Trends in Type of Original Psoriasis Publications by Decade, 1960 to 2010.

CONTEXT: Research investigating psoriasis has spanned decades, and as our understanding of the disease has evolved, the focus of publications has changed. OBJECTIVE: We sought to characterize the trends in original psoriasis-related research from 1960 to 2010 chronologically by decade. METHODS: A literature review was performed using the keyword psoriasis in the MEDLINE database. All original psoriasis-related articles published at the beginning of each decade were searched and categorized by study type and topic. MAIN OUTCOME MEASURE: Number of articles per topic. RESULTS: A total of 869 original psoriasis-related articles were found. The number of publications increased 18 fold over 5 decades. The immunology and pathogenesis of psoriasis was the most frequently researched topic (36%), and retrospective studies were the most common study type (37%). Recent highly published topics included biologic therapy, genetics, and psoriasis-associated cardiovascular disease. CONCLUSION: Original psoriasis-related publications have grown substantially since 1960. Basic science research into the immunology and pathogenesis has been and continues to be the mainstay of psoriasis research. Recent research trends suggest the focus has expanded to topics such as psoriasis-associated cardiovascular disease, genetics, and biologic therapy.

Extensive keloid formation after pemphigus vulgaris.

Pemphigus vulgaris is an immunobullous disease characterized by intraepidermal blister formation. These blisters eventually rupture, leaving erosions that are slow to heal, often leaving hyperpigmented patches, but no scars. We describe a case of a 67- year-old man with pemphigus vulgaris who suffered severe keloidal scarring after the pemphigus lesions became infected. His keloids were treated with intralesional corticosteroids with some improvement. Pemphigus vulgaris, a process confined to the epidermis, may lead to scarring in predisposed individuals, particularly if infection occurs.

Sclerodermoid lesions in a patient with multiple transplants and porphyria cutanea tarda.

Patients with chronic graft versus host disease may exhibit a range of sclerotic features. Herein we present a patient with confirmed porphyria cutanea tarda who subsequently developed chronic graft versus host disease.

Safety of hydroinfusion in percutaneous thermal ablation of hepatic malignancies.

PURPOSE: Hydroinfusion is a commonly used ancillary procedure during percutaneous thermal ablation of the liver that is used to separate and protect sensitive structures from the ablation zone. However, risks of hydroinfusion have not been systematically studied. The purpose of the present study was to systematically examine the frequency and severity of local and systemic complications related to hydroinfusion. MATERIALS AND METHODS: From January 2009 to April 2012, 410 consecutive patients underwent percutaneous thermal hepatic tumor ablation. One hundred fifty patients in the study group underwent hydroinfusion and 260 in the control group did not. Patient charts and imaging studies of both groups were reviewed to compare incidences of complications that could potentially be caused by hydroinfusion, including pleural effusion, bowel injury, infection, electrolyte imbalance, and hyperglycemia. RESULTS: Pleural effusions were found to occur more commonly in the hydroinfusion group (45.3%) than in the control group (16.5%). Pleural effusions were significantly larger (P < .001) and more likely to be symptomatic (six of 150 patients; P = .006) in the hydroinfusion group than in the control group (one of 260 patients). Multiple patient and tumor characteristics were analyzed for association with development of major hydroinfusion-type complications (requiring therapy or extended/repeat hospitalization). Subcapsular location of tumor was the only variable to reach statistical significance (P = .009), with all major hydroinfusion-type complications (n = 10) occurring in patients with subcapsular tumors. CONCLUSIONS: Hydroinfusion is a safe procedure overall. However, pleural effusions occur commonly after hydroinfusion, tend to be moderate or large in size, and are occasionally symptomatic.

Bariatric surgery and psoriasis.

Obesity is associated with psoriasis and poses a significant obstacle to psoriasis management. Bariatric surgery is an effective procedure for weight loss, and some reports suggest that it may improve psoriasis. However, more evidence is needed before definitive conclusions can be drawn. Bariatric surgery procedures, in particular the Roux-en-Y gastric bypass, may one day be a viable option for obese patients with refractory psoriasis.

Intra-articular calcifications following arthroscopic ACL reconstruction: prevalence and possible significance.

PURPOSE: The goal of our study was to determine the frequency of intra-articular calcifications on initial postoperative radiographs following arthroscopic ACL reconstruction, describe their appearance, hypothesize their etiology, and determine their significance. MATERIALS AND METHODS: Review of records and post-operative radiographs for individuals undergoing arthroscopic ACL reconstruction at our institution identified 758 knees between November 2002 and April 2010. All patients underwent femoral and tibial tunnel drilling regardless of graft source. All but 23 underwent notchplasty. RESULTS: Intra-articular calcifications on initial postoperative radiographs were observed in 252 knees. The majority of calcifications were curvilinear, paralleling the posterior femoral condyles. Nineteen of the patients with calcifications on initial studies had repeat radiographs within 6 years. The calcifications resolved in every case. CONCLUSIONS: This study shows that intra-articular calcifications are a common finding on initial post-operative radiographs following ACL reconstruction. We feel they are of doubtful clinical significance, and in our limited experience, they eventually resolve. They should not be confused with chondrocalcinosis or vascular calcification.

Effect of treating psoriasis on cardiovascular co-morbidities: focus on TNF inhibitors.

Psoriasis patients are at increased risk for cardiovascular disease. Literature on rheumatoid arthritis has shown the association of treatment with tumor necrosis factor (TNF) inhibitors and improvement of cardiovascular disease. Recent literature has also shown similar findings in psoriasis patients. We present a review of the literature on the effect of TNF inhibitors for psoriasis treatment on cardiovascular disease, cardiovascular biomarkers, and insulin resistance. We conclude that TNF inhibitors may be especially beneficial in preventing myocardial infarction, to a degree greater than methotrexate, especially in the Caucasian population. The effects of TNF inhibitors in altering insulin sensitivity or preventing new onset diabetes have been contradictory. Case reports of both hyperglycemia and hypoglycemia developing in patients under TNF inhibitor treatment teach us to warn patients about these side effects. More robust clinical studies are needed to evaluate the true effect of TNF inhibitors in diabetic psoriasis patients. More studies are also needed to assess the effect of TNF inhibitors on hypertension, dyslipidemia, and stroke.

Immunogenicity of novel consensus-based DNA vaccines against Chikungunya virus.

Chikungunya virus (CHIKV) is an emerging arbovirus and is an important human pathogen. Infection of humans by CHIKV can cause a syndrome characterized by fever, headache, rash, nausea, vomiting, myalgia, arthralgia and occasionally neurological manifestations such as acute limb weakness. It is also associated with a fatal haemorrhagic condition. CHIKV is geographically distributed from Africa through Southeast Asia and South America, and its transmission to humans is mainly through the Aedes aegypti species mosquitoes. The frequency of recent epidemics in the Indian Ocean and La Reunion islands suggests that a new vector perhaps is carrying the virus, as A. aegypti are not found there. In fact, a relative the Asian tiger mosquito, Aedes albopictus, may be the culprit which has raised concerns in the world health community regarding the potential for a CHIK virus pandemic. Accordingly steps should be taken to develop methods for the control of CHIKV. Unfortunately, currently there is no specific treatment for Chikungunya virus and there is no vaccine currently available. Here we present data of a novel consensus-based approach to vaccine design for CHIKV, employing a DNA vaccine strategy. The vaccine cassette was designed based on CHIKV capsid- and envelope-specific consensus sequences with several modifications, including codon optimization, RNA optimization, the addition of a Kozak sequence, and a substituted immunoglobulin E leader sequence. The expression of capsid, envelope E1 and E1 was evaluated using T7-coupled transcription/translation and immunoblot analysis. A recently developed, adaptive constant-current electroporation technique was used to immunize C57BL/6 mice with an intramuscular injection of plasmid coding for the CHIK-Capsid, E1 and E2. Analysis of cellular immune responses, including epitope mapping, demonstrates that electroporation of these constructs induces both potent and broad cellular immunity. In addition, antibody ELISAs demonstrate that these synthetic immunogens are capable of inducing high titer antibodies capable of recognizing native antigen. Taken together, these data support further study of the use of consensus CHIK antigens in a potential vaccine cocktail.