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Psoriasis: HELP
Articles from Houston
Based on 88 articles published since 2008
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These are the 88 published articles about Psoriasis that originated from Houston during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline From the Medical Board of the National Psoriasis Foundation: Recommendations for screening for hepatitis B infection prior to initiating anti-tumor necrosis factor-alfa inhibitors or other immunosuppressive agents in patients with psoriasis. 2014

Motaparthi, Kiran / Stanisic, Vladimir / Van Voorhees, Abby S / Lebwohl, Mark G / Hsu, Sylvia / Anonymous1850775. ·Department of Dermatology, Baylor College of Medicine, Houston, Texas. · University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. · Mount Sinai School of Medicine, New York, New York. · Department of Dermatology, Baylor College of Medicine, Houston, Texas. Electronic address: shsu@bcm.edu. ·J Am Acad Dermatol · Pubmed #24220724.

ABSTRACT: BACKGROUND: No consensus exists regarding the optimal laboratory screening for hepatitis B infection that should be performed before initiating therapy with tumor necrosis factor-alfa inhibitors or other immunosuppressive agents. OBJECTIVE: We sought to give guidelines on which tests to order for hepatitis B screening. METHODS: We review the pathophysiology and serology of hepatitis B infection and provide recommendations for screening for hepatitis B infection in patients with psoriasis before beginning anti-tumor necrosis factor-alfa therapy or other immunosuppressive agents. RESULTS: We propose the standardized use of triple serology testing: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody in combination with liver function tests as screening. LIMITATIONS: Conclusions based on review of available literature is a limitation. CONCLUSIONS: All patients with psoriasis who are candidates for tumor necrosis factor-alfa inhibitor should undergo screening for hepatitis B virus infection using the triple serology: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody. It is advisable that patients, who are candidates for ustekinumab, cyclosporine, or methotrexate undergo the same screening.

2 Guideline Consensus guidelines for the management of plaque psoriasis. 2012

Hsu, Sylvia / Papp, Kim Alexander / Lebwohl, Mark G / Bagel, Jerry / Blauvelt, Andrew / Duffin, Kristina Callis / Crowley, Jeffrey / Eichenfield, Lawrence F / Feldman, Steven R / Fiorentino, David F / Gelfand, Joel M / Gottlieb, Alice B / Jacobsen, Carmen / Kalb, Robert E / Kavanaugh, Arthur / Korman, Neil J / Krueger, Gerald G / Michelon, Melissa A / Morison, Warwick / Ritchlin, Christopher T / Stein Gold, Linda / Stone, Stephen P / Strober, Bruce E / Van Voorhees, Abby S / Weiss, Stefan C / Wanat, Karolyn / Bebo, Bruce F / Anonymous4210715. ·Department of Dermatology, Baylor College of Medicine, Houston, TX 77030, USA. shsu@bcm.edu ·Arch Dermatol · Pubmed #22250239.

ABSTRACT: The Canadian Guidelines for the Management of Plaque Psoriasis were reviewed by the entire National Psoriasis Foundation Medical Board and updated to include newly approved agents such as ustekinumab and to reflect practice patterns in the United States, where the excimer laser is approved for psoriasis treatment. Management of psoriasis in special populations is discussed. In the updated guidelines, we include sections on children, pregnant patients or pregnant partners of patients, nursing mothers, the elderly, patients with hepatitis B or C virus infections, human immunodeficiency virus-infected patients, and patients with malignant neoplasms, as well as sections on tumor necrosis factor blockers, elective surgery, and vaccinations.

3 Guideline National Psoriasis Foundation consensus statement on screening for latent tuberculosis infection in patients with psoriasis treated with systemic and biologic agents. 2008

Doherty, Sean D / Van Voorhees, Abby / Lebwohl, Mark G / Korman, Neil J / Young, Melodie S / Hsu, Sylvia / National Psoriasis Foundation, ?. ·Department of Dermatology, Baylor College of Medicine, Houston, Texas 77030, USA. ·J Am Acad Dermatol · Pubmed #18485527.

ABSTRACT: BACKGROUND: Chronic immunosuppression is a known risk factor for allowing latent tuberculosis (TB) infection to transform into active TB. Immunosuppressive/immunomodulatory therapies, while highly efficacious in the treatment of psoriasis and psoriatic arthritis, may be associated with an increased rate of active TB in patients receiving some of these therapies. OBJECTIVE: Our aim was to arrive at a consensus on screening for latent TB infection in psoriasis patient treated with systemic and biologic agents. METHODS: Reports in the literature were reviewed regarding immunosuppressive therapies and risk of TB. RESULTS: Screening patients for latent TB infection before commencement of treatment is of utmost importance when beginning treatment with the tumor necrosis factor-alpha inhibitors, T-cell blockers, cyclosporine, or methotrexate. The currently recommended method for screening is the tuberculin skin test. It is preferable that positively screened patients be treated with a full course of latent TB infection prophylaxis before immunosuppressive/immunomodulatory therapy is initiated. However, in the opinion of many experts, patients may be started on the immunosuppressive/immunomodulatory therapy after 1 to 2 months, if their clinical condition requires, as long as they are strictly adhering to and tolerating their prophylactic regimen. LIMITATIONS: There are few evidence-based studies on screening for latent TB infection in psoriasis patients treated with systemic and biologic agents. CONCLUSIONS: The biologic TNF-alpha inhibitors are very promising in the treatment of psoriasis. However, because TNF-alpha is also an important cytokine in preventing TB infection and in keeping latent TB infection from becoming active disease, the use of TNF-alpha inhibitors has been associated with an increased risk of developing active TB. A higher incidence of TB has also been reported with other immunosuppressive/immunomodulatory treatments for psoriasis. It is, therefore, of utmost importance to appropriately screen all patients for latent TB infection prior to initiating any immunologic therapy. Delaying immunologic therapy until latent TB infection prophylaxis is completed is preferable. However, if the patient is adhering to his prophylactic regimen and is appropriately tolerating the regimen, therapy may be started after 1 to 2 months if the clinical condition requires.

4 Editorial Coronary Plaque Characterization in Psoriasis. 2017

Kivelevitch, Dario / Schussler, Jeffrey M / Menter, Alan. ·From Division of Dermatology (D.K., A.M.) and Department of Cardiology (J.M.S), Baylor Scott & White and Texas A&M College of Medicine, Dallas. · From Division of Dermatology (D.K., A.M.) and Department of Cardiology (J.M.S), Baylor Scott & White and Texas A&M College of Medicine, Dallas. amderm@gmail.com. ·Circulation · Pubmed #28716831.

ABSTRACT: -- No abstract --

5 Review Dermatologic manifestations in spaceflight: a review. 2018

Dunn, Carly / Boyd, McKenna / Orengo, Ida. ·Department of Dermatology, Baylor College of Medicine, Houston, Texas. carlyd@bcm.edu. ·Dermatol Online J · Pubmed #30695973.

ABSTRACT: With manned missions to Mars on the horizon, understanding and preparing for the medical conditions these astronauts might face becomes vital. According to the literature, the most commonly reported medical events in space are dermatological in nature. Dermatologic conditions rarely threaten an astronaut's life or the mission. However, manifestations and management of dermatologic events become an important consideration in anticipation of spaceflights to Mars and beyond. Given the limited number of articles written about dermatological conditions in this specific population, this review summarizes current knowledge related to dermatology in space. Overall, common dermatologic conditions found during spaceflight include viral reactivations, contact dermatitis or eczematous patches, and skin infections. Diagnosis and treatment can be difficult given the lack of resources in space as well as the hazards and side effects of certain treatments. In this review article we aim to summarize common skin changes induced by spaceflight, describe previously reported skin conditions including current treatment options, explore the risk of skin cancer in this unique population, and address the challenge of remote diagnosis.

6 Review Skin and Diet: An Update on the Role of Dietary Change as a Treatment Strategy for Skin Disease. 2018

Katta, Rajani / Kramer, Mary Jo. ·Baylor College of Medicine, Houston, TX, USA. · Georgetown University School of Medicine, Washington, DC, USA. ·Skin Therapy Lett · Pubmed #29357214.

ABSTRACT: An increasing body of research indicates that dietary change may serve as a component of therapy for certain skin conditions. This includes conditions such as acne, atopic dermatitis, aging skin, psoriasis, and rosacea. Certain nutrients, foods, or dietary patterns may act as disease "triggers", while others may prove beneficial. Avoidance or elimination diets may be helpful in some conditions, although testing may be recommended first. In terms of beneficial effects, an eating pattern that emphasizes the consumption of whole foods over highly processed foods may help in the treatment of certain skin conditions, and will certainly help in the prevention of associated co-morbidities.

7 Review Pediatric psoriasis: Evolving perspectives. 2018

Eichenfield, Lawrence F / Paller, Amy S / Tom, Wynnis L / Sugarman, Jeffrey / Hebert, Adelaide A / Friedlander, Sheila Fallon / Siegfried, Elaine / Silverberg, Nanette / Cordoro, Kelly M. ·Department of Dermatology, University of California, San Diego School of Medicine and Rady Children's Hospital, San Diego, CA, USA. · Department of Pediatrics, University of California, San Diego School of Medicine and Rady Children's Hospital, San Diego, CA, USA. · Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. · Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. · Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, CA, USA. · Pediatric Dermatology, McGovern School of Medicine and Children's Memorial Hermann Hospital, Houston, TX, USA. · Department of Pediatrics, Saint Louis University School of Medicine, Cardinal Glennon Children's Hospital, St. Louis, MO, USA. · Department of Dermatology, Saint Louis University School of Medicine, Cardinal Glennon Children's Hospital, St. Louis, MO, USA. · Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, NY, USA. · Department of Pediatrics, Icahn School of Medicine at Mt Sinai, New York, NY, USA. · Department of Pediatrics, University of California, San Francisco School of Medicine, San Francisco, CA, USA. ·Pediatr Dermatol · Pubmed #29314219.

ABSTRACT: BACKGROUND/OBJECTIVES: Childhood-onset psoriasis is a common skin disorder that has recently received increasing attention, particularly because of its significant medical, social, financial, and psychological burdens and its associated comorbidities. With limited data available and lack of standardized management guidelines for pediatric psoriasis, an expert panel desired to provide an updated critical overview and practical guidance for management of the affected population. METHODS: A panel of pediatric dermatologists with extensive experience in pediatric psoriasis defined and prioritized a core set of topics, performed an English-language literature review, prepared critical evaluations and presentations of topic areas, and carried out a consensus meeting and follow-up consensus manuscript. RESULTS: The summation of evolving perspectives in pediatric psoriasis includes epidemiology and natural history of the disease, precipitating factors and comorbidities, quality of life and burden of disease, clinical features and disease presentation, differential diagnosis, pathogenesis and treatment, including topical, photo, and systemic therapies. CONCLUSION: Pediatric psoriasis is an important immune-mediated inflammatory skin disease with potential for significant impact on affected individuals and their caregivers. Current state-of-the-art care is based primarily on experience and expert consensus, but pediatric data are accumulating and therapeutic options are rapidly evolving.

8 Review Epidemiology of mental health comorbidity in psoriasis. 2018

Wu, J J / Feldman, S R / Koo, J / Marangell, L B. ·a Kaiser Permanente Los Angeles Medical Center , Los Angeles , CA , USA. · b Wake Forest University School of Medicine , Winston-Salem , NC , USA. · c University of California San Francisco , San Francisco , CA , USA. · d The University of Texas McGovern School of Medicine , Houston , TX , USA. · e Brain Health Consultants , Houston , TX , USA. ·J Dermatolog Treat · Pubmed #29057684.

ABSTRACT: AIM: The occurrence of mental health comorbidities such as depression, anxiety, and suicidal ideation or behavior is not uncommon in the context of psoriasis. The negative influence of psoriatic disease on a patient's physical and mental well-being, in combination with overlapping pathophysiology, increase the risk for clinically significant psychiatric conditions. These psychiatric conditions, in turn, influence the patient's outlook and potentially, prognosis. Although the healthcare community increasingly recognizes the association of mental health comorbidities with psoriasis, the extent of the correlation is not fully appreciated. To better understand the relationship between mental health comorbidities and psoriasis, including prevalence, risk factors, and response of psychiatric comorbidities to psoriasis treatment, a narrative review of the published literature was conducted. METHODS: Data from epidemiologic, observational, and clinical studies demonstrate a substantially greater mental health comorbidity burden in patients with psoriasis compared with those without psoriasis or patients with other dermatologic conditions. RESULT: The influence of contemporary drug therapies on measures of depression and anxiety are predominantly positive, although further data are needed to better understand the effects of long-term therapy. CONCLUSION: Clinicians should consider the heightened potential for mental health comorbidities when determining an optimal management strategy for their patients with psoriasis.

9 Review Psychiatric adverse events during treatment with brodalumab: Analysis of psoriasis clinical trials. 2018

Lebwohl, Mark G / Papp, Kim A / Marangell, Lauren B / Koo, John / Blauvelt, Andrew / Gooderham, Melinda / Wu, Jashin J / Rastogi, Shipra / Harris, Susan / Pillai, Radhakrishnan / Israel, Robert J. ·Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: lebwohl@aol.com. · K. Papp Clinical Research and Probity Medical Research, Waterloo, Ontario, Canada. · The McGovern School of Medicine of the University of Texas, Houston, Texas; Brain Health Consultants, Houston, Texas. · University of California San Francisco Psoriasis and Skin Treatment Center, San Francisco, California. · Oregon Medical Research Center, Portland, Oregon. · Skin Centre for Dermatology and Probity Medical Research, Peterborough, Ontario, Canada. · Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. · Valeant Pharmaceuticals North America LLC, Bridgewater, New Jersey. · Dow Pharmaceutical (a division of Valeant Pharmaceuticals North America LLC), Petaluma, California. ·J Am Acad Dermatol · Pubmed #28985956.

ABSTRACT: BACKGROUND: Individuals with psoriasis are at increased risk for psychiatric comorbidities, including suicidal ideation and behavior (SIB). OBJECTIVE: To distinguish between the underlying risk and potential for treatment-induced psychiatric adverse events in patients with psoriasis being treated with brodalumab, a fully human anti-interleukin 17 receptor A monoclonal antibody. METHODS: Data were evaluated from a placebo-controlled, phase 2 clinical trial; the open-label, long-term extension of the phase 2 clinical trial; and three phase 3, randomized, double-blind, controlled clinical trials (AMAGINE-1, AMAGINE-2, and AMAGINE-3) and their open-label, long-term extensions of patients with moderate-to-severe psoriasis. RESULTS: The analysis included 4464 patients with 9161.8 patient-years of brodalumab exposure. The follow-up time-adjusted incidence rates of SIB events were comparable between the brodalumab and ustekinumab groups throughout the 52-week controlled phases (0.20 vs 0.60 per 100 patient-years). In the brodalumab group, 4 completed suicides were reported, 1 of which was later adjudicated as indeterminate; all patients had underlying psychiatric disorders or stressors. LIMITATIONS: There was no comparator arm past week 52. Controlled study periods were not powered to detect differences in rare events such as suicide. CONCLUSIONS: Comparison with controls and the timing of events do not indicate a causal relationship between SIB and brodalumab treatment.

10 Review Depression and suicidality in psoriasis: review of the literature including the cytokine theory of depression. 2017

Koo, J / Marangell, L B / Nakamura, M / Armstrong, A / Jeon, C / Bhutani, T / Wu, J J. ·San Francisco Medical Center, University of California, San Francisco, CA, USA. · Brain Health Consultants, Houston, TX, USA. · University of Southern California, Los Angeles, CA, USA. · Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA. ·J Eur Acad Dermatol Venereol · Pubmed #28681405.

ABSTRACT: Psoriasis can be a socially isolating disease due to debilitating physical symptoms and the stigma patients feel because of the appearance of their skin. Mental health comorbidities such as anxiety, depression and suicidal ideation and behaviour (SIB) are prevalent in patients with psoriasis. Patients with mild psoriasis can experience psychiatric comorbidities; however, disorders such as depression and SIB are more common in patients with severe psoriasis or psoriatic arthritis. Psychiatric disorders can both result from and contribute to progression of psoriasis, suggesting that psoriasis and psychiatric conditions, such as depression, may have overlapping biological mechanisms. Proinflammatory cytokines such as interleukin (IL)-1 and IL-6 are elevated in both psoriasis and depression, indicating that the inflammatory process may be involved in the progression of both diseases. Elevated cytokine levels in the central nervous system cause physiologic and biochemical changes that may contribute to the development of depression. In this review of the literature, we discuss the evidence that supports the association of psoriasis with mental health disorders and the tools used to detect the presence of these comorbidities. Additionally, we review the most prominent hypotheses on the mechanisms by which the inflammatory response and elevated cytokines can cause depression. These results highlight the role that systemic inflammation plays in the various mental health comorbidities associated with psoriasis, including depression and SIB.

11 Review A Review of Guselkumab, an IL-23 Inhibitor, for Moderate-to-Severe Plaque Psoriasis. 2017

Nawas, Z / Hatch, M / Ramos, E / Liu, M / Tong, Y / Peranteau, A / Tyring, S. ·Center For Clinical Studies, Houston, TX, USA. · Texas Tech School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA. · Baylor College of Medicine, Houston, TX, USA. · Center For Clinical Studies, Houston, TX, USA; Department of Dermatology, University of California San Diego, La Jolla, CA, USA. · Department of Dermatology, University of Texas Health Science Center, Houston, TX, USA. ·Skin Therapy Lett · Pubmed #28329405.

ABSTRACT: Psoriasis is a chronic inflammatory skin disorder that affects 2% of the population. Evidence suggests that interleukin (IL)-23 plays a pivotal role in the pathogenesis of psoriasis. Guselkumab is a subcutaneously administered, humanized anti-IL23 monoclonal antibody indicated for the treatment of moderate-to-severe plaque psoriasis. Data from Phase I-III trials in this patient population reveal that guselkumab has proven to be superior to placebo or adalimumab based on achieving a Psoriasis Area and Severity Index (PASI) 90% reduction, or a static Physician Global Assessment (sPGA) score of 0 or 1 from baseline. This article reviews the current status of guselkumab as a therapy for moderate-to-severe plaque psoriasis.

12 Review A Review of Brodalumab, an IL-17 Receptor Antagonist, for Moderate-to-Severe Plaque Psoriasis. 2017

Tong, Y / Peranteau, A J / Nawas, Z / Tyring, S K. ·Center for Clinical Studies, Houston, TX, USA; Department of Dermatology, University of California San Diego, La Jolla, CA, USA. · Center for Clinical Studies, Houston, TX, USA. · Center for Clinical Studies, Houston, TX, USA; Department of Dermatology, The University of Texas Health Science Center at Houston, Houston, TX, USA. ·Skin Therapy Lett · Pubmed #28122092.

ABSTRACT: Psoriasis is a chronic immune-mediated inflammatory disease with epidermal hyperplasia that affects 2-3% of the population. Interleukin (IL)-17 signaling has a central role in its pathogenesis. Brodalumab is a monoclonal antibody that neutralizes IL-17 receptor type A. Brodalumab is highly effective in the reversal of psoriatic phenotype and gene expression patterns.

13 Review A Review of Ixekizumab, an Anti-Interleukin-17A Monoclonal Antibody, for Moderate-to-Severe Plaque Psoriasis. 2016

Peranteau, A J / Turkeltaub, A E / Tong, Y / Nawas, Z / Tyring, S K. ·Center for Clinical Studies, Houston, TX, USA. · Baylor College of Medicine, Houston, TX, USA. · Department of Dermatology, University of California San Diego, San Diego, CA, USA. · Department of Dermatology, University of Texas Health Science Center at Houston, Houston, TX, USA. · Center for Clinical Studies, Houston, TX, USA; Department of Dermatology, University of Texas Health Science Center at Houston, Houston, TX, USA. ·Skin Therapy Lett · Pubmed #27825174.

ABSTRACT: Psoriasis is a multifactorial chronic skin disease that can have significant detrimental effects on patients' physical, mental, antibodypsychosocial wellbeing. Patients often suffer from a decreased quality of life along with numerous comorbidities. Recent advances in our understanding of the innate and adaptive immune systems have led to the identification of interleukin (IL)-17 as a key pro-inflammatory mediator in psoriasis. This knowledge has in turn led to the development of newer biologic agents that have been shown to be more effective than traditional therapies. In this article, we review phase 1-3 clinical trials of the anti-IL-17 monoclonal antibody, ixekizumab, for treatment of moderate-to-severe plaque psoriasis.

14 Review Biomarkers of An Autoimmune Skin Disease--Psoriasis. 2015

Jiang, Shan / Hinchliffe, Taylor E / Wu, Tianfu. ·Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA. · Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA. · Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA. Electronic address: twu13@Central.UH.EDU. ·Genomics Proteomics Bioinformatics · Pubmed #26362816.

ABSTRACT: Psoriasis is one of the most prevalent autoimmune skin diseases. However, its etiology and pathogenesis are still unclear. Over the last decade, omics-based technologies have been extensively utilized for biomarker discovery. As a result, some promising markers for psoriasis have been identified at the genome, transcriptome, proteome, and metabolome level. These discoveries have provided new insights into the underlying molecular mechanisms and signaling pathways in psoriasis pathogenesis. More importantly, some of these markers may prove useful in the diagnosis of psoriasis and in the prediction of disease progression once they have been validated. In this review, we summarize the most recent findings in psoriasis biomarker discovery. In addition, we will discuss several emerging technologies and their potential for novel biomarker discovery and diagnostics for psoriasis.

15 Review New and emerging biologic therapies for moderate-to-severe plaque psoriasis: mechanistic rationales and recent clinical data for IL-17 and IL-23 inhibitors. 2015

Gaspari, Anthony A / Tyring, Stephen. ·Department of Dermatology, University of Maryland Medical Center, Baltimore, Maryland. · Department of Dermatology, University of Texas Health Science Center, Houston, Texas. ·Dermatol Ther · Pubmed #26201310.

ABSTRACT: The development of effective and well-tolerated biologic therapies has advanced the management of psoriasis by enabling clinicians to treat underlying disease mechanisms. Biologics approved for the treatment of moderate-to-severe psoriasis include three tumor necrosis factor alpha inhibitors and an interleukin-12/interleukin-23 inhibitor. The establishment of the immunological basis of psoriasis has led to the development of biologic agents targeting specific downstream mediators in the psoriatic cascade. These drugs inhibit cytokines and cytokine signaling/transcription mediators like interleukin-17, which plays an important role in immunopathogenesis. Several interleukin-17 inhibitors are undergoing phase 3 clinical studies. In addition, biologics that selectively inhibit interleukin-23 have been assessed in phase 2 studies. This review describes how the dissection of pathways in the immunopathogenesis of psoriasis has led to the development of therapeutic agents and highlights the latest clinical efficacy, safety and tolerability data on new and emerging biologic therapies that selectively target interleukin-17 or interleukin-23.

16 Review Extracorporeal photopheresis for the treatment of autoimmune diseases. 2015

Adamski, Jill / Kinard, Theresa / Ipe, Tina / Cooling, Laura. ·Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, AZ, USA. Electronic address: Adamski.Jill@mayo.edu. · Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, AZ, USA. · Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA. · Department of Pathology, University of Michigan, Ann Arbor, MI, USA. ·Transfus Apher Sci · Pubmed #25886694.

ABSTRACT: The immune system is tasked with the unique challenge of recognizing foreign pathogens and damaged cells while at the same time preserving and protecting the integrity of "self". When this process fails, severe consequences including cancer and autoimmunity are the end result. Current therapies aimed at treating autoimmune disorders result in generalized immunosuppression and place the patient at increased risk for infection and malignancy. ECP is a potential therapeutic intervention that recapitulates natural physiologic processes of tolerance induction to restore immune homeostasis. Several clinical trials suggest that ECP may be used to treat a broad spectrum of autoimmune diseases.

17 Review Interleukin-23 in the pathogenesis and treatment of psoriasis. 2015

Kollipara, Ramya / Downing, Christopher / Gordon, Rachel / Tyring, Stephen. ·Center for Clinical Studies, Houston, TX, USA. · Department of Dermatology, University of Texas Health Science Center at Houston, Houston, TX, USA. ·Skin Therapy Lett · Pubmed #25807335.

ABSTRACT: In the past three decades, major advances have been made in understanding the pathogenesis of psoriasis. The currently accepted theory is that T-cell mediated immune dysregulation triggers keratinocyte hyperproliferation in psoriasis. Recent research indicates that the Th17/interleukin (IL)-23 pathway plays a prominent role in the amplification phase of psoriasis. The discovery of the Th17/ IL-23 pathway provides targets for new drug development. This review focuses on the role of IL-23 in psoriasis pathogenesis and the current therapies targeting IL-23 that are in clinical trials.

18 Review From the Medical Board of the National Psoriasis Foundation: The risk of cardiovascular disease in individuals with psoriasis and the potential impact of current therapies. 2014

Hugh, Jeremy / Van Voorhees, Abby S / Nijhawan, Rajiv I / Bagel, Jerry / Lebwohl, Mark / Blauvelt, Andrew / Hsu, Sylvia / Weinberg, Jeffrey M. ·Department of Dermatology, St Luke's-Roosevelt Hospital Center, New York, New York. · Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania. · Psoriasis Treatment Center of Central New Jersey, East Windsor, New Jersey. · Department of Dermatology, Mount Sinai School of Medicine, New York, New York. · Oregon Medical Research Center, Portland, Oregon. · Department of Dermatology, Baylor College of Medicine, Houston, Texas. · Department of Dermatology, St Luke's-Roosevelt Hospital Center, New York, New York. Electronic address: jmw27@columbia.edu. ·J Am Acad Dermatol · Pubmed #24184141.

ABSTRACT: BACKGROUND: Many studies have identified cardiovascular risk factors in patients with psoriasis. Some psoriasis therapies may increase cardiovascular disease (CVD) and others may decrease CVD. OBJECTIVE: We reviewed the literature to define the impact of common psoriasis therapies on cardiovascular measures and outcomes. RESULTS: Phototherapy has no major cardiovascular impact and may reduce levels of proinflammatory cytokines. Acitretin increases serum lipids and triglycerides, but has not been shown to increase cardiovascular risk. Cyclosporine A increases blood pressure, serum triglycerides, and total cholesterol. Methotrexate is associated with a decreased risk of CVD morbidity and mortality. Among the biologics, data for tumor necrosis factor inhibitors suggest an overall reduction in cardiovascular events. Most data on short-term ustekinumab use suggest no effect on major adverse cardiovascular events, however some authorities remain concerned. Nevertheless, ustekinumab use over a 4-year period shows a decrease in major adverse cardiovascular events when compared both with the general US population and with psoriatics in Great Britain. LIMITATIONS: Most studies lack the power and randomization of large clinical trials and long-term follow-up periods. In addition, the increased risk of CVD associated with psoriasis itself is a confounding factor. CONCLUSION: Some therapies for moderate to severe psoriasis, including methotrexate and tumor necrosis factor inhibitors, may reduce cardiovascular events in psoriatic patients. Ustekinumab appears to be neutral but there may be a long-term benefit. Appropriate patient counseling and selection and clinical follow-up are necessary to maximize safety with these agents. Further long-term study is necessary to quantify the benefits and risks associated with biologic therapies.

19 Review Progressive multifocal leukoencephalopathy and reversible progressive leukoencephalopathy syndrome in dermatologic therapy. 2013

Ladizinski, Barry / Heller, Misha M / Bhutani, Tina / Zitelli, Kristine B / Koo, John Y M. ·DermSurgery Associates, Houston, TX , USA. ·J Drugs Dermatol · Pubmed #23377400.

ABSTRACT: Progressive multifocal leukoencephalopathy (PML) is a frequently fatal demyelinating disease of the brain caused by activation of the John Cunningham virus. It typically occurs in immunocompromised patients, including transplant recipients on immunosuppressant medications, patients receiving chemotherapy for hematologic malignancies, and patients with human immunodeficiency virus. Unfortunately, there is no effective treatment for PML. By contrast, reversible progressive leukoencephalopathy syndrome (RPLS) is a generally treatable disorder that is diagnosed based on clinical symptoms (eg, altered mental status, visual abnormalities, headache, and seizures) and neuroradiographic changes (eg, cerebral edema). It is classically associated with malignant hypertension and immunosuppressive medications. Symptoms usually resolve over time, or with treatment of the underlying cause. Amid the relatively recent withdrawal of efalizumab from the US market because of its association with PML, and the added warning found on ustekinumab describing RPLS as a possible adverse effect, there has been an increasing level of concern in dermatology that biologics and other systemic medications used in the treatment of psoriasis may be related to an increased risk of specific leukoencephalopathies. In this review, we evaluate the association of prebiologics (eg, cyclosporine, methotrexate, acitretin) and biologics (eg, adalimumab, alefacept, efalizumab, etanercept, infliximab, rituximab, and ustekinumab) with the potential risk of developing PML and RPLS.

20 Review Genetics of spondyloarthritis--beyond the MHC. 2012

Reveille, John D. ·The University of Texas Health Science Center at Houston, MSB 5.270, 6431 Fannin, Houston, TX 77030, USA. john.d.reveille@uth.tmc.edu ·Nat Rev Rheumatol · Pubmed #22487796.

ABSTRACT: Ankylosing spondylitis (AS), psoriasis and inflammatory bowel disease (IBD) often coexist in the same patient and in their families. In AS, genes within the MHC region, in particular HLA-B27, account for nearly 25% of disease hereditability, with additional small contributions from genes outside of the MHC locus, including those involved in intracellular antigen processing (that is, ERAP1, which interacts with HLA-B27) and cytokine genes such as those involved in the IL-17-IL-23 pathway. Similar to AS, the strongest genetic signal of susceptibility to psoriasis and psoriatic arthritis also emanates from the MHC region (attributable mostly to HLA-C(*)06:02 although other genes have been implicated), and gene-gene interaction of HLA-C with ERAP1. The remaining hereditary load is from genes involved in cytokine production, specifically genes in the IL-17-IL-23 pathway, the NFκB pathway and the type 2 T-helper pathway. In IBD, similar genetic influences are operative. Indeed, genes important in the regulation of the IL-17-IL-23 pathway and, in Crohn's disease, genes important for autophagy (that is, NOD2 and ATG16L1 and IRGM) have a role in conferring susceptibility of individuals to these diseases. Thus, AS, psoriasis and IBD seem to share similar pathogenic mechanisms of aberrant intracellular antigen processing or elimination of intracellular bacteria and cytokine production, especially in the IL-17-IL-23 pathway.

21 Review Alcohol and skin disorders: with a focus on psoriasis. 2011

Kazakevich, Natalia / Moody, Megan N / Landau, Jennifer M / Goldberg, Leonard H. ·Well Cornell Medical College, Methodist Hospital, Houston, TX, USA. ·Skin Therapy Lett · Pubmed #21611681.

ABSTRACT: Alcohol is a serious cause of morbidity and mortality in our society and is implicated in multiple health conditions, including hepatic failure, neurological damage, hematological disorders, and nutritional deficiencies, to name a few. Although alcohol induced cutaneous abnormalities can also cause significant morbidity, they tend to be overshadowed by the other disease states associated with alcohol use. In addition to the cutaneous stigmata linked to chronic alcoholic liver disease, alcohol can directly cause or exacerbate several skin conditions. In particular, alcohol misuse is implicated in the development of psoriasis and discoid eczema, as well as confers increased susceptibility to skin and systemic infections. Alcohol misuse might also exacerbate rosacea, porphyria cutanea tarda, and post adolescent acne. Herein, we review the evidence concerning the influences of alcohol in skin conditions with a focus on psoriasis.

22 Review The genetic basis of spondyloarthritis. 2011

Reveille, John D. ·The University of Texas-Houston Health Science Center, MSB 5.270, 6431 Fannin, Houston, TX 77030, USA. john.d.reveille@uth.tmc.edu ·Ann Rheum Dis · Pubmed #21339218.

ABSTRACT: Modern technological innovations have advanced our understanding of the genetic basis of spondyloarthritis. In ankylosing spondylitis (AS), where the major histocompatibility complex (MHC) accounts for nearly half of the predisposition, most comes from HLA-B27, for which 65 subtypes are now recognised, although other genes are also at work including HLA-B60 (B*40:01). Other genes have been identified, including those involved in peptide editing for loading onto class I MHC molecules (ERAP1) and cytokine genes such as interleukin 1A (IL-1A) and those involved in the Th17 network (IL-23R, an association seen primarily in Caucasians) and others. In acute anterior uveitis, these associations are also seen as well as a region on chromosome 9p and genes whose confirmation is under way. Psoriasis and psoriatic arthritis fall into this disease spectrum, with the largest region of susceptibility coming from the MHC (most likely HLA-C, ie, C*06:02 although additional influences are also being implicated), and most of the other genetic susceptibility coming from genes involved in cytokine production, specifically genes in the Th17 pathway (IL-12B, IL-23A and IL-23R, the latter, like in AS, not seen in Asians), genes in the nuclear factor κB pathway (TNFAIP3 and TNIP1) and genes in the Th2 pathway (IL-4 and IL-13). Given that more than half of patients with AS have evidence on colonoscopy of at least occult inflammatory bowel disease (IBD), it is not surprising that shared genetic influences are operative. In IBD, genes important in the innate immune response (NOD2), autophagy (ATG6L1) and regulation of the IL-23 pathway (IL-23R) play a role in disease susceptibility.

23 Review Psoriatic skin lesions induced by tumor necrosis factor antagonist therapy: clinical features and possible immunopathogenesis. 2010

Collamer, Angelique N / Battafarano, Daniel F. ·Rheumatology Service, Brooke Army Medical Center, Fort Sam Houston, Texas 78234, USA. angelique.collamer@us.af.mil ·Semin Arthritis Rheum · Pubmed #20580412.

ABSTRACT: OBJECTIVE: The induction or exacerbation of psoriasis in patients treated with tumor necrosis factor (TNF) antagonists is a well-established phenomenon. The goals of this comprehensive literature analysis were to update currently available data regarding this adverse event, to identify any clinical patterns in the cohort of reported patients, and to review the possible immunopathogenesis. METHODS: A systematic literature review was performed utilizing PubMed and Medline databases (1996 to August 2009) searching the index terms "tumor necrosis factor alpha inhibitor," "TNF," "infliximab," "etanercept," "adalimumab," combined with the terms "psoriasis," "pustular," "skin," "rash," "palmoplantar," and "paradoxical." All relevant articles were reviewed. Patients who did not appear to meet accepted classification criteria for their treated disease, who had a more probable explanation or other likely diagnosis for their skin findings or known possible triggering factor for the skin eruption, including infection, were excluded from this analysis. RESULTS: Two hundred seven cases met inclusion criteria for review. Of these, 43% were diagnosed with rheumatoid arthritis, 26% with seronegative spondyloarthropathy, and 20% with inflammatory bowel disease. Mean patient age was 45 years and 65% were female. Fifty-nine percent were being treated with infliximab, 22% with adalimumab, and 19% with etanercept. Lesion morphology included pustular psoriasis in 56%, plaque psoriasis in 50%, and guttate lesions in 12%; 15% experienced lesions of more than 1 type. No statistically significant predisposing factors for the development of new-onset psoriasis were found. Sixty-six percent of patients were able to continue TNF antagonist therapy with psoriasis treatments. The pathogenesis appears to involve disruption of the cytokine milieu with production of unopposed interferon-α production by plasmacytoid dendritic cells in genetically predisposed individuals. Genetic polymorphisms may play a role in this paradoxical reaction to TNF blockade. CONCLUSIONS: TNF antagonist induced psoriasis is a well-described adverse event without any known predisposing risk factors. Most patients can be managed conservatively without drug withdrawal. Registry data reporting is necessary to define the true incidence and prevalence of this condition. Genomic studies of affected patients may assist with identification of predisposed patients and elucidation of the molecular trigger of this perplexing response.

24 Review The role of biologics and other systemic agents in the treatment of pediatric psoriasis. 2010

Wright, Natalie A / Piggott, Caroline D S / Eichenfield, Lawrence F. ·University of Texas Medical School at Houston. ·Semin Cutan Med Surg · Pubmed #20430304.

ABSTRACT: -- No abstract --

25 Review Efficacy and safety of topical tazarotene: a review. 2009

Talpur, Rakhashandra / Cox, Katherine / Duvic, Madeleine. ·University of Texas, MD Anderson Cancer Center, Department of Dermatology, Houston, Texas, USA. rtalpur@mdanderson.org ·Expert Opin Drug Metab Toxicol · Pubmed #20213916.

ABSTRACT: BACKGROUND: Tazarotene (Tazorac, Avage, Allergan, Inc., Irvine, CA, USA) is a synthetic retinoic acid receptor- betagamma topical retinoid approved for the treatment of plaque psoriasis and acne vulgaris. OBJECTIVES: To review a decade of experience using tazarotene as a monotherapy or as combination therapy for approved and other indications: acne, psoriasis, photoaging, basal cell carcinomas and various keratinization disorders. METHODS: We reviewed the published literature available on PubMed for safety and efficacy of topical tazarotene gel or cream preparations. RESULTS/CONCLUSIONS: Tazarotene, in both gel and cream formulations, has been used both as monotherapy and as an adjuvant therapy. For psoriasis it has been combined with steroids, calcipotriene and phototherapy, and for acne, with antibiotics. Tazarotene has been shown to upregulate the tumor suppressor, tazarotene induced gene 3, which is overexpressed in psoriasis and skin cancer. Adverse effects are limited to mild to moderate local irritation and erythema as seen with the 'retinization period' of other topical retinoid therapies. Daily application of tazarotene is effective with sustained benefits and limited local side effects.

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