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The results of patch testing with a series containing components of cigarettes and matches were reviewed. 2 years were reviewed, 1987 and 1997. 314 patients were patch tested to this series, 203 in 1987 and 111 in 1997. 31 patients had clinically relevant positive reactions to the series, 25 in 1987 and 6 in 1997. 26 patients had relevant positive tests to cigarette components in the series. There were 14 relevant positive reactions to phosphorus sesquisulfide in 1987 and one in 1997. All patients with relevant positive reactions to red match tips also had reactions to phosphorus sesquisulfide. There was a significant association between cigarette and fragrance hypersensitivity. The eczema in 3 of 4 patients who stopped smoking improved. A series containing match heads, smoked cigarette filters and remnants of tobacco from smoked cigarettes may be useful in smokers with eczema of the lace, neck or hands. [ABSTRACT FROM AUTHOR]

It has been suggested that allergic contact dermatitis (ACD) is uncommon in psoriasis, but associated with flexural and palmoplantar involvement. Previous studies have suggested an association between site and morphology of psoriasis and allergic contact sensitivity but it was found that a similar proportion of patients with and without positive patch test reactions had flexural, palmoplantar and chronic plaque psoriasis. Contact allergy to medicaments including dithranol has been recorded in psoriatics.

Background Psychocutaneous medicine concerns the recognition and treatment of psychological distress and psychiatric morbidity associated with dermatological diseases. A study in 2004 examining resources in the UK highlighted a number of deficiencies, and recommended that psychodermatology services be available, at least regionally, in the UK. Although there is now increased recognition of psychodermatology, this study of the availability of these services shows that provision has deteriorated since 2004. Aim To study the service provision of psychocutaneous medicine in the UK. Methods Consultants in dermatology units across the UK were asked to take part in an online survey, accessible via an emailed link. This consisted of 10 questions concerning availability of psychodermatology services and psychological support for patients within their local trusts, both in adult and in child and adolescent medicine. Basic percentages were used to analyse quantitative data and content analysis for qualitative data. Results From 154 surveys, 127 responses were returned. The data indicated that despite frequently encountering patients who required psychological and psychiatric input, a large majority of UK dermatologists have inadequate access to appropriate support in their department. Importantly, this included the child and adolescent medicine and skin cancer departments, despite there being clear objectives for these services to be routinely available. Conclusions A lack of resources in psychocutaneous medicine was highlighted in 2004, and the situation has not improved, or is, if anything, worse. Essential access to psychiatric and psychological support for patients is not currently available in most dermatology departments across the country. [ABSTRACT FROM AUTHOR]

It is well documented that patients with human leucocyte antigen ( HLA)-Cw6+ (type 1) psoriasis have increased severity and reduced age of onset of psoriasis. However, not much is known about any differential response of this genetic subgroup to various treatments. We set out to determine if there was any genetic association of the HLA-Cw6 allele with the first-line systemic treatment commonly used in psoriasis, methotrexate. A cohort of patients from Tayside in Scotland was recruited through a novel generic consenting process (GoShare); they were extensively phenotyped and analysed for an association of their HLA-Cw6 genotype status with treatment outcomes. HLA-Cw6+ patients showed notably improved response to methotrexate ( P = 0.05), and further analysis demonstrated an even greater response in a subcohort of the HLA-Cw6+ patients, who did not have concomitant psoriatic arthritis ( P = 0.01). HLA-Cw6+ patients also exhibited fewer treatment-limiting adverse events. In addition to these findings, the methodology and primary clinical outcome phenotype, which we validate here, will greatly facilitate replication of the present results in independent cohorts. [ABSTRACT FROM AUTHOR]

The article discusses several aspects related to role of methotrexate for treatment of psoriasis including tolerability and long-term efficiency. Topics discussed include documentation on requirements of patients surviving skin disease psoriasis, evaluations made by National Health Service, and observations based on intensity of skin disease.

.ASA-A two-compound ointment containing calcipotriol 50 µg g−1 and betamethasone dipropionate 0·5 mg g−1 has recently been shown to be an effective treatment for psoriasis. This study was designed to investigate efficacy and safety of different treatment regimens with the two-compound product (Daivobet®/Dovobet®; LEO Pharma, Ballerup, Denmark) and calcipotriol 50 µg g−1 ointment (Daivonex®/Dovonex®; LEO Pharma). In total, 972 patients with psoriasis vulgaris were randomized to one of three treatment regimens: group 1, the two-compound product once daily for 8 weeks followed by calcipotriol ointment once daily for 4 weeks; group 2, the two-compound product once daily for 4 weeks followed by 8 weeks of treatment with calcipotriol ointment once daily on weekdays and the two-compound product once daily at weekends; and group 3, calcipotriol ointment twice daily for 12 weeks. The efficacy was evaluated by Psoriasis Area and Severity Index (PASI) and investigators' global assessments of disease severity. The primary response criteria were percentage reduction in PASI and proportion of patients with absent/very mild disease according to the investigators' global assessments after 8 weeks of treatment. The mean reduction in PASI from baseline to the end of 8 weeks of treatment was 73·3% for group 1, 68·2% for group 2 and 64·1% for group 3. The proportion of patients with absent/very mild disease at the end of 8 weeks of treatment was 55·3% for group 1, 47·7% for group 2 and 40·7% for group 3. For both primary response criteria, group 1 was statistically superior to group 3 ( P < 0·001), whereas group 2 did not differ significantly from group 3. The difference between group 1 and group 2 was statistically significant with regard to PASI but not regarding the proportion of patients with absent/very mild disease. Patients receiving initial therapy with the two-compound product achieved the fastest treatment response, and the maximum treatment effect for these patients was seen after 5 weeks. This effect was maintained with continued treatment with the two-compound product for up to 8 weeks. After 12 weeks of treatment, no significant differences were seen between the three groups with regard to reduction in PASI, whereas the proportion of patients with absent/very mild disease in group 2 was superior to that in group 3. Patients receiving therapy with the two-compound product experienced fewer lesional/perilesional adverse drug reactions than the calcipotriol-treated patients ( P < 0·001): 10·9% in group 1, 11·5% in group 2 and 22·3% in group 3. Two different short-term treatment regimens employing a recently developed two-compound product (calcipotriol/betamethasone dipropionate) provided rapid and marked clinical efficacy and were shown to be safe therapies for psoriasis vulgaris. [ABSTRACT FROM AUTHOR]