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Psoriasis is a complex immune-mediated inflammatory disorder that generates enormous interest within the scientific communities worldwide, with new therapeutic targets being constantly identified and tested. Despite the numerous topical and systemic medications available for the treatment of psoriasis, alternative therapies are still needed for the optimal management of some patients who present with localized, resistant lesions. Novel insights into the contribution of cutaneous neurogenic inflammation in the pathogenesis of psoriasis have yielded exciting new potential roles of nerve-targeting treatments, namely botulinum toxin type A (BoNT-A), for the management of this disease. This paper aims to review the existing literature on knowledge regarding the potential role of BoNT-A in psoriasis treatment, with a focus on its ability to interfere with the immunopathogenetic aspects of psoriatic disease. Furthermore, in our paper, we are also including the first report of psoriatic lesions remission following local BoNT-A injections that were administered for treating upper limb spasticity, in a patient that concomitantly suffered from psoriasis and post-stroke spasticity.

Background. Stroke is a leading cause of long-term disability. Gait impairment post-stroke has a major implication for health and it is an essential predictor for functional independence. A common gait impairment is the presence of genu recurvatum in post-stroke patients, whether spastic or non-spastic. Aims. To evaluate the efficacy of the rehabilitation program and botulinum toxin upon gait spatial and temporal parameters, muscle spasticity, functionality of lower limb and risk of fall in post-stroke patients with spastic and non-spastic genu recurvatum. Methods. We conducted a two-year prospective study (April 2018 - April 2020) of forty hemiparetic patients with spastic (20) and non-spastic (20) genu recurvatum who underwent a rehabilitation program for three weeks and ultrasound guided botulinum toxin injection for the spastic group. Results. In the non-spastic group, statistically significant differences were observed post-treatment (after 3 weeks) in the case of gait speed from 0.457 meters/sec (T0) to 0.6265 m/sec (T1), TUG from 16.3 (T0) to 14.15 (T1) and LEFS from 32.45 (T0) to 34.7 (T1). In the spastic group, gait speed also had significant differences, from 0.467 (T0) to 0.7145 (T1). LEFS had an increase from 32.45 (T1) to 34.75 (T2). MAS had a decrease from 2.65 (T0) to 1.55 at (T1). Conclusions. Following a 3-week rehabilitation program and using ultrasound guided botulinum toxin injections, in the case of spasticity, improves gait spatiotemporal asymmetry and ameliorates functionality, lowering the risk of fall in hemiparetic patients with post-stroke genu recurvatum whether spastic or non-spastic. [ABSTRACT FROM AUTHOR]

Background. The definition of genu recurvatum is the presence of more than 5° hyperextension of the knee. Biomechanically, genu recurvatum appears during the stance phase, with the ground reaction force line passing anterior to the knee. From a practical point of view, retraining the gait in patients with genu recurvatum is relatively complex because of diverse etiologies. Aims. To present multiple approaches of rehabilitation strategies and their outcomes for treating patients with genu recurvatum. Methods. We performed a systematic literature review in different databases, PubMed, Science Direct, using the following key words: "genu recurvatum", "knee hyperextension", "rehabilitation". Results. Ten articles met our selection criteria. Three assessed retraining methods (functional electric stimulation or electrogoniometric feedback), five articles focused on orthoses and two articles on botulinum toxin. Conclusions. Genu recurvatum has a multifactorial etiology mechanism such as spasticity, muscle weakness and many others, and among post-stroke patients almost half of them develop genu recurvatum. Genu recurvatum is a disability factor, affecting gait, the quality of life of patients, generating pain and increasing the risk of fall-related injuries. [ABSTRACT FROM AUTHOR]