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BackgroundEntheseal involvement is a frequent and distinctive feature of psoriatic arthritis (PsA). It is detected clinically but lacks sensitivity and reliability. Musculoskeletal ultrasound (MSUS) is an important tool for accurate detection of enthesitis.Aim of the workTo determine the frequency and distribution of subclinical entheseal abnormalities at lower limbs using MSUS in patients with psoriasis for early detection of PsA, and to evaluate its relation to disease severity.Patients and methods80 patients with psoriasis were studied. Psoriasis Area and Severity Index (PASI) was assessed. High-resolution MSUS assessment of quadriceps, patellar and Achilles tendons, and plantar fascia entheses was performed. Glasgow Ultrasound Enthesitis Scoring System (GUESS) was assessed.ResultsThe median (interquartile range; difference between 75th and 25th quartile) age of the patients was 46(26.3) years and were 42 males. The disease duration was 9(12) years, PASI was 10.9(18.9), and GUESS 6(4). Nail dystrophy was found in 48(60%). Clinical enthesitis was found in 15(18.8%) patients; MSUS revealed lower limb enthesopathy in at least one enthesis in 76(95%) patients, and abnormality in 421 of 800 entheses (52.6%). Distal insertion of the patellar tendon was the most frequently involved (68.8%). GUESS significantly correlated with the age, body mass index (BMI), and PASI.ConclusionPsoriasis is associated with a relevant frequency of asymptomatic entheseal abnormalities. MSUS is a valuable, simple, and noninvasive tool in early detection of enthesopathy in psoriatic patients, especially in the presence of older age, high BMI, and high PASI as potential parameters for detection of psoriatic enthesitis.  相似文献   
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目的:检测外周血中CD4~+CD25~+调节性T细胞(简称Treg细胞)与Th17细胞在寻常型银屑病(PV)中的表达。方法:34例寻常型银屑病患者,18例正常人作为对照。采用流式细胞术检测外周血中Treg细胞、FOXP3~+Treg细胞及Th17细胞的表达水平。结果:PV患者外周血中Treg细胞比例和FOXP3~+Treg细胞比例分别为(3.68±1.22)%和(0.53±0.19)%,低于正常对照组的(6.63±1.00)%和(0.76±0.14)%(P0.05)。Th17细胞比例为(2.20±0.78)%,高于正常对照组的(0.65±0.22)%(P0.05)。PV患者外周血中Treg细胞的表达与FOXP3~+Treg细胞的表达呈正相关(r=0.563,P0.05),而Treg细胞的表达与Th17细胞的表达呈负相关(r=-0.522,P0.05);Treg细胞和Th17细胞二者与PASI评分无相关性,与病程亦无相关性。结论:Treg细胞表达的减少及Th17细胞应答的增强,可能是导致PV免疫失衡的重要原因。  相似文献   
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Background

Resolvin D1 (RvD1), a pro-resolution lipid mediator derived from docosahexaenoic acid (DHA), has been described to promote several kinds of inflammatory resolution. However, the effects and anti-inflammatory mechanisms of RvD1 on psoriasis have not been previously reported.

Objective

The present study aimed to determine the protective effects and the underlying mechanisms of RvD1 on imiquimod (IMQ)-induced psoriasiform dermatitis.

Methods

Mice were topically treated with IMQ to develop psoriasiform dermatitis on their shaved back, pretreated intraperitoneally (i.p.) with or without RvD1 or tert-butoxycarbonyl Met-Leu-Phe peptide (Boc), a lipoxin A4 (ALX) receptor antagonist. The severity was monitored and graded using a modified human scoring system, the Psoriasis Area and Severity Index (PASI), histopathology, and the signature cytokines of psoriasis (IL-23, IL-17, IL-22 and TNF-α). The mRNA and protein levels of inflammatory cytokines were quantified by quantitative real-time PCR (QRT-PCR) and ELISA. The expressions of signaling proteins MAPKs and NF-κB p65 were analyzed using western blotting. Electrophoretic mobility shift assay (EMSA) was used to check NF-κB p65 DNA binding activity.

Results

Our study showed that RvD1 alleviated IMQ-induced psoriasiform dermatitis and improved skin pathological changes. RvD1 markedly inhibited IMQ-induced activation of ERK1/2, p38, JNK (c-Jun N-terminal protein kinase, a subfamily of MAPKs), and NF-κB. Furthermore, pretreatment with Boc, would not exacerbate skin inflammation of IMQ-induced mice, but significantly reversed the beneficial effects of RvD1 on IMQ-induced psoriasiform inflammation.

Conclusion

RvD1 can obviously improve skin inflammation in IMQ-induced mice psoriasiform dermatitis. The protective mechanisms might be related to its selective reaction with lipoxin A4 receptor/Formyl-peptide receptor 2 (ALX/FPR2), by downregulating relevant cytokines of the IL-23/IL-17 axis expression, the inhibition of MAPKs and NF-κB signaling transduction pathways. Thus, these results show that RvD1 could be a possible candidate for psoriasis therapy.  相似文献   
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There is a range of psoriasis treatments available, from topical applications to biologic therapy, with corresponding cost variations. The efficacy of each treatment is usually evaluated by objective measures such as the Psoriasis Area and Severity Index (PASI) or subjective measures such as the Dermatology Life Quality Index (DLQI). However, the social and economic impacts of psoriasis, including cost‐effectiveness, have not been assessed in Japan. The EuroQol 5‐Dimension (EQ‐5D) is a generic instrument used worldwide to calculate quality‐adjusted life years, on which calculations of treatment cost‐effectiveness are based. We conducted a pilot study to determine the cost‐effectiveness of psoriasis treatment in Japan. We administered a questionnaire to 133 patients with psoriasis (105 men and 28 women) who visited four university hospitals in Fukuoka Prefecture. The questionnaire covered medical costs, satisfaction and willingness to pay (WTP), and we investigated the relationships between these items. PASI was evaluated by physicians. More participants indicated satisfaction with treatment in the group paying less than ¥5000/month. WTP, PASI and EQ‐5D showed little correlation. However, the DLQI and EQ‐5D showed a moderate correlation (r = 0.472). WTP seemed more dependent on participants' economic backgrounds. We found that it was difficult to reflect the PASI with the EQ‐5D. However, the DLQI may be used to estimate the cost–benefit relationship in patients with psoriasis. This is the first study to evaluate the EQ‐5D in patients with psoriasis in Japan.  相似文献   
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心理治疗对寻常性银屑病患者疗效及生活质量的研究   总被引:5,自引:0,他引:5  
目的:探讨心理治疗对寻常性银屑病患者疗效及生活质量的影响。方法:纳入了152例生活质量受明显影响的寻常型银屑病患者,随机分为治疗组、对照组,分别于治疗前、治疗后用皮肤病生活质量表(DQOLS)、银屑病皮损面积与严重程度指数(PASI)进行评价。结果:治疗组患者DQOLS和PASI积分均得到明显改善,优于对照组(P<0.01);治疗组DQOLS的改善程度与PASI的改善程度显著相关(P<0.05)。结论:心理治疗有利于皮损症状的改善,从而提高寻常性银屑病患者的生活质量。  相似文献   
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This study aimed to prove the similarity of the composition of non-aromatic Croatian naphthalane (NAN) with brown naphthalane (BN), which is used in the treatment of psoriasis vulgaris. The comparison of the compositions was performed by obtaining GC fingerprints, which were supported by GC-MS data. In spite of remarkable differences in general profiles of the GC chromatograms, lower and medium molecular weight components of NAN were found to be qualitatively the same as the saturated constituents of BN. Quantitatively, lower molecular weight components as well as all n-alkanes were comparatively lower in NAN. NAN, additionally, contained higher molecular weight components, among which there were saturated oligocyclic hydrocarbons (up to pentakishomohopanes), described as responsible for the curing effect of naphthalane. The composition characteristics of NAN including its non-aromatic character made it suitable for a clinical study. In the treatment, the efficacy was determined by means of comparison of Psoriasis Area Severity Indices, PASI, at the beginning and at the end of the therapy. Adult volunteer-patients, nine males and six females, applied NAN over the whole body, except the scalp, at the room temperature for 20 min and this was followed by the selective UVB radiation. After the 3-week therapy, all essential clinical manifestations as erythema, desquamation and infiltration were significantly reduced in 14 patients; in nine cases the improvement was 50–93%, while the state of five patients improved between 25 and 50%. In one case, there was no obvious change. No exacerbation occurred during the therapy period. No adverse effect on hematological or biochemical parameters was noticed.  相似文献   
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