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  • 2005-2009  (4)
  • 1995-1999  (13)
  • 1990-1994  (9)
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  • 1
    Electronic Resource
    Electronic Resource
    A multicentre evaluation of the guidelines for the use of cyclosporin A in severe psoriasis (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of the European Academy of Dermatology and Venereology 7 (1996), S. 0 
    Details
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Controversy still exists as lo whether a dosage scheme for the treatment of severe psoriasis with cyclosporin A (CsA) should start with low dosages (3 mg/kg/day) or rather with high dosages (5 mg/kg/day).Aims In this open prospective multi-centre trial guidelines for the use of CsA in psoriasis beginning with low dosages were evaluated. A secondary aim of the study was to elucidate factors predicting efficacy of CsA treatment.Methods Efficacy and tolerability of CsA were evaluated monthly during 16 weeks in 86 patients (56 males, 30 females, mean age 43,0 ± 14,9 years) suffering from chronic severe plaque-type psoriasis, not responding to topical therapy (mean PASI 18.0 ± 8.1). All patients started with 3 mg/kg/day. Patients were defined as responders with a PASI reduction 〉 25% at month 1, ≥ 25% at month 1, ≥ 60% at month 3 and ≥ 70% at month 4. When a patient was a failure, the dose was increased by 1 mg/kg/day lo a maximum of 5 mg/kg/day.Results A gradual mean PASI reduction of 38%. 59%, 72% to 76% was reached with a mean CsA dose of 3.0, 3.2, 3.5, and 3.6 mg/kg/day at weeks 4, 8, 12 and 16. respectively. At the end of the study period, 39 patients were still on 3, 24 patients were on 4 and 15 patients were on 5 mg/kg/day. Due to subjective side-effects 6 patients dropped out on 3 mg/kg/day and 2 on 4 mg/kg/day. Diastolic and systolic blood pressure and creatinine levels were stable. Overall, CsA was relatively well tolerated. Absence of previous therapies, low baseline PASI and failure at week 4 were predictive for higher drop-out and failure rate and lower PASI at the end of study.Conclusions This study shows that a significant proportion of severe psoriasis patients can be treated with 3 mg/kg/day CsA with good tolerability and excellent clinical results. It is concluded that a treatment scheme with an optimal risk-benefit ratio should start with low dosages of CsA (3 mg/kg/day).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1468-3083.1996.tb00556.x
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  • 2
    Electronic Resource
    Electronic Resource
    Atopic dermatitis (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of the European Academy of Dermatology and Venereology 7 (1996), S. 0 
    Details
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: General description Atopic dermatitis is a common disease with a genetic background known as atopic syndrome. New findings as to possible genes involved are in accordance with a suspected pathogenesis of immune dysregulation. A preferential outgrowth of IL-4 secreting Th2 cells upon stimulation with relevant allergens results in B cell stimulation and the production of allergen-specific IgE. Non-specific and specific immunological and inflammatory processes form the pathological basis of the clinical condition eczema. Therapeutical options include general measures such as allergen avoidance, prescription of emollients, and the use of (sedating) antihistamines. Specific topical agents are tar preparations, corticosteroids and possibly topical non-steroidal anti-inflammatory drugs. Systemic therapy is sometimes required and corticosteroids and cyclosporin are available for that purpose. Photo(chemo)therapy is another modality and long-wave UVA seems to be promising in that respect. Learning objective The reader will have knowledge of new developments in the genetics and immunopathology of atopy and atopic dermatitis. Knowledge of the imniunodiagnosis and management of atopic dermatitis as well as its complications will be reviewed and updated with insights in new therapeutic modalities as well as in the changes of how the existing modalities should be used.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1468-3083.1996.tb00605.x
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  • 3
    Electronic Resource
    Electronic Resource
    The long-term safety and efficacy of cyclosporin in severe refractory atopic dermatitis: a comparison of two dosage regimens (1996)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 135 (1996), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: An open, randomized trial was performed to determine the optimal dosage schedule with regard to the efficacy and safety of cyclosporin in severe atopic dermatitis. The study also provided clinical experience with regard to the efficacy and safety of long-term cyclosporin treatment. During a 2-month dose-finding period. 78 patients with severe, long-standing atopic dermatitis received cyclosporin at a dose of either 5 mg/kg per day, decreasing to 3 mg/kg per day (Group A), or 3 mg/kg per day, increasing to 5 mg/kg per day (Group B). Patients were maintained on their optimal dose for a further 10 months. Patients in Group A showed a significantly greater improvement in efficacy parameters over the first 2 weeks than with patients in Group B, but as the dose was decreased in Group A and increased in Group B, these differences were minimized. After 1 year, cyclosporin showed an efficacy of 59.8% in Group A and 51.7% in Group B, assessed by a severity score. Assessed in terms of an area score, these figures were 48.7% and 40%, respectively. Cyclosporin demonstrated a good safety profile during long-term treatment and was generally well tolerated. The lower starting dosage was not associated with higher dropout rates. This study showed no differences in efficacy or adverse events between the two dosage schedules in long-term treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1996.tb00704.x
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  • 4
    Electronic Resource
    Electronic Resource
    Oral cyclosporin A in the treatment of psoriasis: an overview of studies performed in The Netherlands (1990)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 122 (1990), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This is a review of the clinical studies performed so far in The Netherlands of the treatment of psoriasis with cyclosporin A (CyA), a selective immunosuppressive drug that has caused a major breakthrough in transplant medicine. Data derived from a double-blind placebocontrolled study (5 mg/kg/day of CyA), dose-finding studies (2.5 mg vs 5 mg/kg/day and 1 mg, 2 mg or 3 mg/kg/day), and long-term treatment of chronic plaque-type psoriasis (1.1–7.2 mg/kg/day) suggest an initial starting dose of 3 mg/kg/day irrespective of the severity of the disease. Long-term treatment brought about dose- and time-dependent (reversible) side effects, including renal dysfunction and hypertension. Efforts to reduce the dose included concomitant administration of drugs known to have anti-psoriatic efficacy. Only combination with topical steroids appeared to add to the clinical efficacy of CyA, but did not allow a dose reduction sufficient to restore renal function. Dose reduction through intermittent treatment, however, postponed exacerbations sufficiently to permit at least partial normalization of serum creatinine levels. A similar effect was seen in the treatment of pustular palmoplantar psoriasis, which responded to doses of 1.1–6–1 mg/kg/day.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1990.tb02879.x
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  • 5
    Electronic Resource
    Electronic Resource
    Linear connective tissue naevus of the proteoglycan type (‘naevus mucinosus’) (1994)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 131 (1994), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We report a case of naevus mucinosus, a recently described condition. Clinically, the lesions presented as unilateral, multiple, firm, 3–5-mm-diameter, coalescent papules in a linear arrangement on the back of a 23-year-old man. Histologically, large amounts of acid mucoploysaccharides (proteoglycans) were demonstrated in the superficial dermis. As far as we are aware, this is the first report of the onset of naevus mucinosus in an adult. Naevus mucinosus appears to be a distinct type of connective tissue naevus which is characterized by an increase in proteoglycans.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1994.tb08526.x
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  • 6
    Electronic Resource
    Electronic Resource
    The skin in severe combined immunodeficiency: a case with transient cutaneous presence of γ/δ(TRC1+) T cells (1992)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 127 (1992), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary We report the case of a boy with severe combined immunodeficiency (SCID) and serious skin problems. The level of purine 5′-nucleotidase was greatly reduced in the lymphocytes of this patient. To our knowledge, no patients with SCID and this enzyme deficiency have been described previously. The relationship between reduced levels of this enzyme and the immunodeficiency is unclear. This case is also unusual because of the presence of large numbers of T lymphocytes expressing TCR1 (γ/δ) in the skin. Moreover, the presence of so many TCR1-positive cells was not consistent with the low numbers of these cells in the peripheral blood. These cells were not present in skin biopsies taken at a later stage during the course of the disease. An oligoclonal lymphocytosis developed during follow-up, and a monoclonal antibody reactive with these clones was found, indicating that these lymphocytes were present in the skin.This case report illustrates the benefit of the use of monoclonal antibodies in identifying the cells involved in the cutaneous inflammation in SCID, in order to gain a better insight into the characteristics of these cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1992.tb00129.x
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  • 7
    Electronic Resource
    Electronic Resource
    A multicentre, randomized, double-blind, controlled study of long-term treatment with 0·1% tacrolimus ointment in adults with moderate to severe atopic dermatitis (2005)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 152 (2005), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Atopic dermatis (AD) is a chronic disease that often requires long-term treatment. Topical corticosteroids are the usual therapy for patients with AD, but prolonged usage can result in skin atrophy and other side-effects.Objectives  In a randomized, double-blind, comparative study, to compare the efficacy and safety of a 6-month treatment period with 0·1% tacrolimus ointment vs. a corticosteroid ointment regimen in adults with moderate to severe AD.Methods  Treatment was applied twice daily for a maximum of 6 months. Patients in the tacrolimus treatment group (n = 487) applied 0·1% tacrolimus ointment to all affected areas over the whole body. The patients treated with the corticosteroid regimen (n = 485) applied 0·1% hydrocortisone butyrate ointment to affected areas on the trunk and extremities and 1% hydrocortisone acetate ointment to affected areas on the face and neck. The study primary endpoint was the response rate, i.e. the proportion of patients with at least 60% improvement in the modified Eczema Area and Severity Index (mEASI) between baseline and month 3.Results  By month 3, more patients in the 0·1% tacrolimus group responded to treatment (72·6% vs. 52·3% in the corticosteroid group, P 〈 0·001). The patients treated with 0·1% tacrolimus also showed greater improvement in mEASI, EASI, affected body surface area and physician and patient assessments of global response. Patients applying 0·1% tacrolimus ointment experienced more skin burning (52·4% vs. 13·8% in the corticosteroid group; P 〈 0·001). In most patients, skin burning was mild to moderate in severity and decreased rapidly after the first week of treatment. There was no increase in the incidence of infections or malignancies over time in either treatment group.Conclusions  Long-term treatment with 0·1% tacrolimus ointment is significantly more efficacious than a corticosteroid ointment regimen in adults with moderate to severe AD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.2005.06592.x
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  • 8
    Electronic Resource
    Electronic Resource
    A multicentre evaluation of the guidelines for the use of cyclosporin A in severe psoriasis [J. Eur. Acad. Dermatol. Venereol. 7 (1996) 49–58] (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of the European Academy of Dermatology and Venereology 8 (1997), S. 0 
    Details
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1468-3083.1997.tb00477.x
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  • 9
    Electronic Resource
    Electronic Resource
    The effectiveness of cyclosporine and photochemotherapy in the treatment of psoriasis: a retrospective study (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of the European Academy of Dermatology and Venereology 9 (1997), S. 0 
    Details
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective In this retrospective study, the effectiveness of cyclosporine A (CsA) and photochemotherapy (PUVA) in inducing and maintaining remission has been evaluated for a 1 year period in 50 patients.Methods CsA was administered for induction of remission and continued as maintenance therapy. PUVA was given as a single course. Patients were classified into two groups: moderate psoriasis and severe psoriasis.Results Efficacy parameters showed a remission of 93% following one course of PUVA therapy versus 80% in the CsA group (P 〈 0.01) in moderate psoriasis. In severe psoriasis no differences were detectable. The mean induction of remission period with CsA was 12.5 weeks and with PUVA 13.5 weeks. Nine of 25 CsA treated patients and five of 25 PUVA treated patients failed to reach a remission within a period of 16 weeks. The mean maintenance of remission was 39 weeks in the CsA group and 33 weeks in the PUVA group.Conclusion These results indicate a preferential position of PUVA therapy to treat both moderate and severe psoriasis that does not respond to topical treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1468-3083.1997.tb00508.x
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  • 10
    Electronic Resource
    Electronic Resource
    Leukocyte extravasation as a target for anti-inflammatory therapy – Which molecule to choose? (2005)
    Oxford, UK; Malden, USA : Munksgaard International Publishers
    Experimental dermatology 14 (2005), S. 0 
    Details
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract:  In view of the central pathogenic importance of leukocyte extravasation in inflammatory skin diseases, therapeutic interference with this – surprisingly complex – process is clearly a promising new approach for treating these dermatoses. Despite some disappointments during the clinical use of these agents and despite their crippling price tag, the recent incorporation of biologicals that target defined molecular controls of leukocyte extravasation into dermatological and rheumatological practise, consequently, has greatly enriched our therapeutic options for battling major, chronic, inflammatory dermatoses such as psoriasis. However, the – as yet unresolved and still rather controversially discussed – critical question is: Which of the multiple steps that control leukocyte extravasation in the human system really offer the most promising, most pragmatic, and safest molecular targets for therapeutic intervention for which disease entity? The current debate intends to stimulate public and rational debate of this crucial issue, beyond the evident commercial interests that are touched by whatever stand one takes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0906-6705.2005.290a.x
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