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  • 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 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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  • 8
    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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  • 9
    Electronic Resource
    Electronic Resource
    Serum neopterin as a marker for reactional states in leprosy (1999)
    Oxford, UK : Blackwell Publishing Ltd
    FEMS immunology and medical microbiology 24 (1999), S. 0 
    Details
    ISSN: 1574-695X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology , Medicine
    Notes: Reactions, a relatively common phenomenon among leprosy patients in treatment, require early detection and proper management to prevent serious sequelae. It is generally accepted that reactional states are immunologically mediated and, as such, usually improve with immunomodulatory treatments such as corticosteroids or thalidomide. Neopterin, a product of γ-interferon-activated macrophages, is a marker for cell-mediated immune activation and may be useful to detect reactional states in leprosy. Here, we compared neopterin levels in single serum samples from leprosy patients with and without reaction with untreated controls and, when available, serial samples among patients with and without reaction. Levels in the single sample measurements, conducted in 22 patients with a reversal reaction (mean 14.5 nmol l−1, S.D. 8.7) and 13 with erythema nodosum leprosum (mean 16.9 nmol l−1, S.D. 13.6), were significantly higher (P=0.02 and P=0.001, respectively) than levels in 26 untreated patients (mean 9.1 nmol l−1, S.D. 7.3). Values above the upper limit of normal (10 nmol l−1) were found in seven of 26 untreated patients, 14 of the 22 reversal reaction patients (P=0.01) and 10 of the 13 ENL patients (P=0.003). Serial serum samples, obtained from six patients that developed reactions and 14 that remained free of reaction, indicated that reversal reaction or erythema nodosum leprosum paralleled a concomitant increase in the serum neopterin level. Neopterin levels generally declined upon corticosteroid therapy. Neopterin may be a useful marker for reactional states in leprosy by providing a laboratory parameter to assess the onset, progression, response to therapy and resolution.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1574-695X.1999.tb01312.x
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  • 10
    Electronic Resource
    Electronic Resource
    Photoisomerization spectrum of urocanic acid in human skin and in vitro: effects of simulated solar and artificial ultraviolet radiation (1995)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 132 (1995), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary Ultraviolet (UV) irradiation of trans-urocanic acid (UCA), a major UV absorbing component of the epidermis, leads to the formation of cis-UCA, which mediates immunosuppressive effects. In this study, the net yield of cis-UCA was measured after the photoisomerization of urocanic acid by narrow UV wavebands (spectral range 295–405 nm), with the irradiation doses related to solar irradiance at sea level. The formation of cis-UCA in Caucasian skin (in vivo), as well as in aqueous solution (in vitro), was determined by HPLC analysis. The same irradiation conditions were met in both components of the study. The in vivo experiments showed high efficiency of cis-UCA formation in the spectral region of 305–341 nm, whereas high efficiency in vitro was found at 305 and 326 nm. At 350 and 363 nm, cis-UCA was formed in vivo, but not in vitro. At longer test wavelengths up to 405 nm. no significant formation of cis-UCA was detectable. The established partition between UVB and UVA at 320 nm is not relevant for the isomerization pattern of UCA. Additional studies revealed substantial cis-UCA formation in human skin by UVA phototherapy lamps. Furthermore, raised levels of 295 nm irradiation doses, a possible effect of stratospheric ozone depletion, were found to increase the cis-UCA yield. Our results demonstrate that the formation of cis-UCA in the skin with common exposures takes place over a broad spectrum range of UVB and UVA, up to at least 363 nm. These findings emphasize the potency of UVA to isomerize UCA, and they may contribute to further elucidation of the effects of phototherapy and sunbathing.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1995.tb16943.x
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