Psoriasis clinical aspects

Chondroitin sulfates have been used in clinical trials of osteoarthritis, where they improved knee mobility and reduced pain, by providing better lubrication (41,42). This effect is claimed to be achieved not only by local injection but also by increased dietary intake of chondroitin sulfates (43,44). However, the effect was only achieved when the compounds were taken regularly over a period of at least 6 months (43,44), and therefore, oral administration must be approached with caution, also taking into account bioavailability aspects. In a much smaller study, chondroitin sulfates were administered to patients with osteoarthritis who also suffered from psoriasis, and the outcome showed reduced skin thickness, less skin inflammation, and flaking (45). 

Kanerva L, Jolanki R, Toikkanen J, Tarvainen K, Estlander T (1995) Statistics on occupational dermatoses in Finland. In Eisner P, Maibach HI (eds) Irritant dermatitis. New clinical and experimental aspects. Curr Probl Dermatol 23 28-40 Kanerva L, Talvi A, Estlander T (1998) Occupational contact psoriasis. Eur J Dermatol 8 217-218 Lammintausta K, Kalimo K, Havu VK (1982) Occurrence of contact allergy and hand eczema in hospital wet work. Contact Dermatitis 8 84-90... 

Psoriatic patients frequently present with altered ser am urate levels, a disturbance which is commonly attributed to some changes in nucleoprotein metabolism directly linked to the pathological process of the skin lesions in fact, it is well known that an increased turnover rate of the epidermal cells (from the normal value of 27 days to 3-4 days only) is responsible for the psoriatic skin changes (Fitzpatrick and Haynes, 1980). To date, no tracer turnover studies with labelled uric acid have been reported in patients affected by psoriasis. We present here the metabolic results obtained with the aid of C-uric acid in a group of psoriatic patients with various degrees of severity of the disease. The aim of the study was to elucidate some pathophysiologic aspects of uric acid turnover in such clinical conditions. 

An important apphcation of psoralens and UV-A light (PUVA therapy) was introduced into clinical practice by Parrish et al. A treatment consisting of the oral administration of 8-methoxypsoralen (8-MOP), followed by artificial ultraviolet illumination (UV-A) of patients skin was used for the first time to cure psoriasis, a disease characterized by hyperproliferation of skin cells. It is now recognized that psoriasis is an autoimmune disorder, and hyperproliferation is only one aspect of its manifestation. 

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