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Psoriasis is a chronic debilitating disease that impairs patients' physical and social functioning. The assessment of health-related quality of life (HRQoL) provides a comprehensive insight into the actual disease burden that are not captured by the traditional clinical parameters. The objective of this study is to identify factors that may impact patients' HRQoL. We conducted a cross-sectional study, recruiting a total of 414 psoriasis vulgaris patients between January 2008 and December 2011. Our study found no significant correlation between disease severity or duration of psoriasis with HRQoL. Female patients have poorer HRQoL. Psoriatic arthritis, nail involvement, burning and itching sensation have a detrimental effect on HRQoL. This study highlighted that specific disease-associated symptoms such as itching and burning sensation, nail involvement and/or concomitant arthritis were important factors that may impact patients' HRQoL devoid of clinical severity. Physicians should carefully consider these factors when treating psoriasis patients., (© 2015 Japanese Dermatological Association.)

Background Effective management of psoriasis is a cause for much concern. In Taiwan, there is a lack of consensus on management strategies for psoriasis, especially the principles of drug prescribing in psoriatic patients. Objectives The Taiwanese Dermatological Association convened Expert Panel meetings three times between 2012 and 2015 to discuss the management strategies for treatment of psoriasis in order to fill the knowledge gap and provide a reference tool for Taiwanese dermatologists. Results This paper reports the final output from the three meetings, with the aim of aiding clinical decision making in terms of principles of prescribing, including dosing strategies, efficacy profiles, and safety concerns in connection with eight categories of antipsoriatic treatment: topical agents, phototherapy, nonbiologic conventional systemic agents, licensed biologic systemic agents, newly emerging therapies, combination therapy, transitional therapy, and traditional Chinese medicine. Conclusion The Expert Panel, comprising distinguished Taiwanese dermatologists, succeeded in developing a consensus about the management of psoriasis in Taiwanese patients. Unavailability of data in certain areas may suggest a possibility of new directions in research. [ABSTRACT FROM AUTHOR]

Background/Objective The incidence of psoriasis vulgaris in Asians is estimated at 0.05–0.30%. Studies in North America and Europe demonstrated that adalimumab, a fully human monoclonal IgG1 antibody, is an efficacious treatment for psoriatic arthritis and chronic plaque psoriasis. The aim of this study was to evaluate the efficacy and safety of adalimumab in treating psoriatic arthritis (PsA) in patients who have moderate to severe psoriasis. Methods This was a retrospective study comprising 12 patients with chronic plaque psoriasis and psoriatic arthritis who were treated with adalimumab between October 2008 and February 2013. All had failed treatment with conventional systemic agents. Patients were started on adalimumab 40 mg every other week. Results At week 12, 3 of 12 patients (25%) achieved a 75% improvement in their Psoriasis Area and Severity Index (PASI 75). With regard to PsA, at week 12, the improved Psoriatic Arthritis Response Criteria (PsARC) response was experienced by 75% (9 of 12) of the patients. Mean improvement in Dermatology Life Quality Index (DLQI) was 42%. Five of 12 patients (42%) experienced adverse events, which were generally mild. Conclusion Patients with refractory psoriatic arthritis appeared to be responsive to adalimumab. The achievement rate of PsARC in our study was comparable to the efficacy reported in previous literature. Detection of antinuclear antibodies was not associated with the responsiveness in this trial, nor did it influence the potential for adverse effects. Adalimumab as a monotherapy is generally effective and safe. [ABSTRACT FROM AUTHOR]

Abstract: Background: Psoriasis is a chronic inflammatory disease affecting the quality of life of patients. Traditional treatments are limited by adverse side effects. Etanercept is a biological agent used as an alternative treatment for psoriasis. Methods: This open-label, observational study conducted in Taiwan involved 22 patients with recalcitrant psoriasis who received a 24-week treatment with etanercept—50 mg twice weekly (BIW) during the first 12 weeks and 25 mg BIW in the next 12 weeks. Psoriasis Area and Severity Index (PASI) score at Weeks 0, 12, and 24 were recorded. Levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), antinuclear antibody (ANA), and tumor necrosis factor-alpha (TNF-α) at baseline, Week 12, and Week 24 were obtained. Adverse events and blood tests were recorded as safety assessment. Results: At Week 12, 54.5% and 13.6% patients achieved ≥50% improvement from baseline in PASI score (PASI 50 and PASI 75, respectively); at Week 24, 66.7% and 23.8% patients achieved PASI 50 and PASI 75, respectively. The mean improvement in PASI was 49.8% at Week 12 and 59.8% at Week 24, while 100% and 62.5% patients had reduced ESR and CRP levels, respectively. There were no deaths or serious adverse events. Four patients developed positive ANA, one of whom had poor psoriasis control. Most patients (93.8%) had higher serum TNF-α levels compared to baseline. Conclusions: Etanercept is effective and safe in treating recalcitrant psoriasis, reduces ESR and CRP levels, and occasionally induces positive ANA titer associated with poor psoriasis control. Serum TNF-α level may increase after treatment, but this does not seem to affect PASI improvement. [Copyright &y& Elsevier]

A 15-year-old boy with T-cell acute lymphoblastic leukemia (ALL) (FAB L1), diagnosed in 1995, received combination chemotherapy consisting of 6 weeks of induction (vincristine, epirubicin, L-asparaginase, prednisolone) and 2 weeks of consolidation (cytosine arabinosides, etoposide). After achieving remission, for further maintenance of remission, he was treated with 14 cycles of intensive chemotherapy consisting of 6-MP, 10 mg/kg orally on the first 4 days, and cyclophosphamide, 1200 mg/m[sup 2], vincristine, 1.5 mg/m[sup 2], epirubicin, 15 mg/m[sup 2], and cytosine arabinoside, 40 mg/m[sup 2], intravenously on days 4, 11, 39, and 40, respectively. On day 18 of each cycle, he received intravenous methotrexate (MTX) infusion in a total dose of 150 mg/m[sup 2] plus oral leucovorin (30 mg/m[sup 2] ) rescue 36 h after starting MTX therapy. In addition, oral trimethoprim–sulfamethoxazole was given regularly to prevent Pneumocystis carinii infection. The patient achieved remission during the first course of treatment, but 8 months later the disease relapsed. He then received four doses of MTX (800 mg intravenously) plus leucovorin rescue in the following 4 months. During the last MTX therapy, small hemorrhagic bullae were found on the lateral side of the right ankle, but subsided after a few days. Due to partial remission of the disease, he was admitted again in January 1999 for high-dose MTX therapy. An initial hemogram on admission revealed hemoglobin 7.2 g/dL, white cell count 15,200/mm[sup 3], platelet count 153/mm[sup 3], blood creatinine 0.5 mg/dL, and alanine leucine aminotransferase (ALT) 20 U/L. He received 8500 mg of MTX (5000 mg/m[sup 2] ) as a continuous intravenous infusion for 24 h. Thirty-six hours after the start of MTX infusion, leucovorin (30 mg, intravenous) rescue was initiated every 6 h for 3 days. Another preventive measure to cover MTX toxicity included aggressive intravenous fluid replacement (4 L/m[sup 2] /day) and the addition of... [ABSTRACT FROM AUTHOR]