Videocapillaroscopic findings in the microcirculation of the psoriatic plaque during etanercept therapy.
Clin Exp Dermatol
; 38(6): 633-7, 2013 Aug.
Article
em En
| MEDLINE
| ID: mdl-23763515
ABSTRACT
BACKGROUND:
Vascular endothelial growth factor (VEGF) is a pivotal cytokine in the pathogenesis of psoriasis, and upregulation of VEGF by tumour necrosis factor (TNF)-α and inflammatory factors causes marked alterations in the cutaneous microcirculation. Etanercept is a fully soluble TNF receptor fusion protein that primarily binds soluble TNF-α, thus blocking its pro-angiogenic function.AIM:
To assess the modifications in the superficial capillary bed in psoriatic plaques during treatment with etanercept.METHODS:
The study enrolled 22 patients (13 men, 9 women; age range 31-74 years) with plaque psoriasis resistant to conventional therapy. The patients were stated on etanercept 50 mg/week, which was continued for 24 weeks. At the beginning of the study (baseline), and at weeks 6, 12, 18 and 24, in vivo videocapillaroscopy analysis of a selected plaque was performed. Levels of erythema, scaling and infiltration were assessed using a four-point plaque severity score, with an overall score obtained by the sum of these three scores. The Psoriasis Activity and Severity Index (PASI) was also determined.RESULTS:
Etanercept produced a significant reduction in PASI, plaque severity score and diameter of the basket-weave area at every time point. Four patients had complete remission, although none of the patients regained a normal capillaroscopic pattern.CONCLUSIONS:
Similar to other conventional therapies, etanercept is able to improve PASI, plaque severity score and basket-weave area diameter, but it is unable to induce normalization of the microcirculation in psoriatic plaques.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Psoríase
/
Imunoglobulina G
/
Receptores do Fator de Necrose Tumoral
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Antirreumáticos
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article