- Email: [email protected]
Treatment of psoriasis at the Dead Sea Spa Medical Center in Jordan
Sl66
Free comnumicarion FC21. Psoriasis and related disorders
and to determine whether there is a relation between these vtiables and symptom severity. 50 psoriatic patients were examined dermatologically and psychiatrically and then they were given Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Scale (STAI I-II), Life Satisfaction Scale (LSS), Courtauld Emotional Control Scale (CECS). The psoriatic symptom severity was measured by Psoriasis Area Severity Index (PASI). 68% (n = 34) of patients declared that they had psychologically stressful event in the last 3 months prior to the beginning of the illness. The mean of PAS1 score was 1.75 f 1.65; BDI score was 13.58 f 6.11; STAI-I score was 39.54 f 9.18; STAI-II score was 46.58 f 8.05; LSS score was 9.18 f 4.39; CECS score was 51.64 f 9.75. We can conclude that these patients were slightly depressed, their state anxiety levels were low. but their trait anxiety levels were relatively high. They had average life satisfaction and low affective expression levels. The only variable reloted to the symptom severity was the low affective expression level (P 5 0.05). FC21-5
Vulvar psoriasis
H. Binet, J.C. No&l, D. Parent. Hipita Libre de Bruxelles, Belgique
Erasme, Universirt?
The prevalence of psoriasis is about 2% of the population. The genital area is rarely involved alone, however it is often associated to other forms of the disease. Psoriasis of the genitalia occurs in all age groups. We report eleven cases of vulvar psoriasis (aged from 28 to 70 years). On mons pubis and labia majora, the lesions have the common clinical aspect found in cutaneous areas: erythema and scaling (2 cases). Flexural (inverse) psoriasis is observed in inguinal creases and gluteal cleft which showed erythema and fissures associated with itching (5 cases). One patient has both vulgaris psoriasis and flexural psoriasis. Three patients, referred for vulvodynia, present an erythema of the mucosa which covers the labia minora and the vestibule. They complain of burning and dypareunia. Only two of these women present psoriatic lesions elsewhere on the body. Psoriasis is not evoked clinically in mucosal lesions but histology confirms the diagnosis in all cases. Topical corticosteroid (class IV) applications were the first-line treatment, except in case of viral vulvar disease (genital herpes, condyloma). This treatment is never prescribed longer than 4 to 6 weeks. When healing is not obtained or when the use of local corticosteroid is contra-indicated, topical calcipotriolO.O5% is applied once a day. This ointment is well tolerated even on the mucosa. In 3 cases, psoriasis of the vulvar mucosa, presenting as vulvodynia was confirmed by histologic examination.
FC21-6 Treatment of psoriasis at the Dead Sea Spa Medical Center in Jordan Zuhair Z. Bisharat. Dead Sea Spa Medical Center; Jordan The Dead Sea area, fourhundred meters below Sea level, the lowest point on earth, has unique natural healing properties, these special qualities are utilized to treat different diseases such as psoriasis, psoriasis arthritis, atopic dermatitis and joint disorders. 600 Patients were enrolled in this study at the Dead Sea Spa Medical Center in Jordan.
Thirtyone point eight percent of the patients had a complete clearance. fifty five point four percent of the patients had a significant and eleven point eight percent a moderate improvement, The follow up of twohundred twenty six patients showed that the majority maintained a clearance for longer time compared to other modalities of therapy. The treatment consists of gradually increasing sunlight exposure and bathing in the Dead Sea, oliveoil, oilbath, lubricants, keratolytic agents are used topically and tar ointments are applied if needed. Climatotherapy is a natural and safe therapy which leeds to significant improvment.
FC21-7 Has psoriasis its characteristic trichogram? A. Stanimirovic’, T. Stipic*, T. Beck3, A. Basta-Juzbasic4, D. Ivankovic5. ‘DMZ Klinik, Ein Bokek, Israel; ‘Medical Center Vukovar; ‘Dpt. of Dermatology, University of Zugreb; sSchool of Public Health, University of Zagreb, Croatia; ‘Private Practice, Dortmund, Germany The aim of this study was to determine if there were characteristic trichogram changes in scalp psoriasis in patients without clinically evident effluvium or alopecia. A total of 45 patients (17 men and 28 women, aged from 15 to 73 years) with clinically and histologically confirmed psoriasis vulgaris with scalp involvement were included. The control group consisted of 60 volunteers (23 males and 37 females aged from 15 to 74 years) with no scalp involvement. Our results in psoriatic group showed highly increased proportion of the dysplastic hair roots - median proportion was 50% with 95% confidence interval (CI) for median 30-60%, whereas telogen hair ratio was slightly increased - median proportion was 16% with 95% CI for median 15-20%. Within the psoriasis patients group no statistically significant correlations were found between the proportion of dysplastic hairs and the patients’ age, sex and the intensity and duration of disease. According to results of this study, the dysplastic hairs in scalp psoriasis are statistically significantly much more frequent comparing to the control group. Thus, the increased proportion of dysplastic hairs in scalp psoriasis without effluvium or alopecia might be its characteristic trichogram sign.
FC21-8 Dose finding studies of a novel vitamin D analogue 22.oxacalcitriol ointment on psoriasis vulgaris H. Nakagawa’, M. Ohkido*, S. Harada3, M. Kawashima4, A. Ohkawara’, K. Yoshikawa6, A. Ozawa*. ‘Jichi Med. School; 2Tokai Univ. School of Medicine: ‘Kant0 Teishin Hosp.; 4Tokyo Womens’ Med. School; 5Hokkaido Univ. School of Medicine; 60saka Univ. School of Medicine and OCT Clinical Study Group, Tokyo, Japan Recently, topical vitamin D analogues have attracted attention as therapeutic agents for psoriasis vulgaris. 22-oxacalcitriol (OCT), a novel vitamin D analogue, has an oxygen atom at position 22 of the side chains. OCT has more inhibitory effects on proliferation of normal human keratinocytes and psoriatic libroblasts than 1,25(OH)2D3 in vitro. OCT also showed less
Free comnumicarion FC21. Psoriasis and related disorders
and to determine whether there is a relation between these vtiables and symptom severity. 50 psoriatic patients were examined dermatologically and psychiatrically and then they were given Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Scale (STAI I-II), Life Satisfaction Scale (LSS), Courtauld Emotional Control Scale (CECS). The psoriatic symptom severity was measured by Psoriasis Area Severity Index (PASI). 68% (n = 34) of patients declared that they had psychologically stressful event in the last 3 months prior to the beginning of the illness. The mean of PAS1 score was 1.75 f 1.65; BDI score was 13.58 f 6.11; STAI-I score was 39.54 f 9.18; STAI-II score was 46.58 f 8.05; LSS score was 9.18 f 4.39; CECS score was 51.64 f 9.75. We can conclude that these patients were slightly depressed, their state anxiety levels were low. but their trait anxiety levels were relatively high. They had average life satisfaction and low affective expression levels. The only variable reloted to the symptom severity was the low affective expression level (P 5 0.05). FC21-5
Vulvar psoriasis
H. Binet, J.C. No&l, D. Parent. Hipita Libre de Bruxelles, Belgique
Erasme, Universirt?
The prevalence of psoriasis is about 2% of the population. The genital area is rarely involved alone, however it is often associated to other forms of the disease. Psoriasis of the genitalia occurs in all age groups. We report eleven cases of vulvar psoriasis (aged from 28 to 70 years). On mons pubis and labia majora, the lesions have the common clinical aspect found in cutaneous areas: erythema and scaling (2 cases). Flexural (inverse) psoriasis is observed in inguinal creases and gluteal cleft which showed erythema and fissures associated with itching (5 cases). One patient has both vulgaris psoriasis and flexural psoriasis. Three patients, referred for vulvodynia, present an erythema of the mucosa which covers the labia minora and the vestibule. They complain of burning and dypareunia. Only two of these women present psoriatic lesions elsewhere on the body. Psoriasis is not evoked clinically in mucosal lesions but histology confirms the diagnosis in all cases. Topical corticosteroid (class IV) applications were the first-line treatment, except in case of viral vulvar disease (genital herpes, condyloma). This treatment is never prescribed longer than 4 to 6 weeks. When healing is not obtained or when the use of local corticosteroid is contra-indicated, topical calcipotriolO.O5% is applied once a day. This ointment is well tolerated even on the mucosa. In 3 cases, psoriasis of the vulvar mucosa, presenting as vulvodynia was confirmed by histologic examination.
FC21-6 Treatment of psoriasis at the Dead Sea Spa Medical Center in Jordan Zuhair Z. Bisharat. Dead Sea Spa Medical Center; Jordan The Dead Sea area, fourhundred meters below Sea level, the lowest point on earth, has unique natural healing properties, these special qualities are utilized to treat different diseases such as psoriasis, psoriasis arthritis, atopic dermatitis and joint disorders. 600 Patients were enrolled in this study at the Dead Sea Spa Medical Center in Jordan.
Thirtyone point eight percent of the patients had a complete clearance. fifty five point four percent of the patients had a significant and eleven point eight percent a moderate improvement, The follow up of twohundred twenty six patients showed that the majority maintained a clearance for longer time compared to other modalities of therapy. The treatment consists of gradually increasing sunlight exposure and bathing in the Dead Sea, oliveoil, oilbath, lubricants, keratolytic agents are used topically and tar ointments are applied if needed. Climatotherapy is a natural and safe therapy which leeds to significant improvment.
FC21-7 Has psoriasis its characteristic trichogram? A. Stanimirovic’, T. Stipic*, T. Beck3, A. Basta-Juzbasic4, D. Ivankovic5. ‘DMZ Klinik, Ein Bokek, Israel; ‘Medical Center Vukovar; ‘Dpt. of Dermatology, University of Zugreb; sSchool of Public Health, University of Zagreb, Croatia; ‘Private Practice, Dortmund, Germany The aim of this study was to determine if there were characteristic trichogram changes in scalp psoriasis in patients without clinically evident effluvium or alopecia. A total of 45 patients (17 men and 28 women, aged from 15 to 73 years) with clinically and histologically confirmed psoriasis vulgaris with scalp involvement were included. The control group consisted of 60 volunteers (23 males and 37 females aged from 15 to 74 years) with no scalp involvement. Our results in psoriatic group showed highly increased proportion of the dysplastic hair roots - median proportion was 50% with 95% confidence interval (CI) for median 30-60%, whereas telogen hair ratio was slightly increased - median proportion was 16% with 95% CI for median 15-20%. Within the psoriasis patients group no statistically significant correlations were found between the proportion of dysplastic hairs and the patients’ age, sex and the intensity and duration of disease. According to results of this study, the dysplastic hairs in scalp psoriasis are statistically significantly much more frequent comparing to the control group. Thus, the increased proportion of dysplastic hairs in scalp psoriasis without effluvium or alopecia might be its characteristic trichogram sign.
FC21-8 Dose finding studies of a novel vitamin D analogue 22.oxacalcitriol ointment on psoriasis vulgaris H. Nakagawa’, M. Ohkido*, S. Harada3, M. Kawashima4, A. Ohkawara’, K. Yoshikawa6, A. Ozawa*. ‘Jichi Med. School; 2Tokai Univ. School of Medicine: ‘Kant0 Teishin Hosp.; 4Tokyo Womens’ Med. School; 5Hokkaido Univ. School of Medicine; 60saka Univ. School of Medicine and OCT Clinical Study Group, Tokyo, Japan Recently, topical vitamin D analogues have attracted attention as therapeutic agents for psoriasis vulgaris. 22-oxacalcitriol (OCT), a novel vitamin D analogue, has an oxygen atom at position 22 of the side chains. OCT has more inhibitory effects on proliferation of normal human keratinocytes and psoriatic libroblasts than 1,25(OH)2D3 in vitro. OCT also showed less