Wetenschappelijk onderzoek over de behandeling van psoriasis

Het protocol voor de behandeling van psoriasis is op basis van wetenschappelijke publicaties ontwikkeld. Hierbij is gebruik gemaakt van de National Library of Medicine (PubMed). Daar waar mogelijk werden studies die opgezet zijn volgens het “placebo controlled cross-over” principe gebruikt. Andere vormen die vaak werden gebruik zijn reviews en epidemiologisch onderzoek. Publicaties uit bladen als The Lancet, American Journal of Cardiology, The New England Journal of Medicine hadden de voorkeur

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Causes

National Library of Medicine (PubMed)

    Supplements

    Algemeen

      Omega-3 Fatty Acids

        RCT
      1. Mayser P, Mrowietz U, Arenberger P, Bartak P, Buchvald J, Christophers E, Jablonska S, Salmhofer W, Schill WB, Krämer HJ, Schlotzer E, Mayer K, Seeger W, Grimminger F. J Am Acad Dermatol. 1998 Apr;38(4):539-47. Omega-3 fatty acid-based lipid infusion in patients with chronic plaque psoriasis: results of a double-blind, randomized, placebo-controlled, multicenter trial
        Intravenous omega-3-fatty acid administration is effective in the treatment of chronic plaque-type psoriasis. This effect may be related to changes in inflammatory eicosanoid generation.[Abstract]
      2. Mayser P, Mayer K, Mahloudjian M, Benzing S, Krämer HJ, Schill WB, Seeger W, Grimminger F. JPEN J Parenter Enteral Nutr. 2002 May-Jun;26(3):151-8. A double-blind, randomized, placebo-controlled trial of n-3 versus n-6 fatty acid-based lipid infusion in atopic dermatitis
        IV n-3-fatty acid administration is effective in acutely improving the severity of atopic dermatitis, paralleled by changes in plasma and membrane fatty acid composition and lipid mediator synthesis.[Abstract]
      3. Søyland E, Funk J, Rajka G, Sandberg M, Thune P, Rustad L, Helland S, Middelfart K, Odu S, Falk ES, et al. Br J Dermatol. 1994 Jun;130(6):757-64. Dietary supplementation with very long-chain n-3 fatty acids in patients with atopic dermatitis. A double-blind, multicentre study
        The overall clinical score, as evaluated by the physicians, improved during the trial by 30% in the fish oil (P < 0.001) and 24% in the corn oil group (P < 0.001). This was also consistent with the results from a selected skin area, and it was further confirmed by the total subjective clinical score reported by the patients.[Abstract]
      4. Søyland E, Lea T, Sandstad B, Drevon A. Eur J Clin Invest. 1994 Apr;24(4):236-42. Dietary supplementation with very long-chain n-3 fatty acids in man decreases expression of the interleukin-2 receptor (CD25) on mitogen-stimulated lymphocytes from patients with inflammatory skin diseases
        T-cell activation and cytokine production play an important role in several chronic inflammatory diseases. Because n-3 fatty acids exert beneficial effects on the clinical state of some of these diseases, we examined the effect of dietary supplementation of n-3 fatty acids on T-cell proliferation, expression of CD25 (interleukin-2 receptor alpha-chain), secretion of interleukin-2, interleukin-6 and tumour necrosis factor from T-cells from patients with psoriasis and atopic dermatitis.[Abstract]
      5. Grimminger F, Mayser P, Papavassilis C, Thomas M, Schlotzer E, Heuer KU, Führer D, Hinsch KD, Walmrath D, Schill WB, et al. Clin Investig. 1993 Aug;71(8):634-43. A double-blind, randomized, placebo-controlled trial of n-3 fatty acid based lipid infusion in acute, extended guttate psoriasis. Rapid improvement of clinical manifestations and changes in neutrophil leukotriene profile
        In conclusion, modulation of eicosanoid metabolism by intravenous n-3 fatty acid supplementation appears to exert a rapid beneficial effect on inflammatory skin lesions in acute guttate psoriasis.[Abstract]
      6. Gupta AK, Ellis CN, Tellner DC, Anderson TF, Voorhees JJ. Br J Dermatol. 1989 Jun;120(6):801-7. Double-blind, placebo-controlled study to evaluate the efficacy of fish oil and low-dose UVB in the treatment of psoriasis
        The improvement in the fish oil group was statistically significantly greater for all parameters compared to the change in the olive oil group. The apparent safety and general health-promoting features of fish oil could provide an ideal adjunctive therapy for psoriasis. PMID: 2667615 [PubMed – indexed for MEDLINE].[Abstract]
      7. Bittiner SB, Tucker WF, Cartwright I, Bleehen SS. Lancet. 1988 Feb 20;1(8582):378-80. A double-blind, randomised, placebo-controlled trial of fish oil in psoriasis
        28 patients with stable chronic psoriasis completed a trial in which they were randomly allocated to receive either 10 fish-oil capsules (‘MaxEPA’) or 10 placebo capsules (olive oil) daily. Patients were specifically instructed not to change their normal diet. After 8 weeks’ treatment there was a significant lessening of itching, erythema, and scaling in the active treatment group, with a trend towards an overall decrease in body surface area affected. No change occurred in the placebo group.[Abstract]
      8. Stoof TJ, Korstanje MJ, Bilo HJ, Starink TM, Hulsmans RF, Donker AJ. J Intern Med. 1989 Dec;226(6):437-41. Does fish oil protect renal function in cyclosporin-treated psoriasis patients?
        The results of this pilot study suggest that fish oil can reduce CyA-associated renal dysfunction in psoriasis patients.[Abstract]
      9. Bjørneboe A, Smith AK, Bjørneboe GE, Thune PO, Drevon CA. Br J Dermatol. 1988 Jan;118(1):77-83. Effect of dietary supplementation with n-3 fatty acids on clinical manifestations of psoriasis
        In a double-blind, block randomized study we investigated the effect of dietary supplementation with eicosapentaenoic acid in patients with psoriasis. The experimental group received 10 g of fish oil daily containing approximately 1.8 g eicosapentaenoic acid, while the controls were given an isoenergetic amount of olive oil. We found no significant change in the clinical manifestations of psoriasis in either group after 8 weeks of treatment. In the experimental group, the amount of n-3 fatty acids in serum phospholipids was significantly increased at the end of trial as compared to pre-treatment values, whereas the level of n-6 fatty acids was decreased.[Abstract]
      10. Gupta AK, Ellis CN, Tellner DC, Anderson TF, Voorhees JJ. Br J Dermatol. 1989 Jun;120(6):801-7. Double-blind, placebo-controlled study to evaluate the efficacy of fish oil and low-dose UVB in the treatment of psoriasis
        The improvement in the fish oil group was statistically significantly greater for all parameters compared to the change in the olive oil group. The apparent safety and general health-promoting features of fish oil could provide an ideal adjunctive therapy for psoriasis.[Abstract]
      11. REVIEW
      12. Mayser P, Grimm H, Grimminger F. Br J Nutr. 2002 Jan;87 Suppl 1:S77-82. n-3 fatty acids in psoriasis
        In conclusion, intravenous n-3-fatty acid administration causes reduction of psoriasis, which may be related to changes in inflammatory eicosanoid generation. The rapidity of the response to intravenous n-3 lipids exceeds by orders of magnitude the hitherto reported kinetics of improvement of psoriatic lesions upon use of oral supplementation.[Abstract]
      13. Simopoulos AP. J Am Coll Nutr. 2002 Dec;21(6):495-505. Omega-3 fatty acids in inflammation and autoimmune diseases
        Coronary heart disease, major depression, aging and cancer are characterized by an increased level of interleukin 1 (IL-1), a proinflammatory cytokine. Similarly, arthritis, Crohn’s disease, ulcerative colitis and lupus erythematosis are autoimmune diseases characterized by a high level of IL-1 and the proinflammatory leukotriene LTB(4) produced by omega-6 fatty acids. There have been a number of clinical trials assessing the benefits of dietary supplementation with fish oils in several inflammatory and autoimmune diseases in humans, including rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis, lupus erythematosus, multiple sclerosis and migraine headaches. Many of the placebo-controlled trials of fish oil in chronic inflammatory diseases reveal significant benefit, including decreased disease activity and a lowered use of anti-inflammatory drugs.[Abstract]

      XP-828L

        RCT
      1. Poulin Y, Bissonnette R, Juneau C, Cantin K, Drouin R, Poubelle PE. Altern Med Rev. 2007 Dec;12(4):352-9. XP-828L in the treatment of mild to moderate psoriasis: randomized, double-blind, placebo-controlled study
        Oral administration of 5 g/d XP-828L compared with a placebo significantly improved the PGA score of patients with mild to moderate psoriasis.[Article]
      2. Drouin R, Moroni O, Cantin K, Juneau C. Altern Med Rev. 2008 Jun;13(2):145-52. A double-blind, placebo-controlled, randomized trial of XP-828L (800 mg) on the quality of life and clinical symptoms of patients with mild-to-moderate psoriasis
        In summary, daily administration of 800 mg XP-828L for 56 days is adequate to improve the quality of life and decrease disease severity in patients with mild-to-moderate psoriasis.[Abstract]
      3. Poulin Y, Bissonnette R, Juneau C, Cantin K, Drouin R, Poubelle PE. J Cutan Med Surg. 2006 Sep-Oct;10(5):241-8. XP-828l in the treatment of mild to moderate psoriasis: randomized, double-blind, placebo-controlled study
        Oral administration of 5 g/d XP-828L compared with a placebo significantly improved the PGA score of patients with mild to moderate psoriasis.[Abstract]
      4. CLINICAL TRIAL
      5. Drouin R, Lamiot E, Cantin K, Gauthier SF, Pouliot Y, Poubelle PE, Juneau C. Can J Physiol Pharmacol. 2007 Sep;85(9):943-51. XP-828L (Dermylex), a new whey protein extract with potential benefit for mild to moderate psoriasis
        Although the in vivo mechanism of action of XP-828L remains unknown, XP-828L represents an NHP to be used as an alternative or concomitant treatment for mild to moderate psoriasis and potentially for other immune-mediated diseases.[Abstract]
      6. Poulin Y, Pouliot Y, Lamiot E, Aattouri N, Gauthier SF. J Cutan Med Surg. 2005 Dec;9(6):271-5. Safety and efficacy of a milk-derived extract in the treatment of plaque psoriasis: an open-label study
        No clinically significant adverse events or laboratory abnormalities occurred. XP-828L may improve psoriasis in patients with mild-to-moderate psoriasis.[Abstract]

      Mahonia aquifolium

        WIKI
      1. From Wikipedia, the free encyclopedia Mahonie (plant)
        Mahonie (Berberis aquifolium, synoniem: Mahonia aquifolium) is een giftige, groenblijvende struik die behoort tot de berberisfamilie (Berberidaceae). De plant wordt ook wel druifstruik genoemd. Naast de wilde vorm bestaan er ook veel cultivars, die gebruikt worden voor sierdoeleinden.[Article]
      2. RCT
      3. Bernstein S, Donsky H, Gulliver W, Hamilton D, Nobel S, Norman R. Am J Ther. 2006 Mar-Apr;13(2):121-6. Treatment of mild to moderate psoriasis with Reliéva, a Mahonia aquifolium extract–a double-blind, placebo-controlled study
        The results indicate statistically significant (P < 0.05) improvements in PASI and QLI in the Mahonia-treated group, compared with the control group. The side effects reported were infrequent, < 1% and minor; the most frequent side effects were rash, a burning sensation when applying the cream, and clothing stain. These data indicate that Reliéva, a proprietary form of M. aquifolium, is effective and well tolerated in patients with mild to moderate psoriasis.[Abstract]
      4. REVIEW
      5. Klövekorn W, Tepe A, Danesch U. Int J Clin Pharmacol Ther. 2007 Nov;45(11):583-91. A randomized, double-blind, vehicle-controlled, half-side comparison with a herbal ointment containing Mahonia aquifolium, Viola tricolor and Centella asiatica for the treatment of mild-to-moderate atopic dermatitis
        However, a subanalysis indicated that the cream might be effective under conditions of cold and dry weather.[Abstract]
      6. Gulliver WP, Donsky HJ. Am J Ther. 2005 Sep-Oct;12(5):398-406. A report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasis
        Taken together, these clinical studies conducted by several investigators in several countries indicate that Mahonia aquifolium is a safe and effective treatment of patients with mild to moderate psoriasis.[Abstract]
      7. Augustin M, Andrees U, Grimme H, Schöpf E, Simon J. Forsch Komplementarmed. 1999 Apr;6 Effects of Mahonia aquifolium ointment on the expression of adhesion, proliferation, and activation markers in the skin of patients with psoriasis
        These results indicate efficacy of Mahonia aquifolium and dithranol in psoriatic skin both on cellular cutaneous immune mechanisms and on the hyperproliferation of keratinocytes. The effect of dithranol appears to be more potent than that of Mahonia aquifolium.[Abstract]
      8. Reuter J, Merfort I, Schempp CM. Am J Clin Dermatol. 2010;11(4):247-67. doi: 10.2165/11533220-000000000-00000. Botanicals in dermatology: an evidence-based review
        Mahonia and Capsicum (capsaicin) are the next candidates suggested by present evidence.[Abstract]
      9. LETTER
      10. Müller K, Ziereis K, Gawlik I. Planta Med. 1995 Feb;61(1):74-5. The antipsoriatic Mahonia aquifolium and its active constituents; II. Antiproliferative activity against cell growth of human keratinocytes
        The extract of the bark of Mahonia aquifolium is an inhibitor of keratinocyte growth with an IC50 of 35 microM. Of its main alkaloids tested, berberine inhibited cell growth to the same extent as did the Mahonia extract, while the benzylisoquinoline alkaloids berbamine and oxyacanthine were more potent inhibitors by a factor of three.[Abstract]
      11. OTHER
      12. Reuter J, Wölfle U, Weckesser S, Schempp C. J Dtsch Dermatol Ges. 2010 Oct;8(10):788-96. doi: 10.1111/j.1610-0387.2010.07496.x. Which plant for which skin disease? Part 1: Atopic dermatitis, psoriasis, acne, condyloma and herpes simplex
        Mahonia aquifolium, Indigo naturalis and Capsicum frutescens are effective treatments for psoriasis.[Abstract]
      13. Bezáková L, Misik V, Máleková L, Svajdlenka E, Kostálová D. Pharmazie. 1996 Oct;51(10):758-61. Lipoxygenase inhibition and antioxidant properties of bisbenzylisoqunoline alkaloids isolated from Mahonia aquifolium
        Products of lipoxygenase metabolism are known to play a role in the pathogenesis of psoriasis. Six bisbenzylisoquinoline (BBIQ) alkaloids, oxyacanthine, armoline, baluchistine, berbamine, obamegine, aquifoline, isolated from Mahonia aquifolium, were tested for lipoxygenase inhibition. Berbamine and oxyacanthine were the most potent lipoxygenase inhibitors, whereas aromoline and baluchistine exhibited only very low potencies. Oxyacanthine and berbamine were also among the most active compounds to inhibit lipid peroxidation. Between the results of lipoxygen. Inhibition of lipoxygenase by these compounds may contribute to the therapeutic effect of Mahonia aquifolium extracts in treatment of diseases in pathogenesis of which he products of lipoxygenase metabolism are involved.[Abstract]

      14. .[Abstract]

      Calcipotriol/Betamethasone

        WIKI
      1. From Wikipedia, the free encyclopedia Calcipotriol
        Calcipotriol (INN) or calcipotriene (USAN) is a synthetic derivative of calcitriol or vitamin D. It is used in the treatment of psoriasis, marketed under the trade name Dovonex or Daivonex.[Article]
      2. From Wikipedia, the free encyclopedia Betamethasone
        Betamethasone is a potent glucocorticoid steroid with anti-inflammatory and immunosuppressive properties. Unlike other drugs with these effects, betamethasone does not cause water retention. It is applied as a topical cream, ointment, foam, lotion or gel to treat itching. Betamethasone sodium phosphate is sometimes prescribed as an intramuscular injection (I.M) for itching from various ailments, including allergic reactions to poison ivy and similar plants.[Article]
      3. RCT
      4. Vakirlis E, Kastanis A, Ioannides D. Ther Clin Risk Manag. 2008 Feb;4(1):141-8. Calcipotriol/betamethasone dipropionate in the treatment of psoriasis vulgaris
        Psoriasis is one of the most common skin diseases. The mainstay of treatment for the vast majority of patients is topical therapy. A rising first-line treatment modality for psoriasis vulgaris is the two-compound ointment containing calcipotriol 50 mug/g plus betamethasone dipropionate 0.5 mg/g (Dovobet((R)), Daivobet((R)), Taclonex((R))), which combines a vitamin D analog and a corticosteroid. This innovative formulation preserves the activity and bioavailability of the two components and many clinical studies have demonstrated that it has a greater efficacy, tolerability, and a rapid onset of action compared with its individual ingredients or tacalcitol.[Article]
      5. van der Velden HM, Pasch MC, van Erp PE, van Lingen RG, Otero ME, de Boer-van Huizen RT, van de Kerkhof PC. J Dermatolog Treat. 2010 Jan;21(1):13-22. Treatment of plaque psoriasis with the two-compound product calcipotriol/betamethasone dipropionate versus both monotherapies: an immunohistochemical study
        In conclusion, the investigated markers of the skin immune system and epidermal proliferation indicated an added value of the two-compound product over both monotherapies.[Abstract]
      6. Jemec GB, van de Kerkhof PC, Enevold A, Ganslandt C. J Eur Acad Dermatol Venereol. 2011 Jan;25(1):27-32. doi: 10.1111/j.1468-3083.2010.03682.x. Significant one week efficacy of a calcipotriol plus betamethasone dipropionate scalp formulation
        Conclusion: This data indicates that the two-compound scalp formulation demonstrated significant efficacy already after 1 week, with a faster onset of effect than either of the individual components in the same vehicle, in the treatment of scalp psoriasis.[Abstract]
      7. Ortonne JP, Ganslandt C, Tan J, Nordin P, Kragballe K, Segaert S. J Eur Acad Dermatol Venereol. 2009 Aug;23(8):919-26. Quality of life in patients with scalp psoriasis treated with calcipotriol/betamethasone dipropionate scalp formulation: a randomized controlled trial
        The two-compound scalp formulation was superior to calcipotriol scalp solution in improving QoL in patients with scalp psoriasis.[Abstract]
      8. Kragballe K, Hoffmann V, Ortonne JP, Tan J, Nordin P, Segaert S. Br J Dermatol. 2009 Jul;161(1):159-66. Efficacy and safety of calcipotriol plus betamethasone dipropionate scalp formulation compared with calcipotriol scalp solution in the treatment of scalp psoriasis: a randomized controlled trial
        A once-daily combination of calcipotriol plus betamethasone dipropionate was significantly more effective and better tolerated than twice-daily calcipotriol scalp solution in the treatment of scalp psoriasis.[Abstract]
      9. RCT DOVONEX / DAIVONEX
      10. Langley RG, Gupta A, Papp K, Wexler D, Østerdal ML, Cur?i? D. Dermatology. 2011;222(2):148-56. Calcipotriol plus betamethasone dipropionate gel compared with tacalcitol ointment and the gel vehicle alone in patients with psoriasis vulgaris: a randomized, controlled clinical trial
        Once-a-day treatment with the 2-compound Daivobet/Dovobet gel is a safe and efficacious therapeutic regimen for individuals with psoriasis on the body.[Abstract]
      11. Levine D, Even-Chen Z, Lipets I, Pritulo OA, Svyatenko TV, Andrashko Y, Lebwohl M, Gottlieb A. J Am Acad Dermatol. 2010 Nov;63(5):775-81. Pilot, multicenter, double-blind, randomized placebo-controlled bilateral comparative study of a combination of calcipotriene and nicotinamide for the treatment of psoriasis
        This study provides evidence that using the combination nicotinamide and calcipotriene may provide additional benefit in the topical treatment for patients with psoriasis and may be an adequate steroid-sparing substitute treatment.[Abstract]

      Vitamin D3

        RCT
      1. Durakovic C, Malabanan A, Holick MF. Br J Dermatol. 2001 Mar;144(3):500-6. Rationale for use and clinical responsiveness of hexafluoro-1,25-dihydroxyvitamin D3 for the treatment of plaque psoriasis: a pilot study
        Topical F6-1,25(OH)2D3 is a safe and effective once a day treatment for psoriasis.[Abstract]
      2. Fleming C, Ganslandt C, Guenther L, Johannesson A, Buckley C, Simon JC, Stegmann H, Vestergaard Tingleff L. Eur J Dermatol. 2010 Jul-Aug;20(4):465-71. Calcipotriol plus betamethasone dipropionate gel compared with its active components in the same vehicle and the vehicle alone in the treatment of psoriasis vulgaris: a randomised, parallel group, double-blind, exploratory study
        A two-compound ointment containing calcipotriol plus betamethasone dipropionate is an effective treatment for psoriasis vulgaris. This exploratory study showed that the two-compound gel was safe and more efficacious than its individual ingredients in the treatment of psoriasis vulgaris.[Abstract]
      3. Van de Kerkhof PC, Green C, Hamberg KJ, Hutchinson PE, Jensen JK, Kidson P, Kragballe K, Larsen FG, Munro CS, Tillman DM. Dermatology. 2002;204(3):214-21. Safety and efficacy of combined high-dose treatment with calcipotriol ointment and solution in patients with psoriasis
        The combined use of calcipotriol ointment/scalp solution did not affect the indices of calcium metabolism or bone turnover and was significantly more effective than dithranol/tar in reducing disease severity and extent in patients with extensive psoriasis.[Abstract]
      4. van de Kerkhof PC. Skin Pharmacol Appl Skin Physiol. 1998 Jan-Feb;11(1):2-10. An update on vitamin D3 analogues in the treatment of psoriasis
        Vitamin D3 analogues have revolutionized the topical treatment of psoriasis during the last decade. The mode of action of this ligand for the vitamin D3 receptor is via modulation of the transcription of genes with vitamin D3 response elements in their promoter region. Vitamin D3 analogues cause inhibition of various aspects of cutaneous inflammation and epidermal proliferation with enhancement of normal keratinization. In vivo, active vitamin D3 analogues proved to have a substantial antipsoriatic effect. Calcipotriol (50 micrograms/g in ointment or cream), tacalcitol (4 micrograms/g in ointment) and calcitriol (3 micrograms/g in ointment) have been shown to have an antipsoriatic effect in placebo-controlled studies. The most extensive body of information on comparative studies and on combination therapies is available for the analogue calcipotriol. So far, calcipotriol is available as a routine treatment in most countries, whereas tacalcitol has been registered in Japan and some European countries. From the available data in the literature we may conclude that calcipotriol is a first-line treatment for psoriasis and is advantageous in the combination with several other antipsoriatic treatments such as topical corticosteroids, PUVA, cyclosporin and acitretin. Tacalcitol 4 micrograms/g as a once-daily principle is effective in psoriasis. Comparative studies will indicate the position of the existing and new vitamin D3 analogues.[Abstract]
      5. Lebwohl M. Cutis. 2002 Nov;70(5 Suppl):5-8. Vitamin D and topical therapy
        A sequential therapy regimen involving an initial clearing phase of daily applications of calcipotriene 0.005% ointment and halobetasol 0.05% ointment for 2 weeks, followed by halobetasol applied twice daily on weekends and calcipotriene applied twice daily on weekdays, has been shown to be effective in the management of chronic plaque psoriasis. As a clearing regimen, the combined use of halobetasol and calcipotriene for 2 weeks was superior to monotherapy with either agent. Subsequently, the use of halobetasol on weekends and calcipotriene on weekdays allowed 76% of patients to stay in remission for up to 6 months, compared with 40% of patients who applied halobetasol on weekends only and placebo on weekdays. Calcipotriene can be inactivated when mixed with some topical preparations; however, halobetasol propionate 0.05% ointment and cream have been shown to be compatible with calcipotriene for up to 2 weeks. The compatibility of calcipotriene and halobetasol permits the use of these agents together.[Abstract]
      6. OTHER
      7. el-Azhary RA, Peters MS, Pittelkow MR, Kao PC, Muller SA.Mayo Clin Proc. 1993 Sep;68(9):835-41. Efficacy of vitamin D3 derivatives in the treatment of psoriasis vulgaris: a preliminary report
        We conclude that a subset of patients with psoriasis responds well to 1,25(OH)2D3. Calcipotriene is efficacious and an excellent alternative to topically applied corticosteroids.[Abstract]
      8. O’Neill JL, Feldman SR. Drugs Today (Barc). 2010 May;46(5):351-60. Vitamine D analogue-based therapies for psoriasis
        Topical vitamin D3 analogues can be a cost-effective addition to a psoriasis treatment regimen, especially when compliance is encouraged by the tolerability of these agents and more costly systemic agents are avoided.[Abstract]

      coal tar solution

      1. Alora-Palli MB, Perkins AC, Van Cott A, Kimball AB. Am J Clin Dermatol. 2010;11(4):275-83. doi: 10.2165/11530380-000000000-00000. Efficacy and tolerability of a cosmetically acceptable coal tar solution in the treatment of moderate plaque psoriasis: a controlled comparison with calcipotriene (calcipotriol) cream
        The newly formulated LCD solution, applied twice daily at home for 12 weeks, was more effective and as well tolerated and cosmetically acceptable as the calcipotriene cream over 12 weeks of treatment and 6 weeks of follow-up. The LCD solution is a patient-accepted and effective corticosteroid-sparing treatment alternative for psoriasis patients.[Abstract]
      2. Goodfield M, Kownacki S, Berth-Jones J. J Dermatolog Treat. 2004 Jan;15(1):14-22. Double-blind, randomised, multicentre, parallel group study comparing a 1% coal tar preparation (Exorex) with a 5% coal tar preparation (Alphosyl) in chronic plaque psoriasi
        1% coal tar lotion is more effective than a conventional coal tar lotion in mild to moderate psoriasis and may be preferred for first-line topical treatment.[Abstract]
      3. Sharma V, Kaur I, Kumar B. Int J Dermatol. 2003 Oct;42(10):834-8. Calcipotriol versus coal tar: a prospective randomized study in stable plaque psoriasis
        It was found that 0.005% calcipotriol ointment produced a faster initial response and had better cosmetic acceptability in patients, although after a long period of treatment, i.e. 12 weeks, 5% coal tar ointment had comparable efficacy.[Abstract]
      4. Kumar B, Kumar R, Kaur I. Int J Dermatol. 1997 Apr;36(4):309-12. Coal tar therapy in palmoplantar psoriasis: old wine in an old bottle?
        Crude coal tar is a safe, effective, and inexpensive modality for the treatment of PPP. We recommend coal tar under occlusion, along with the liberal use of emollients, as the first line of therapy for all cases of PPP.[Abstract]

      5. .[Abstract]

      B12

        RCT
      1. Stücker M, Memmel U, Hoffmann M, Hartung J, Altmeyer P. Dermatology. 2001;203(2):141-7. Vitamin B(12) cream containing avocado oil in the therapy of plaque psoriasis
        The results of this clinical trial provide evidence that the recently developed vitamin B(12) cream containing avocado oil has considerable potential as a well-tolerated, long-term topical therapy of psoriasis.[Abstract]
      2. Miura T, Torinuki W, Makino Y. J Dermatol. 1976 Aug;3(4):155-8. Treatment of pustulosis palmaris et plantaris with large doses of vitamin B12
        Thirty-three patients with pustulosis palmaris et plantaris were treated with large doses of vitamin B12 (cyanocobalamin and/or coenzyme B12). Those patients receiving large doses for a long period of time showed a better response than those who received small doses for a shorter period.[Abstract]

      topical aloe vera

      1. Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. J Eur Acad Dermatol Venereol. 2010 Feb;24(2):168-72. A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis
        AV cream may be more effective than 0.1% TA cream in reducing the clinical symptoms of psoriasis; however, both treatments have similar efficacy in improving the quality of life of patients with mild to moderate psoriasis.[Abstract]
      2. Syed TA, Ahmad SA, Holt AH, Ahmad SA, Ahmad SH, Afzal M. Trop Med Int Health. 1996 Aug;1(4):505-9. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study
        The findings of this study suggest that topically applied Aloe vera extract 0.5% in a hydrophilic cream is more effective than placebo, and has not shown toxic or any other objective side-effects. Therefore, the regimen can be considered a safe and alternative treatment to cure patients suffering from psoriasis.[Abstract]

      Antioxidant

        RCT
      1. Kharaeva Z, Gostova E, De Luca C, Raskovic D, Korkina L. Nutrition. 2009 Mar;25(3):295-302. Clinical and biochemical effects of coenzyme Q(10), vitamin E, and selenium supplementation to psoriasis patient
        Supplementation with antioxidants coenzyme Q(10), vitamin E, and selenium could be feasible for the management of patients with severe forms of psoriasis.[Abstract]
      2. Uta? S, Köse K, Yazici C, Akda? A, Kele?timur F. Clin Biochem. 2002 May;35(3):241-6. Antioxidant potential of propylthiouracil in patients with psoriasis
        These findings may provide some evidence for a potential role of increased lipid peroxidation and decreased antioxidant activity in psoriasis. PTU may be considered as treatment model in psoriasis, in particular for resistant cases, because of its antioxidant potential, and also antiproliferative and immunomodulatory effects.[Abstract]

      Kurkuma

        REVIEW
      1. Bright JJ. Adv Exp Med Biol. 2007;595:425-51. Curcumin and autoimmune disease
        Recent studies have shown that curcumin ameliorates multiple sclerosis, rheumatoid arthritis, psoriasis, and inflammatory bowel disease in human or animal models. Curcumin inhibits these autoimmune diseases by regulating inflammatory cytokines such as IL-1beta, IL-6, IL-12, TNF-alpha and IFN-gamma and associated JAK-STAT, AP-1, and NF-kappaB signaling pathways in immune cells.[Abstract]
      2. Hatcher H, Planalp R, Cho J, Torti FM, Torti SV. Cell Mol Life Sci. 2008 Jun;65(11):1631-52. Curcumin: from ancient medicine to current clinical trials
        Curcumin exhibits great promise as a therapeutic agent, and is currently in human clinical trials for a variety of conditions, including multiple myeloma, pancreatic cancer, myelodysplastic syndromes, colon cancer, psoriasis and Alzheimer’s disease.[Abstract]

      3. .[Abstract]

      Coeliac disease

        WIKI
      1. From Wikipedia, the free encyclopedia Coeliac diseas
        Coeliac disease is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages from middle infancy onward. Symptoms include chronic diarrhoea, failure to thrive (in children), and fatigue, but these may be absent, and symptoms in other organ systems have been described.[Article]
      2. REVIEW
      3. Abenavoli L, Proietti I, Leggio L, Ferrulli A, Vonghia L, Capizzi R, Rotoli M, Amerio PL, Gasbarrini G, Addolorato G. World J Gastroenterol. 2006 Feb 14;12(6):843-52. Cutaneous manifestations in celiac disease
        Celiac disease (CD) is an autoimmune gluten-dependent enteropathy characterized by atrophy of intestinal villi that improves after gluten-free diet (GFD). CD is often associated with extra-intestinal manifestations; among them, several skin diseases are described in CD patients. The present review reports all CD-associated skin manifestations described in the literature and tries to analyze the possible mechanisms involved in this association. The opportunity to evaluate the possible presence of CD in patients affected by skin disorders is discussed.[Article]
      4. OTHER
      5. Abenavoli L, Proietti I, Zaccone V, Gasbarrini G, Addolorato G. Expert Rev Clin Immunol. 2009 Nov;5(6):789-800. Celiac disease: from gluten to skin
        Celiac disease (CD) is an autoimmune gluten-dependent enteropathy characterized by atrophy of the intestinal villi that improves after a gluten-free diet. CD is often associated with extraintestinal manifestations. In the past few years, growing evidence has documented the involvement of skin diseases among the extraintestinal manifestations of CD. This association could be related to the impairment of intestinal absorption and motility, other than to immunological and hormonal changes. The aim of this review is to report all CD-associated skin manifestations described in the literature and to analyze the possible mechanisms involved in this association. The opportunity to evaluate the possible presence of CD in patients affected by skin disorders is discussed.[Abstract]
      6. Woo WK, McMillan SA, Watson RG, McCluggage WG, Sloan JM, McMillan JC. Br J Dermatol. 2004 Oct;151(4):891-4. Coeliac disease-associated antibodies correlate with psoriasis activity
        The presence of CD-associated antibodies in psoriasis patients correlates with greater disease activity.[Abstract]
      7. Damasiewicz-Bodzek A, Wielkoszy?ski T. J Eur Acad Dermatol Venereol. 2008 Sep;22(9):1055-61. Serologic markers of celiac disease in psoriatic patients
        Our results seem to imply an association between psoriasis and asymptomatic celiac disease/gluten intolerance. High percentage of positive results to guinea pig-derived tTG could be due to cellular activity of tissue transglutaminase in psoriasis.[Abstract]
      8. Birkenfeld S, Dreiher J, Weitzman D, Cohen AD. Br J Dermatol. 2009 Dec;161(6):1331-4. Coeliac disease associated with psoriasis
        Patients with psoriasis have a greater prevalence of CD than matched controls. Recent studies showed a possibility of undiagnosed CD among patients with psoriasis. Therefore, physicians treating patients with psoriasis should be aware of this possible association.[Abstract]
      9. Montesu MA, Dessì-Fulgheri C, Pattaro C, Ventura V, Satta R, Cottoni F. Acta Derm Venereol. 2011 Jan;91(1):92-3. Association between psoriasis and coeliac disease? A case-control study
        The first published data concerning a possible relationship between psoriasis and pathologies of the gastrointestinal tract appeared as long as 30 years ago (1, 2), and subsequently there have been numerous reports on psoriasis and coeliac disease (3–5). [Article]
      10. Lindqvist U, Rudsander A, Boström A, Nilsson B, Michaëlsson G. Rheumatology (Oxford). 2002 Jan;41(1):31-7. IgA antibodies to gliadin and coeliac disease in psoriatic arthritis
        Patients with PsoA have an increased prevalence of raised serum IgA AGA and of coeliac disease. Patients with raised IgA AGA seem to have more pronounced inflammation than those with a low IgA AGA concentration.[Article]
      11. CASE
      12. Addolorato G, Parente A, de Lorenzi G, D’angelo Di Paola ME, Abenavoli L, Leggio L, Capristo E, De Simone C, Rotoli M, Rapaccini GL, Gasbarrini G. Digestion. 2003;68(1):9-12. Rapid regression of psoriasis in a coeliac patient after gluten-free diet. A case report and review of the literature
        The present case supports the association between CD and psoriasis and the concept that psoriasis in CD patients can be improved by GFD. Future studies are needed to clarify the possible mechanisms involved in this association.[Abstract]

      Gluten Intolerance

      1. Humbert P, Pelletier F, Dreno B, Puzenat E, Aubin F. Eur J Dermatol. 2006 Jan-Feb;16(1):4-11. Gluten intolerance and skin diseases
        Thus, gluten intolerance gives rise to a variety of dermatological manifestations which may benefit from a gluten-free diet.[Abstract]

      Calcipotriol

        WIKI
      1. From Wikipedia, the free encyclopedia Calcipotriol
        Calcipotriol (INN) or calcipotriene (USAN) is a synthetic derivative of calcitriol or vitamin D. It is used in the treatment of psoriasis, marketed under the trade name Dovonex or Daivonex.[Article]
      2. RCT
      3. Levine D, Even-Chen Z, Lipets I, Pritulo OA, Svyatenko TV, Andrashko Y, Lebwohl M, Gottlieb A. J Am Acad Dermatol. 2010 Nov;63(5):775-81. Pilot, multicenter, double-blind, randomized placebo-controlled bilateral comparative study of a combination of calcipotriene and nicotinamide for the treatment of psoriasis
        This study provides evidence that using the combination nicotinamide and calcipotriene may provide additional benefit in the topical treatment for patients with psoriasis and may be an adequate steroid-sparing substitute treatment.[Abstract]
      4. Zhu X, Wang B, Zhao G, Gu J, Chen Z, Briantais P, Andres P. J Eur Acad Dermatol Venereol. 2007 Apr;21(4):466-72. An investigator-masked comparison of the efficacy and safety of twice daily applications of calcitriol 3 microg/g ointment vs. calcipotriol 50 microg/g ointment in subjects with mild to moderate chronic plaque-type psoriasis
        Calcitriol administered twice daily over a 12-week treatment period demonstrated similar efficacy to calcipotriol, while showing a significantly better safety profile.[Abstract]
      5. Körver JE, Vissers WH, van Rens DW, Pasch MC, van Erp PE, Boezeman JB, van De Kerkhof PC. Br J Dermatol. 2007 Jan;156(1):130-7. A double-blind, randomized quantitative comparison of calcitriol ointment and calcipotriol ointment on epidermal cell populations, proliferation and differentiation
        Both calcitriol and calcipotriol gave a significant improvement in clinical scores. However, treatment with calcipotriol resulted in a normalization of K6, K10 and K15, whereas treatment with calcitriol did not. Comparison of both treatments showed a tendency towards significance for the above-mentioned markers for calcipotriol only.[Abstract]
      6. Koo J, Blum RR, Lebwohl M. J Am Acad Dermatol. 2006 Oct;55(4):637-41. A randomized, multicenter study of calcipotriene ointment and clobetasol propionate foam in the sequential treatment of localized plaque-type psoriasis: short- and long-term outcomes
        The combination of clobetasol foam and calcipotriene ointment is significantly more effective than monotherapy for short-term treatment. Weekday calcipotriene plus weekend pulse clobetasol foam shows a consistent trend toward greater maintenance of remission.[Abstract]
      7. Lebwohl M, Yoles A, Lombardi K, Lou W. J Am Acad Dermatol. 1998 Sep;39(3):447-50. Calcipotriene ointment and halobetasol ointment in the long-term treatment of psoriasis: effects on the duration of improvement
        The addition of calcipotriene ointment applied on weekdays to a weekend pulse therapy regimen of superpotent corticosteroids can increase the duration of remission of psoriasis.[Abstract]
      8. White S, Vender R, Thaçi D, Haverkamp C, Naeyaert JM, Foster R, Martinez Escribano JA, Cambazard F, Bibby A. Am J Clin Dermatol. 2006;7(3):177-84. Use of calcipotriene cream (Dovonex cream) following acute treatment of psoriasis vulgaris with the calcipotriene/betamethasone dipropionate two-compound product (Taclonex): a randomized, parallel-group clinical trial
        Four weeks of treatment with the calcipotriene/betamethasone dipropionate two-compound product followed by 8 weeks of maintenance treatment with calcipotriene cream is effective and safe. As an alternative maintenance regimen, treatment with calcipotriene cream on weekdays and the two-compound product on weekends is also effective and safe.[Abstract]

      9. .[Abstract]

      10. .[Abstract]
      11. REVIEW
      12. Scott LJ, Dunn CJ, Goa KL. Am J Clin Dermatol. 2001;2(2):95-120. Calcipotriol ointment. A review of its use in the management of psoriasis
        Extensive clinical experience, along with several short and long term clinical trials, has shown calcipotriol ointment to be an effective and well tolerated topical agent in adult patients with psoriasis. In addition, calcipotriol ointment proved beneficial in combination with other topical, phototherapy or systemic antipsoriatic treatments, reducing the dosage and/or duration of some of these treatments and potentially improving their benefit/risk ratio. Calcipotriol ointment is valuable as a first- or second-line therapy option for the management of mild to moderate psoriasis and in combination with other antipsoriatic agents for more severe psoriasis.[Abstract]

      13. .[Abstract]

      xxxx


      1. .[Abstract]

      2. .[Abstract]

      3. .[Abstract]

      Yeast infection

      1. Zisova L, Valtchev V, Sotiriou E, Gospodinov D, Mateev G. Mycoses. 2012 Mar;55(2):143-7. doi: 10.1111/j.1439-0507.2011.02053.x Onychomycosis in patients with psoriasis–a multicentre study
        1-3% of human population is affected by psoriasis. Nail disorders are reported in 10-80% of patients with psoriasis. Nail deformations vary according to their degree of severity but are mainly represented by pitting, Beau’s lines, hyperkeratosis, onycholysis, leuconychia or oil drops. Onychomycosis is a fungal infection of the nails, caused by dermatophytes, yeast and moulds. In this study, 228 patients with psoriasis aged between 18 and 72 were examined (48 – from Plovdiv, Bulgaria; 145 – from Pleven, Bulgaria and 35 – from Thessaloniki, Greece); 145 of them were male and 83 of them were female. The examination of the nail material was performed via direct microscopy with 20% KOH and nail samples plated out on Sabouraud agar methodology. The severity of the nail disorders was determined according to the Nail Psoriasis Severity Index (NAPSI). Positive mycological cultures were obtained from 62% of the patients with psoriasis (52%- Plovdiv, Bulgaria; 70%- Pleven, Bulgaria and 43%- Thessaloniki, Greece). In 67% of the cases, the infection was caused by dermatophytes, in 24% by yeast, in 6% by moulds and in 3% by a combination of causes. All patients with psoriasis were identified with high levels of NAPSI, whereas the ones with isolated Candida had even higher levels. Seventeen percentage of the patients have been treated with methotrexate, 6% have been diagnosed with diabetes and 22% have been reported with onychomycosis and tinea pedis within the family. An increased prevalence of onychomycosis among the patients with psoriasis was found. Dystrophic nails in psoriasis patients are more predisposed to fungal infections. The mycological examination of all psoriasis patients with nail deformations is considered obligatory because of the great number of psoriasis patients diagnosed with onychomycosis.[Abstract]
      2. Natarajan V, Nath AK, Thappa DM, Singh R, Verma SK. Indian J Dermatol Venereol Leprol. 2010 Nov-Dec;76(6):723. Coexistence of onychomycosis in psoriatic nails: a descriptive study
        Out of 48 patients with psoriatic nail change, 23 (47.91%) had investigative evidence of onychomycosis. The fungal isolates on culture were non-dermatophytic molds in nine patients (18.75%) and yeast like fungi also in nine patients (18.75%).[Article]
      3. Waldman A, Gilhar A, Duek L, Berdicevsky I. Mycoses. 2001 May;44(3-4):77-81. Incidence of Candida in psoriasis–a study on the fungal flora of psoriatic patients
        Our results reinforce the hypothesis that C. albicans is one of the triggers to both exacerbation and persistence of psoriasis. We propose that in psoriatics with a significant quantity of Candida in faeces, an antifungal treatment should be considered as an adjuvant treatment of psoriasis.[Abstract]
      4. Rosenberg EW, Noah PW, Skinner RB Jr. J Natl Med Assoc. 1994 Apr;86(4):305-10. Microorganisms and psoriasis
        We recommend that a microbiologic investigation and a trial of antimicrobial treatment should precede any plan to treat psoriasis patients with anything more than the simplest topical agents.[Article]

      Leefstijl

        RCT
      1. Collier PM, Ursell A, Zaremba K, Payne CM, Staughton RC, Sanders T. Eur J Clin Nutr. 1993 Apr;47(4):251-4. Effect of regular consumption of oily fish compared with white fish on chronic plaque psoriasis
        It is concluded that dietary advice to increase the daily intake of oily fish is a useful adjunct in the treatment of psoriasis. The fish that should be recommended include mackerel, sardine, salmon, pilchard, kipper and herring.[Abstract]
      2. Wolters M. Hautarzt. 2006 Nov;57(11):999-1004. The significance of diet and associated factors in psoriasis
        Psoriasis is a T cell mediated inflammatory skin disease characterized by hyperproliferation and reduced differentiation of epidermal keratinocytes. In severe cases, the disease can result in an insufficient nutritional status which may even be promoted by nutrient-drug interactions. Both the general diet and single food components have been suggested to play a role in etiology and pathogenesis of psoriasis. Fasting periods, vegetarian diets, and diets rich in omega-3 polyunsaturated fatty acids from fish oil have all been associated with improvement in some studies. The most likely explanation is the reduced amounts of arachidonic acid and the increased eicosapentaenoic acid intake resulting in a modulated eicosanoid profile. However, only one of four controlled studies showed a benefit of omega-3 fatty acids compared to placebo. Some psoriasis patients are gluten-sensitive and may benefit from a gluten free diet. The active form of vitamin D exhibits anti-proliferative and immunoregulatory effects and has been shown to be useful in the treatment of psoriasis.[Abstract]
      3. Wolters M. Br J Dermatol. 2005 Oct;153(4):706-14. Diet and psoriasis: experimental data and clinical evidence
        Psoriasis is considered as a T-cell-mediated inflammatory skin disease which is characterized by hyperproliferation and poor differentiation of epidermal keratinocytes. While susceptibility to psoriasis is inherited, the disease is influenced by environmental factors such as infections and stress. Diet has been suggested to play a role in the aetiology and pathogenesis of psoriasis. Fasting periods, low-energy diets and vegetarian diets improved psoriasis symptoms in some studies, and diets rich in n-3 polyunsaturated fatty acids from fish oil also showed beneficial effects. All these diets modify the polyunsaturated fatty acid metabolism and influence the eicosanoid profile, so that inflammatory processes are suppressed. Some patients with psoriasis show an elevated sensitivity to gluten. In patients with IgA and/or IgG antigliadin antibodies the symptoms have been shown to improve on a gluten-free diet. The active form of vitamin D, 1,25-dihydroxyvitamin D(3), exhibits antiproliferative and immunoregulatory effects via the vitamin D receptor, and thus is successfully used in the topical treatment of psoriasis. In this review, dietary factors which play a role in psoriasis are assessed and their potential benefit is evaluated. Furthermore, the risk of drug-nutrient interactions in psoriasis therapy is discussed.[Abstract]
      4. Brockow T, Schiener R, Franke A, Resch KL, Peter RU. J Altern Complement Med. 2007 Sep;13(7):725-32. A pragmatic randomized controlled trial on the effectiveness of highly concentrated saline spa water baths followed by UVB compared to UVB only in moderate to severe psoriasis
        The study indicates that HC-SSW-UVB are superior to routine UVB at the end of a 6-week treatment course.[Abstract]
      5. Gaston L, Crombez JC, Lassonde M, Bernier-Buzzanga J, Hodgins S. Acta Derm Venereol Suppl (Stockh). 1991;156:37-43. Psychological stress and psoriasis: experimental and prospective correlational studies
        Stress reduction techniques can thus be regarded as part of the treatment offered to some patients suffering from psoriasis.[Abstract]

      6. .[Abstract]