1
|
Chen L, Cheng Y, Peng L, Jia X, Liu G, Shen Z. Clinical Characteristics and Therapeutic Aspects of Blaschko Linear Psoriasis. Dermatol Ther (Heidelb) 2024; 14:1039-1048. [PMID: 38578386 PMCID: PMC11052961 DOI: 10.1007/s13555-024-01140-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION Blaschko linear psoriasis (BLP) is characterized by the linear distribution of psoriatic skin lesions along the Blaschko lines. BLP can be divided into type I and type II, mainly on the basis of clinical manifestations. BLP can easily cause psychological burdens in patients and clinical confusion for physicians. Here, we summarize clinical cases to provide a better understanding of BLP. METHODS The subjects included patients with BLP who visited our dermatology departments and those reported in the literature obtained from the PubMed and Wanfang databases. Quantitative data were presented as means ± SD (standard deviation), and qualitative data were represented by the frequency. Student's t test was employed to compare means, whereas chi-square tests were used for analyzing qualitative data. RESULTS A total of 74 patients with BLP (5 our patients, 69 from literature) were included, with 61 type I and 13 type II patients. We summarize BLP's characteristics as follows: (1) More frequent in male individuals, especially in type II; (2) Earlier onset than classical psoriasis; (3) Mainly distributed unilaterally, and no preference for left or right site; (4) Asymptomatic or slight pruritus; (5) Mostly negative family history of psoriasis; (6) Possible involvement of the nails/scalp (mainly for type II); (7) Possible exogenous triggering or aggravation factors; (8) Possible concomitant classical plaque or guttate psoriasis lesions, especially in type II; (9) Conforming to histopathology features of classical psoriasis; (10) Relatively favorable response to antipsoriatic treatment, although poor for superimposed areas in type II. CONCLUSION This study analyzed the clinical characteristics and therapeutic aspects of BLP. Compared with published studies, we have new findings, such as gender bias. Besides traditional antipsoriatic treatment, a personalized selection of biologics may also be a promising choice. Dermatologists should recognize and understand the significance of this disease, and provide patients with appropriate psychological counseling and clinical treatments.
Collapse
Affiliation(s)
- Ling Chen
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Yufan Cheng
- Department of Dermatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, Guangdong, China
| | - Lu Peng
- Department of Dermatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, Guangdong, China
| | - Xuesong Jia
- Department of Dermatology, The First Affiliated Hospital of Shihezi University, Xinjiang, 832008, China
| | - Guangren Liu
- Department of Dermatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, Guangdong, China
| | - Zhu Shen
- Department of Dermatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, Guangdong, China.
| |
Collapse
|
2
|
Kim J, Bae KN, Son JH, Shin K, Kim HS, Ko HC, Kim MB, Kim B. Unilateral Psoriasis on the Left Leg and Poliomyelitis of the Right Leg: A Case Report and Review of the Etiology. Ann Dermatol 2023; 35:S93-S96. [PMID: 37853875 PMCID: PMC10608392 DOI: 10.5021/ad.21.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/07/2021] [Accepted: 11/26/2021] [Indexed: 10/20/2023] Open
Abstract
Psoriasis is a common immune-mediated, inflammatory skin disease. However, unilateral psoriasis is rare and few cases have been reported. A 59-year-old male with a polio-affected right leg presented with exfoliative skin on the left leg for three months. He had been treated under the diagnosis of contact dermatitis with secondary infection. After the exfoliative skin lesions improved, psoriatic papules were noted, which was ultimately diagnosed as psoriasis and successfully treated with topical steroid and vitamin D agents. We propose that the Koebner phenomenon has acted as the triggering and aggravating factor of unilateral psoriasis in this patient.
Collapse
Affiliation(s)
- Jongwook Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kyung-Nam Bae
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jin-Hwa Son
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kihyuk Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Byungsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
| |
Collapse
|
3
|
Successful treatment with ixekizumab of lower-limb linear psoriasis in a child. Ann Dermatol Venereol 2022; 149:216-218. [DOI: 10.1016/j.annder.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/22/2021] [Accepted: 02/09/2022] [Indexed: 11/22/2022]
|
4
|
Branisteanu DE, Georgescu S, Serban IL, Pinzariu AC, Boda D, Maranduca MA, Glod M, Branisteanu CI, Bilibau R, Dimitriu A, Nicolescu AC, Branisteanu DC. Management of psoriasis in children (Review). Exp Ther Med 2021; 22:1429. [PMID: 34707710 PMCID: PMC8543441 DOI: 10.3892/etm.2021.10864] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/26/2021] [Indexed: 12/12/2022] Open
Abstract
Psoriasis is a common long-lasting, inflammatory disease that mainly affects the skin. The incidence of this condition has increased significantly over time and at this point, it affects approximately 1% of children. Psoriasis can appear at any age, including childhood and adolescence, with a higher frequency in girls, an earlier onset being associated with severe psoriasis. The pathology is the result of the interaction between genetics and trigger factors such as infections, stress, diet, obesity, and chemical irritants. Paradoxically, tumor necrosis factor (TNF)-α inhibitors (infliximab, adalimumab) may induce psoriasis in children. Psoriasis is a long-term condition with periods of exacerbation; thus, the quality of life can be affected and patients should receive psychosocial support. Although most children have mild disease and topical treatment is efficient, some cases are challenging to treat. The aim of this review was to provide an overview of the current knowledge concerning the epidemiology, etiology, pathogenesis, clinical features, comorbidities, and treatment of psoriasis in children and also to emphasize the need for a multidisciplinary approach to this complex pathology.
Collapse
Affiliation(s)
- Daciana Elena Branisteanu
- Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Simona Georgescu
- Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ionela Lacramioara Serban
- Department of Physiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Constantin Pinzariu
- Department of Physiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daniel Boda
- Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Minela Aida Maranduca
- Department of Physiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihai Glod
- Department of Surgery, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | | | - Roxana Bilibau
- Department of Dermatology, ‘Railway Clinical Hospital’, 700506 Iasi, Romania
| | - Andreea Dimitriu
- Department of Dermatology, ‘Arcadia Hospitals and Medical Centers’, 700620 Iasi, Romania
| | - Alin Codrut Nicolescu
- Department of Dermatology, Roma Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
| | | |
Collapse
|
5
|
Huang PW, Chu CY. Pembrolizumab-induced linear psoriasis. Lung Cancer 2020; 146:378-379. [DOI: 10.1016/j.lungcan.2020.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/13/2020] [Indexed: 11/25/2022]
|
6
|
Wang W, Shu GF, Lu KJ, Xu XL, Sun MC, Qi J, Huang QL, Tan WQ, Du YZ. Flexible liposomal gel dual-loaded with all-trans retinoic acid and betamethasone for enhanced therapeutic efficiency of psoriasis. J Nanobiotechnology 2020; 18:80. [PMID: 32448273 PMCID: PMC7245867 DOI: 10.1186/s12951-020-00635-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 05/12/2020] [Indexed: 12/22/2022] Open
Abstract
Background Psoriasis is a chronic immune-mediated inflammatory skin disease without effective treatment. The utilization of all trans-retinoic acid (TRA) and betamethasone (BT) for the treatment of psoriasis is still facing difficulties, due to their relatively poor stability, limited skin permeation, and systemic side effects. Flexible liposomes are excellent in deeper skin permeation and reducing the side effects of drugs, which is promising for effective treatment of skin disorders. This work aimed to establish dual-loaded flexible liposomal gel for enhanced therapeutic efficiency of psoriasis based on TRA and BT. Results Flexible liposomes co-loaded with TRA and BT were successfully prepared in our study. The characterization examination revealed that flexible liposomes featured nano-sized particles (around 70 nm), high drug encapsulation efficiency (> 98%) and sustained drug release behaviors. Flexible liposomes remarkably increased the drug skin permeation and retention as compared with free drugs. Results on HaCaT cells suggested that flexible liposomes were nontoxic, and its cellular uptake has a time-dependent manner. In vivo studies suggested the topical application of TRA and BT dual-loaded liposomal gel had the best ability to reduce the thickness of epidermal and the level of cytokines (TNF-α and IL-6), largely alleviating the symptoms of psoriasis. Conclusions Flexible liposomal gel dual-loaded with TRA and BT exerted a synergistic effect, which is a promising topical therapeutic for the treatment of psoriasis.![]()
Collapse
Affiliation(s)
- Wei Wang
- Department of Pharmacy, The Third People's Hospital of Hangzhou, 38 West Lake Avenue, Hangzhou, 310009, China
| | - Gao-Feng Shu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Kong-Jun Lu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Xiao-Ling Xu
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Min-Cheng Sun
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Jing Qi
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China
| | - Qiao-Ling Huang
- Department of Pharmacy, The Third People's Hospital of Hangzhou, 38 West Lake Avenue, Hangzhou, 310009, China.
| | - Wei-Qiang Tan
- Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016, China.
| | - Yong-Zhong Du
- Institute of Pharmaceutics, College of Pharmaceutical Sciences, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China.
| |
Collapse
|
7
|
Saylam Kurtipek G, Zekey E, Tuncez Akyurek F, Akyurek M, Unal M. Unusual relapse in a psoriasis patient receiving secukinumab: Linear psoriasis. Dermatol Ther 2020; 33:e13346. [DOI: 10.1111/dth.13346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 03/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Emre Zekey
- Department of Dermatology Selcuk University Faculty of Medicine Konya Turkey
| | | | - Mehmet Akyurek
- Department of Dermatology Selcuk University Faculty of Medicine Konya Turkey
| | - Mehmet Unal
- Department of Dermatology Private Mardin Park Hospital Mardin Turkey
| |
Collapse
|