A Case of Guttate Psoriasis after Treatment with IFN-alpha / 대한피부과학회지

Psoriasis is considered to be an autoimmune disease of abnormal keratinocyte proliferation induced by T lymphocytes. An association with several cytokines has been suggested. Interferon (IFN) is a cytokine secreted by virus-infected cells and has the ability to prevent further infection of cells that were exposed to it. It has therefore been used as a therapeutic agent for many chronic viral diseases such as chronic hepatitis C. Recently, however, IFN has also been considered to be a triggering factor in the development of psoriasis. We describe an 18-year-old woman presenting with guttate psoriasis, who suffered soft tissue sarcoma and underwent chemotherapy containing IFN-alpha. This is possibly the first case of guttate psoriasis associated with IFN-alpha in the Korean literature.

Comparison of the Expression Profile of JunB, c-Jun, and S100A8 (Calgranulin A) in Psoriasis Vulgaris and Guttate Psoriasis

BACKGROUND: Psoriasis is a chronic, inflammatory, immune- mediated skin disease. Recently, several psoriasis-linked genetic loci have been reported; PSORS4 contains S100A8 (calgranulin A), and PSOR6 (19p13) locus harbors JunB (19p13.2). S100A8 is considered to be a marker of inflammation in a variety of diseases. The expression of JunB and c-Jun have been reported to be reduced in psoriatic lesions. OBJECTIVE: We attempted to assess the role and correlation of S100A8, JunB, and c-Jun in the pathogenesis of guttate psoriasis and psoriasis vulgaris by studying whether any difference of immunohistochemical expression existed. METHODS: Skin biopsy specimens from patients with psoriasis vulgaris (n=37) and guttate psoriasis (n=17), and a normal skin controls (n=9) were utilized in the study. Formalin-fixed and paraffin-embedded tissue sections were prepared and JunB, c-Jun, and calgranulin A were immunohistochemically stained in order to compare the expression of those three proteins in each group. RESULTS: Reduced JunB expression was observed in patients with psoriasis vulgaris and guttate psoriasis, as compared to patients in the control group; however, c-Jun expression was reduced only in the psoriasis vulgaris group. The expression of S100A8 increased in the psoriasis groups as compared to the control group. In addition, the expression of S100A8 was different between the psoriasis vulgaris and guttate psoriasis groups; S100A8 was expressed more profoundly in the guttate psoriasis group (p<0.05). CONCLUSION: Our results indicate that S100A8 contributes to the pathogenesis of guttate psoriasis, and it may be a good target for therapy for guttate psoriasis provoked by microorganisms.

The efficacy of erythromycin stearate in guttate psoriasis: A randomized, double-blind, placebo-controlled trial

Erythromycin is known to have both antibiotic and anti-inflammatory activity. It has been used to treat guttate psoriasis. A double-blind, placebo controlled trial was performed using 34 patients with guttate psoriasis at the Out Patient Department of the Philippine General Hospital. Each patient received either placebo or erythromycin stearate 1g in divided doses for 14 days. The response was graded according to the percentage change in Psoriasis Activity and Severity Index (PASI) score after 2 weeks. The results reveal similar baseline demographic characteristics between two treatment groups. After 2 weeks, the average PASI score change improved in the placebo group (9.1 to 8.5) and worsened in the treatment group (9.1 to 11.3). Using the two sample t-tests, there was no significant difference between the to treatment groups in terms of PASI score after 2 weeks. Thus, at present we cannot recommend antibiotic monotherapy in patients with guttate psoriasis.

A Case of Guttate Psoriasis in the Recipients of Allogeneic Bone Marrow Transplantation / 대한피부과학회지

In many studies, it has been demonstrated that donor-derived cells would eventually replace the hematopoietic and immune system of the recipient after allogeneic bone marrow transplantation (BMT). And there are several case reports describing resolution or development of autoimmune diseases after BMT. Psoriasis is considered to be an autoimmune disease of abnormal keratinocyte proliferation induced by T lymphocytes. Herein we describe a 17-year-old woman presenting with guttate psoriasis, who suffered from acute lymphocytic leukemia and underwent allogeneic BMT 6 months ago. This is the first case of guttate psoriasis possibly associated with BMT in the Korean literature.