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Psoriasis: HELP
Articles from Malaysia
Based on 36 articles published since 2008
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These are the 36 published articles about Psoriasis that originated from Malaysia during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review Emerging landscape in psoriasis management: From topical application to targeting biomolecules. 2018

Rapalli, Vamshi Krishna / Singhvi, Gautam / Dubey, Sunil Kumar / Gupta, Gaurav / Chellappan, Dinesh Kumar / Dua, Kamal. ·Department of Pharmacy, Birla Institute of Technology & Science (BITS), Pilani, Pilani Campus, Rajasthan, 333031, India. · Department of Pharmacy, Birla Institute of Technology & Science (BITS), Pilani, Pilani Campus, Rajasthan, 333031, India. Electronic address: gautam.singhvi@pilani.bits-pilani.ac.in. · School of Pharmaceutical Sciences, Jaipur National University, Jagatpura, 302017, Jaipur, India. Electronic address: gauravpharma25@gmail.com. · Department of Life Sciences, International Medical University, Kuala Lumpur, 57000, Malaysia. · Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo NSW 2007, Australia; School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW 2308, Australia; Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305, Australia. ·Biomed Pharmacother · Pubmed #29990862.

ABSTRACT: Psoriasis is a chronic autoimmune skin disorder affecting 2-3% of the world population. It has characteristic features such as increased keratinocyte proliferation and production of inflammatory mediators. The treatment involves various strategies including topical, systemic, phototherapy and biologics. Topical therapies are preferred for mild to moderate psoriasis conditions over the systemic therapies which are ideal in severe disease conditions. The systemic therapies include immunosuppressants, biological agents and recently approved phosphodiesterase-4 (PDE4) inhibitors. There are various limitations associated with the existing therapies where the new findings in the pathogenesis of psoriasis are paving a path for newer therapeutics to target at the molecular level. Various small molecules, PDE-4 inhibitors, biologics, and immunomodulator proved efficacious including the new molecules targeting Janus kinases (JAK) inhibitors that are under investigation. Furthermore, the role of genetic and miRNAs in psoriasis is still not completely explored and may further help in improving the treatment efficacy. This review provides an insight into various emerging therapies along with currently approved treatments for psoriasis.

2 Review Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism: epidemiology, metabolism and the associated diseases. 2015

Liew, Siaw-Cheok / Gupta, Esha Das. ·Department of Clinical Skills and Simulation Centre, International Medical University, Kuala Lumpur, Malaysia. Electronic address: siawcheok_liew@imu.edu.my. · Department of Internal Medicine, International Medical University, Seremban, Malaysia. Electronic address: eshadas_gupta@imu.edu.my. ·Eur J Med Genet · Pubmed #25449138.

ABSTRACT: The Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism is associated with various diseases (vascular, cancers, neurology, diabetes, psoriasis, etc) with the epidemiology of the polymorphism of the C677T that varies dependent on the geography and ethnicity. The 5,10-Methylenetetrahydrofolate reductase (MTHFR) locus is mapped on chromosome 1 at the end of the short arm (1p36.6). This enzyme is important for the folate metabolism which is an integral process for cell metabolism in the DNA, RNA and protein methylation. The mutation of the MTHFR gene which causes the C677T polymorphism is located at exon 4 which results in the conversion of valine to alanine at codon 222, a common polymorphism that reduces the activity of this enzyme. The homozygous mutated subjects have higher homocysteine levels while the heterozygous mutated subjects have mildly raised homocysteine levels compared with the normal, non-mutated controls. Hyperhomocysteinemia is an emerging risk factor for various cardiovascular diseases and with the increasing significance of this polymorphism in view of the morbidity and mortality impact on the patients, further prevention strategies and nutritional recommendations with the supplementation of vitamin B12 and folic acid which reduces plasma homocysteine level would be necessary as part of future health education. This literature review therefore focuses on the recent evidence-based reports on the associations of the MTHFR C677T polymorphism and the various diseases globally.

3 Review A retrospective review of methotrexate-induced hepatotoxicity among patients with psoriasis in a tertiary dermatology center in Malaysia. 2013

Ng, Lim Chui / Lee, Yin Yin / Lee, Chew Kek / Wong, Su-Ming. ·Department of Medicine, University Malaya, Kuala Lumpur, Malaysia. ·Int J Dermatol · Pubmed #23278617.

ABSTRACT: BACKGROUND: Methotrexate (MTX) is a common and efficacious systemic agent used for the treatment of moderate to severe psoriasis. Nevertheless, its use is associated with the risk of hepatotoxicity. This study was performed to study the association of MTX dose with regards to hepatotoxicity as evidenced by deranged transaminases. METHODS: This was a retrospective review of patients with psoriasis on MTX from 2000 to 2009 at the outpatient dermatology clinic, University Malaya Medical Centre (UMMC). We analyzed patients' demography, serial laboratory investigations, liver ultrasounds, and liver biopsies of patients on MTX. RESULTS: Sixty-six of 710 (9.30%) patients with psoriasis were prescribed MTX throughout the 10-year period. Among them 57.6% developed deranged transaminases, with six requiring MTX withdrawal due to hepatotoxicity. The mean cumulative dose of MTX at the detection of liver enzyme derangement was 552.3 ± 596.1 mg. CONCLUSION: A high proportion of patients on MTX had deranged transaminases. However, the number of serious events was low. We concluded from this study that the use of MTX is relatively safe in patients with moderate to severe psoriasis.

4 Clinical Trial Inhibition of the Interleukin-36 Pathway for the Treatment of Generalized Pustular Psoriasis. 2019

Bachelez, Hervé / Choon, Siew-Eng / Marrakchi, Slaheddine / Burden, A David / Tsai, Tsen-Fang / Morita, Akimichi / Turki, Hamida / Hall, David B / Shear, Michael / Baum, Patrick / Padula, Steven J / Thoma, Christian. ·Sorbonne Paris Cité Université Paris Diderot, Paris, France herve.bachelez@aphp.fr. · Monash University Malaysia, Johor Bahru, Malaysia. · Hedi Chaker University Hospital, Sfax, Tunisia. · University of Glasgow, Glasgow, United Kingdom. · National Taiwan University, Taipei, Taiwan. · Nagoya City University, Nagoya, Japan. · Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT. · Boehringer Ingelheim International, Biberach, Germany. · Boehringer Ingelheim International, Ingelheim, Germany. ·N Engl J Med · Pubmed #30855749.

ABSTRACT: -- No abstract --

5 Article Asian consensus on assessment and management of mild to moderate plaque psoriasis with topical therapy. 2018

Imafuku, Shinichi / Zheng, Min / Tada, Yayoi / Zhang, Xibao / Theng, Colin / Thevarajah, Suganthi / Zhao, Yi / Song, Hae Jun. ·Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. · Department of Dermatology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. · Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan. · Institute of Dermatology, Guangzhou Medical University, Guangzhou, China. · The Skin Specialists & Laser Clinic, Singapore. · Department of Dermatology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia. · Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China. · Department of Dermatology, Guro Hospital, College of Medicine, Korea University, Seoul, Korea. ·J Dermatol · Pubmed #29740870.

ABSTRACT: A working group of dermatologists in Asian countries assessed the current status of psoriatic management in the region to prepare a consensus report on topical treatment in mild to moderate plaque psoriasis. Even though the association of psoriasis with systemic comorbidities is increasingly acknowledged, psoriasis is still lower in health-care priority lists in the region. The psychosocial impact of psoriasis may be greater in Asian countries due to cultural norms and social discrimination. Non-adherence to treatment is also common among Asians. The current care given to patients with mild to moderate psoriasis needs to be streamlined, enhanced and organized with a patient-centered care approach to achieve better outcomes. A comprehensive assessment of the disease severity and its impact on a patient's life is required before initiating treatment. Education and active involvement of the patient in the treatment plan is an important part of psoriatic management. It is recommended to personalize topical treatment to meet the needs of the patient, depending on disease severity, psychosocial impact, the patient's expectations and, more importantly, the patient's willingness and ability to actively follow the treatment procedure. Fixed-dose combination of corticosteroid and vitamin D analogs is the preferred topical medication for both initial and maintenance phases of treatment. The fast containment of the disease is the goal of the initial phase of 4-8 weeks and it demands a potent fast-acting topical therapy. Satisfactory control of the disease and prevention of relapses should be achieved during the maintenance phase with twice a week or weekend applications.

6 Article Determinants of quality of life and psychological status in adults with psoriasis. 2018

Kwan, Zhenli / Bong, Yii Bonn / Tan, Leng Leng / Lim, Shu Xian / Yong, Adrian Sze Wai / Ch'ng, Chin Chwen / Tan, Maw Pin / Ismail, Rokiah. ·Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. zhenli@ummc.edu.my. · Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia. zhenli@ummc.edu.my. · Institute of Research Management and Services, University of Malaya, Kuala Lumpur, Malaysia. · Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. · Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · School of Healthy Aging, Medical Aesthetics and Regenerative Medicine, UCSI University, Kuala Lumpur, Malaysia. ·Arch Dermatol Res · Pubmed #29687328.

ABSTRACT: We investigated whether disease severity and clinical manifestations were associated with depression, anxiety, stress and quality of life in adults with psoriasis. Participants were recruited from a dermatology outpatient clinic at a teaching hospital. Information on sociodemographic characteristics, disease severity, presence of arthropathy and head involvement was specifically recorded. Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). Quality of life and psychological symptoms were measured using the Dermatology Life Quality Index (DLQI) and the Depression Anxiety Stress Scale (DASS), respectively. One hundred individuals were recruited. Unadjusted analysis revealed that head involvement was associated with depression [odds ratio (OR) 8.509; 95% confidence interval (CI) 1.077-67.231] and anxiety (OR 6.46; 95% CI 1.401-29.858). Severe disease was associated with a poorer quality of life compared to mild disease (OR 3.750; 95% CI 1.330-10.577). Younger age was associated with an increased risk of depression [mean difference (MD) - 8.640; 95% CI - 16.390 to - 0.890], anxiety (MD - 11.553; 95% CI - 18.478 to- 4.628), stress (MD - 11.440; 95% CI - 19.252 to - 3.628) and severely impaired quality of life (MD - 12.338; 95% CI - 19.548 to - 5.127). Following adjustments for age and disease severity, anxiety, stress and depression remained associated with severely impaired quality of life.

7 Article Enhancement of physicochemical properties of nanocolloidal carrier loaded with cyclosporine for topical treatment of psoriasis: in vitro diffusion and in vivo hydrating action. 2017

Musa, Siti Hajar / Basri, Mahiran / Fard Masoumi, Hamid Reza / Shamsudin, Norashikin / Salim, Norazlinaliza. ·Department of Chemistry, Faculty of Science. · Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia. ·Int J Nanomedicine · Pubmed #28405165.

ABSTRACT: Psoriasis is a chronic autoimmune disease that cannot be cured. It can however be controlled by various forms of treatment, including topical, systemic agents, and phototherapy. Topical treatment is the first-line treatment and favored by most physicians, as this form of therapy has more patient compliance. Introducing a nanoemulsion for transporting cyclosporine as an anti-inflammatory drug to an itchy site of skin disease would enhance the effectiveness of topical treatment for psoriasis. The addition of nutmeg and virgin coconut-oil mixture, with their unique properties, could improve cyclosporine loading and solubility. A high-shear homogenizer was used in formulating a cyclosporine-loaded nanoemulsion. A D-optimal mixture experimental design was used in the optimization of nanoemulsion compositions, in order to understand the relationships behind the effect of independent variables (oil, surfactant, xanthan gum, and water content) on physicochemical response (particle size and polydispersity index) and rheological response (viscosity and

8 Article Juvenile generalized pustular psoriasis is a chronic recalcitrant disease: an analysis of 27 patients seen in a tertiary hospital in Johor, Malaysia. 2017

Lau, Bi-Wen / Lim, Dee-Zhen / Capon, Francesca / Barker, Jonathan N / Choon, Siew-Eng. ·School of Medicine and Health Sciences, Monash University, Melbourne, Vic., Australia. · Division of Genetics and Molecular Medicine, King's College, London, UK. · Department of Dermatology Hospital Sultanah Aminah, Johor Bahru, Malaysia. ·Int J Dermatol · Pubmed #28194751.

ABSTRACT: BACKGROUND: Limited information exists regarding juvenile generalized pustular psoriasis (GPP). We aim to determine the clinical profile and outcome of Malaysians with juvenile GPP. METHODS: Review of hospital case notes on patients with juvenile GPP. RESULTS: Twenty-seven patients with juvenile GPP were identified. Female to male ratio was 1.4:1. The median age at onset of GPP was 6.5 years. Ten patients had prior psoriasis with a median pre-pustular duration of 2.7 years. Onset of GPP was earlier in patients without prior psoriasis (5.1 years vs. 12.0 years, P = 0.002). Precipitating factors identified included stress, upper respiratory tract infection, systemic steroid use, vaccination, and pregnancy. A positive family history of psoriasis and GPP was present in six and one patient(s), respectively. Twenty-one patients had acute, five annular, and one localized variant of GPP. Arthritis was present in 22.2%. Fever, leukocytosis, and transaminitis were mainly seen in patients with acute GPP at 80.9, 72.2, and 11.1%, respectively. Among 20 patients screened, eight carry IL36RN variants and one has CARD14 mutation. IL36RN-positive patients have more severe disease characterized by early onset, low prevalence of prior plaque psoriasis, high prevalence of systemic inflammation, and need for continuous long-term systemic therapy. Acitretin and cyclosporine were effective in aborting acute GPP in 100% of 16 and 66.7% of six patients treated, respectively. However, relapses were common. Only three of the 17 patients whose initial acute GPP was controlled with systemic agents were successfully weaned off treatment. CONCLUSIONS: Juvenile GPP is a chronic recalcitrant disease. IL36RN-positive patients have more severe disease.

9 Article Socioeconomic and sociocultural determinants of psychological distress and quality of life among patients with psoriasis in a selected multi-ethnic Malaysian population. 2017

Kwan, Zhenli / Bong, Yii Bonn / Tan, Leng Leng / Lim, Shu Xian / Yong, Adrian Sze Wai / Ch'ng, Chin Chwen / Tan, Maw Pin / Thevarajah, Suganthi / Ismail, Rokiah. ·a Division of Dermatology, Department of Medicine, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia. · b Faculty of Medicine , Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia. · c Institute of Research Management and Monitoring , University of Malaya , Kuala Lumpur , Malaysia. · d Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine , University of Malaya , Kuala Lumpur , Malaysia. · e Department of Dermatology , Hospital Kuala Lumpur , Kuala Lumpur , Malaysia. · f Faculty of Medicine, MARA University of Technology , Shah Alam , Malaysia. ·Psychol Health Med · Pubmed #27541601.

ABSTRACT: Patients with psoriasis may have increased risk of psychological comorbidities. This cross-sectional study aimed at determining associations between sociocultural and socioeconomic factors with the Depression Anxiety Stress Scale (DASS) scores and the Dermatology Life Quality Index (DLQI) scores. Adult patients with psoriasis were recruited from a Dermatology outpatient clinic via convenience sampling. Interviews were conducted regarding socio-demographic factors and willing subjects were requested to complete the DASS and DLQI questionnaires. The Pearson χ

10 Article Clinico-epidemiological profile, including body mass index of Malaysian children with psoriasis. 2016

Choon, S E / Ngim, C F / Premaa, S / Tey, K W / Nalini, M N. ·Hospital Sultanah Aminah Johor Bahru, Dermatology, Jalan Scudai, Johor Bahru, Johor 80100, Malaysia. choonse@yahoo.co.uk. · Hospital Sultanah Aminah Johor Bahru, Dermatology, Jalan Scudai, Johor Bahru, Johor 80100, Malaysia. ·Med J Malaysia · Pubmed #27770115.

ABSTRACT: BACKGROUND: Limited information exists regarding paediatric psoriasis and its association with body mass index (bMI) in Asia. OBJECTIVES: to determine the clinico-epidemiological profile and to compare the bMI of children with and without psoriasis. METHODS: A case-control study of 92 children with psoriasis versus 59 with atopic eczema and 56 with non-inflammatory skin conditions. RESULTS: Psoriasis was more common in Malay and Indian children when compared to Chinese with odds ratios (Or) of 4.30 (95% CI, 1.85-9.99) and 3.00 (95% CI, 1.02-8.81) respectively. Prevalence of psoriasis was similar between Malay and Indian children (Or 1.43, 95% CI, 0.63-3.25). Male:female ratio was 1:1.09. the mean onset age of psoriasis was 7.9 years. Median onset age was earlier in males (6.5 years versus 9.0 years in females, p=0.05). Plaque psoriasis was the most common phenotype (89.1%) and 94.5% had scalp lesions. Arthritis was seen in 4.3%. Odds of excess adiposity, defined as bMI ≤85th percentile, was higher in children with psoriasis versus noninflammatory controls (Or 2.35, 95% CI 0.99-5.56, p= 0.052). No increased risk of adiposity was noted between children with psoriasis and eczema (Or 1.14, 95% CI 0.5-2.62, p=0.753). More children with psoriasis (17.4%) and eczema (20.3%) were underweight (bMI <5th percentile) compared to non-inflammatory controls (10.7%). CONCLUSION: Malays and Indians are three to four times more likely than Chinese to have psoriasis in multi-ethnic Malaysia. Plaque psoriasis is the most common phenotype. Odds of excess adiposity is about two times higher in children with psoriasis compared to non-inflammatory controls although this observation just missed conventional statistical significance.

11 Article AP1S3 Mutations Cause Skin Autoinflammation by Disrupting Keratinocyte Autophagy and Up-Regulating IL-36 Production. 2016

Mahil, Satveer K / Twelves, Sophie / Farkas, Katalin / Setta-Kaffetzi, Niovi / Burden, A David / Gach, Joanna E / Irvine, Alan D / Képíró, László / Mockenhaupt, Maja / Oon, Hazel H / Pinner, Jason / Ranki, Annamari / Seyger, Marieke M B / Soler-Palacin, Pere / Storan, Eoin R / Tan, Eugene S / Valeyrie-Allanore, Laurence / Young, Helen S / Trembath, Richard C / Choon, Siew-Eng / Szell, Marta / Bata-Csorgo, Zsuzsanna / Smith, Catherine H / Di Meglio, Paola / Barker, Jonathan N / Capon, Francesca. ·Division of Genetics and Molecular Medicine, King's College London, London, UK. · MTA-SZTE Dermatological Research Group, Szeged, Hungary. · Department of Dermatology, University of Glasgow, Glasgow, UK. · Department of Dermatology, Birmingham Children's Hospital, Birmingham, UK. · Paediatric Dermatology, Our Lady's Children's Hospital, Dublin, Ireland. · Department of Dermatology and Allergology, University of Szeged, Hungary. · Dokumentationszentrum schwerer Hautreaktionen (dZh) and RegiSCAR-study, Department of Dermatology, Medical Center-University of Freiburg, Freiburg, Germany. · National Skin Centre, Singapore. · Department of Medical Genomics, Royal Prince Alfred Hospital, Camperdown, Australia. · Department of Skin and Allergic Diseases, Helsinki University Central Hospital, Helsinki, Finland. · Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. · Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain. · Department of Dermatology, University Hospital, Galway, Ireland. · Department of Dermatology, Henri Mondor Hospital, Paris, France. · Department of Dermatology, University of Manchester. · Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Malaysia. · MTA-SZTE Dermatological Research Group, Szeged, Hungary; Institute of Medical Genetics, University of Szeged, Hungary. · MTA-SZTE Dermatological Research Group, Szeged, Hungary; Department of Dermatology and Allergology, University of Szeged, Hungary. · Mill Hill Laboratory, The Francis Crick Institute, London, UK. · Division of Genetics and Molecular Medicine, King's College London, London, UK. Electronic address: francesca.capon@kcl.ac.uk. ·J Invest Dermatol · Pubmed #27388993.

ABSTRACT: Prominent skin involvement is a defining characteristic of autoinflammatory disorders caused by abnormal IL-1 signaling. However, the pathways and cell types that drive cutaneous autoinflammatory features remain poorly understood. We sought to address this issue by investigating the pathogenesis of pustular psoriasis, a model of autoinflammatory disorders with predominant cutaneous manifestations. We specifically characterized the impact of mutations affecting AP1S3, a disease gene previously identified by our group and validated here in a newly ascertained patient resource. We first showed that AP1S3 expression is distinctively elevated in keratinocytes. Because AP1S3 encodes a protein implicated in autophagosome formation, we next investigated the effects of gene silencing on this pathway. We found that AP1S3 knockout disrupts keratinocyte autophagy, causing abnormal accumulation of p62, an adaptor protein mediating NF-κB activation. We showed that as a consequence, AP1S3-deficient cells up-regulate IL-1 signaling and overexpress IL-36α, a cytokine that is emerging as an important mediator of skin inflammation. These abnormal immune profiles were recapitulated by pharmacological inhibition of autophagy and verified in patient keratinocytes, where they were reversed by IL-36 blockade. These findings show that keratinocytes play a key role in skin autoinflammation and identify autophagy modulation of IL-36 signaling as a therapeutic target.

12 Article Clinical characteristics of patients with facial psoriasis in Malaysia. 2016

Syed Nong Chek, Sharifah Rosniza / Robinson, Suganthy / Mohd Affandi, Azura / Baharum, Nurakmal. ·Department of Dermatology, Hospital Kuala Lumpur, Malaysia. srsyed@doctors.net.uk. · Department of Dermatology, Hospital Kuala Lumpur, Malaysia. · Biostatistics Unit, National Clinical Research Centre, Malaysia. ·Int J Dermatol · Pubmed #27061170.

ABSTRACT: BACKGROUND: Psoriasis involving the face is visible and can cause considerable emotional distress to patients. Its presence may also confer a poorer prognosis for the patient. This study sought to evaluate the characteristics of facial psoriasis in Malaysia. METHODS: A cross-sectional study conducted using data from the Malaysian Psoriasis Registry from 2007 to 2011. Specific risk factors, i.e., age, age of onset, gender, duration of disease, obesity group, body surface area, Dermatology Life Quality Index (DLQI), family history of psoriasis, nail involvement, psoriatic arthritis, phototherapy, systemic therapy, clinic visit, days of work/school, and hospital admission due to psoriasis in the last 6 months were analyzed. RESULTS: A total of 48.4% of patients had facial psoriasis. Variables significantly associated with facial psoriasis are younger age, younger age of onset of psoriasis of ≤ 40 years, male, severity of psoriasis involving >10% of the body surface area, higher DLQI of >10, nail involvement, and history of hospitalization due to psoriasis. CONCLUSION: This study found that facial psoriasis is not as rare as previously thought. Ambient ultraviolet light, sebum, and contact with chemicals from facial products may reduce the severity of facial psoriasis, but these factors do not reduce the prevalence of facial psoriasis. The association with younger age, younger age of onset, higher percentage of body surface area involvement, higher DLQI of > 10, nail involvement, and hospitalization due to psoriasis support the notion that facial psoriasis is a marker of severe disease.

13 Article Activating CARD14 Mutations Are Associated with Generalized Pustular Psoriasis but Rarely Account for Familial Recurrence in Psoriasis Vulgaris. 2015

Berki, Dorottya M / Liu, Lu / Choon, Siew-Eng / David Burden, A / Griffiths, Christopher E M / Navarini, Alexander A / Tan, Eugene S / Irvine, Alan D / Ranki, Annamari / Ogo, Takeshi / Petrof, Gabriela / Mahil, Satveer K / Duckworth, Michael / Allen, Michael H / Vito, Pasquale / Trembath, Richard C / McGrath, John / Smith, Catherine H / Capon, Francesca / Barker, Jonathan N. ·Department of Medical and Molecular Genetics, King's College London, London, UK. · St John's Institute of Dermatology, King's College London, London, UK. · Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Malaysia. · Department of Dermatology, University of Glasgow, Glasgow, UK. · Department of Dermatology, University of Manchester, Manchester, UK. · Department of Dermatology, Zurich University Hospital, Zurich, Switzerland. · National Skin Centre, Singapore, Singapore. · Paediatric Dermatology, Our Lady's Children's Hospital, Dublin, Ireland; Clinical Medicine, Trinity College Dublin, Dublin, Ireland. · Department of Dermatology, Venereology and Allergic Disease, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. · Department of Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan. · Dipartimento di Scienze e Tecnologie, Università degli Studi del Sannio, Benevento, Italy. · Queen Mary, University of London, Barts and The London School of Medicine and Dentistry, London, UK. · Department of Medical and Molecular Genetics, King's College London, London, UK. Electronic address: francesca.capon@kcl.ac.uk. · St John's Institute of Dermatology, King's College London, London, UK. Electronic address: jonathan.barker@kcl.ac.uk. ·J Invest Dermatol · Pubmed #26203641.

ABSTRACT: Caspase recruitment family member 14 (CARD14, also known as CARMA2), is a scaffold protein that mediates NF-κB signal transduction in skin keratinocytes. Gain-of-function CARD14 mutations have been documented in familial forms of psoriasis vulgaris (PV) and pityriasis rubra pilaris (PRP). More recent investigations have also implicated CARD14 in the pathogenesis of pustular psoriasis. Follow-up studies, however, have been limited, so that it is not clear to what extent CARD14 alleles account for the above conditions. Here, we sought to address this question by carrying out a systematic CARD14 analysis in an extended patient cohort (n=416). We observed no disease alleles in subjects with familial PV (n=159), erythrodermic psoriasis (n=23), acral pustular psoriasis (n=100), or sporadic PRP (n=29). Conversely, our analysis of 105 individuals with generalized pustular psoriasis (GPP) identified a low-frequency variant (p.Asp176His) that causes constitutive CARD14 oligomerization and shows a significant association with GPP in Asian populations (P=8.4×10(-5); odds ratio=6.4). These data indicate that the analysis of CARD14 mutations could help stratify pustular psoriasis cohorts but would be mostly uninformative in the context of psoriasis and sporadic PRP.

14 Article Probing the effects of fish oil on the delivery and inflammation-inducing potential of imiquimod. 2015

Rehman, Khurram / Aluwi, Mohd Fadhlizil Fasihi Mohd / Rullah, Kamal / Wai, Lam Kok / Mohd Amin, Mohd Cairul Iqbal / Zulfakar, Mohd Hanif. ·Centre for Drug Delivery Research, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia. · Drugs and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia. · Centre for Drug Delivery Research, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia. Electronic address: hanif@pharmacy.ukm.my. ·Int J Pharm · Pubmed #26003416.

ABSTRACT: Imiquimod is a chemotherapeutic agent for many skin-associated diseases, but it has also been associated with inflammatory side effects. The aim of this study was to prevent the inflammatory effect of commercial imiquimod (Aldara(®)) by controlled release of imiquimod through a hydrogel/oleogel colloidal mixture (CA bigel) containing fish oil as an anti-inflammatory agent. Imiquimod permeability from Aldara® cream and bigel through mice skin was evaluated, and the drug content residing in the skin via the tape stripping technique was quantified. The fish oil fatty acid content in skin along with its lipophilic environment was also determined. An inflammation study was conducted using animal models, and Aldara(®) cream was found to potentially cause psoriasis-like inflammation, which could be owing to prolonged application and excessive drug permeation. Controlled release of imiquimod along with fish oil through CA bigel may have caused reduced imiquimod inflammation. NMR studies and computerized molecular modeling were also conducted to observe whether the fish oil and imiquimod formed a complex that was responsible for improving imiquimod transport and reducing its side effects. NMR spectra showed dose-dependent chemical shifts and molecular modeling revealed π-σ interaction between EPA and imiquimod, which could help reduce imiquimod inflammation.

15 Article Determinants of health-related quality of life in psoriasis patients in Malaysia. 2015

Nyunt, Wint Wint Thu / Low, Wah Yun / Ismail, Rokiah / Sockalingam, Sargunan / Min, Aung Ko Ko. ·MAHSA University, Kuala Lumpur, Malaysia wint2008@gmail.com. · University of Malaya, Kuala Lumpur, Malaysia. · MAHSA University, Kuala Lumpur, Malaysia. ·Asia Pac J Public Health · Pubmed #23858523.

ABSTRACT: Psoriasis is a chronic dermatological disorder that has a negative impact on quality of life (QoL). This hospital-based cross-sectional study determined factors associated with health-related QoL (HRQoL) impairment in adult psoriasis patients. HRQoL was assessed using the Dermatology Life Quality Index (DLQI). Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). A total of 223 patients, aged 18 to 83 years, were recruited. For 67 (30%) patients, psoriasis had very large to extremely large effect on their life (DLQI score = 11-30). The median DLQI score was 7 (interquartile range = 7). Factors significantly associated with severe impact on HRQoL (DLQI ≥ 10) were disease severity, single status, working status, sports activities, nail dystrophy, exposed area involvement, itch, disturbed sleep, stress, and infection. The factor predictive of severe impact of psoriasis on HRQoL was disease severity. A holistic approach in the management, including psychosocial issues, is absolutely crucial for the optimal care of psoriasis patients.

16 Article AP1S3 mutations are associated with pustular psoriasis and impaired Toll-like receptor 3 trafficking. 2014

Setta-Kaffetzi, Niovi / Simpson, Michael A / Navarini, Alexander A / Patel, Varsha M / Lu, Hui-Chun / Allen, Michael H / Duckworth, Michael / Bachelez, Hervé / Burden, A David / Choon, Siew-Eng / Griffiths, Christopher E M / Kirby, Brian / Kolios, Antonios / Seyger, Marieke M B / Prins, Christa / Smahi, Asma / Trembath, Richard C / Fraternali, Franca / Smith, Catherine H / Barker, Jonathan N / Capon, Francesca. ·Division of Genetics and Molecular Medicine, King's College London, London SE1 9RT, UK. · Randall Division of Cell and Molecular Biophysics, King's College London, London SE1 9RT, UK. · Institut National de la Santé et de la Recherche Médicale Unité 781, Institut Imagine, Hopital Necker - Enfant Malades, Paris 75015, France; Department of Dermatology, Sorbonne Paris Cité Université Paris Diderot and Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Paris 75010, France. · Department of Dermatology, University of Glasgow, Glasgow G11 6NT, UK. · Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru 80100, Malaysia. · Department of Dermatology, University of Manchester, Manchester M6 8HD, UK. · Department of Dermatology, St. Vincent University Hospital, Dublin 4, Ireland. · Department of Dermatology, Zurich University Hospital, Zurich 8091, Switzerland. · Department of Dermatology, Radboud University Nijmegen Medical Centre, 6500HB Nijmegen, the Netherlands. · Dermatology Service, Geneva University Hospital, 1211 Geneva 14, Switzerland. · Institut National de la Santé et de la Recherche Médicale Unité 781, Institut Imagine, Hopital Necker - Enfant Malades, Paris 75015, France. · Division of Genetics and Molecular Medicine, King's College London, London SE1 9RT, UK; Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London EC1M 6QB, UK. · Division of Genetics and Molecular Medicine, King's College London, London SE1 9RT, UK. Electronic address: francesca.capon@kcl.ac.uk. ·Am J Hum Genet · Pubmed #24791904.

ABSTRACT: Adaptor protein complex 1 (AP-1) is an evolutionary conserved heterotetramer that promotes vesicular trafficking between the trans-Golgi network and the endosomes. The knockout of most murine AP-1 complex subunits is embryonically lethal, so the identification of human disease-associated alleles has the unique potential to deliver insights into gene function. Here, we report two founder mutations (c.11T>G [p.Phe4Cys] and c.97C>T [p.Arg33Trp]) in AP1S3, the gene encoding AP-1 complex subunit σ1C, in 15 unrelated individuals with a severe autoinflammatory skin disorder known as pustular psoriasis. Because the variants are predicted to destabilize the 3D structure of the AP-1 complex, we generated AP1S3-knockdown cell lines to investigate the consequences of AP-1 deficiency in skin keratinocytes. We found that AP1S3 silencing disrupted the endosomal translocation of the innate pattern-recognition receptor TLR-3 (Toll-like receptor 3) and resulted in a marked inhibition of downstream signaling. These findings identify pustular psoriasis as an autoinflammatory phenotype caused by defects in vesicular trafficking and demonstrate a requirement of AP-1 for Toll-like receptor homeostasis.

17 Article Clinical profile, morbidity, and outcome of adult-onset generalized pustular psoriasis: analysis of 102 cases seen in a tertiary hospital in Johor, Malaysia. 2014

Choon, Siew Eng / Lai, Nai Ming / Mohammad, Norshaleyna A / Nanu, Nalini M / Tey, Kwee Eng / Chew, Shang Fern. ·Department of Dermatology, Hospital Sultanah Aminah Johor Bahru, Johor, Malaysia. ·Int J Dermatol · Pubmed #23967807.

ABSTRACT: BACKGROUND: Generalized pustular psoriasis (GPP) is a severe but rare variant of psoriasis. Our objective is to review the clinical profile, comorbidities, and outcome of patients with GPP. MATERIALS AND METHODS: A retrospective note review of all patients with adult-onset GPP. RESULTS: A total of 102 patients with adult-onset GPP were diagnosed between 1989 and November 2011, with a female to male ratio of 2 : 1. The mean age at onset of GPP was 40.9 years (range: 21-81 years). Acute GPP was the most common variant seen (95 cases), followed by four localized variants of GPP and three with annular pustular psoriasis. Fever and painful skin were present in 89% of patients, arthritis in 34.7%, and leukocytosis in 78.4%. Common triggers were systemic steroids (45 cases), pregnancy (17 cases), and upper respiratory tract infections (16 cases). A positive family history of psoriasis and GPP was present in 29% and 11%, respectively. Comorbidities included obesity (42.9%), hypertension (25.7%), hyperlipidemia (25.7%), and diabetes mellitus (23.7%). The mean duration of admission and pustular flare for acute GPP was 10.3 days (range: 3-44 days) and 16 days (range: 7-60 days), respectively. Fifty-four patients responded to systemic retinoid, 21 to methotrexate, eight to cyclosporine, and one to adalimumab, but recurrences were common. CONCLUSIONS: Our study confirms the poor response of GPP to currently available anti-psoriatic agents, with frequent flare-ups. There is a need for a more effective targeted therapy for this condition.

18 Article 3D surface roughness measurement for scaliness scoring of psoriasis lesions. 2013

Ahmad Fadzil, M Hani / Prakasa, Esa / Asirvadam, Vijanth Sagayan / Nugroho, Hermawan / Affandi, Azura Mohd / Hussein, Suraiya Hani. ·Centre for Intelligent Signal and Imaging Research, Department of Electrical & Electronic Engineering, Universiti Teknologi PETRONAS, Perak, Malaysia. Electronic address: fadzmo@petronas.com.my. ·Comput Biol Med · Pubmed #24054912.

ABSTRACT: Psoriasis is an incurable skin disorder affecting 2-3% of the world population. The scaliness of psoriasis is a key assessment parameter of the Psoriasis Area and Severity Index (PASI). Dermatologists typically use visual and tactile senses in PASI scaliness assessment. However, the assessment can be subjective resulting in inter- and intra-rater variability in the scores. This paper proposes an assessment method that incorporates 3D surface roughness with standard clustering techniques to objectively determine the PASI scaliness score for psoriasis lesions. A surface roughness algorithm using structured light projection has been applied to 1999 3D psoriasis lesion surfaces. The algorithm has been validated with an accuracy of 94.12%. Clustering algorithms were used to classify the surface roughness measured using the proposed assessment method for PASI scaliness scoring. The reliability of the developed PASI scaliness algorithm was high with kappa coefficients>0.84 (almost perfect agreement).

19 Article Quality of life and cost of illness in patients with psoriasis in Malaysia: a multicenter study. 2013

Tang, Min Moon / Chang, Choong Chor / Chan, Lee Chin / Heng, Agnes. ·Department of Dermatology, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia. minmoon2005@yahoo.com ·Int J Dermatol · Pubmed #23414155.

ABSTRACT: BACKGROUND: Psoriasis is an immune-mediated, chronic, inflammatory skin disease which affects approximately 2% of the world's population. It has a major impact on the patient's quality of life (QoL), influencing career, social activities, family relationships, and all other aspects of life. Many studies have described the various ways in which psoriasis can affect a patient's life. Very little is known, however, about the impact of psoriasis on the QoL of patients treated in Malaysia and the cost of illness in this region. OBJECTIVES: This study aims to describe the extent to which psoriasis affects the QoL of patients treated in government-run dermatology clinics in Malaysia and to estimate the cost of illness. METHODS: A total of 250 psoriasis patients treated at eight dermatology clinics in government-run hospitals in Malaysia were studied. The severity of psoriasis was assessed by dermatologists. Quality of life was evaluated using the Dermatology Life Quality Index (DLQI) and Version 2 of the 12-Item Short-Form Health Survey (SF-12v2). Scores on the SF-12v2 of healthy subjects and of patients with other medical conditions, such as depression, diabetes mellitus, hypertension, and ischemic heart disease, were also assessed for comparison. The costs of dermatology outpatient consultant fees, medications, investigations, procedures, transportation, over-the-counter medications, and hospitalization were retrospectively estimated using questionnaires. RESULTS: The cohort studied had a median Psoriasis Area Severity Index (PASI) score of 9.9 and a median DLQI score of 10.0. The average SF-12v2 scores were 43.68 (standard deviation [SD] 9.23) and 42.25 (SD 10.7) on the Physical Health Summary and Mental Health Summary, respectively. The impact of disease on QoL was found to be greater in those with more extensive psoriatic lesion involvement, in younger patients, and in those with psoriatic arthropathy. Psoriasis was found to affect QoL in both genders equally. Body mass index had no effect on the severity of psoriasis or QoL. Patients with psoriasis had a significantly lower SF-12v2 score than healthy subjects. Comparisons with data for patients with other chronic medical conditions demonstrated that psoriasis has a negative effect on health-related QoL similar to the impact of other chronic conditions. The estimated cost of illness for psoriasis in the current cohort was ringgit Malaysia (RM) 1307.47 per person per year excluding costs of hospitalization. Patients were noted to spend a large amount of money on over-the-counter products obtained without doctors' prescriptions. CONCLUSIONS: The QoL of patients with psoriasis was significantly impaired compared with that of healthy subjects and was comparable with that of patients with other chronic medical illnesses. The estimated cost of illness of psoriasis in the current study was lower than in other countries, mainly because healthcare costs in public hospitals are heavily subsidized by government and because usage of newer but more expensive treatment options is low in Malaysia.

20 Article Comorbidities associated with psoriasis - data from the malaysian psoriasis registry. 2012

Mazlin, M B / Chang, C C / Baba, R. ·Hospital Kuala Lumpur, Department of Dermatology, Jalan Pahang, 50586 Kuala Lumpur, Malaysia. ccchor@gmail.com. ·Med J Malaysia · Pubmed #23770870.

ABSTRACT: All around the world, there is growing evidence of the association between psoriasis and comorbidities which increase the risk of cardiovascular disease. This study aims to determine the prevalence of various comorbidities among adult psoriasis patients in Malaysia. A cross-sectional study was conducted among patients in the Malaysian Psoriasis Registry from January 2007 to December 2008. A total of 2,267 adult patients with psoriasis from 13 dermatology centers were included. Prevalence of various comorbidities were: hypertension 25.9%, diabetes mellitus 17.7 %, dyslipidaemia 17.8%, overweight 33.2%, obesity 20.7%, ischaemic heart disease 5.8% and cerebrovascular disease 1.4%. These comorbidities were more prevalent in patients with psoriasis of late-onset and longer duration. Active screening of these comorbidities in all adult psoriasis patients is recommended.

21 Article Body surface area measurement and soft clustering for PASI area assessment. 2012

Hani, Ahmad Fadzil M / Prakasa, Esa / Nugroho, Hermawan / Affandi, Azura M / Hussein, Suraiya H. ·Centre for Intelligent Signal and Imaging Research, Universiti Teknologi PETRONAS, Malaysia. fadzmo@petronas.com.my ·Conf Proc IEEE Eng Med Biol Soc · Pubmed #23366902.

ABSTRACT: Psoriasis is a common skin disorder with a prevalence of 0.6 - 4.8% around the world. The most common is plaques psoriasis and it appears as red scaling plaques. Psoriasis is incurable but treatable in a long term treatment. Although PASI (Psoriasis Area and Severity Index) scoring is recognised as gold standard for psoriasis assessment, this method is still influenced by inter and intra-rater variation. An imaging and analysis system called α-PASI is developed to perform PASI scoring objectively. Percentage of lesion area to the body surface area is one of PASI parameter. In this paper, enhanced imaging methods are developed to improve the determination of body surface area (BSA) and lesion area. BSA determination method has been validated on medical mannequin. BSA accuracies obtained at four body regions are 97.80% (lower limb), 92.41% (trunk), 87.72% (upper limb), and 83.82% (head). By applying fuzzy c-means clustering algorithm, the membership functions of lesions area for PASI area scoring have been determined. Performance of scoring result has been tested with double assessment by α-PASI area algorithm on body region images from 46 patients. Kappa coefficients for α-PASI system are greater than or equal to 0.72 for all body regions (Head - 0.76, Upper limb - 0.81, Trunk - 0.85, Lower limb - 0.72). The overall kappa coefficient for the α-PASI area is 0.80 that can be categorised as substantial agreement. This shows that the α-PASI area system has a high reliability and can be used in psoriasis area assessment.

22 Article Differential expression of the angiogenesis growth factors in psoriasis vulgaris. 2012

Liew, Siaw-Cheok / Das-Gupta, Esha / Chakravarthi, Srikumar / Wong, Shew-Fung / Lee, Nagarajah / Safdar, Najeeb / Jamil, Adawiyah. ·Department of Postgraduate Studies and Research, International Medical University, Kuala Lumpur, Malaysia. siawcheok_liew@imu.edu.my ·BMC Res Notes · Pubmed #22537619.

ABSTRACT: BACKGROUND: Angiogenesis has been reported to be one of the contributory factors to the pathogenesis of psoriasis vulgaris. This study aims to compare the expression of different angiogenesis growth factors namely (1) the vascular endothelial growth factor (VEGF) subfamily: A, B, C, D and placenta growth factor (PlGF); (2) nerve growth factor (NGF) and (3) von Willebrand factor (vWFr) in the skins of patients with psoriasis vulgaris and non-psoriatic volunteers. RESULTS: Comparative immunohistochemistry study was performed on the paraffin-sectioned psoriatic and healthy skins with the abovementioned markers. VEGF-C (p = 0.016) and NGF (p = 0.027) were expressed intensely in the cases when compared with the controls. The NGF was the only marker that was solely expressed in the cases and absent in all the controls. CONCLUSION: The NGF (angiogenesis) and VEGF-C (lymphangiogenesis) might play a crucial role in the pathogenesis of psoriasis vulgaris and could be researched further as potential new targeted therapies for psoriasis vulgaris.

23 Article Methotrexate toxicity presenting as ulcerated psoriatic plaques. 2012

Wong, Su-ming / Chong, Yew Thong / Thevarajah, Suganthi / Baba, Roshidah. ·Dermatology Unit, Department of Medicine, University Malaya, Kuala Lumpur, Malaysia. suming1@yahoo.com ·Australas J Dermatol · Pubmed #22309341.

ABSTRACT: Methotrexate toxicity is known to cause erosions of existing psoriatic plaques, although rare. We describe two patients who developed painful ulcerated psoriatic plaques as an early presenting sign of methotrexate toxicity and review the risk factors associated with this manifestation.

24 Article Association of methylentetraydrofolate reductase (MTHFR) 677 C > T gene polymorphism and homocysteine levels in psoriasis vulgaris patients from Malaysia: a case-control study. 2012

Liew, Siaw C / Das-Gupta, Esha / Wong, Shew F / Lee, Nagarajah / Safdar, Najeeb / Jamil, Adawiyah. ·Department of Postgraduate Studies and Research, International Medical University, Kuala Lumpur, Malaysia. siawcheok_liew@imu.edu.my ·Nutr J · Pubmed #22217364.

ABSTRACT: BACKGROUND: The methylenetetrahydrofolate reductase (MTHFR) enzyme catalyzes the reduction of 5, 10-methylenetetrahydrofolate to 5-methyltetrahydrofolate and methyl donors. The methyl donors are required for the conversion of homocysteine to methionine. Mutation of MTHFR 677 C > T disrupts its thermostability therefore leads to defective enzyme activities and dysregulation of homocysteine levels. METHODS: This case-control study (n = 367) was conducted to investigate the correlation of the MTHFR gene polymorphism [NM_005957] and psoriasis vulgaris amongst the Malaysian population. Overnight fasting blood samples were collected from a subgroup of consented psoriasis vulgaris patients and matched controls (n = 84) for the quantification of homocysteine, vitamin B12 and folic acid levels. RESULTS: There was no significant increase of the MTHFR 677 C > T mutation in patients with psoriasis vulgaris compared with controls (χ(2) = 0.733, p = 0.392). No significant association between homocysteine levels and MTHFR gene polymorphism in cases and controls were observed (F = 0.91, df = 3, 80, p = 0.44). However, homocysteine levels in cases were negatively correlated with vitamin B12 (r = -0.173) and folic acid (r = -0.345) levels. Vitamin B12 and folic acid levels in cases were also negatively correlated (r = -0.164). CONCLUSIONS: Our results indicate that there was no significant association between the MTHFR gene polymorphism and psoriasis vulgaris in the Malaysian population. There was no significant increase of the plasma homocysteine level in the psoriasis patients compared to the controls.

25 Article Severe psoriatic acroosteolysis in the absence of psoriatic arthropathy. 2011

Sakthiswary, R / Naicker, A S / Htwe, O / Shahrir, M S Mohd / Sazliyana, S S. ·Department of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. sakthis5@hotmail.com ·BMJ Case Rep · Pubmed #22669957.

ABSTRACT: -- No abstract --

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