Current Issue : January - March Volume : 2014 Issue Number : 1 Articles : 7 Articles
Psoriasis is considered to be an inflammatory autoimmune disease, where angiogenesis plays an undefined pathogenetic role. The\r\nwell-known changes of the superficial microvasculature in the psoriatic plaque can be easily assessed in vivo by videocapillaroscopy.\r\nIn the last years, several studies reported the clinical and capillaroscopic response of the psoriatic plaque during different topical and\r\nsystemic treatments. In the present work we evaluated the effects of acitretin (0.8mg/kg/day) on videocapillaroscopic alterations\r\nand the clinical response in 11 patients affected by plaque psoriasis at the baseline (T0) and after 4 (T1), 8 (T2), and 12 (T3) weeks. A\r\nclinical improvement during the treatment with a complete clinical healing of the plaque in 7 of the 11 patients was observed. The\r\ntypical ââ?¬Å?basket-weaveââ?¬Â capillaries of the psoriatic lesions showed a reduction of 65.4% in diameter at the end of the study; only 3\r\npatients returned to a normal capillaroscopic pattern. As observed during previous our studies, we found a discrepancy between\r\nclinical and capillaroscopic results, with a far greater improvement in the first than in the second. This finding could be in agreement\r\nwith a secondary role of blood vessels in the pathogenesis and persistence of psoriatic lesions....
Background. Acne is a dermatosis that involves an altered sebum pattern. Objectives. (1) To evaluate if a treatment based on\r\nantibiotics (lymecycline) can alter fatty acids contents of the sebum of patients with acne; (2) to evaluate if oral supplementation of\r\nfatty acids can interfere with fatty acids contents of the sebum of patients with acne; (3) to evaluate if there is any interaction in fatty\r\nacids contents of the sebum of patients with acne when they use both antibiotics and oral supplementation of fatty acids. Methods.\r\nForty-five male volunteers with inflammatory acne vulgaris were treated with 300mg of lymecycline per day, with 540mg of ??-\r\nlinolenic acid, 1,200mg of linoleic acid, and 510mg of oleic acid per day, or with both regimens for 90 days. Every 30 days, a sample\r\nof sebum from the forehead was collected for fatty acids� chromatographic analysis. Results. Twelve fatty acids studied exhibited\r\nsome kind of pattern changes during the study: C12:0, C14:0, C15:0, C16:1, C18:0, C18:1n9c+C18:1n9t, C18:2n6t, C18:3n6, C18:3n3,\r\nC20:1, C22:0, and C24:0. Conclusions. The daily administration of lymecycline and/or specific fatty acids may slightly influence\r\nsome fatty acids levels present in the sebum of patients with inflammatory acne vulgaris....
Background: Parents and carers of children with eczema often underuse emollient therapy, essential to repairing\r\nand protecting the defective skin barrier in atopic eczema. Educational interventions delivered by specialist\r\ndermatology nurses in hospital settings have been shown to improve emollient use and reduce symptoms of\r\natopic eczema, but benefits of community-based interventions are uncertain. Support and information about\r\nappropriate care may often be inadequate for patients and carers in the community.\r\nMethods: A multifaceted educational support programme was evaluated as a method of increasing emollient use\r\nand reducing atopic eczema in children. Support provided for parents and carers included an educational DVD,\r\nonline daily diary and telephone helpline. The before and after study included 136 British children and their parents,\r\nproviding baseline and 12 week follow-up data while receiving the programme. Measures included emollient use,\r\nPOEM and PEST scores, and cost of care.\r\nResults: Average emollient use increased by 87.6 g (95% CI: 81.9 to 119.5 g, p = 0.001) from baseline with the change\r\nbeing immediate and persistent. The POEM score reduced on average by 5.38 (95% CI: 4.36 to 6.41, p = 0.001), a 47%\r\nreduction from baseline. Similarly the PEST score reduced on average by 0.61 (95% CI: 0.47 to 0.75, p = 0.001), a 48%\r\nreduction from baseline. Sleep disturbance was reduced by 1.27 nights per week (95% CI: 0.85 to 1.68, p = 0.001) and\r\nparental feeling of control improved by 1.32 points (95% CI: 1.16 to 1.48, p = 0.001). From the NHS perspective, the\r\nprogramme was cost neutral overall within the study period.\r\nConclusion: A community-based multifaceted educational support programme greatly increased emollient use,\r\nreducing symptoms of atopic eczema and general practitioner contacts, without increasing cost. Significant benefits\r\nmay accrue to the families and carers of children with atopic eczema due to improved sleep patterns and greater\r\nfeeling of control. PEST, a new simple measure of acute and remitting atopic eczema severity designed to help parents\r\nand children to monitor and manage eczema, merits further evaluation....
Background: MR spectroscopy of intact biopsies can provide a metabolic snapshot of the investigated tissue. The\r\naim of the present study was to explore the metabolic pattern of uninvolved skin, psoriatic skin and corticosteroid\r\ntreated psoriatic skin.\r\nMethods: The three types of skin biopsy samples were excised from patients with psoriasis (N = 10). Lesions were\r\nevaluated clinically, and tissue biopsies were excised and analyzed by one-dimensional 1H MR spectroscopy.\r\nRelative levels were calculated for nine tissue metabolites. Subsequently, relative amounts of epidermis, dermis and\r\nsubcutaneous tissue were scored by histopathological evaluation of HES stained sections.\r\nResults: Seven out of 10 patients experienced at least 40% reduction in clinical score after corticosteroid treatment.\r\nTissue biopsies from psoriatic skin contained lower levels of the metabolites myo-inositol and glucose, and higher\r\nlevels of choline and taurine compared to uninvolved skin. In corticosteroid treated psoriatic skin, tissue levels of\r\nglucose, myo-inositol, GPC and glycine were increased, whereas choline was reduced, in patients with good\r\ntherapeutic effect. These tissue levels are becoming more similar to metabolite levels in uninvolved skin.\r\nConclusion: This MR method demonstrates that metabolism in psoriatic skin becomes similar to that of uninvolved\r\nskin after effective corticosteroid treatment. MR profiling of skin lesions reflect metabolic alterations related to\r\npathogenesis and treatment effects....
Xyloglucans (XGs) of Tamarindus indica L. Fabaceae are used as drug vehicles or as ingredients of cosmetics. Two xyloglucans\r\nwere extracted from T. indica seed with cold water (TSw) and copper complex precipitation (TSc). Both were analyzed in regard\r\nto composition and influence on cell viability, proliferation, cell cycle progression, migration, MAPK phosphorylation, and gene\r\nexpression of human skin keratinocytes (NHEK and HaCaT) and fibroblasts (NHDF) in vitro. TSw and TSc differed in molecular\r\nweight, rhamnose content, and ratios of xylose, arabinose, galactose, and glucose. Both XGs improved keratinocytes and fibroblast\r\nproliferation, promoted the cell cycle, and stimulated migration and intracellular enzyme activity of NHDF after endosomal\r\nuptake. Only TSw significantly enhanced HaCaT migration and extracellular enzyme activity of NHDF and HaCaT. TSw and TSc\r\npredominantly enhanced the phosphorylation of molecules that referred to Erk signaling in NHEK. In NHDF parts of the integrin\r\nsignaling and SAPK/JNK pathway were affected. Independent of cell type TSw marginally regulated the expression of genes, which\r\nreferred to membrane proteins, cytoskeleton, cytokine signaling, and ECMas well as to processes ofmetabolismand transcription.\r\nResults show that T. indica xyloglucans promote skin regeneration by a direct influence on cell proliferation and migration....
Background: Acne is a common disorder of the human pilosebaceous unit, yet the mechanisms underlying\r\nhyperkeratinisation and subsequent inflammation (comedogenesis) remain to be determined, although cutaneous\r\npathogens are implicated. Previously, it was reported that the release of the cytokine interleukin-1a (IL-1a) by\r\nkeratinocytes of the sebaceous duct was pivotal in the life cycle of the comedone, mediating both its development\r\nand its spontaneous resolution. Toll-like receptors are a family of molecules that recognise pathogen associated\r\nmolecular patterns (PAMPs) presented by microorganisms, initiating a signalling cascade terminating in the release\r\nof antimicrobial compounds and cytokines.\r\nMethods: We used ex vivo sebaceous gland and primary monolayer keratinocyte culture, alongside ELISAs,\r\nimmunohistochemistry, Western blotting and RT-PCR to investigate the contribution of TLR activation to\r\nacne pathogenesis.\r\nResults: We found TLR2 to be expressed in basal and infundibular keratinocytes, and sebaceous glands, and its\r\nactivation provoked the release of IL-1a from primary human keratinocytes in vitro. The exposure of\r\nmicrodissected human sebaceous glands to PAMPs specific for TLR2 in vitro resulted in a pattern of IL-1a like\r\ncornification after seven days of exposure.\r\nConclusions: TLR activation and secretion of IL-1a from keratinocytes may be initiating steps in comedogenesis\r\nand, therefore, critical to the pathophysiology of acne....
Background: In the UK, referrals to specialists are initiated by general practitioners (GPs). Study objectives were to\r\nestimate the incidence of diagnosed psoriasis in the UK and identify factors associated with GP referrals to\r\ndermatologists.\r\nMethods: Newly diagnosed patients with psoriasis were identified in The Health Improvement Network (THIN)\r\ndatabase between 01 July 2007-31 Oct 2009. Incidence of diagnosed psoriasis was calculated using the number of\r\nnew psoriasis patients in 2008 and the mid-year total patient count for THIN in 2008. A nested caseââ?¬â??control design\r\nand conditional logistic regression were used to identify factors associated with referral.\r\nResults: Incidence rate of diagnosed adult psoriasis in 2008 was 28/10,000 person-years. Referral rate to\r\ndermatologists was 18.1 (17.3-18.9) per 100 person-years. In the referred cohort (N=1,950), 61% were referred within\r\n30 days of diagnosis and their median time to referral was 0 days from diagnosis. For those referred after 30 days\r\n(39%, median time to referral: 5.6 months), an increase in the number of GP visits prior to referral increased the\r\nlikelihood of referral (OR=1.87 95% CI:1.73-2.01). A prescription of topical agents such as vitamin D3 analogues 30\r\ndays before referral increased the likelihood of being referred (OR=4.67 95% CI: 2.78-7.84), as did corticosteroids\r\n(OR=2.45 95% CI: 1.45-4.07) and tar products (OR=1.95 95% CI: 1.02-3.75).\r\nConclusions: Estimates of the incidence of diagnosed adult psoriasis, referral rates to dermatologists, and\r\ncharacteristics of referred patients may assist in understanding the burden on the UK healthcare system and\r\nmanaging this population in primary and secondary care...
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