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  • 11
    Electronic Resource
    Electronic Resource
    (25) Long-term follow-up of low-dose cyclosporin treatment for psoriasis (1988)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 119 (1988), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1988.tb05399.x
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  • 12
    Electronic Resource
    Electronic Resource
    The effects of cyclosporin A on T lymphocyte and dendritic cell sub-populations in psoriasis (1987)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 116 (1987), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Sequential skin biopsies from six patients with severe psoriasis were studied during treatment with cyclosporin. Four of the patients cleared completely and the remaining two showed a marked improvement. A subset of dendritic cells, HLA-DR+ but lacking the T6 antigen characteristically expressed by Langerhans cells (DR+ 6-), was observed in lesional epidermis. They disappeared during treatment, before clinical improvement was apparent and at a rate which correlated with clearance of psoriasis. These cells were not found in normal or uninvolved psoriatic epidermis and their number in lesional skin appeared to be related to the clinical severity of the disease. Total numbers of CD4 and CD8, and HLA-DR+ CD8 T cells were substantially reduced in both epidermis and dermis prior to clinical improvement. In contrast, there was generally no decrease in the number of HLA-DR + CD4 T cells in the epidermis during resolution, whereas these cells were reduced by an average of 68% in the dermis. The beneficial effects of cyclosporin in psoriasis further support the hypothesis that T cells play a central role in the pathogenesis of psoriasis. The cellular changes observed in the skin during cyclosporin treatment may help to elucidate the effects of this drug on immunoregulatory mechanisms in man.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1987.tb05869.x
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  • 13
    Electronic Resource
    Electronic Resource
    Four years of experience with cyclosporin A for psoriasis (1990)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 122 (1990), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Forty-four patients with severe psoriasis have been treated with cyclosporin A (CyA) for 2–50 months (mean 17 months). During the study, 31 (70%) of these patients achieved a 〉 70% reduction in PASI score, 39 (88%) achieved a 〉 60% reduction and 42 (95%) a 〉 50% reduction. The mean initial dose of CyA was 3 mg/kg/day and the mean dose was 3–3 mg/kg/day throughout the study. Twenty-five (57%) patients were maintained on 〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:00070963:BJD13:les" location="les.gif"/〉 3 mg and six (14%) required 〉 5 mg/kg/day for limited periods to obtain significant improvement. In three of these patients, this was achieved with 6 mg/kg/day but, of the remainder, one required 7 mg and two required 10 mg/kg/day. Of the 44 patients, 32 (73%) are still taking CyA. Patients were discontinued because of: side-effects directly attributable to treatment (n= 4); remission of psoriasis (n= 4); death (n= 1); defaulting (n= 1); infrequent attendance (n= 1); high doses of NSAID were necessary for arthritis (n= 1). Before starting CyA, 39 patients were normotensive; 21 (54%) developed mild hypertension. In 28 patients where the GFRs were estimated before and during treatment, there was a 16% reduction (P 〉 0–0001) during a mean period of 8 months. Two patients developed malignancies. The incidence of hypertension and percentage decrease in GFR were strongly correlated with the dose required to control the psoriasis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1990.tb02877.x
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  • 14
    Electronic Resource
    Electronic Resource
    Renal function after long-term low-dose cyclosporin for psoriasis (1990)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 122 (1990), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Two groups of patients receiving cyclosporin A (CyA) for psoriasis had their renal function assessed by measurement of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). The first group comprised 13 patients who had taken low dose (average 3 mg/kg per day) CyA for an average period of 25 years. Seven of the 13 had a normal GFR of 108 (77–121) ml/min (median; range). In the other six patients the GFR was low at 63 (50–77) ml/min and CyA was discontinued for periods ranging from 3 to 17 weeks. The GFR rose in all six patients, to 79 (60–91) ml/min; this change was significant (P〈o05). The six patients restarted CyA because their psoriasis recurred and after a mean interval of 15 weeks the GFR had fallen in all six to 63 (46–80) ml/min (P 〈0·05) and the ERPF decreased from 339 (231–414) ml/min to 244 (177–321) ml/min (P 〈0.05). In the second group of 11 patients measurements were made prior to starting CyA and after taking CyA for a mean of 9 weeks. The GFR fell in eight out of 11 subjects, the GFR for the 11 patients being 117 (72–128) ml/min before taking CyA and 97 (51–122) ml/min after CyA (P 〈0·02). The ERPF was measured in nine of the 11 patients and fell in seven of the nine. The ERPF for the nine patients before CyA was 490 (296–642) ml/min and for the II patients after CyA was 410 (195–543) ml/min (P〈0·01). This study shows that impairment of renal function is reversible in patients with psoriasis after long-term dosage with CyA. However, this impairment may occur after short- as well as long-term treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1990.tb07288.x
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  • 15
    Electronic Resource
    Electronic Resource
    Four years'experience of cyclosporin for psoriasis (1990)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 123 (1990), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1990.tb04451.x
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  • 16
    Electronic Resource
    Electronic Resource
    Rosacea induced by PUVA therapy (1989)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 121 (1989), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1989.tb01440.x
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  • 17
    Electronic Resource
    Electronic Resource
    Immunofluorescent studies in ocular cicatricial pemphigoid (1988)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 118 (1988), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Twenty nine patients with cicatrizing conjunctivitis were studied; 17 with a clinical diagnosis of cicatricial pemphigoid, five with a clinical diagnosis of pseudopemphigoid caused by long-term application of topical medication and seven who had a cicatrizing conjunctivitis from other causes. Biopsies from clinically uninvolved bulbar conjunctiva were taken for direct immunofluorescence and blood was taken for indirect immunofluorescence using normal human conjunctiva, oral mucosa and skin as substrates.On direct immunofluorescence, in vivo bound immunoglobulins were found along the basement membrane in 10 of the 17 patients with cicatricial pemphigoid, one of the five with pseudopemphigoid and two of the seven with a cicatrizing conjunctivitis associated with other diseases. Circulating anti-basement membrane zone antibodies were found only when conjunctiva was used as a substrate. These were present in seven of the patients with cicatricial pemphigoid, three of those with pseudopemphigoid and two of those with a cicatrizing conjunctivitis caused by other diseases.These results indicate that direct immunofluorescence is a useful, but not absolute diagnostic marker for ocular cicatricial pemphigoid. The results in the pseudopemphigoid group argue that this is an immunologically mediated disorder indistinguishable from spontaneous cicatricial pemphigoid and probably triggered by the drugs. The presence of circulating antibodies should allow for precise identification of the antigen involved in cicatricial pemphigoid using SDS electrophoresis and Western blot analysis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1988.tb01776.x
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  • 18
    Electronic Resource
    Electronic Resource
    (8) Comparison of psoriasis treated with cyclosporin alone or cyclosporin and clobetasol propionate (1987)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 117 (1987), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cyclosporin A (CyA) in the low dosage of 3 mg/kg/day has been shown to clear psoriasis; however, the disease relapses soon after withdrawal of the drug. Immunological studies have demonstrated persistence of activated T helper (TH) cells within the epidermis after clearance of psoriatic plaques with cyclosporin but disappearance if clearance is achieved by the use of topical clobetasol propionate (CP). If the relapse is a result of resumption of function by epidermal-activated TH cells then combination therapy with CP and CyA should delay the rate of relapse.Six patients with chronic plaque psoriasis were treated with CyA at a dose of 3 mg/kg/day for a period of 6 weeks; during the first 2 weeks CP was applied twice daily to the psoriatic plaques. A second group of six psoriatic patients was treated with cyclosporin alone. The psoriasis was scored at weekly intervals during treatment using the Psoriasis Area and Severity Index (PASI), and for 4 weeks after cessation of treatment.Using CyA alone, the mean time taken to achieve 80% reduction in PASI score was 7·3 ± 2·4 weeks compared to 4·2 ± 2·1 weeks with CyA and CP (P 〈 0·05). Four weeks after withdrawal of treatment the average percentage deterioration in PASI score was 29·2 in the CyA group and 17·8 in the CyA + CP group. This difference was not significant.Thus, the addition of CP to CyA in the management of psoriasis cleared psoriasis faster than CyA alone but did not slow the relapse rate. It would seem that the initiating factor responsible for attracting TH cells into the epidermis is not cleared by either treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1987.tb12026.x
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  • 19
    Electronic Resource
    Electronic Resource
    Is epidermal cell proliferation in psoriatic skin grafts on nude mice driven by T-cell derived cytokines? (1992)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 126 (1992), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Plasminogen activity and DNA synthesis by epidermal cells have been reported to be doubled in psoriatic skin grafts compared with grafts of normal skin 6 weeks after transplantation to nude mice. In our study human lymphocytes disappeared from such grafts within 48 h whilst some DR-positive human dendritic cells were retained in the grafts for up to 4 weeks. However, the grafts were infiltrated by Thy 1.2+ mouse lymphocytes within 6 days and this infiltration persisted at a moderate level throughout the observation period. It consisted of perivascular aggregates, scattered dermal and papillary T cells, and some mouse T cells were also found in the epidermal compartment. Grafts of psoriatic and non-psoriatic control skin were infiltrated to a similar extent, suggesting a low-grade rejection response against the human xenografts. These findings raise the possibility that psoriatic keratinocytes are responding abnormally to inflammatory cytokines released by mouse lymphocytes reacting against the skin grafts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1992.tb07805.x
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  • 20
    Electronic Resource
    Electronic Resource
    Autoimmune disease in dermatitis herpetiformis (1989)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 121 (1989), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1989.tb05949.x
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