factors, erythema, scaling and thickness, were evaluated; all were significantly lower where the formulated ointment had been applied (P = 0.01, P = 0.004, P = 0.04). Hypericum perforatum ointment applied twice daily may be effective in reducing PASI scores in mild plaque-type psoriasis, however, further larger studies need be conducted to achieve a more conclusive result.     

寻常型银屑病颗粒层消失的组织病理研究

经病理切片观察 ,发现寻常型银屑病旁边的“正常表皮”颗粒层消失者占 70 8% (重的占 45 8% )。因而提出寻常型银屑病旁边的“正常表皮”颗粒层消失与进行期密切相关 ,它极可能是寻常型银屑病在表皮的最早的组织病变。     

Efficacy of biologic therapies in psoriasis vulgaris

Psoriasis is a chronic, immune‐mediated skin disease that also has systemic manifestations. Biologic preparates: Adalimumab, Etanercept, and Infliximab are licensed for psoriasis vulgaris treatment in Albania. To compare the efficacy of biologic therapies used for psoriasis based in our experience. A cohort prospective study during the years 2016–2018 at UHC “Mother Teresa” Tirana. In the study took place 78 patient diagnosed with psoriasis and treated with biologic therapies. Psoriasis Area Severity Index (PASI) 50 and PASI 75 index were the parameters of response outcomes. PASI 50 was achieved for 6.8, 7.02, and 7.2 weeks in patients with Etanercept, Adalimumab, and Infliximab respectively and PASI 75 for 12.8, 11.4, and 11.42 weeks. X2 = 0.076, p > .05, nonsignificant difference. PASI 50 was achieved in 27.2% of subject treated with Etanercept, 67.4% Adalimumab, and 55.5% with Infliximab for the weeks mentioned above. Meanwhile PASI 75 was achieved in 45.4% of subject treated with Etanercept, 61.7% Adalimumab, and 25% with Infliximab. X2 = 15.28, p < .05, significant difference. Biologics have revolutionized the treatment of psoriasis. To select the most appropriate agent for patient, should be considered multiple factors including adverse effects, tolerance, patient preference, cost, and mode of administration.     

甘肃地区寻常性银屑病病情相关因素分析

目的探讨影响银屑病发病及病情的饮食因素及其他因素,指导银屑病患者合理饮食与健康生活。方法采用问卷调查的方法,运用1:1配比病例对照研究,使用单因素Logistic回归分析结合多因素条件Logistic回归模型分析。结果与银屑病病情密切相关的因素主要有:面粉(OR=2.214)、牛肉(OR=3.308)、羊肉(OR=2.145)、鱼虾(OR=1.952)、辣椒(OR=2.559)、洋葱(OR=1.519)、吸烟(OR=2.515)、饮酒(OR=2.205)、咸菜和酸菜(OR=1.752),以及失眠(OR=1.502)与肥胖(OR=1.557),这些可能是银屑病的危险因素;而大米(OR=0.422)、粗粮(OR=0.252)、蛋类(OR=0.459)、鲜奶(OR=0.576)、苹果(OR=0.650)、香蕉(OR=0.656)、芹菜(OR=0.515)、茄子(OR=0.652)可能是银屑病的保护因素。结论银屑病患者应戒烟、戒酒,避免失眠,避免进食鱼虾、辛辣、羊肉、牛肉、辣椒、面粉、洋葱等食物,多食大米、粗粮、鸡蛋、鲜奶、苹果、香蕉、芹菜、茄子等食物,注意控制体重,保证睡眠质量。     

Reciprocal altered expression of T-cadherin and P-cadherin in psoriasis vulgaris

BACKGROUND: The most characteristic change in psoriasis vulgaris is markedly increased, persistent keratinocyte proliferation. The underlying mechanism of excessive epidermal growth is controversial. We previously found and reported that T-cadherin was expressed in keratinocytes and confined to the basal layer of mouse and human skin. Invasive cutaneous squamous cell carcinoma showed a loss of T-cadherin expression. Another study showed that T-cadherin was a negative growth regulator of epidermal growth factor in T-cadherin transfectant neuroblastoma cells. OBJECTIVES: To obtain insight into the role of T-cadherin in keratinocyte proliferation and to investigate further the pathogenesis of psoriasis vulgaris, we examined the expression of T-cadherin, as well as E- and P-cadherin, in psoriasis vulgaris. METHODS: Four untreated active psoriatic skin samples from psoriasis vulgaris patients and four normal human skin samples from plastic surgery were collected, cryosectioned and immunohistochemically stained by antihuman T-, P- and E-cadherin antibodies. Further, the immunofluorescence intensities of T- and P-cadherin on the basal layer of the epidermis were quantitatively measured by the histogram function of LSM 510 software installed in a Zeiss laser scanning confocal microscope. The data were statistically analysed by Student's t-test. RESULTS: It was observed that T-cadherin was weakly and discontinuously expressed on the basal layer of psoriatic skin, while it was intensively expressed on all basal keratinocytes in normal human skin. In contrast, P-cadherin was strongly expressed throughout the entire epidermal layer in psoriatic skin samples, although its expression is restricted to the basal cell layer in normal human skin. There were no obvious differences in E-cadherin expression between normal human skin and psoriatic skin. Statistical analyses showed that the immunofluorescence intensity of T-cadherin in the basal cell layer of psoriatic skin (35 +/- 9.08) was significantly decreased compared with that in normal human skin (131.75 +/- 3.49, P = 2.46 x 10(-6)). There was a significant increase (P = 0.00139) in the immunofluorescence intensity of P-cadherin in the basal layer of psoriatic skin (68.25 +/- 12.13) compared with normal human skin (26 +/- 4.90). CONCLUSIONS: The present study demonstrates that there is downregulation of T-cadherin expression and upregulation of P-cadherin expression in psoriatic skin, which are considered to be involved in the hyperproliferation of keratinocytes in psoriasis vulgaris.     

寻常型银屑病患者外周血髓系树突状细胞CD47的表达

目的：检测寻常型银屑病患者外周血髓系树突状细胞（mDCs）表面整合素相关蛋白（CD47）的表达水平。方法：流式细胞仪检测寻常型银屑病患者和健康对照者外周血mDCs表面CD47及CD4+调节性T细胞（Treg）表达水平；Luminex液相芯片技术检测上清液IL-23、IL-17和TNF-α浓度。结果：共检测46例患者和46名健康对照，患者组mDCs细胞CD47表达水平为32.8低于对照组的63.6，差异有统计学意义（P<0.05）。患者组mDCs细胞CD47表达水平与银屑病皮损面积和严重程度指数（PASI）负相关（r=-0.651, P<0.05）；患者组Treg细胞比例显著低于对照组，差异具有统计学意义（P<0.05）；IL-23、IL-17和TNF-α浓度显著高于对照组，差异具有统计学意义（P<0.05）。结论：银屑病外周血mDCs表面CD47及Treg细胞表达下降。     

银屑病皮损区肥大细胞分布和血管内皮细胞CD34表达的研究

目的探讨肥大细胞(MC)和血管内皮细胞在银屑病发病中的作用.方法采用组织化学和免疫组化的方法,观察寻常性银屑病皮损处MC和CD34标记血管内皮细胞的分布情况.结果经甲苯胺蓝特殊染色发现,银屑病患者真皮区的MC密度在进行期(33.07±14.63)个/mm2,高于静止期(21.80±4.86)个/mm2,静止期又高于正常对照组(15.85±6.93)个/mm2,它们之间的差异均有显著性;免疫组化观察发现,银屑病真皮区CD34标记的微血管密度在进行期(2931±4.04)个/mm2,明显高于静止期(2231±2.07)个/mm2,而静止期又明显高于正常对照组(18.81±2.59)个/mm2.结论寻常性银屑病皮损处真皮内肥大细胞和血管内皮细胞密度明显增加,且与病情变化有关.     

寻常型银屑病复发相关因素分析及自我管理干预研究

目的:明确寻常型银屑病相关复发因素,建立科学有效的自我管理模式.方法:收集2017年3月至2018年12月皮肤科门诊就诊的寻常型银屑病复诊患者,填写调查问卷,通过Logistic回归法分析相关影响因素,根据影响因素制定个体化健康教育处方.将复诊的患者随机分为对照组和干预组,分别实施常规健康教育和个体化健康教育处方的临床...     

窄谱中波紫外线不同照射剂量治疗寻常性银屑病临床疗效观察

目的：观察311nm窄谱中波紫外线（NB—UVB）不同照射剂量以及维持照射治疗寻常性银屑病的疗效及安全性。方法：采用半身、单盲、不同照射剂量方案治疗25例寻常性银屑病患者．回顾性分析维持照射以及不干预方案对银屑病复发的影响。结果：92％的患者银屑病皮损面积和严重度指数（PASI）评分改善率〉75％;大剂量方案起效较快;低增量方案的平均累积剂量较低,平均治疗次数较多,平均治疗费用也较高;维持照射以及不干预方案对于患者1年后的复发率无明显影响。结论：NB—UVB治疗寻常性银屑病疗效好、不良反应小;低增量方案有望在取得满意疗效的同时降低紫外线治疗的潜在风险;对已取得满意疗效的银屑病患者不建议采用维持光疗方案。     

308nm单频准分子光治疗寻常性银屑病和掌跖银屑病临床疗效观察

目的:评估308nm单频准分子光局部照射治疗寻常性银屑病和掌跖银屑病的临床疗效及安全性。方法:采用单频准分子光局部照射治疗35例寻常性银屑病和15例掌跖银屑病患者皮损,每周照射1次或2次,每2周评估疗效1次,并记录不良反应。结果:30例寻常性银屑病患者经16次照射,有效率达70%,慢性斑块型疗效较好。15例掌跖银屑病患者经25次照射,有效率为53.3%。单频准分子光局部照射主要不良反应为瘙痒,局部出现红斑,偶有水疱。结论:308nm单频准分子光局部照射治疗寻常性银屑病和掌跖银屑病见效快,疗程短,且不良反应少。     

Acitretin exerted a greater influence on T‐helper (Th)1 and Th17 than on Th2 cells in treatment of psoriasis vulgaris

T‐helper (Th) cells, including Th1, Th2 and Th17 cells, may play an important role in the pathogenesis of psoriasis vulgaris (PV). Acitretin is an effective treatment for PV; however, its influence on Th cells during the treatment of PV is unclear. This study aimed to investigate the influence of acitretin on Th1, Th2 and Th17 cells in PV patients. PV patients (n = 30) received acitretin p.o. (20 mg/day) for 8 weeks. Sera and skin biopsies were obtained before and after treatment. Double‐labeled immunofluorescence was used to analyze T, Th1, Th2 and Th17 cells in skin lesions. Enzyme‐linked immunosorbent assay and western blot were used to analyze the expressions of interferon (IFN)‐γ, interleukin (IL)‐4 and IL‐17 in sera and skin lesions. The expressions of IFN‐γ mRNA, IL‐4 mRNA and IL‐17 mRNA in skin lesions were detected by in situ hybridization. Acitretin decreased the quantity of T, Th1 and Th17 cells in PV lesions, but had no significant influence on Th2 cells. Acitretin also decreased the expression of IFN‐γ and IL‐17 in serum and lesions. The expressions of IFN‐γ mRNA and IL‐17 mRNA decreased significantly after 8 weeks of therapy. However, acitretin had no significant influence on the expression of IL‐4 protein and mRNA. Acitretin can reverse Th1 and Th17 preponderance in PV patients to some degree. This may be due to the mechanism of acitretin on PV; however, Th2 cells were not affected by acitretin treatment.