Aparecimento de psoríase durante o tratamento das doenças inflamatórias intestinais com infliximabe: A terapia biológica deve ser suspensa?

Context - Several paradoxical cases of infliximab-induced or-exacerbated psoriatic lesions have been described in the recent years. There is disagreement regarding the need to discontinue infliximab in order to achieve the resolution of these adverse cutaneous reactions specifically in inflammatory bowel disease (IBD) patients. Objective - To systematically review the literature to collect information on IBD patients that showed this adverse cutaneous reaction, focusing mainly on the therapeutic approach. Methods - A systematic literature review was performed utilizing Medline, Embase, SciELO and Lilacs databases. Published studies were identified, reviewed and the data were extracted. Results - Thirty-four studies (69 IBD patients) met inclusion criteria for review. There was inconsistency in reporting of some clinical and therapeutic aspects. Most patients included had Crohn's disease (89.86%), was female (47.83%), had an average age of 27.11 years, and no reported history of psoriasis (84.05%). The patients developed primarily plaque-type psoriasis (40.58%). There was complete remission of psoriatic lesions in 86.96% of IBD patients, existing differences in the therapeutic approaches; cessation of infliximab therapy led to resolution in 47.83% of cases and 43.48% of patients were able to continue infliximab therapy. Conclusion - As increasing numbers of IBD patients with psoriasis induced or exacerbated by infliximab, physicians should be aware of its clinical manifestations so that appropriate diagnosis and treatment are properly established. The decision whether to continue or discontinue infliximab should be individualized.

Keratinase production by new strain of Bacillus Amyloliquefaciens: Application of statistical experimental design for optimization of keratinase production

Feathers are rich in amino acids and can be employed as a dietary protein supplement for animal feed. Microbial degradation is an alternative technology for improving the nutritional value of feathers. Other potential applications of keratinase include use in the leather industry, detergents and medicine as well as the pharmaceutical for the treatment of acne, psoriasis and calluses. A new keratinolytic enzyme production bacterium was isolated from a poultry processing plant. To improve keratinase yield, statistically based experimental designs were applied to optimize three significant variables: temperature, substrate concentration (feathers) and agitation speed. Response surface methodology demonstrated an increase in keratinolytic activity at temperature, agitation speed and substrate concentration of 26.6°C, 150 rpm and 2%, respectively. Liquid chromatography revealed the release of amino acids in the Bacillus amyloliquefaciens culture broth, thereby demonstrating the potential of feather meal in the animal feed industry. © Global Science Publications.

Induction or exacerbation of psoriatic lesions during anti-TNF-α therapy for inflammatory bowel disease: A systematic literature review based on 222 cases

Background: Paradoxical cases of psoriatic lesions induced or exacerbated by anti-tumor necrosis factor (TNF)-α therapy have been reported more frequently in recent years, but data related to inflammatory bowel disease (IBD) are rare. A systematic literature review was performed to provide information about this adverse effect in patients with IBD who receive anti-TNF therapy. Methods: Published studies were identified by a search of Medline, Embase, Cochrane, SciELO, and LILACS databases. Results: A total of 47 studies (222 patients) fulfilled the inclusion criteria and were selected for analysis. Clinical and therapeutic aspects varied considerably among these reports. Of the 222 patients, 78.38% were diagnosed with Crohn's disease, and 48.20% were female. The mean patient age was 26.50. years, and 70.72% of patients had no history of psoriasis. Patients developed psoriasiform lesions (55.86%) more often than other types of psoriatic lesions, and infliximab was the anti-TNF-α therapy that caused the cutaneous reaction in most patients (69.37%). Complete remission of cutaneous lesions was observed in 63.96% of the cases. Conclusions: We found that psoriatic lesions occurred predominantly in adult patients with Crohn's disease who received infliximab and had no previous history of psoriasis. Most patients can be managed conservatively without discontinuing anti-TNF-α therapy. © 2012 European Crohn's and Colitis Organisation.

Nanotechnology-based drug delivery systems for treatment of hyperproliferative skin diseases - a review

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A criança com psoríase e as relações vinculares com a mãe e a família

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Correlação entre parâmetros de gravidade clínica e histopatológica em pacientes com psoríase em placas antes e após tratamento sitêmico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos do curcumin na modulação da inflamação e reabsorção óssea em dois modelos de doença periodontal em roedor

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Desenvolvimento e caracterização de sistemas líquido-cristalinos para aplicação tópica de metotrexato: estudos de liberação, retenção e permeação in vitro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Mycetoma caused by Nocardia brasiliensis in an immunocompetent patient

Dendritic cells play a central role in the regulation of immunological reactivity. The existence of functionally specialized populations of dendritic cells in the skin is a consequence of qualitatively different attacks on our organism. slanDCs are human inflammatory dendritic cells that are characterized by the specific expression of the carbohydrate 6-sulfo LacNAc (slan). After phenotypic maturation, slanDCs are capable of producing very high amounts of proinflammatory mediators such as IL-12, TNF-, IL-1 and IL-23. Recent data describe a potential role of slanDCs in a number of different diseases like psoriasis, lupus erythematosus, and tumors, thus opening up new areas of research on their respective pathogenesis. Furthermore, a slanDC-specific targeting system has been developed as a basis for direct therapeutic manipulation. Future challenges of slanDC research include deepening our understanding of the significance of slanDCs in the regulation of adaptive and innate immune responses, as well as translating this knowledge into therapeutic options.

Avaliação do potencial de sistemas nanoestruturados estabilizados com poliéter funcional siloxano para administração tópica de metotrexato

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Serum levels of 25-hydroxy vitamin D in psoriatic patients

Studies have shown a relationship between vitamin D and psoriasis. We compared serum levels of vitamin D of 20 psoriasis patients and 20 controls. The median vitamin D level was 22.80 +/- 4.60 ng/ml; the median in the cases was 23.55 +/- 7.6 ng/ml, and in controls 22.35 +/- 3.10 ng/ml (p = 0.73). Only 2 cases and 4 controls had sufficient levels of vitamin D, although without statistical significance between the groups (p = 0.608). Levels were lower in women with psoriasis compared with those in male patients (20.85 +/- 6.70 x 25.35 +/- 2.90 ng/ml, p = 0.03), a finding that was not observed among controls.

Positividade do imunomarcador FOXP3 em células T reguladoras em lesões de micose fungoide em fases clínicas iniciais e em dermatoses inflamatórias como fator auxiliar para o diagnóstico diferencial

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)