M Lebwohl

..It selectively reduces CD45RO(+) memory T cells and inhibits T-cell activation. Clinical data support its safety and efficacy in a substantial subset of patients with psoriasis...

..Ustekinumab targets interleukin (IL)-12 and IL-23 in the treatment of moderate-to-severe psoriasis...

..Systemic therapies such as methotrexate, retinoids, and ciclosporin are effective for patients with refractory or extensive cutaneous disease...

..Calcipotriene, the only vitamin D analog already approved for psoriasis in the USA, has been used successfully in combination with ultraviolet B and psoralen plus ultraviolet A...

..Clinical improvement was maintained for up to 52 weeks, with no clinical effect on calcium homeostasis or other relevant laboratory test parameters...

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..To determine the incidence of cutaneous squamous cell carcinoma (SCC) in patients with rheumatoid arthritis receiving etanercept, a tumor necrosis factor antagonist, for up to 5 years...

..The immune system plays a critical role in the development and pathogenesis of actinic keratosis (AK). Imiquimod has been shown to stimulate the cutaneous immune response and be effective for the treatment of nonmelanoma skin cancers...

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..Patients with psoriasis tend to be overweight, and the efficacy of fixed-dose biologics may be compromised by high body weight...

..Because some degree of therapy will always be necessary, ranging from maintenance of long-term remission to control of acute psoriasis flares, each patient requires an individualized plan...

..Calcitriol 3 microg/g ointment has demonstrated good clinical efficacy as well as topical and systemic safety when used to treat psoriasis...

..Although numerous data exist regarding the use of acitretin and biologic agent therapy alone for psoriasis, little is known about the efficacy, safety, and tolerability of acitretin combined with biologic agents...

..With the creation of the newer"biologics," however, the treatment of psoriasis is being re-evaluated...

..The purpose of the algorithms is to make optimum use of phototherapy, traditional cytotoxic and immunosuppressive agents, retinoids, and newer biologic agents...

..It is notable that in subjects who were being treated with a variety of agents, the addition of clobetasol propionate spray 0.05% during the course of the study resulted in improvements in disease severity...

..Participants should also have a better understanding of side effects associated with each treatment, which should help in determining options for therapy...

..A new class of topical receptor-selective acetylenic retinoids, the first of which is tazarotene, has been developed...

..These results suggest that the intercalation of genistein and estradiol into DNA may alter the DNA structural integrity, interrupt the production of oxidizing species, and subsequently reduce the formation of 8-OHdG by UV radiation...

..05% ointment and cream have been shown to be compatible with calcipotriene for up to 2 weeks. The compatibility of calcipotriene and halobetasol permits the use of these agents together...

..Other biologic agents are likely to be added to this list in the future...

..This article focuses on the transition for patients with psoriasis being managed with methotrexate and cyclosporine to retinoids, phototherapy, and newer agents...

..As long as treatments are used correctly, the benefits of combination therapy with vitamin D analogues usually outweigh the few drawbacks...

..Combinations of different treatments are addressed and investigational therapies that are in development are reviewed...

..Conclusions Ustekinumab improves HRQoL in patients with moderate-to-severe psoriasis. Patient-reported outcomes measured a treatment effect beyond that indicated by clinical measures...

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..Patients with psoriasis, in particular, tend to be above normal weight. Three of the 5 biologics used to treat psoriasis are fixed-dosed treatments: alefacept, etanercept, and adalimumab. Dosing regimens do not account for weight...

..0001) based on a Static Severity Score. Adverse events were similar in the 0.1% tacrolimus ointment and vehicle groups. Conclusion Tacrolimus ointment is an effective treatment for psoriasis of the face or intertriginous areas...

..0007). Adverse events were similar between groups. CONCLUSION: Pimecrolimus cream 1% is an effective treatment for inverse psoriasis with a rapid onset of action, and is safe and well-tolerated...

..CONCLUSION: The combination of acitretin with narrowband UVB results in faster improvement even in more difficult-to-treat patients. In combination the treatments appear to have synergistic effects...

..05). Our results suggest that genistein exerts its anti-initiational and anti-promotional effects on skin carcinogenesis probably through blockage of DNA adduct formation and inhibition of oxidative and inflammatory events in vivo...

..Acitretin should be considered as a maintenance therapy for psoriasis patients developing squamous cell carcinomas as a result of PUVA therapy...

..These results suggest that tazarotene gel can be successfully coprescribed with a range of commonly used topical psoriasis treatments without adversely affecting the chemical stability of either agent...

..05% caused a significantly greater reduction in epidermal thickness compared with fluocinonide cream 0.1% when used twice daily for 2 weeks (P<.001). However, neither drug caused significant clinical signs of atrophy...

..We will discuss the use of disease-modifying antirheumatic drugs and the biologic therapies in the treatment of patients with moderate to severe psoriatic arthritis...

..TNF inhibitors represent new therapeutic options for patients with PsA. The potential advantages of treatment with etanercept and infliximab early in the disease course are discussed...

..CONCLUSION: In the base case analyses, tacrolimus ointment was more cost-effective than HPTCs administered in 2-week treatment cycles, and similar in cost-effectiveness to 4-week cycles of HPTCs...

..Effective psoriasis therapies are needed for long-term symptom control...

..Low-dose acitretin has been used for many years as monotherapy or in combination with other systemic therapies for psoriasis. Evidence to date suggests that the frequency of symptomatic bony effects is quite low in these patients...

..Our studies suggest that reduction of oxidative damages to biological macromolecules in vitro and in vivo may at least in part explain the anti-carcinogenic and chemopreventive actions of tamoxifen...

..These findings support the use of alefacept as a viable treatment of psoriasis, without the toxicities associated with some of the current systemic treatments available...

..There is strong evidence that actinic keratoses can progress to squamous cell carcinoma, underscoring the need to identify and treat patients at risk...

..In addition, none of the patients developed cataracts or glaucoma during the study. In summary, tacrolimus ointment 0.1% may be a safe and effective treatment option for patients with moderate to severe eyelid dermatitis...

..A clobetasol propionate foam product is as effective as clobetasol propionate solution in the treatment of scalp psoriasis...

..The excellent safety profile of desonide revealed by this pharmacovigilance program is supported by a review of published clinical trial results...

..Both physicians and patients should be aware of the risks involved with each medicine so that the correct drug is chosen to suit each patient...

..In summary, tacrolimus 0.1% ointment may be a safe and effective treatment option for patients with psoriasis on the face, intertriginous areas, or both...

..Mental creases commonly occur in patients with PXE. In young patients they are a sensitive and highly specific physical finding of this disorder. The presence of exaggerated mental creases is, thus, a useful physical marker for PXE...

..Enhancements in topical therapy and phototherapy have also increased the armamentarium of treatments available for this disorder...

..By inhibiting proinflammatory cytokines such as interleukin-12, interleukin-23, and tumor necrosis factor-alfa, nicotinamide may enhance the efficacy of calcipotriene therapy when used in combination...

..Our patient's response to a novel regimen of low dose bexarotene combined with PUVA has been excellent and suggests that this regimen may be a useful method for treatment of MF...

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..Mechanisms of action of the biologic therapies suggest that there is potential for additive benefit when used in combination regimens...

..Weekday calcipotriene plus weekend pulse clobetasol foam shows a consistent trend toward greater maintenance of remission...

..Physicians may need to improve communication with their patients and should reevaluate their management of psoriasis...

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..Furthermore, PXE and normal skin elastins had the same amount of desmosines per milligram purified elastin. This method could be used to evaluate the extent of elastosis or elastolysis in a particular lesion...

..618% +/- 0.339% to 1.467% +/- 0.695%). CONCLUSION: Further studies are warranted to examine the safety and efficacy of 0.005% fluticasone propionate ointment for the treatment of eyelid dermatoses...

..Imiquimod 5% cream applied twice weekly for 16 weeks is effective for treating actinic keratoses but may be limited by local side effects...

..0074). CONCLUSION: Long-term treatment with tretinoin emollient cream 0.05% is safe and effective in subjects with moderate to severe facial photodamage...

..Methotrexate remains a valuable option for the treatment of psoriasis. This report will summarize studies regarding the use of methotrexate since the last guidelines were published in 1998...

..Treatments were well tolerated. Imiquimod cream appears to be effective in the treatment of actinic keratoses. The main adverse effect is local inflammation, which can be avoided by reducing the frequency of application...

..Extended dosing with alefacept appeared to have a similar safety profile to 12-week dosing and may offer further benefit to some patients for disease improvement...

..Thus, the antioxidative properties of genistein may explain for the mechanisms of anti-photocarcinogenic action of genistein...

..The aim of this study was to evaluate and compare the sensory irritation caused by hydrocortisone butyrate lipocream 0.1% using a non-invasive and inexpensive technique...

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..The implications of our findings serve as compelling validation to our conclusions that genistein may serve as a potent chemopreventive agent against photocarcinogenesis...

..The potent scavenging of oxygen species and blocking of UV-induced oxidative DNA damage may, at least in part, explain the mechanism(s) by which green/black teas inhibit photocarcinogenesis...

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..The presence of both of these findings, especially with skin thickening or axillary skin calcification, should suggest a diagnosis of PXE. The majority of breast calcifications in PXE are benign...

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..05%, was calculated to be 2.55. Our assay was able to detect and quantify even minimal cutaneous irritation secondary to application of topical medications...

..CONCLUSIONS: Ciclopirox shampoo 1% is effective and safe in the treatment of seborrheic dermatitis of the scalp...

..This article reviews the pharmacology, mechanism of action, side effects, and clinical applications of these therapies...

..005). These results indicate that genistein protects the skin from PUVA-induced photodamage...

..We conclude that one week of therapy with terbinafine 1% solution is highly effective, superior to vehicle, and safe for use in superficial fungal infections...

..The clinical uses of these agents are illustrated in part through case presentations drawn from the authors' practices, and the supportive role of the National Psoriasis Foundation is reviewed...

..Paraneoplastic pemphigus, a recently characterized autoimmune vesicular eruption, produces painful mucocutaneous ulcerations in patients with an occult neoplasm, such as chronic lymphocytic leukemia or malignant lymphoma...

..Therefore all first-degree relatives of affected patients should receive a full dermatologic examination as well as a funduscopic examination. If even mild typical skin or eye findings are present, then skin biopsy should be performed...

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..G-->A mutations induced by BaP or BaP-UVA at position 38 of codon 13 have not been reported previously. C-->T transitions were detected in p53 hot spots of exon 8 in 2 of 19 BaP-UVA-induced tumors but were not found in nontumor skin...

..We report 2 patients with pseudoxanthoma elasticum who had characteristic rhytides and horizontal creases of the chin ("mental" creases). Rhytides and horizontal creases were successfully treated with injectable collagen...

..80). These results indicate that genetic damage caused by exposures to BaP plus UVA accumulates with time and increases the potential for inductive events leading to carcinogenesis and tumor formation...

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..Finally, we will discuss the safety and efficacy of the biologic treatments used to treat patients with psoriasis...

..Reduction in lesional, activated T cells induces improvement in psoriatic plaques. Galiximab (IDEC-114), an IgG(1) anti-CD80 antibody, binds to CD80, a costimulatory molecule involved in T-cell activation...

..CONCLUSIONS: Efalizumab therapy resulted in significant improvements in plaque psoriasis in subjects with moderate-to-severe disease. Extending treatment from 12 to 24 weeks resulted in both maintenance and improvement of responses...

..We sought to assess whether patients with psoriasis with moderate or severe disease are being treated with systemic therapy...

..Skin-infiltrating lymphocytes expressing type 1 cytokines have been linked to the pathophysiology of psoriasis. We evaluated the safety and efficacy of a human interleukin-12/23 monoclonal antibody in treating psoriasis...

..It also provides recommendations for future clinical studies with tacrolimus ointment...

..Intermittent dosing of a topical calcineurin inhibitor for preventing atopic dermatitis (AD) disease relapse in patients with stabilized AD has not been evaluated...

..These results provide further support for the deleterious roles of CD4+ and CD8+ memory T-cell subpopulations in psoriasis pathogenesis...

..30 [1.26-4.19]). Alefacept provided incremental efficacy over 5 successive 12-week treatment courses...

..The serum half-life of IDEC-114 was approximately 13 days. A single dose of IDEC-114 appears to be safe and well tolerated and has promising clinical activity in psoriasis...