P083 Combination therapy with cyclosporin and methotrexate in severe psoriasis

Posters - General Dermatology to x3 the predetermined minimal erythema dose of solar simulated radiation and biopsies were taken 0.5, 1, 2, 4 and 24 hours after irradiation as well as control unirradiated skin from the opposite buttock. A similar staining pattern was observed in each of the three volunteers. ~53 protein was detectable in all skin samples examined. p21WafnCir protein was visible in the nuclei of cells at 4 hours and staining intensity increased at 24 hours. MDM2 protein expression was noted in isolated nuclei in the epidermis at 24 hours. Bax cytoplasmic staining was evident in the basal layer of the epidermis of all samples and this staining appeared to increase in intensity in the 4 and 24 hour specimens. There was no Bcl-2 immunohistochemical staining in any sample. These results suggest that ~53 and p53 functionally related proteins are altered or activated in normal human skin in response to solar simulated radiation. Work supported by the EU (Environment Programme), Grant number EVSV-CT94-0564.

General Dermatology

IPO83

Combination therapy with cyclosporin and methotrexate in severe psoriasis

D.K.B. Armstrong, J.C. McMillan. Department of Dermatology, Belfast City Hospital, Lisburn Road, Belfast, N Ireland Psoriasis may be a severe and disabling dermatosis or rarely a life-threatening condition. In such cases systemic treatment with agents with potentially serious side-effects is often indicated. The traditional approach to drug treatment is a stepwise use of one medication at a time. Combination regimes offer the potential for improved efficacy but at the risk of increased toxicity. We present five cases of severe psoriasis treated with a combination of cyclosporin and methotrexate. Indications for combination therapy included lack of efficacy of monotherapy, unacceptable toxicity of monotherapy at a dose necessary to control the psoriasis and severe associated arthropathy. Although follow-up to date is limited, combination therapy has been well tolerated. We propose that combination treatment with cyclosporin and methotrexate is a therapeutic option in these difficult cases.

IPO84

The use of Daivonexscalp solution in the treatment of patient with scalp psoriasis

I. Hartmane. Clinic of Dermatovenerology

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after the treatment, including serum calcium. After the treatment significant improvement has been stated in 28 patients. Eighteen of 30 patients noted a quick response within two weeks or less, in two patients of 30 patients - without clinical effect. There was a statistically significant reduction in the mean of score from 5.3 at baseline to 2.3 at the end of treatment (p < 0.01). No serious adverse effects and no clinically significant consistent changes in laboratory parameters have been reported. In conclusion, Duivonex scalp solution is well tolerated and effective treatment for scalp psoriasis. ElPO85 A case of extremely widespread and severe

bullous mastocytosis

N. Martinovic ’ , S. Vesif ’ , K. Martinovic 2. ‘Institute for skin and veneral diseases, School ofMedicine, University of Belgrade: 2Clinic for dermatology, University of Priftina, Yugoslavia A case of extremely widespread bullous mastocytosis in a one month old girl is presented. A papular urticarial and bullous eruption was associated with rhinorrhoea, vomiting, diarrhoea and hypovolemic crises. Histopathological findings revealed massive mastocytic infiltration of dermis, with 95% of the cells showing metachromatic change. I PO86 Can helicobacter pylori be a factor in

rosacea etiopathogenesis?

B. Ciesla, B. Raszeja-Kotelba. Department of Dermatology Karol Marcinkowski University of Radical Sciences, Poznari, Polund Rosacea is considered as polietiologic dermatosis. Helicobacter pylori (H.p.) infection seems to be one of the etiopathogenetic factors due to dyspeptic complaints and digestive tract disorders in rosacea patients. Fifty eight patients with rosacea (41 women, 17 men) mean aged 44, 21 with dyspeptic complains and 37 without dyspeptic complains were examinated. The control group consisted of 11 healthly volunteers. All patients underwent gastroscopy with biopsy. H.p. was detected by positive urease test and positive microbiologic or histopathologic examination. Anti-H.p. antibodies were tested in patients sera. H.p. infection in rosacea patients occurred more frequently (76%) compared to control group (27%). Tetracycline and metronidazol have been used for years in rosacea therapy with good results. H.p. is eradicated from digestive tract by those drugs which confirms the role of H.p. in rosacea pathogenesis.

in Riga, Latvia

The aim of study was to examine effectiveness and side-effects of the vitamin D analogue calcipotriol scalp solution applied locally to psoriatic lesions on the scalp localizations. 30 patients (age 18-16, duration of illness 3-12 years) with psoriasis vulgaris which presented with psoriatic lesions in the scalp were observed and treated with Daivonex scalp solution, which contain 50 mcg/ml calcipotriol twice daily for four weeks. The extent and severity of psoriatic lesions of scalp was evaluated and expressed with a grading system like as PAS1 score (sum of redness, thickness and scaliness) in the course of treatment. Laboratory examinations were performed before and

ElPO87 Clobetasol propionate in psoriasis -

Monotherapy and in combinations

B.T. Gjertsen ’ , J. Korsvold2. ‘Dept. of Dermatology, Sentral Hospital in Sogn; 2Fjordane, nor@, Glaxo Wellcome AS, Bergen, Norway Background: Rapid healing and shorter treatment periods are significant considerations for successful management strategies for patients with psoriasis. Clobetasol propionate (CP) offer effective and rapid healing of psoriatic lesions, but has limited usefulness as monotherapy in long-term, daily treatment, due