ABSTRACT
BACKGROUND: Psoriasis is a chronic inflammatory skin disorder affecting approximately 1~3% of the general population. Ustekinumab is a recently developed human monoclonal antibody for psoriasis that binds to the p40 subunit shared by the interleukins IL-12 and IL-23. OBJECTIVE: The purpose of this study was to evaluate the effect of combination treatment with ustekinumab and topical agents in 30 Korean patients with psoriasis regarding different clinical parameters. METHODS: We retrospectively searched to identify patients with moderate-to-severe plaque-type psoriasis who had initiated treatment with ustekinumab between January 2012 and January 2016. Among them, our study was conducted in 30 patients with psoriasis who were treated with ustekinumab and topical agents for at least 16 weeks by analyzing their clinical charts and photographs. RESULTS: Overall, 16.7%, 93.3%, and 96.2% patients achieved PASI 75 response rates at weeks 4, 16, and 40, respectively. Furthermore, fifteen patients achieved 90% improvement in their PASI score at 100 weeks and five patients maintained their PASI score at 160 weeks. The efficacy of treatment with ustekinumab was different in sub-group analysis. Non-smokers enjoyed a higher therapeutic effect than did smokers. In addition, the therapeutic effect of ustekinumab was lower in the groups with psoriatic arthritis and nail psoriasis. However, it was not statistically significant. None of the patients experienced serious adverse events requiring the interruption of treatment. CONCLUSION: Combination treatment with ustekinumab and topical agents provides effective treatment results for Korean patients with psoriasis.
Subject(s)
Humans , Arthritis, Psoriatic , Follow-Up Studies , Interleukin-12 , Interleukin-23 , Interleukins , Psoriasis , Retrospective Studies , Skin , UstekinumabABSTRACT
Topical agents are widely used in the care of burn patients; however the efficacy to prevent local infections and/or sepsis has not been clearly established in studies with a high level of evidence. This systematic review was conducted to assess the comparative efficacy among different topical agents. Material and Methods. The literature search was performed using the Medline database. Key MESH terms were: (burn* or scald*) AND (antibacterial or antibiotic*) AND (topic*) AND (therap* or prophylax*). Only randomized or quasi-randomized clinical trials, with a primary endpoint of local infection and/or sepsis were included. Studies were scored and classified regarding methodological key issues according to their level of evidence. Results. The initial search identified 457 studies of which 14 were eligible for final evaluation, and full text was available for 11 of them. Conclusions. The evidence found in our review does not support differences in efficacy of topical agents to reduce sepsis and/or local infections in burn patients.
Los agentes tópicos son ampliamente utilizados en el cuidado de los pacientes quemados. Con el objetivo de evaluar la eficacia comparativa entre diferentes agentes tópicos habitualmente utilizados para la prevención de infecciones, llevamos a cabo una revisión sistemática. Material y métodos. La búsqueda bibliográfica se realizó en la base Medline. Las palabras clave utilizadas, fueron: burn* or scald* AND antibacterial or antibiotic* AND topic* AND therap* or prophylax*. Solamente se incluyeron estudios con asignación aleatorizada o cuasi-aleatorizada de las intervenciones y cuya variable principal fuera la presencia de infección local y/o sepsis. Resultados. La búsqueda inicial detectó 457 artículos, de los cuales se seleccionaron 14 para su evaluación final, disponiendo del texto de 11 de ellos. Conclusiones. Las evidencias halladas sobre el tema fueron de calidad científica moderada. No se identificaron evidencias que demostraran la superioridad de alguno de los agentes tópicos sobre otros para reducir la infección o la sepsis en el paciente quemado.
Subject(s)
Humans , Anti-Bacterial Agents/administration & dosage , Burns/complications , Skin Diseases, Bacterial/prevention & control , Administration, Topical , Silver Compounds/administration & dosageABSTRACT
Lamellar ichthyosis is an inherited autosomal recessive disorder characterized by non-bullous erythroderma and scaling at birth. We report a patient born encased in a collodion membrane, who later developed generalized, brownish, plate-like scales, anhidrotic skin, scarring alopecia, bilateral ectropion, with a family history of similar-looking skin condition. Skin biopsy demonstrated marked lamellated orthohyperkeratosis and areas of hypergranulosis. Therapeutic trial of four topical agents (extravirgin coconut oil, urea lotion, mineral oil and petroleum jelly) was done which gave minimal improvement of scaling and dryness. Oral retinoids (Acitretin) was then initiated and yielded better results.