Plaque psoriasis

Etretinate 0 i COOR Oral 0.25-1.0 mg/kg/d Generalized pustular psoriasis, exfoliative psoriasis, plaque psoriasis ... 

Serup, J. and Blichmann, C. Epidermal hydration of psoriasis plaques and the relation to scaling. Acta Derm. Venereol. (Stockh). 1987 67 357-359. 

Alefacept Amevive (Biogenidec) Psoriasis, plaque type... 

Skin A 56-year-old man with recalcitrant psoriasis treated with efalizumab developed multiple brown patches and papules, in the exact distribution of the previous psoriasis plaques the pathological diagnosis was seborrheic keratoses with overlapping features of solar lentigo [127 ]. 

Vestergaard ME, Kossard S, Murrell DF. Seborrhoeic keratoses appearing in sites of previous psoriasis plaques during treatment with efalizumab. Clin Exp Dermatol 2009 34(8) e564-6. 

The objective of the current study was to compare the anti-psoriatic effect of six topical producfs using a modified version of the original psoriasis plaque test with emphasis on the predictive capacity of fhis model. Validation of the use of immunohistochemical and histological scoring of biopsy materials, in conjxmction with chemical scoring, in the prediction of anti-psoriatic effecfs was an additional objective [S ]. 

This study has demonstrated that the modified psoriasis plaque test can provide a relatively quick and effective method to evaluate the anti-psoriatic effect of several topical treatments in small cohorts and that, by combining clinical scoring and histological assessment, more accurate prediction of the antiseptic affect can be made. Furthermore... 

QueiUe-Roussel C, Hoffmann V, Ganslandt S, Hansen KK. Comparison of the anti-psoriatic effect and tolerability of calcipotriol-containing products in the treatment of psoriasis vulgaris using a modified psoriasis plaque test. Clin Drug Invest 2012 32(9) 613-9. 

In the treatment of diseases where the metaboUtes are not being deUvered to the system, synthetic metaboUtes or active analogues have been successfully adrninistered. Vitamin metaboUtes have been successfully used for treatment of milk fever ia catde, turkey leg weakness, plaque psoriasis, and osteoporosis and renal osteodystrophy ia humans. Many of these clinical studies are outlined ia References 6, 16, 40, 51, and 141. The vitamin D receptor complex is a member of the gene superfamily of transcriptional activators, and 1,25 dihydroxy vitamin D is thus supportive of selective cell differentiation. In addition to mineral homeostasis mediated ia the iatestiae, kidney, and bone, the metaboUte acts on the immune system, P-ceUs of the pancreas (iasulin secretion), cerebellum, and hypothalamus. 

RAR 3 > RARy > > RARa. It does not bind to any of the RXRs. This retinoid derivative is said to have lower cytotoxic effects than other retinoids while achieving sustained therapeutic efficacy in the treatment of plaque type psoriasis. 

Topical antipsoriatics are drugs used in the treatment of psoriasis (a chronic skin disease manifested by bright red patches covered with silvery scales or plaques). These drug help remove tiie plaques associated with this disorder. Examples of antipsoriatics include antiiralin (Anthra-Derm) and calcipotriene (Dovonex). 

PUVA) monotherapy, tacalcitol plus PUVA and tazarotene plus PUVA in patients with chronic plaque-type psoriasis. Br J Dermatol 147 748-753... 

Diagnosis of psoriasis is usually based on recognition of the characteristic plaque lesion, and not based on lab tests. 

Treatment goals for patients with psoriasis are to minimize signs such as plaques and scales, alleviate symptoms such as pruritus, reduce the frequency of flare-ups, and ensure appropriate treatment of associated conditions such as psoriatic arthritis or clinical depression, and minimize treatment-related morbidity. 

Inverse psoriasis spares the areas commonly involved in plaque psoriasis and instead appears in intertriginous areas, where scaling is minimal. 

Cuttate psoriasis presents as a sudden eruption of small, disseminated erythematosquamous papules and plaques, and is often preceded by a streptococcal infection 2 to 3 weeks prior. 

Minimizing or eliminating the signs of psoriasis such as plaques and scales. 

Management of patients with psoriasis generally involves both nonpharmacologic and pharmacologic therapies. Pharmacologic alternatives for plaque psoriasis include topical treatments, phototherapy, photochemotherapy, and systemic therapies alone (orally or by injection). The choice of treatment is usually dictated by the severity of disease.15-17 In some cases, a combination of treatment options may be preferred. Topical therapies can be used in patients with limited or mild... 

The patient s psoriatic condition remains well controlled for about 10 years, then flare-ups become a frequent occurrence. The patient did not respond well to UVB therapy used alone. He is currently presenting with fairly extensive plaque psoriasis, affecting about two-thirds of his body surface area. 

Etanercept is a fully human dimeric fusion protein composed of human TNF-a p75 receptor fused to the Fc portion of human IgG 1.41 It acts as a tumor necrosis factor-a (TNF-a) inhibitor by binding to and inactivating TNF-a, thus preventing interactions with its cell surface receptors.41 This agent is useful for chronic moderate to severe plaque psoriasis and for psoriatic... 

The appearance of some BCCs is similar to plaque, psoriasis, or eczema, and these benign disorders are included in... 

Psoriasis is a common chronic inflammatory disease characterized by recurrent exacerbations and remissions of thickened, erythematous, and scaling plaques. 

Calcipotriene (Dovonex) is a synthetic vitamin D analog used for mild to moderate plaque psoriasis. Improvement is usually seen within 2 weeks of treatment, and approximately 70% of patients demonstrate marked improvement after 8 weeks. Adverse effects occur in about 10% of patients and include lesional and perilesional burning and stinging. Calcipotriene 0.005% cream, ointment, or solution is applied one or two times a day (no more than 100 g/wk). 

Tazarotene (Tazorac) is a synthetic retinoid that is hydrolyzed to its active metabolite, tazarotenic acid, which modulates keratinocyte proliferation and differentiation. It is available as a 0.05% or 0.1% gel and cream and is applied once daily (usually in the evening) for mild to moderate plaque psoriasis. Adverse effects are dose- and frequency related and include mild to moderate pruritus, burning, stinging, and erythema. Application of the gel to eczematous skin or to more than 20% of body surface area is not recommended because this may lead to extensive systemic absorption. Tazarotene is often used with topical corticosteroids to decrease local adverse effects and increase efficacy. 

Infliximab (Remicade) is a chimeric monoclonal antibody directed against TNF-a. Recently, its indications have been expanded to include psoriatic arthritis and treatment of adults with chronic severe plaque psoriasis. An advantage over other systemic psoriasis treatments is that infliximab does not adversely affect blood counts, hepatic enzyme levels, or kidney function. The recommended dose is 5 mg/kg as an IV infusion at weeks 0, 2, and 6, then every 8 weeks thereafter. For psoriatic arthritis, it may be used with or without methotrexate. Adverse effects include headaches, fever, chills, fatigue, diarrhea, pharyngitis, upper respiratory and urinary tract infec-... 

Adalimumab (Humira) is a human immunoglobulin Gj monoclonal TNF-a antibody. The binding of adalimumab results in inactivation of the proinflammatory cytokine TNF-a. It is indicated for psoriatic arthritis and treatment of adults with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy. The recommended dose for psoriatic arthritis is 40 mg subcutaneously every other week. The recommended dose for adults with plaque psoriasis is an initial dose of 80 mg, followed by 40 mg every other week starting 1 week after the initial dose. The most common adverse reactions are infections (e.g., upper respiratory, sinusitis), injection site reactions, headache, and rash. 

Alefacept (Amevive) is a dimeric fusion protein that binds to CD2 on T cells to inhibit cutaneous T-cell activation and proliferation. It also produces a dose-dependent decrease in circulating total lymphocytes. Alefacept is approved for treatment of moderate to severe plaque psoriasis and is also effective for treatment of psoriatic arthritis. Significant response is usually achieved after about 3 months of therapy. The recommended dose is 15 mg intramuscularly once weekly for 12 weeks. Adverse effects are mild and include pharyngitis, flu-like symptoms, chills, dizziness, nausea, headache, injection site pain and inflammation, and nonspecific infection. 

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