Efficacy of 5-fluorouracil plus epinephrine, pulsed dye laser and betamethasone on the improvement of psoriatic plaques [a comparative study]

Many efforts are made to find new and more effective treatments for psoriasis. Intralesional 5-Fluorouracil [5-FU] +epinephrine is a cheap option which can be administered with long intervals. The effectiveness of Pulse Dye Laser [PDL] on psoriasis has been already assessed. We decided to evaluate the effectiveness of 5-FU+epinephrine and compare it to betamethasone and PDL. A group of 22 patients with chronic stable plaque psoriasis were included. Three plaques on each patient were treated with 5- FU + epinephrine, PDL and betamethasone, respectively. Psoriasis Severity Index [PSI] scoring was applied to assess each plaque before treatment and in weeks 2, 4, 6, 12, and 24. Photos of each plaque were taken before treatment and at each treatment and follow-up session. They were finally compared and scored by a dermatologist. Decline in mean Psoriasis Severity Index [PSI] in week 6 [2 weeks after treatment] and in week 24 [the last follow-up session] was statistically significant as compared to baseline in all groups. [P<0.001] The highest decline in mean PSI score was in the 5-FU + epinephrine group while the lowest belonged to the PDL group [80% vs. 27%].The mean period of remission in the 5-FU+epinephrine group was significantly longer in comparison to the two other groups. [P<0.001] In photographic evaluation, the best response was observed in the 5- FU + epinephrine group. 5-FU + epinephrine is a cheap option which can provide a rapid response and long remission .With respect to limited effectiveness, short remission and high cost; PDL dose not seem to be a preferred choice in the treatment of psoriasis

[P53 antigen expression in cutaneous Melanoma and its relation to tumor thickness]

P53 tumor suppressor gene mutation is one of the most common genetic alterations in human malignancies. The mutated from of the gene is stable and can be detected with immunohistochemistry methods. There is much controversy about the expression rate of this gene in malignant melanoma. To determine the frequency of the P53 antigen expression by sex, age, type and thickness of melanoma, and site of the antigen expression. Paraffin embedded blocks of 50 patients [45 primary and 5 metastatic] with documented diagnosis of melanoma were deparaffinized and immunostained with D0-7 monoclonal antibody. The lesions were divided depending on the degree of the staining as follows: 1][No staining], 2] Mild [Less than 10%], 3] Moderate [10%-50%], 4] Severe [More than 50%]. Of 50 cases, 27 [54%] evaluated skin biopsy specimens belonged to female patients and 23 [46%] skin biopsies were related to male patients. 40% of lesions were graded as no staining. 36% of lesions showed mild staining, 14% moderate and 10% severe staining. Site of expression was exclusively in the cytoplasm. There was no meaningful statistical relationship between severity of staining and the age group, and sex of the patients, type and thickness of melanoma [P > 0.05]. Mutation in P53 tumor suppressor gene probably occurs in the early stages of melanoma