Psoriasis forum最新文献

Background: Psoriatic arthritis is a potentially destructive, inflammatory joint disease that affects 20% to 30% of patients with psoriasis. Psoriasis precedes the onset of joint inflammation by approximately 10 years, providing a unique opportunity to intervene and prevent or delay onset of musculoskeletal manifestations. The emergence of sensitive imaging modalities and cellular biomarkers may facilitate early identification of patients with psoriasis who have subclinical joint disease and might help stratify patients with an early onset of arthritis.

Methods: The translational studies described herein are focused on the development of cellular biomarkers identified with flow cytometry and cell culture techniques in patients with psoriasis and psoriatic arthritis.

Results and conclusion: The combination of power Doppler ultrasound imaging and cellular biomarkers (ie, CD16 and dendritic cell specific transmembrane protein) to diagnose early psoriatic arthritis and to stratify patients with established psoriatic arthritis provides a new opportunity to optimize treatment outcomes in this potentially disabling disease.

Hydroxyurea is a drug that has been long forgotten for the treatment of psoriasis. In addition to its anti-psoriatic effects, it has also been shown to have antiviral effects. This dual effect makes it a drug that dermatologists may want to consider when treating psoriasis in HIV-infected individuals. There are currently no studies that discuss the safety and efficacy of hydroxyurea in the treatment of psoriasis in this immunocompromised group; however, there are multiple reports that discuss the safety and efficacy of hydroxyurea in psoriasis and HIV separately. This review suggests that hydroxyurea is generally safe and effective. The main risk involves the hematologic adverse events (anemia, leukopenia, thrombocytopenia, and macrocytosis) which appear to be dose-dependent. Because of the common hematologic adverse events, hydroxyurea may be considered as a viable therapeutic option for patients with generalized psoriasis inadequately responsive to other safer options, whether the patient is HIV-positive or not.

The biologic agents vary considerably in terms of their long-term duration of effect. Using the definitions provided by the National Psoriasis Foundation Medical Board, the objective of this review was to compare all biologic agents with respect to time to relapse and potential for rebound. Overall, alefacept had the longest off-treatment benefit (29.9 weeks in Psoriasis Area and Severity Index [PASI] 75 responders), followed by ustekinumab (22 weeks), infliximab (19.5 weeks), adalimumab (18 weeks), etanercept (12.1 weeks in PASI 50 responders), and, lastly, efalizumab (9.6 weeks). Rebound was reported commonly for efalizumab (14%) and, extremely rarely, for etanercept (0.002%).

Psoriatic arthritis is a major comorbidity of psoriasis that significantly impairs quality of life and physical function. Because skin lesions classically precede joint symptoms, dermatologists are in a unique position to identify patients at risk for psoriatic arthritis before irreversible joint damage occurs. Here we review the literature to identify the clinical and genetic factors most highly associated with development of psoriatic arthritis, with the goal of assisting dermatologists in risk-stratifying their psoriasis patients.