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Psoriasis: HELP
Articles from Lebanon
Based on 27 articles published since 2009

These are the 27 published articles about Psoriasis that originated from Lebanon during 2009-2019.
+ Citations + Abstracts
Pages: 1 · 2
1 Review Disease burden and treatment challenges of psoriatic arthritis in Africa and the Middle East. 2019

Bedaiwi, Mohamed / Al-Homood, Ibrahim A / El-Garf, Ayman / Uthman, Imad / Sunna, Nancy / Nassier, Reenad / Mohamed, Haytham / Al Saleh, Jamal. ·Division of Rheumatology, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia. dr.mkbedaiwi@gmail.com. · Department of Medical Specialties, Rheumatology Section, King Fahad Medical City, Riyadh, Saudi Arabia. · Rheumatology Department, Cairo University Hospitals, Cairo University, Cairo, Egypt. · Division of Rheumatology, American University of Beirut Medical Center, Beirut, Lebanon. · Pfizer Inc, Amman, Jordan. · Pfizer Inc, Jeddah, Saudi Arabia. · Rheumatology Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates. ·Rheumatol Int · Pubmed #31134289.

ABSTRACT: Psoriatic arthritis (PsA) is a chronic, inflammatory arthropathy occurring in up to 30% of patients with psoriasis, and is characterized by multiple manifestations including peripheral arthritis, enthesitis, dactylitis, spondylitis, and psoriatic skin and nail disease. This complex and heterogeneous disease is poorly understood and its diagnosis and treatment are suboptimal, particularly in Africa and the Middle East, where very few studies into the impact of PsA have been carried out. This article aims to highlight the disease burden of PsA in the region as well as to identify unmet clinical needs. A non-systematic review was carried out in the PubMed database and the most relevant publications were selected. Expert rheumatologists practicing in Africa and the Middle East provide an insight into the challenges of treating PsA in daily practice, along with recommendations for improvements.

2 Review Vitamin D and the Skin: An Update for Dermatologists. 2018

Kechichian, Elio / Ezzedine, Khaled. ·Department of Dermatology, Hôpital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France. · Faculty of Medicine, Saint Joseph University, Beirut, Lebanon. · Department of Dermatology, Hôpital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France. Khaled.ezzedine@aphp.fr. · EA EpiDermE (Epidémiologie en Dermatologie et Evaluation des Thérapeutiques), UPEC-Université Paris-Est Créteil, 94010, Créteil, France. Khaled.ezzedine@aphp.fr. ·Am J Clin Dermatol · Pubmed #28994020.

ABSTRACT: Vitamin D plays a key role in skeletal and cardiovascular disorders, cancers, central nervous system diseases, reproductive diseases, infections, and autoimmune and dermatological disorders. The two main sources of vitamin D are sun exposure and oral intake, including vitamin D supplementation and dietary intake. Multiple factors are linked to vitamin D status, such as Fitzpatrick skin type, sex, body mass index, physical activity, alcohol intake, and vitamin D receptor polymorphisms. Patients with photosensitive disorders tend to avoid sun exposure, and this practice, along with photoprotection, can put this category of patients at risk for vitamin D deficiency. Maintaining a vitamin D serum concentration within normal levels is warranted in atopic dermatitis, psoriasis, vitiligo, polymorphous light eruption, mycosis fungoides, alopecia areata, systemic lupus erythematosus, and melanoma patients. The potential determinants of vitamin D status, as well as the benefits and risks of vitamin D (with a special focus on the skin), will be discussed in this article.

3 Review The problem in differentiation between psoriatic-related polyenthesitis and fibromyalgia. 2018

Marchesoni, Antonio / De Marco, Gabriele / Merashli, Mira / McKenna, Frank / Tinazzi, Ilaria / Marzo-Ortega, Helena / McGonagle, Dennis G. ·UOC Day Hospital of Rheumatology, ASST Gaetano Pini-CTO Hospital, Milano, Italy. · NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK. · Division of Rheumatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. · Rheumatology Department, Central Manchester University Hospitals NHS Trust, Trafford General Hospital, Manchester, UK. · Unit of Rheumatology, Sacro Cuore Don Calabria Hospital, Negrar, Italy. ·Rheumatology (Oxford) · Pubmed #28387854.

ABSTRACT: The recognition of the primacy of enthesitis in animal models of spondyloarthritis and the prevalence of clinically occult enthesopathy in psoriatic subjects and of persistent joint pain in PsA subjects who have ostensibly good reduction of joint swelling under biological therapy has highlighted the potential impact of polyenthesitis in psoriatic disease. In daily practice, the formal demonstration of enthesitis is challenging for the following reasons: the relatively avascular nature of enthesis, often leading to the absence of overt clinical inflammatory signs; the frequent lack of elevation of inflammatory markers; and finally, the limitations of current imaging techniques to provide supportive evidence for inflammation in these areas. Consequently, enthesitis may present as widespread pain indistinguishable from FM or may emerge as the dominant feature after successful biological therapy for suppression of synovitis. The unmet needs in the differentiation between FM and enthesitis in psoriatic disease patients are highlighted and critically evaluated in this article.

4 Review Retinoids: a journey from the molecular structures and mechanisms of action to clinical uses in dermatology and adverse effects. 2017

Khalil, Samar / Bardawil, Tara / Stephan, Carla / Darwiche, Nadine / Abbas, Ossama / Kibbi, Abdul Ghani / Nemer, Georges / Kurban, Mazen. ·a Department of Internal Medicine , American University of Beirut , Beirut , Lebanon. · b Department of Dermatology , American University of Beirut , Beirut , Lebanon. · c Department of Biochemistry and Molecular Genetics , American University of Beirut , Beirut , Lebanon. · d Department of Dermatology , Columbia University Medical Center , New York , NY , USA. ·J Dermatolog Treat · Pubmed #28318351.

ABSTRACT: Retinoids are a class of compounds derived from vitamin A or having structural and/or functional similarities with vitamin A. They are classified into three generations based on their molecular structures. Inside the body, retinoids bind to several classes of proteins including retinoid-binding proteins and retinoid nuclear receptors. This eventually leads to the activation of specific regulatory regions of DNA - called the retinoic acid response elements - involved in regulating cell growth, differentiation and apoptosis. Several clinical trials have studied the role of topical and systemic retinoids in disease, and research is still ongoing. Currently, retinoids are used in several fields of medicine. This paper aims to review the structure, mechanisms of action, and adverse effects of retinoids, as well as some of their current uses in Dermatology.

5 Review The Role of Interleukin-1 in Inflammatory and Malignant Human Skin Diseases and the Rationale for Targeting Interleukin-1 Alpha. 2017

Bou-Dargham, Mayassa J / Khamis, Zahraa I / Cognetta, Armand B / Sang, Qing-Xiang Amy. ·Department of Chemistry and Biochemistry, Florida State University, Tallahassee, FL, 32306. · Institute of Molecular Biophysics, Florida State University, Tallahassee, FL, 32306. · Department of Chemistry and Biochemistry, Lebanese University, Faculty of Sciences, Hadath-Beirut, Lebanon. · Dermatology Associates of Tallahassee and Division of Dermatology, Florida State University College of Medicine, Tallahassee, FL, 32308. ·Med Res Rev · Pubmed #27604144.

ABSTRACT: Inflammation plays a major role in the induction and progression of several skin diseases. Overexpression of the major epidermal proinflammatory cytokines interleukin (IL) 1 alpha (IL-1α) and 1 beta (IL-1β) is positively correlated with symptom exacerbation and disease progression in psoriasis, atopic dermatitis, neutrophilic dermatoses, skin phototoxicity, and skin cancer. IL-1β and the interleukin-1 receptor I (IL-1RI) have been used as a therapeutic target for some autoinflammatory skin diseases; yet, their system-wide effects limit their clinical usage. Based on the local effects of extracellular IL-1α and its precursor, pro-IL-1α, we hypothesize that this isoform is a promising drug target for the treatment and prevention of many skin diseases. This review provides an overview on IL-1α and IL-β functions, and their contribution to inflammatory and malignant skin diseases. We also discuss the current treatment regimens, and ongoing clinical trials, demonstrating the potential of targeting IL-1α, and not IL-1β, as a more effective strategy to prevent or treat the onset and progression of various skin diseases.

6 Review Experience and challenges for biologic use in the treatment of moderate-to-severe psoriasis in Africa and the Middle East region. 2017

Al Hammadi, Anwar / Al-Sheikh, Afaf / Ammoury, Alfred / Ghosn, Samer / Gisondi, Paolo / Hamadah, Issam / Kibbi, Abdul-Ghani / Shirazy, Khalid. ·a Department of Dermatology , Rashid Hospital , Dubai , UAE. · b Department of Dermatology , King Abdulaziz Medical City , Riyadh , Saudi Arabia. · c Department of Dermatology , St George Hospital University Medical Center , Beirut , Lebanon. · d Department of Dermatology , American University of Beirut Medical Center , Lebanon. · e Department of Dermatology , University Hospital of Verona , Italy. · f Department of Dermatology , King Faisal Hospital and Research Centre , Riyadh , Saudi Arabia. · g Pfizer Inc , Dubai , UAE. ·J Dermatolog Treat · Pubmed #27196814.

ABSTRACT: The incidence of psoriasis in Africa and the Middle East (AfME) is high as in other regions and represents a significant problem for both dermatologists and patients. Psoriasis co-morbidities such as obesity, cardiovascular disease and psoriatic arthritis (PsA) are also particularly common in these regions and may be under-recognized and under-treated. Despite this, regional guidelines to aid physicians on the appropriate use of biologic agents in their clinical practice are limited. A group of expert dermatologists from across the AfME region were surveyed to help establish best practice across the region, alongside supporting data from the literature. Although biologics have significantly improved patient outcomes since their introduction, the results of this survey identified several unmet needs, including the lack of consensus regarding their use in clinical practice. Discrepancy also exists among AfME physicians concerning the clinical relevance of immunogenicity to biologics, despite increasing data across inflammatory diseases. Significant treatment and management of challenges for psoriasis patients remain, and a move towards individualized, tailored care may help to address these issues. The development of specific local guidelines for the treatment of both psoriasis and PsA could also be a step towards understanding the distinct patient profiles in these regions.

7 Review Splinter hemorrhages of the nails: a systematic review of clinical features and associated conditions. 2016

Haber, Roger / Khoury, Rana / Kechichian, Elio / Tomb, Roland. ·Department of Dermatology, Hotel Dieu de France University Hospital, Beirut, Lebanon. roger.haber@net.usj.edu.lb. · Department of Dermatology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon. roger.haber@net.usj.edu.lb. · Department of Dermatology, Hotel Dieu de France University Hospital, Beirut, Lebanon. · Department of Dermatology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon. ·Int J Dermatol · Pubmed #27420914.

ABSTRACT: Splinter hemorrhages (SHs) of the nails represent a frequent although not specific clinical finding that has been associated with conditions of varying severity. However, to date, there is no single report of their characteristics and etiologies. The aim of this study is to guide clinical practice by reviewing all of the data concerning SH of the nails that have become available since the first description of this condition was published in 1923, with particular reference to all clinical features, associated medical conditions, pathogenesis, and necessary workup. PubMed and EMBASE were searched using the keywords "splinter" AND "hemorrhage*"; the only articles excluded were those studying SHs of the retina. Splinter hemorrhage is a frequent nail disorder that may be idiopathic, drug-induced, or a sign of a dermatological disease, such as psoriasis and lichen planus, or a wide range of systemic disorders, the most important of which are infections and vasculitis. Clinicians and dermatologists should be aware of all the clinical features of both SH and associated medical conditions.

8 Review Update on the role of plasmacytoid dendritic cells in inflammatory/autoimmune skin diseases. 2016

Saadeh, Dana / Kurban, Mazen / Abbas, Ossama. ·Dermatology Department, American University of Beirut Medical Center, Beirut, Lebanon. ·Exp Dermatol · Pubmed #26837058.

ABSTRACT: Plasmacytoid dendritic cells (pDCs) represent a specialized dendritic cell population that exhibit plasma cell morphology, express CD4, CD123, blood-derived dendritic cell antigen-2 (BDCA-2) and Toll-like receptor (TLR)7 and TLR9 within endosomal compartments. When activated, pDCs are capable of producing large quantities of type I IFNs (mainly IFN-α/β), which provide antiviral resistance and link the innate and adaptive immunity. While generally lacking from normal skin, pDCs infiltrate the skin and appear to be involved in the pathogenesis of several inflammatory, infectious (especially viral) and neoplastic entities. In recent years, pDC role in inflammatory/autoimmune skin conditions has been extensively studied. Unlike type I IFN-mediated protective immunity that pDCs provide at the level of the skin by regulated sensing of microbial or self-nucleic acids upon skin damage, excessive sensing may elicit IFN-driven inflammatory/autoimmune diseases. In this review, focus will be on the role of pDCs in cutaneous inflammatory/autoimmune dermatoses.

9 Review Effect of glucagon-like peptide-1 receptor agonists in patients with psoriasis. 2014

Al-Badri, Marwa R / Azar, Sami T. ·Department of Internal Medicine, Division of Endocrinology and Metabolism, American University of Beirut- Medical Center, New York, USA. · Department of Internal Medicine, Division of Endocrinology and Metabolism, American University of Beirut-Medical Center, 3 Dag Hammarskjold Plaza, 8th floor, New York, NY 10017, USA. ·Ther Adv Endocrinol Metab · Pubmed #25152810.

ABSTRACT: Glucagon-like peptide-1 (GLP-1) agonists are a class of drugs used for the treatment of type 2 diabetes mellitus. GLP-1 is released in response to meal intake; these classes of drugs enhance glucose-dependent insulin secretion and exhibit other antihyperglycemic effects following their release into the circulation from the gut. Psoriasis is a chronic skin condition affecting approximately 2% of the Western population. It is considered to be an autoimmune disease that involves the Th1 pathway and is associated with metabolic syndrome and its components, such as obesity, diabetes, and hypertension. We have reviewed reports in the literature that indicate a beneficial anti-inflammatory effect of GLP-1 in patients with diabetes or who have insulin resistance and psoriasis.

10 Review Metformin in dermatology: an overview. 2013

Badr, D / Kurban, M / Abbas, O. ·Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon. ·J Eur Acad Dermatol Venereol · Pubmed #23437788.

ABSTRACT: For several decades, metformin has been used as an oral hypoglycaemic agent, where it is the first line of treatment in overweight and obese type 2 diabetic patients. This is because it decreases the hepatic glucose output and acts as an insulin sensitizer by increasing the glucose utilization by muscles and adipocytes. As a result of the improvement in glycaemic control, serum insulin concentrations decline slightly, thus improving hyperinsulinaemia and its signs. In addition, it has been shown that metformin has platelet anti-aggregating and antioxidant effects. These pharmacological properties have allowed metformin to be effective in non-diabetic situations including cutaneous conditions. This is an evidence-based review on the use of metformin in the treatment of skin disorders such as hirsutism, acne, hidradenitis suppurativa, acanthosis nigricans, psoriasis, skin cancer, among others. In addition, cutaneous side-effects such as leukocytoclastic vasculitis, bullous pemphigoid, psoriasiform drug eruption, lichen planus and acute alopecia have been associated with metformin use and are discussed in the article.

11 Review Bariatric surgery and its effects on the skin and skin diseases. 2013

Halawi, Ali / Abiad, Firass / Abbas, Ossama. ·Department of Dermatology, American University of Beirut Medical Center, P.O.Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon. ·Obes Surg · Pubmed #23297168.

ABSTRACT: In light of the increasing prevalence of obesity worldwide, the popularity of bariatric surgery is on the rise. As with any other invasive procedure, these surgeries, especially with the obesity risk factor, carry the risk of direct cutaneous complications following the penetration and manipulation of tissues. In addition, bariatric surgery has an effect on skin structure and function. It also appears to be affiliated with several dermatoses. Some of these represent preexisting diseases the course of which is altered by the procedure, such as psoriasis. On the other hand, other skin disorders are triggered by the surgery itself. This article reviews and summarizes these cutaneous effects and complications.

12 Review Patented small molecules against psoriasis. 2009

Abdelnoor, Alexander M. ·American University of Beirut, Department of Microbiology & Immunology, Riad el-Solh, Beirut 1107 2020, Lebanon. aanoor@aub.edu.lb ·Expert Opin Ther Pat · Pubmed #19566378.

ABSTRACT: BACKGROUND: It is hypothesized that psoriasis is an autoimmune disease. The most recent therapeutic approach that proved to be more effective than earlier methods of treatment is the use of mAb/fusion proteins. Efforts nowadays are focused on investigating the antipsoriatic affect of small molecules that can be administered orally, some of which are capable of entering cells, and being selective in targeting intracellular pathways. OBJECTIVE: Preclinical patented small molecules that are recommended for the treatment of psoriasis are reviewed. Emphasis is placed on their mechanism of action. METHODS: http://ep.espacenet.com/ , Pubmed, Scopus and Google websites were the main sources used for the patented small molecule search. A number of patents were poorly described and difficulties were faced in trying to figure out the patentee(s) explanation. Moreover, most patents were recommended for the treatment of a number of autoimmune diseases and cancer, and not only for psoriasis. RESULTS/CONCLUSIONS: Small molecules that inhibit the activation of T lymphocytes, leukocyte trafficking, leukotriene activity/production and angiogenesis, and promote apoptosis have been patented. Small molecules that have been patented for the treatment of other autoimmune diseases and could be used for treating psoriasis are described. Moreover, other possible mechanistic approaches using small molecules are discussed.

13 Article HLA-B27 prevalence in axial spondyloarthritis patients and in blood donors in a Lebanese population: Results from a nationwide study. 2019

Ziade, Nelly / Abi Karam, Ghada / Merheb, Georges / Mallak, Iyad / Irani, Laure / Alam, Elie / Messaykeh, Jamil / Menassa, Jeanine / Mroue', Kamel / Uthman, Imad / Masri, Abdel Fattah / Ghorra, Pierre / Witte, Torsten / Baraliakos, Xenofon. ·Rheumatology Department, Saint-Joseph University, Beirut, Lebanon. · Rheumatology Department, Hotel-Dieu de France Hospital, Beirut, Lebanon. · Rheumatology Department, Holy Spirit University, Kaslik, Lebanon. · Rheumatology Department, Notre-Dame des Secours University, Lebanon. · Radiology Department, Hotel-Dieu de France, Beirut, Lebanon. · Lebanese University Hospital, Beirut, Lebanon. · Rizk University Medical Center, Beirut, Lebanon. · Levant Hospital, Sin-el-Fil, Lebanon. · Monla Hospital, Tripoli, Lebanon. · Geitawi Hospital, Beirut, Lebanon. · Al Zahra University Hospital, Beirut, Lebanon. · American University of Beirut Medical Center, Beirut, Lebanon. · Blood Transfusion Center, Hotel-Dieu de France, Beirut, Lebanon. · Medical University, Hannover, Germany. · Rheumazentrum Ruhrgebiet, Herne, Germany. · Ruhr-Universität Bochum, Bochum, Germany. ·Int J Rheum Dis · Pubmed #30729696.

ABSTRACT: AIM: To calculate the prevalence of human leukocyte antigen (HLA)-B27 in axial spondyloarthritis patients (axSpA) compared to blood donors (BD) in Lebanon, to identify the clinical and radiological findings associated with HLA-B27 and to estimate the proportion of patients fulfilling the clinical arm of the Assessment of the Spondyloarthritis International Association (ASAS) criteria. METHOD: Consecutive Lebanese adult axSpA patients fulfilling the ASAS classification criteria were included from 12 rheumatology clinics across Lebanon. BD served as controls. A binary logistic regression was used to study the association between HLA-B27 and the disease features. RESULTS: A total of 247 individuals were included (141 axSpA patients and 106 BD). The prevalence of HLA-B27 was 3.8% in BD and 41.1% in axSpA. Overall, 39.7% of the axSpA patients fulfilled the clinical arm of the ASAS classification criteria. Sensitivity of HLA-B27 for axSpA was 41.1%, specificity was 96.2%, positive predictive value was 93.6%, and negative predictive value was 55.13%. Positive likelihood ratio (LR) was 10.9 and negative LR was 1.63. We found a positive association of HLA-B27 with family history of SpA and psoriasis. CONCLUSION: Our study confirmed a low prevalence of HLA-B27 in axSpA patients and BD in this Lebanese population, However, we found a high specificity and positive LR, as well as the same number of axSpA patients fulfilling the clinical arm of the ASAS criteria as in European studies. HLA-B27 is therefore valuable for identification of axSpA in Lebanese patients despite the overall low prevalence in this population. Our results may guide future evaluations the role of HLA-B27 in planning local referral strategies.

14 Article Successful sclerotherapy and psoriasis: A discussion of koebnerization, report of two cases, and review of the literature. 2018

Saade, Dana S / Vashi, Neelam A. ·Department of Dermatology, American University of Beirut, Beirut, Lebanon. · Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts. ·J Cosmet Dermatol · Pubmed #30537077.

ABSTRACT: -- No abstract --

15 Article Effect of anti-rheumatic treatment on selenium levels in inflammatory arthritis. 2018

Deyab, Gia / Hokstad, Ingrid / Aaseth, Jan / Småstuen, Milada Cvancarova / Whist, Jon Elling / Agewall, Stefan / Lyberg, Torstein / Tveiten, Dag / Hjeltnes, Gunnbjorg / Zibara, Kazem / Hollan, Ivana. ·Department of Medical Biochemistry, Innlandet Hospital Trust, Lillehammer, Norway. Electronic address: Gia.Deyab@sykehuset-innlandet.no. · Lillehammer Hospital for Rheumatic Diseases, Norway. · Inland Norway University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway. · Department of Public Health, Faculty of Nursing sciences, Oslo and Akershus University College, Oslo, Norway. · Department of Medical Biochemistry, Innlandet Hospital Trust, Lillehammer, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway. · University Hospital, Ullevål, Norway; Institute of Clinical Sciences, University of Oslo, Norway. · Department of Medical Biochemistry, Oslo University Hospital, Ullevål, Norway. · Lab1 AS, Sandvika, Norway. · Department of Medicine, Innlandet Hospital Trust, Lillehammer, Norway. · Department of Biology, Faculty of Sciences-l, Lebanese University, Beirut, Lebanon. · Lillehammer Hospital for Rheumatic Diseases, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway; Harvard Medical School, Boston, USA; Brigham and Women's Hospital, Boston, USA. ·J Trace Elem Med Biol · Pubmed #29895378.

ABSTRACT: OBJECTIVES: The reason for increased cardiovascular risk in inflammatory arthritis (IA) is unclear. Interestingly, selenium-deficiency is suspected to contribute to the development of cardiovascular disease (CVD) in the general population. Although the reference range of serum selenium (s-selenium) is 50-120 μg/L, there are indications that levels up to 85 μg/L might not be sufficient for optimal cardioprotection. Our aim was to examine s-selenium levels in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS), to evaluate the effect of anti-rheumatic treatment on s-selenium levels, and to assess relationships between s-selenium levels and clinical and laboratory parameters including markers of disease activity and CVD risk. METHODS: We examined 64 patients with RA, 40 with PsA and 26 with AS starting with methotrexate (MTX) monotherapy or anti-tumor necrosis factor therapy (anti-TNF) with or without methotrexate (anti-TNF ± MTX) due to active disease. S-selenium, inflammatory biomarkers, endothelial function (EF) and other variables were examined at baseline and after 6 weeks and 6 months of treatment. RESULTS: In the total IA group, s-selenium increased within 6 weeks of anti-rheumatic treatment, and thereafter the levels remained stable until the end of the 6 months follow-up period. There were no significant differences in s-selenium changes between the three diagnostic groups and between the two treatment regimens. Changes in s-selenium were negatively related to changes in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), but there were no significant relationships to any other of the examined risk parameters for CVD including EF. CONCLUSION: IA patients had s-selenium within the reference range, but below the level that might be necessary for optimal CVD protection. Anti-rheumatic treatment had a relatively rapid and sustained effect on s-selenium levels. The increase in s-selenium was related to reduction in inflammatory activity. In theory, anti-rheumatic drugs might improve s-selenium levels through inhibition of pro-inflammatory processes or through other mechanisms. Although we have not revealed any significant relationships between s-selenium and CVD risk parameters, the role of suboptimal s-selenium levels in pathogenesis of premature CVD in IA cannot be ruled out.

16 Article [Apparent worsening of psoriasis lesions revealing methotrexate overdosage]. 2018

Haber, R / Baroudjian, B / Battistella, M / Bagot, M / Petit, A. ·Service de dermatologie, St George Hospital University Medical Center, Beirut, Liban. Electronic address: rogerhaber@hotmail.com. · Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France. · Service de pathologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France. ·Ann Dermatol Venereol · Pubmed #28917574.

ABSTRACT: BACKGROUND: Methotrexate (MTX) is an antimetabolite drug used in the treatment of cancers and autoimmune diseases and frequently in dermatology for cutaneous and/or arthritic psoriasis. Toxicities due to MTX overdosage are mainly cutaneous, hepatic and hematologic. Herein, we report a case of MTX overdosage presenting as an erosive and an inflammatory flare of preexisting psoriatic plaques and with new palmar lesions. PATIENTS AND METHODS: A 51-year-old male with a 6-year history of plaque psoriasis resistant to topical corticosteroids was started for the first time on MTX 20mg weekly. One week later, he presented with fever, general weakness and mucocutaneous ulcerations. Physical examination revealed inflammatory, erythematous and partially erosive annular plaques strictly confined to preexisting psoriatic lesions, along with keratotic psoriatic palmar plaques. Further questioning indicated that the patient was taking MTX 20mg daily. Investigations revealed neutropenia (1040/mm DISCUSSION: Skin lesions due to acute MTX toxicity are rare, but they herald later-onset pancytopenia. Identification of these cutaneous lesions might enable earlier treatment initiation. The predilection of MTX toxicity for preexisting lesions or the de novo appearance of palmoplantar pustules should not lead to the erroneous diagnosis of psoriasis flare.

17 Article Understanding the phenotypic similarities between IFAP and Olmsted syndrome from a molecular perspective: the interaction of MBTPS2 and TRPV3. 2017

Nemer, Georges / Safi, Rémi / Kreidieh, Firas / Usta, Julnar / Bergqvist, Christina / Ballout, Farah / Btadini, Waed / Hamzeh, Nour / Abbas, Ossama / Kibbi, Abdul Ghani / Shimomura, Yutaka / Kurban, Mazen. ·Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon. · Department of Pediatrics, American University of Beirut, Beirut, Lebanon. · Department of Dermatology, American University of Beirut, Beirut, Lebanon. · Department of Internal Medicine, American University of Beirut, Beirut, Lebanon. · Department of Biochemistry and Molecular Genetics, Lebanese University, Hadath, Lebanon. · Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. · Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon. mk104@aub.edu.lb. · Department of Dermatology, American University of Beirut, Beirut, Lebanon. mk104@aub.edu.lb. · Department of Pediatrics, American University of Beirut, Beirut, Lebanon. mk104@aub.edu.lb. · Department of Dermatology, Columbia University Medical Center, New York, USA. mk104@aub.edu.lb. · Department of Dermatology, Biochemistry and Molecular Genetics, American University of Beirut Medical Center, Riad El Solh, P. O. Box 11-0236, Beirut, 1107 2020, Lebanon. mk104@aub.edu.lb. ·Arch Dermatol Res · Pubmed #28717930.

ABSTRACT: Ichthyosis Follicularis, Atrichia, and Photophobia (IFAP) is a severe rare genetic disorder caused by mutations in the gene encoding the Membrane-Bound Transcription Factor Peptidase, Site 2 (MBTPS2). Olmsted syndrome is another rare genetic disease with overlapping clinical features caused by mutations in the gene encoding the Transient Receptor Potential Cation Channel, subfamily V (TRPV3). Mutations in MBTPS2 have been recently reported in Olmsted syndrome, underscoring the overlap and the confusion in separating Olmsted from IFAP syndrome. We studied a Lebanese family with IFAP syndrome both, clinically and molecularly, and investigated whether there is a cross relation between TRPV3 and MBTPS2. We identified a recurrent mutation designated p.F475S in MBTPS2 in the affected individuals. This mutation was not found in 100 control individuals from the same population. We determined that TRPV3 regulatory region is a target for MBTPS2. In addition, there was an increased cell death in the cells transfected with the mutant versus the wild-type MBTPS2. In conclusion, we identified a direct regulatory effect of MBTPS2 on TRPV3 which can partially contribute to the overlapping clinical features of IFAP and Olmsted syndromes under a common signaling pathway.

18 Article Adherence to systemic therapies for immune-mediated inflammatory diseases in Lebanon: a physicians' survey from three medical specialties. 2017

Ammoury, Alfred / Okais, Jad / Hobeika, Mireille / Sayegh, Raymond B / Shayto, Rani H / Sharara, Ala I. ·Division of Dermatology, St George Hospital University Medical Center. · Division of Rheumatology, St Joseph University. · AbbVie Levant. · Division of Gastroenterology, St Joseph University. · Department of Internal Medicine, Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon. ·Patient Prefer Adherence · Pubmed #28553086.

ABSTRACT: BACKGROUND: Immune-mediated inflammatory diseases (IMIDs) are chronic conditions that may cause tissue damage and disability, reduced quality of life and increased mortality. Various treatments have been developed for IMIDs, including immune modulators and targeted biologic agents. However, adherence remains suboptimal. METHODS: An adherence survey was used to evaluate physicians' beliefs about adherence to medication in IMID and to evaluate if and how they manage adherence. The survey was distributed to 100 randomly selected physicians from three different specialties. Results were analyzed by four academic experts commissioned to develop an action plan to address practical and perceptual barriers to adherence, integrating it into treatment goals to maximize outcomes in IMID, thereby elevating local standards of care. RESULTS: Eighty-two physicians participated in this study and completed the questionnaire. Most defined adherence as compliance with prescribed treatment. Although the majority of surveyed physicians (74%) did not systematically measure adherence in their practice, 54% identified adherence as a treatment goal of equal or greater importance to therapeutic endpoints. Lack of time and specialized nursing support was reported as an important barrier to measuring adherence. The expert panel identified four key areas for action: 360° education (patient-nurse-physician), patient-physician communication, patient perception and concerns, and market access/cost. An action plan was developed centered on education and awareness, enhanced benefit-risk communication, development of adherence assessment tools and promotion of patient support programs. CONCLUSION: Nonadherence to medication is a commonly underestimated problem with important consequences. A customized target-based strategy to address the root causes of non-adherence is essential in the management of chronic immune-mediated diseases.

19 Article High prevalence of metabolic syndrome in patients with psoriasis in Lebanon: a prospective study. 2016

Itani, Salam / Arabi, Asma / Harb, Dana / Hamzeh, Diana / Kibbi, Abdul-Ghani. ·Department of Dermatology, American University of Beirut, Beirut, Lebanon. · Division of Endocrinology, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon. ·Int J Dermatol · Pubmed #26748974.

ABSTRACT: BACKGROUND: Psoriasis is a chronic inflammatory disease that affects not only the skin but also other organs as well. Genetic factors play an important role in individual predisposition. Lately, a positive association has been confirmed between psoriasis and metabolic syndrome (MBS), in western as well as in Middle Eastern countries. AIM: Assess the prevalence of MBS in Lebanese patients with psoriasis and the differential effect according to types and disease severity. METHODS: This was a case-control study including 150 psoriasis patients and 150 age- and gender-matched controls admitted to the dermatology clinics at the American University of Beirut-Medical Center, a tertiary care center in Beirut. Psoriasis severity was assessed by the Psoriasis Area Severity Index (PASI). Blood samples were collected from fasting subjects and tested for glucose, HDL cholesterol, triglycerides, and C-reactive protein (CRP). Multivariate binary logistic regression models were built to assess the relationship between MBS and psoriasis, after adjustment for smoking as a possible confounding variable. RESULTS: Patients with psoriasis were two times more likely to have MBS as compared to controls (35.3% vs 18.0%, P < 0.001) with an odds ratio (OR) of 2.4. All components of MBS were more prevalent in psoriasis patients than in controls. PASI score was greater in patients with MBS than those without MBS (10.5 ± 11.5 vs. 7.0 ± 8.1, P = 0.05). MBS prevalence tended to be higher in the inverse type than in others (52.2% versus 32.3%; P = 0.06) and in patients with nail pitting versus those without (45.3% vs. 28.2%; P = 0.03). CONCLUSIONS: This was the first study to assess the prevalence of MBS in Lebanese subjects with psoriasis and, to our knowledge, the first study that showed a higher likelihood of MBS in patients with inverse psoriasis and with nail pitting.

20 Article Guidelines for the Topical Treatment of Psoriasis Vulgaris in the Levant and Iraq Area. 2015

Abbas, Ossama / Ammoury, Alfred / Abbadi, Mohammad / Malek, Medhat Abdel / Akkash, Laith / Al-Chakharah, Kamal / Al-Hamdi, Khalil / Al-Qarqaz, Firas / Al-Soudani, Abduljabbar / Al-Soudani, Nameer / Dandashle, Anwar / El-Sayed, Fouad / Ghafir, Yasser / Gargour, Nazek / Kabalan, Said / Kibbi, Abdul-Ghani / Oumeish, Isam / Tannous, Zeina / Tomb, Roland. ·American University of Beirut, Beirut, Lebanon. · Balamand University, Beirut, Lebanon. · Ministry of Health Hospital, Amman Jordan. · Private Practice, Amman, Jordan. · University of Jordan, Amman, Jordan. · Private Practice, Ramallah, Palestinian Authority. · Basra Medical College, Basra, Iraq. · Jordan University of Science and Technology, Irbid, Jordan. · Hawler Medical University, Erbil, Iraq. · Al-Mustansiriya University, Iraq. · German Hospital, Dubai, United Arab Emirates. · Lebanese University, Beirut, Lebanon. · Private Practice, Damascus, Syria. · Private Practice, Lattkia, Syria. · Damascus University, Syria. · American University of Beirut, Beirut, Lebanon; agkibbi@aub.edu.lb. · King Hussein Medical Center, Amman, Jordan. · Lebanese American University, Beirut, Lebanon. · Saint Joseph University, Beirut, Lebanon. ·Skinmed · Pubmed #26861521.

ABSTRACT: Psoriasis vulgaris is a common chronic, inflammatory, multisystem disorder that affects approximately 1.5% to 3.4% of the population in the Middle East. The disease has an impact on the quality of life in a significant number of affected patients. The majority of patients (approximately 70%) have mild to moderate psoriasis that is manageable with topical agents, which generally show a high efficacy to safety ratio. Topical agents can be used alone when treating patients with limited disease or may be used as adjunctive therapy for patients with more extensive psoriasis undergoing systemic treatment. Treatment should also be customized to meet individual patients' needs. To optimize the topical treatment of psoriasis in the Levant and Iraq area, dermatology experts from Iraq, Jordan, Lebanon, Palestine, and Syria met and initiated a project to develop guidelines and recommendations for the topical management of psoriasis. The guidelines are based on literature evidence and experts' opinions. We present recommendations for the use of topical corticosteroids, vitamin D analogues, calcineurin inhibitors, tazarotene, salicylic acid, anthralin, and coal tar, as well as combination therapy, based on their efficacy and safety profiles.

21 Article Prurigo pigmentosa: a clinicopathologic study of 4 cases from the middle East. 2014

Hijazi, Maya / Kehdy, Jessica / Kibbi, Abdul-Ghani / Ghosn, Samer. ·*Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon; †Department of Dermatology, University of Balamand, Beirut, Lebanon; and ‡Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon. ·Am J Dermatopathol · Pubmed #25079199.

ABSTRACT: Prurigo pigmentosa (PP) is a rare inflammatory dermatosis originally reported in Japan. Since then, most reports have originated from Asia, and to a lesser extent from Europe. Although the pathogenesis remains unclear, it is now established that PP is linked to ketoacidotic states. Four patients diagnosed with PP were identified from the dermatopathology database at the American University of Beirut Medical Center between January 2009 and December 2013. Clinicopathologic findings in the 4 patients were similar to those previously reported in the literature. The patients were all female with a mean age of 23.5 years. They all presented with itchy erythematous reticulated papulovesicles/plaques leaving variable reticulated brownish patches. Two patients had, in addition, annular lesions arranged en cocarde and pustules, respectively. In 3 patients, the rash was associated with fasting or dieting. The rash had a predilection to the trunk and proximal part of the upper extremities. One patient had intergluteal area involvement. Two biopsy specimens revealed psoriasiform hyperplasia and neutrophilic exocytosis mimicking psoriasis or an impetiginized spongiotic dermatitis. One biopsy specimen exhibited a mild superficial perivascular lymphocytic infiltrate with ballooning and reticular degeneration, a picture mimicking a viral exanthema. Another biopsy specimen exhibited a picture similar to chronic spongiotic dermatitis. Although mostly described in Japan, PP has been described much less frequently in the Middle East region likely due to mis/underdiagnosis. Therefore, increased awareness is necessary especially because fasting is a common religious practice among Arab countries. Further investigations are necessary to better understand the etiopathogenesis of this rare entity.

22 Article Acrodermatitis continua of Hallopeau is a clinical phenotype of DITRA: evidence that it is a variant of pustular psoriasis. 2013

Abbas, Ossama / Itani, Salam / Ghosn, Samer / Kibbi, Abdul Ghani / Fidawi, Georges / Farooq, Muhammad / Shimomura, Yutaka / Kurban, Mazen. ·Department of Dermatology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon. ·Dermatology · Pubmed #23428889.

ABSTRACT: Acrodermatitis continua of Hallopeau (ACH) is a rare, chronic, sterile, pustular eruption that predominantly affects the fingertips with nail involvement. While some consider ACH a distinct entity, many believe it to be a variant of pustular psoriasis, especially as cases of ACH progressing to generalized pustular psoriasis (GPP) have been reported. Recently, recessively inherited mutations in the IL36RN gene, which encodes interleukin-36 receptor antagonist (IL-36Ra), have been demonstrated to be the cause of familial GPP, a condition termed DITRA (deficiency of IL-36Ra). Here, we identified a homozygous missense mutation c.338C>T (p.Ser113Leu) in the IL36RN gene in a male patient with ACH, as well as in his sister who had a history of GPP.

23 Article Dermacase: Can you identify this condition? Tumid lupus erythematosus. 2012

Abdullah, Lina / Abbas, Ossama. ·Department of Nursing at the American University of Beirut in Lebanon. ·Can Fam Physician · Pubmed #22798463.

ABSTRACT: -- No abstract --

24 Article [Oral lesions in psoriasis]. 2010

Tomb, R / Hajj, H / Nehme, E. ·Département de dermatologie, université Saint-Joseph, Beyrouth, Liban. rtomb@usj.edu.lb ·Ann Dermatol Venereol · Pubmed #21074652.

ABSTRACT: BACKGROUND: The literature contains little information about the incidence or prevalence of oral signs in psoriasis. The pustular forms are the most commonly incriminated, with geographic tongue being the most frequently cited oral sign. The aim of our study was to determine the various types of oral signs seen in a large population of psoriasis patients. PATIENTS AND METHODS: Four hundred psoriasis patients were recruited consecutively and a detailed oral examination performed by two clinicians. Similar examinations were performed over the same period in 1000 nonpsoriasis subjects comprising a control group in order to assess the incidence of the same oral signs in the general population. RESULTS: Comparing the two groups, fissured tongue was seen in 33.2% of psoriasis patients versus 9.9% of control subjects (P<0.0001). There was thus a highly significant (P<0.0001) correlation between geographic tongue and psoriasis (7.7% of psoriasis patients versus 1% of controls). In addition, a strong correlation was seen between the presence of pustular psoriasis and fissured tongue (83.3% of patients with pustular psoriasis versus only 30% of patients with other forms of psoriasis). DISCUSSION: Our study shows a strong correlation between psoriasis and fissured and geographic tongue, although these features are not pathognomonic for the disease. As regards geographic tongue, our results are consistent with the data in the literature. However, the prevalence of fissured tongue was considerably higher among our patients than in series published to date. These two types of sign involving the tongue, and which can occur in all forms of psoriasis, appear to be particularly strongly associated with pustular psoriasis. Patients are generally unaware of this sign and rarely complain of it.

25 Article Superficial morphea: 20-year follow up in a patient with concomitant psoriasis vulgaris. 2009

Saleh, Zenus / Arayssi, Thuraya / Saleh, Zeinab / Ghosn, Samer. ·Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon. ·J Cutan Pathol · Pubmed #19602063.

ABSTRACT: Superficial morphea, a newly described variant of morphea, manifests clinically with hypopigmented or hyperpigmented patches that lack induration. The lesions show on biopsy dermal sclerosis in the superficial to mid-reticular dermis. So far, all cases reported in the literature were skin limited. In this report, we describe a 24-year-old female patient who developed at the age of 4 years plaques characteristic, both clinically and histologically, of superficial morphea. The patient developed later on psoriasis vulgaris. Although the association of scleroderma and psoriasis is rarely reported in the literature, most reports describe a progressive systemic course of scleroderma whenever the two diseases co-exist. This is the first report to describe superficial morphea in association with psoriasis and to provide a 20-year follow-up period during which the superficial morphea remained relatively stable with no evidence of systemic involvement.