The Remarkable Beneficial Effect of Adding Oral Simvastatin to Topical Betamethasone for Treatment of Psoriasis: A Double-Blind; Randomized; Placebo-Controlled Study

Psoriasis is a common chronic inflammatory disease with unpredictable prognosis. Given the immunomodulatory effects of statins; the present study was conducted to determine whether the addition of orally administered simvastatin to the topical betamethasone; a standard antipsoriatic treatment; can produce a more powerful therapeutic response against this clinical conundrum. In a double-blind study; 30 patients with plaque type psoriasis were randomly divided into two equal treatment groups. Group 1 received oral simvastatin (40 mg/d) plus topical steroid (50betamethasone in petrolatum) for 8 weeks and group 2 received oral placebo plus the same topical steroid for the same time period. Psoriasis Area and Severity Index (PASI) score was checked before and at the end of the treatment period. PASI score decreased significantly in both groups; but the decline of PASI score was more significant in patients who received simvastatin (Mann-Whitney test; P-value=0.001). No side effect or any laboratory abnormality was detected in patients. Our work; which is the first doubleblind; randomized; placebo-controlled study on this subject; shows that oral simvastatin enhances the therapeutic effect of topical steroids against psoriasis. The increased risk of cardiovascular accidents in psoriatic patients and the protective effect of statins against cardiovascular disease further encourages their use in the treatment of this clinical conundrum

Psoriasis atypique revelateur de l'infection a VIH chez un jeune Togolais. [Lettre]

Les auteurs rapportent un cas tres atypique de psoriasis revelateur de l'infection par le VIH chez un jeune Togolais. Les lesions cutanees etaient keratosiques et crouteuses disseminees sur tout le corps. Leur association a une stomatite; avec isolement d'une souche de Candida albicans au niveau des lesions cutanees et de la bouche; et la seropositivite ont fait discuter un granulome moniliasique sur terrain immunodeprime. L'echec des traitements antimycosiques; l'amelioration sous l'Etrenitate; l'Onychogryphose et surtout l'histologie ont permis de poser le diagnostic de psoriasis. La redicive et l'aggravation des lesions ont coincide avec l'evolution du patient au stade du SIDA