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Do patients with mild to moderate psoriasis really have a sedentary lifestyle?
Demirel, R, Genc, A, Ucok, K, Kacar, SD, Ozuguz, P, Toktas, M, Sener, U, Karabacak, H, Karaca, S
International journal of dermatology. 2013;(9):1129-34
Abstract
The aim of this study was to compare aerobic exercise capacity, daily physical activity, pulmonary functions, resting metabolic rate, and body composition parameters in patients with psoriasis and healthy controls. A total of 60 participants (30 [15 men, 15 women] patients with psoriasis, and 30 [15 men, 15 women] healthy controls) ranging in age from 22-57 were included in the study. Maximal aerobic capacity was determined by Astrand exercise protocol. Daily physical activity was measured with an accelerometer. Resting metabolic rate was determined with an indirect calorimeter. Pulmonary function tests were performed with a portable spirometer. Body composition was established with a bioelectric impedance analysis system. Skinfold thicknesses and body circumference measurements were carried out. Short Form 36 quality of life questionnaire was applied to all participants. In both genders, daily physical activity parameters were found to be higher in the psoriasis group compared to the control. Maximal aerobic capacity, resting metabolic rate, pulmonary function tests, body fatness, body fat distributions, and quality of life were not statistically different between patients with psoriasis and controls in males and females. We suggest that patients with psoriasis who do not have psoriatic arthritis or severe psoriasis are well in performing daily physical activities. In addition, we suggest that this lifestyle helped to prevent impairments of body fatness, body fat distributions, resting metabolic rate, pulmonary functions, and quality of life in patients with mild to moderate psoriasis.
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2.
Pilot study of folate status in healthy volunteers and in patients with psoriasis before and after UV exposure.
Juzeniene, A, Stokke, KT, Thune, P, Moan, J
Journal of photochemistry and photobiology. B, Biology. 2010;(2):111-6
Abstract
Ultraviolet radiation, UV, is widely used for treatment of psoriasis. UV radiation may destroy blood folates in test tubes, but clinical data are scarce. Folate deficiency may increase the risk of cardiovascular diseases, colorectal carcinoma, megaloblastic anemia, pregnancy and birth complications, depression and dementia. The aim of the present study was to investigate the influence of solar radiation, sunbeds and/or broadband UVB phototherapy on the levels of serum and erythrocyte folate in patients with psoriasis or healthy volunteers. Serum and erythrocyte folate status in patients with psoriasis and healthy volunteers was measured before and after exposure to solar radiation, broadband UVB or use of sunbeds. In some cases plasma homocysteine and serum 25-hydroxyvitamin D (25(OH)D) were also measured. Serum and erythrocyte folate levels in healthy volunteers and in psoriasis patients were not influenced to any statistically significant extent after exposure to solar radiation, to single or to multiple UV treatments. However, a slight decay of blood folates and an increase of plasma homocysteine levels were observed in psoriasis patients after exposure to UV radiation. Exposure to sun or sunbeds does not have any significant effect on the levels of blood folate of healthy humans. High doses of broadband UVB phototherapy may slightly decrease blood folates in psoriasis patients. Further studies, using proper, adequate 5-methyltetrahydrofolate methodology, are needed to clarify the influence of broadband phototherapy on folate degradation and the consequences of these on the health of psoriasis patients.
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3.
Calcipotriol solution in scalp psoriasis.
Duweb, G, Alhaddar, J, Abuhamida, M
International journal of tissue reactions. 2005;(4):163-6
Abstract
Psoriasis is characterized by three main pathogenic features: abnormal differentiation, keratinocyte hyperproliferation and inflammation. The lesions may disappear spontaneously or as a result of therapy, but recurrences are almost certain. Twenty-seven patients with scalp psoriasis were treated with calcipotriol solution 50 g/ml as twice-daily application for 8 weeks. The assessment was based on the mean sign scores (erythema, thickness and scaliness) at 0, 2, 4, 6 and 8 weeks. The results indicated that five patients were excluded from the study (four because of irregularity and one because of irritation), and 22 patients had completed the treatment course. There was a marked reduction in the total mean scores of erythema, thickness and scaling from 2.8, 2.7 and 2.7 to 0.3, 0.34 and 0.4, respectively. Fifteen patients (68.2%) showed complete clearance of their psoriasis, and most of the lesions cleared by week 6 of treatment. Two patients (9.1%) had marked improvement and four (18.2%) patients showed moderate improvement. No response to calcipotriol solution was seen in only one patient. No adverse effects occurred except severe irritation in one patient, who was excluded from this study. In conclusion, calcipotriol could be a valid choice for the treatment of scalp psoriasis.
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4.
The effect of the combination of calcipotriol and betamethasone dipropionate versus both monotherapies on epidermal proliferation, keratinization and T-cell subsets in chronic plaque psoriasis.
Vissers, WH, Berends, M, Muys, L, van Erp, PE, de Jong, EM, van de Kerkhof, PC
Experimental dermatology. 2004;(2):106-12
Abstract
Several reports have indicated that the combination of calcipotriol ointment and potent or ultrapotent corticosteroids are more effective and better tolerated, as compared to the monotherapies. The aim of the present study was to find out the effect of combination of calcipotriol ointment once daily and betamethasone dipropionate ointment once daily vs. the effect of twice-daily applications of each of the two treatments as monotherapy during a four-week treatment period. Seven patients with chronic plaque psoriasis were included for treatment with the three treatment schedules. Biopsies were taken before treatment and after four weeks of treatment, and markers for epidermal proliferation (Ki-67) and epidermal differentiation (keratin-10) were studied using a quantitative image analysis, and T-cell subsets in epidermis and dermis (CD4, CD8, CD25, CD45RO, CD45RA, CD94, CD161, and CD2) were studied using immunohistochemical scoring. The most impressive clinical result was reached with the combination. Calcipotriol proved to have a major effect on the proliferation marker Ki-67 and differentiation marker keratin-10, whereas the effect on T-cell subsets was more selective with major reductions of CD45RO(+) and CD8(+) T cells. In contrast, the effect of betamethasone dipropionate on the epidermis was restricted to a normalization of differentiation with a highly significant increase of keratin-10 positive epidermal surface without a significant effect on Ki-67 positive nuclei, and the effect on T-cell subsets was restricted to a reduction of natural killer T-cell receptors designated by CD94 and CD161 in the epidermis. The combination of the two treatments did not affect the proliferation marker Ki-67 and keratinization marker keratin-10, beyond the effect of calcipotriol monotherapy. However, the combination had a profound effect on, virtually, all T-cell subsets, beyond the effect of the monotherapies. It is concluded that the action spectra of calcipotriol and betamethasone on the psoriatic plaque are different and that the combination has effects on T-cell subsets, beyond the addition of the effects of monotherapies.
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5.
Topical application of natural honey, beeswax and olive oil mixture for atopic dermatitis or psoriasis: partially controlled, single-blinded study.
Al-Waili, NS
Complementary therapies in medicine. 2003;(4):226-34
Abstract
OBJECTIVES To investigate the effects of honey, olive oil and beeswax mixture on patients with atopic dermatitis (AD) or psoriasis vulgaris (PV). MATERIALS AND METHODS Twenty-one patients with dermatitis and 18 patients with psoriasis were entered for patient-blinded, partially controlled study; 11 patients with dermatitis used topical betamethasone esters and 10 patients with psoriasis used clobetasol propionate. Honey mixture contained honey, beeswax and olive oil (1:1:1). Mixtures A, B, and C contained honey mixture with the corticosteroids ointment in a ratio of 1:1, 2:1, and 3:1 respectively. Patients with dermatitis were subjected to controlled bilateral half-body comparison to evaluate the efficacy of honey mixture against Vaseline, or mixture A against Vaseline-betamethasone esters mixture (1:1) in patients using topical corticosteroid treatment. In patients with psoriasis, the effect of honey mixture was compared with paraffin in an individual right/left-sites comparison, or mixture A against paraffin-clobetasol propionate mixture (1:1) in patients using corticosteroid topical therapy. In dermatitis, body lesions on right or left half-body were assessed for erythema, scaling, lichenification, excoriation, indurations, oozing and itching on a 0-4 points scale. In psoriasis, lesions of selected site were assessed for redness, scaling, thickening and itching, on a 0-4 points scale. RESULTS In honey mixture group, 8/10 patients with dermatitis showed significant improvement after 2 weeks, and 5/11 patients pretreated with betamethasone esters showed no deterioration upon 75% reduction of corticosteroid doses with use of mixture C. In psoriasis, 5/8 patients showed a significant response to honey mixture. In patients using clobetasol propionate, 5/10 patients showed no deterioration upon 75% reduction of corticosteroid doses with use of mixture C. CONCLUSION Honey mixture appears useful in the management of dermatitis and psoriasis vulgaris.
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6.
Calcipotriol ointment versus cream in psoriasis vulgaris.
Duweb, G, Aldebani, S, Elzorghany, A, Benghazil, M, Alhaddar, J
International journal of clinical pharmacology research. 2003;(2-3):47-51
Abstract
Psoriasis is a multifactorial, chronically relapsing, inflammatory skin disease occurring in 1-3% of the world's population. Vitamin D3 analogs have effects on proliferation and differentiation, as well as on the infiltration and activation of neutrophils and immunocytes in psoriatic skin lesions. This study aims to assess the efficacy and safety of topical calcipotriol and to compare ointment and cream formulations in the treatment of psoriasis vulgaris. A total of 41 patients with mild to moderate psoriasis vulgaris (18 men and 23 women aged between 5 and 63 years) were enrolled in the study. Each patient was instructed to apply the treatment twice daily over the psoriatic lesions. Routine blood tests and serum calcium were performed prior to and at the end of treatment. Treatment assessment was carried out on weeks 2, 4 and 6 and was based on the Psoriasis Area and Severity Index (PASI) score. Of the 41 patients included in our study, only 29 completed the treatment course. Their PASI before treatment ranged from 1.2 to 43 (mean: 12.1). Both groups, calcipotriol 50 microg/g ointment (11 patients) and calcipotriol 50 microg/g cream (18 patients) showed time-dependent improvement and after 6 weeks there was excellent improvement with a marked reduction in the total mean PASI from 12.1 to 1.02. There was a significant reduction of PASI in the ointment group in comparison with the cream group (mean PASI from 12.7 to 0.8 and 11.1 to 1.15, respectively). No significant adverse effects were observed in either group, except for mild irritation in a few patients in the calcipotriol cream group. In conclusion, calcipotriol was effective, safe and well tolerated in the treatment of psoriasis vulgaris and better results were observed with the ointment formulation. Longer treatment courses could be advised.
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7.
Natural killer cell activity, serum immunoglobulins, complement proteins, and zinc levels in patients with psoriasis vulgaris.
Oztürk, G, Erbaş, D, Gelir, E, Gülekon, A, Imir, T
Immunological investigations. 2001;(3):181-90
Abstract
The role of the immune system in patients with psoriasis vulgaris (PV) was investigated. The genetic and immunological basis for psoriasis is still unknown. Because of the reports of immunological defects in this disease, we investigated serum levels of immunoglobulins IgG, IgM, IgA, complement proteins C3, C4, serum zinc (Zn) levels and natural killer (NK) cell activities. Skin lesions of the psoriatic patients involved in the study comprised less than 10 % of the total body and the disease was in a stationary period. Zn levels were measured by atomic absorption spectrophotometry. NK cell activity was measured by 51Cr (Na2 51CrO4). IgG, IgA, IgM, C3 and C4 assays were done by liquid-phase immunoprecipitation assay with nephelometric endpoint detection. IgG, IgA, C3 and C4 levels were significanty higher in patients with PV than in healty controls (p < 0.05). However, NK cell activity, serum Zn and IgM levels did not show significant differences between these two groups. There are changed immunological responses, which may play an important role in the pathogenesis of the disease. Many controversial results have been related to immunological parameters in psoriatic patients. Therefore, more detailed studies in this field need to be done to determine the relationship between psoriasis and the immune system.