Osseous defect of the anteroinferior femoral head: is it associated with femoroacetabular impingement (FAI)?

OBJECTIVE: To evaluate the prevalence, morphology, and clinical significance of a repeatedly observed yet not examined circumscript osseous defect at the anteroinferior aspect of the femoral head, termed femoral head defect. MATERIALS AND METHODS: Retrospective study with approval of the institutional review board. There was informed consent by all individuals. Magnetic resonance imaging (MRI) hip examinations of 970 individuals (age 15 to 55) were analyzed for femoral head defect. Patients with femoral head defect were matched for age and gender with patients without defect. Two readers independently assessed MRI images regarding presence, location, and morphology of the defect. MR images and radiographs were analyzed for findings of femoroacetabular impingement (FAI). Femoral torsion was measured. Independent t test and chi-square test were used for statistics. RESULTS: Sixty-eight (7%) of 970 MRI examinations exhibited a femoral head defect in an anteroinferior location of the femoral head (29/400 men, 7.3%; 39/570 women, 6.8%; p = 0.8). The most frequent morphology of femoral head defect was type I, dent-like (34; 50%), followed by type II, crater-like (27; 40%), and III, cystic (7; 10%). Femoral head defect was slightly more common on the right hip (39 individuals; 57%) compared to left (29 individuals; 43%), non-significantly (p = 0.115). There was no association between FAI or its subtypes and the presence of femoral head defect (p = 0.890). Femoral antetorsion was reduced in patients with femoral head defect (12.9° ± 8.6) compared to patients without defect (15.2° ± 8.5), without statistical significance (p = 0.121). CONCLUSION: The femoral head defect is a common finding in MRI examinations of the hip and is situated in the anteroinferior location. There was no association with FAI yet a non-significant trend towards lower femoral antetorsion in patients with femoral head defects.

Acetabular coverage differs between standing and supine positions: model-based assessment of low-dose biplanar radiographs and comparison with CT.

OBJECTIVES: To evaluate the feasibility of 2D and 3D acetabular coverage assessments based on low-dose biplanar radiographs (BPR) in comparison with CT, and to demonstrate the influence of weight-bearing position (WBP) on anterior and posterior acetabular coverages. METHODS: Fifty patients (21 females, 29 males) underwent standing BPR and supine CT of the pelvis. Using dedicated software, BPR-based calculations of anterior and posterior 2D coverages and anterior, posterior, and global 3D coverages were performed in standardized anterior pelvic plane (APP) and WBP. CT-based anterior and posterior 2D coverages and global 3D coverage was calculated in APP and compared with BPR-based data. Statistics included intraclass correlation coefficients (ICC) and Bland-Altman plots. RESULTS: Mean anterior 2D coverage was 21.2% (standard deviation, ± 7.4%) for BPR and 23.8% (± 8.4%) for CT (p = 0.226). Mean posterior 2D coverage was 54.2% (± 9.8%) for BPR and 61.7% (± 9.7%) for CT (p = 0.001). Mean global 3D coverage was 46.5% (± 3.0%) for BPR and 45.6% (± 3.6%) for CT (p = 0.215). The inter-method reliability between CT and BPR and inter-reader reliability for BPR-based measurements were very good for all measurement (all ICC > 0.8). Based on BPR, mean anterior and posterior 3D coverages were 20.5% and 26.0% in WBP and APP, while 25 patients increased anterior and 24 patients increased posterior 3D coverage from APP to WBP with a relative change of coverage of up to 11.9% and 10.0%, respectively. CONCLUSIONS: 2D and 3D acetabular coverages can be calculated with very good reliability based on BPR. The impact of standing position on acetabular coverage can be quantified with BPR on an individual basis. KEY POINTS: • 2D and 3D acetabular coverages can be calculated with very good reliability based on biplanar radiographs in comparison with CT. • The impact of standing position on anterior and posterior acetabular coverages can be quantified with BPR on an individual basis.

The evolution of artificial hair implantation.

From the beginning, artificial hair implantation has aroused a lot of interest, sometimes controversial, in the field of hair restoration. The artificial fiber must be of high quality and biocompatible. Biofibre® is a very fine fiber having diameter of 80 m. The standard length of this fiber is 15 or 30 cm, to satisfy multiple patient requests. They are available in 13 colors and 3 different shapes (straight, wavy and curly). Artificial hair implant is indicated in all (male and female) cases of androgenetic alopecia, especially for those who show dismal response to medical therapies and have poor donor area supply for hair transplantation. It has also shown good results to treat scars. One hundred thirty-three cases of androgenetic alopecia were treated with Biofibre® and followed-up for 3 years. A clinical evaluation was carried out after 1 month, 4 months and every other 4 months after the implant. The fiber loss was no more than 10% per year in 91.4% of the cases, 15% in 7.8% of the cases and 20% in 0.8% of the cases. 96.2% of patients declared themselves to be satisfied with the result of the implant while 3.8% declared to be not satisfied. To conclude, modern artificial hair implantation can be considered a safe and easy mode of hair restoration, for male and female patients, especially in donor depleted cases or when an immediate aesthetic result is required.

Laser treatment of leg ulcers: selected concepts.

An overview on different laser devices, available for the treatment of the different phases of wound healing: debridement, wound repair and scars correction.

Between history and gossip: the state of women relative to syphilis, a traditionally male disease.

Despite the new World Health Organization data remind us how syphilis is a disease which affects both sexes equally, this pathology has always been mainly considered a male disease. While several famous men are known to be affected by syphilis, there are very few women affected by this pathology of which we have historical records. Through the lives of Mary Todd Lincoln, Catherine of Aragon, Karen Blixen and Florence Foster Jenkins, this article would like to grant dignity to all the women who contracted syphilis in the wrong historical era where, for a woman, admitting to contracting it was shameful. Through the important women who lived their lives fighting against this disease and its complications, we would like to pay tribute to all those women who still today, in an era of antibiotics and where syphilis is a treatable pathology, they cannot be cured because they are both geographically and socially disadvantaged.

A short novel about the spread of two important diseases in history: syphilis and SARS.

Throughout the centuries, the undefended nature of man has very often manifested in cases of epidemics, which have determined scenarios of suffering and death. Through "historical" observation lens, it is possible to understand the relationship between the spread of viruses, bacteria and parasites responsible for these epidemics and the displacement of ancient or contemporary travellers. We have analysed two infective diseases, syphilis and SARS, and their role in history and in medicine.

Regenerative medicine in the treatment of gastro-esophageal reflux disease and laryngo-pharyngeal reflux. From research to cure.

We present our observational study on 40 patients treated with the medical device containing sodium hyaluronic acid and magnesium alginate, performing a lubricating and hydrating action. This device is in the form of a gel, with topical action to contrast gastroesophageal reflux and to exert a mechanical role of protection of the mucosal tissues (mouth-pharyngo-esophageal mucosa and gastric mucose.). Forty patients were recruited aged between 22- and 72-years-old with painful dyspeptic Gastro Esophageal Reflux Disease (GERD) symptomatology in acute or in clinical phase (25 patients) and with pharyngolaryngo- tracheal symptomatology (15 patients). Patients were divided into two clinical groups: Group A was treated with the medical device, while Group B with conventional treatments without the medical device. Subjects of both groups were also treated with proton pump inhibitors (PPIs). Follow-up was at 10, 20 and 30 days and patients were evaluated for reduction of their subjective symptoms, reduction of symptomatic and occasional therapies, reduction of inflammatory process or disappearance of epithelial lesions of the examined mucosa, healing process. The reduction of subjective symptoms was observed at 10 days in the patient with food bolus (disappearance after 5 days) and in patients with a reduction of 70%. A relevant reduction in the use of symptomatic drugs was noted. Our data are relevant considering symptom relief (heartburn, reflux and dyspepsia). New scenarios for the treatment of inflammatory diseases of the digestive and respiratory tract mucosa are at the horizon. Interdisciplinary translational research brings to the development of novel medical devices (as the one described in this study) with a high safety profile, and extremely active on the inflammation-repair-regeneration complex of different tissues and organs.

A multi-centred open trial of “Dr Michaels®” (also branded as Soratinex®) topical product family in psoriasis.

Psoriasis is a chronic, recurring skin disease affecting 2-4% of the population. Genetic predisposition and precipitating factors play a role in its etiology. The disease can occur in any age or gender group. The most frequently affected areas of the body include scalp, extensor surfaces of the extremities, skin folds and nails. While a number of therapies exist for the treatment of psoriasis with a total resolution of the skin, achieving remission in a high percentage of sufferers, a treatment that results in the maintenance of remission and is free of side effects is still a desirable goal. The aim of the study was to investigate the efficacy and tolerability of Dr Michaels® (Soratinex®) topical product family in psoriasis, in terms of decreasing parakeratosis, inflammation, infiltration and involved area. Seven-hundred-and-twenty-two subjects, mean age 42.3 years (range: 18-68 years) with mild to moderately severe psoriasis, with no other current anti-psoriatic therapy, consisting of 382 males and 340 females, above 18 years of age were included and the observations were subjected to statistical analysis. Triphasic application of Dr Michaels® (Soratinex®) products was employed for 8 weeks, using Cleansing Gel, Scalp and Body Ointment and Skin Conditioner. The treatment proved to be ineffective for 22 patients (3.1%) out of 722. 84 patients (11.6%) had moderate improvement with 26-50% of cleared skin lesions; 102 patients (14.1%) had good improvement with 51-75% of cleared skin lesions; 484 patients (67.0%) experienced outstanding improvement with 76-100% of the cleared skin lesions, with 52% of them achieving total resolution. Twelve patients worsened and discontinued treatment; 18 patients discontinued because of non-compliance; 33 patients developed folliculitis as a side effect. Based on the results of this study, the Dr Michaels® (Soratinex®) product family can be successfully applied in mild to moderately severe psoriasis when considering the exclusion criteria.

A clinical examination of the efficacy of preparation of Dr Michaels® (also branded as Soratinex®) products in the treatment of psoriasis.

Psoriasis is a chronic inflammatory disease with negative impacts both physically and psychologically. It is a common disorder affecting 2-3% of the total world population, in some cases causing changes to the nail and joints as well as skin lesions. The cutaneous manifestations of psoriasis can vary in morphology and severity and therapy should be tailored accordingly. The aim of the study was to investigate the efficacy of Dr Michaels® (Soratinex®) product line in the treatment of psoriatic patients with different age and disease severity. A total number of 270 patients with verified psoriasis, aged 9-60 years old participated in the studies, including 128 children: 23 girls and 105 boys, (all of them selected from the Department of Dermato-allergology of the Russian Pediatric Hospital Clinic, Moscow, and of the 4th Department of Dermatology of the 52nd Moscow City Hospital Clinic). The patients were separated into 3 groups according to the severity of the disease (based on the PASI-index). All the patients have been treated with Dr Michaels® (Soratinex®) products twice daily, as three different forms were available for application: a cleansing gel, an ointment and a conditioner. The severity of the disease and the efficacy of the treatment have been defined with the evaluation of the PASI index of each patient. The obtained results were recorded in a graphic form showing the changes of the PASI-index on days 3, 7, 14, and 21 counted from the start of the trial. Clinical remission was achieved in 147 patients, a significant improvement in 73, partial improvement in 32, while no effect was seen in 12 patients and deterioration in 6. This open trial demonstrated the clinical efficacy of topical application of Dr Michaels® (Soratinex®) preparation. We observed clinical remissions of psoriasis in adults and in children.

Nail psoriasis in an adult successfully treated with a series of herbal skin care products family – a case report.

Psoriasis is a common chronic inflammatory dermatosis that causes significant distress and morbidity. Approximately 50% of patients with cutaneous psoriasis and 90% of patients with psoriatic arthritis demonstrate nail involvement of their psoriasis. Left untreated, nail psoriasis may progress to debilitating nail disease that leads to not only impairment of function but also on quality of life. We report the case of a 50-year-old male patient with recalcitrant nail dystrophies on the fingers since the age of 40, who responded successfully to Dr. Michaels® product family. The patient had a 35-year history of plaque psoriasis localised on the scalp, ears, groin, limbs, and trunk and with psoriatic arthritis. The nail symptoms consisted of onycholysis, onychomycosis, leukonychia, transverse grooves, nail plate crumbling and paronychia of the periungal skin. This case represents the efficacy and safety of the Dr. Michaels® (Soratinex® and Nailinex®) product family with successful resolution of nail dystrophies and surrounding paronychia with no reported adverse events.

Clinical evaluation of the effectiveness of “Dr Michaels®” (also branded as Soratinex®) products in the topical treatment of patients with plaque psoriasis.

Psoriasis is generally considered as an autoimmune inflammatory cutaneous-systemic disease, with chronic course and high rate of recurrence, while its high risk of comorbidities affect the patients’ quality of life significantly. Despite the good therapeutic response, most of the available options show tendency for poor tolerance and high rate of occurrence of side effects. Therefore, the interest of patients and doctors to investigate the possibility of treating psoriasis with natural substances is not surprising. The aim of this study was to investigate the efficacy and safety of the herbal skin-care product Dr Michaels® (Soratinex®) for the management of chronic plaque psoriasis, within a 6 to 8 week treatment course. Thirty patients of both sexes, aged between 24 and 70 years with mild to moderate psoriasis vulgaris were included in this study. The products of Dr Michaels® (Soratinex®) were applied in sequence: cleansing gel, ointment after 3-4 minutes and tonic care (for the fire-smeared ointment) 2 times per day for restorative care and cleansing gel for psoriasis within scalp 3 times a week. The study lasted six weeks. The severity and extent of the lesions were evaluated by PASI score (Psoriasis Area and Severity Index). Based on the obtained result, the products of “Dr Michaels® (Soratinex®)” have proved to be effective in the treatment of mild and moderate psoriasis vulgaris. In the study group, no improvement was observed in 10% of patients, a slight improvement in 20%, good in 40% and very good in 16.6% of patients.

Dr Michaels® (Soratinex®) product for the topical treatment of psoriasis: a Hungarian/Czech and Slovak study.

Psoriasis is a chronic inflammatory T cell-mediated skin disease, affecting about 2% of Hungarian population. Genetic predisposition as well as environmental triggering factors, and innate immune processes play a role in its etiology. Treatment of psoriasis during the initial stages and first years of disease tend to be conservative and frequently based on topical agents. The aim of this study was to investigate and to describe the efficacy and safety of Dr Michaels® (Soratinex®) skin-care products for the topical treatment of stable chronic plaque psoriasis in a Hungarian population. Two-hundred-and-eight-six (120 female/166 male) patients, aged 10-80 years old (mean age 43 years) with mild to moderate plaque psoriasis had participated in the study. The products, including cleansing gel containing a coal tar solution, herbal oils and emulsifiers, were used twice daily and in the same manner for all the skin lesions. The study period was eight weeks. Assessment, using the Psoriasis Activity Severity Index (PASI) scores and photographic analysis, was done 2 weeks before treatment, at time 0, and after 2, 4, 6 and 8 weeks. Patient’s improvement was determined by the percentage reduction of the PASI scores. Side effects and tolerability were also evaluated. After 8 weeks treatment course, 46 patients had a moderate improvement, with the regression of 25-50% of skin lesions; 77 patients showed a good improvement, with the resolution of 51-75% of lesions. Another 115 patients had an outstanding improvement, with the regression of 76-98.9% of lesions. Only 13 patients did not achieve an improvement of psoriasis. Fifteen patients experienced folliculitis, which resolved after cessation of treatment. Seven patients worsened and discontinued treatment. Thirteen patients dropped out because of non-compliance. Our investigation demonstrates that Dr Michaels® (Soratinex®) products, an Australian treatment, can be used successfully in the treatment of stable chronic plaque psoriasis.

Dr Michaels® product family (also branded as Soratinex®) versus Methylprednisolone aceponate - a comparative study of the effectiveness for the treatment of plaque psoriasis.

As one of the most common dermatologic chronic-recurrent disease, variable therapeutic options are available today for management of psoriasis. Although topical high potency corticosteroids, alone or in association with salicylic acid or vitamin D analogues, are still considered the best treatment, they do not seem to possess the capability for a long-term control of the disease or prevent recurrences, as their side effects are major contraindications for continuative use. The aim of this study was to investigate whether Dr. Michaels® product family is comparable to methylprednisolone aceponate (MPA) as a viable alternative treatment option for the treatment and management of stable chronic plaque psoriasis. Thirty adults (13 male, 17 female, mean age 40 years) with mild to severe stable chronic plaque psoriasis, were included in the study. Patients were advised to treat the lesions of the two sides of their body (left and right) with two different unknown modalities for 8 weeks; the pack of Dr. Michaels® products on the left side (consisting of a cleansing gel, an ointment and a skin conditioner) and a placebo pack on the right side, consisting of a cleansing gel, methylprednisolone ointment and a placebo conditioner. Assessment was done using the Psoriasis Activity Severity Index (PASI) scores before treatment and after 2, 4, 6 and 8 weeks. The results achieved with the Dr. Michaels® (Soratinex®) product family for the treatment of chronic plaque psoriasis were better than the results achieved with methylprednisolone aceponate (MPA), even though quicker resolution was achieved with the steroid with 45% of patients achieving resolution within 8-10 days in comparison to 5-6 weeks in the Dr. Michaels® (Soratinex®) group. Before therapy, the mean PASI score of the LHS in Dr. Michaels® (Soratinex®) group was 13.8±4.1 SD and 14.2±4.2 SD in the RHS methylprednisolone aceponate (MPA) group. After 8 weeks of treatment 62% of the Dr. Michaels® (Soratinex®) group had achieved resolution whilst in the methylprednisolone aceponate (MPA) group, the figure remained at 45%. The mean PASI score after 8 weeks of treatment was calculated and in the LHS Dr. Michaels® (Soratinex®) group it was 2.8±1.6 SD and 6.8±2.4 SD in the RHS methylprednisolone aceponate group. In the RHS -methylprednisolone aceponate (MPA) group, 22% of patients failed to respond to the treatment in comparison to 6% in the LHS Dr. Michaels® (Soratinex®) group. Based on the results of this study, Dr. Michaels® products are a more effective treatment option, with insignificant side effects, compared to local treatment with methylprednisolone aceponate (MPA).

A European prospective, randomized placebo-controlled doubleblind Study on the efficacy and safety of Dr Michaels® (also branded as Soratinex®) product family for stable chronic plaque psoriasis.

Psoriasis is a chronic, inflammatory, recurrent, genetically determined dermatitis that affects the skin and joints. Many patients affected by this condition seek alternatives and complementary treatment options such as herbal medicines. In order to establish the safety of these products, trials, according to medical standards should be performed to provide the highest quality of data. The aim of this study was to assess the efficacy and safety of an Australian series of herbal skincare products [Dr. Michaels® (Soratinex®) skin-care products for psoriasis] for the management of stable chronic plaque psoriasis. We studied 142 patients (68 females and 74 males) with mild to moderate, stable, chronic plaque psoriasis and they were randomly assigned to either verum or control group. Exclusion criteria were: severe psoriasis, arthropathic psoriasis, intertriginous psoriasis, palmoplantar psoriasis, use of any antipsoriatic treatment and any medication which could influence or interfere with the course of the disease. Both groups consisted of a cleansing gel, an ointment and an oil blend (skin conditioner), packed in neutral bottles, used twice daily for all lesions except the scalp, for 8 weeks. As control products, we used compositions of well-known neutral ointments and medicinal bathing oil. Assessment, using the Psoriasis Activity Severity Index (PASI) scores, was done before treatment and after 2, 4, 6 and 8 weeks. Patient improvement was determined by the percentage reduction of the PASI scores. Statistical analysis was carried out using the Mann-Whitney-U Test with SPSS for Windows. Our investigation demonstrates that complementary methods can play a role in dermatologic therapy as long as they undergo standardised clinical trials and fulfil the basic requirements such as product safety and quality assurance. This study shows that Dr Michaels (Soratinex®) herbal skin-care products improve mild to moderate stable chronic plaque psoriasis significantly.

Successful treatment of alopecia areata with Dr. Michaels® (Alopinex) product family.

UNLABELLED: Alopecia areata is a highly prevalent organ restricted autoimmune disorder that leads to disfiguring hair loss and is thought to involve a T cell–mediated response to the hair follicle. The treatment of alopecia areata is often problematic and very frustrating, partly due to the unknown aetiology of the condition. The aim of this study was to evaluate the efficacy and tolerability of complementary medicine, Dr. Michaels® product family, in the treatment of alopecia areata. MATERIALS AND METHODS: 40 patients (27 female/13 male), with a mean age of 20.3 years, all of them with 1-3 lesions of stable alopecia areata localized on the scalp were included in this trial. Four patients suffered from Hashimoto thyroiditis, and one had a familial history of LES. Exclusion criteria were the use of any treatment or medication, which may influence or interfere with the course of the disease. All patients were treated with Dr. Michaels® StimOils - applied twice daily (morning and night), Hair Lotion – applied twice daily (morning and night), and oral herbal formulation - PSC 900 2ml twice daily with food for 16 weeks. For each patient, photographs of typical lesions were taken at the beginning and at 4, 8, 12 and 16 weeks follow-up. Patient improvement was determined by the percentage of hair regrowth for each lesion. RESULTS: After 10 weeks of treatment using StimOils, Hair Lotion and PSC 900 from Dr. Michaels® product family, 18 patients had achieved an excellent response with regrowth in all the affected alopecia areata patches. 17 patients achieved the same results after 12 weeks of treatment; the other 5 patients had to continue the therapeutic protocol for another 2-3 weeks. CONCLUSION: This study demonstrates that the Dr. Michaels® StimOils, Hair Lotion and PSC 900 are an effective therapeutic option for the treatment of alopecia areata. This has important implications for resistant cases of alopecia areata where traditional systemic and topical corticosteroid therapies have failed. In addition, this treatment approach may be an attractive option for patients who have growing concern regarding side-effects of long-term corticosteroid therapy.

Scalp psoriasis: a promising natural treatment.

Psoriasis is a lifelong chronic inflammatory disease affecting 2-3% of the worldwide population. Scalp psoriasis is a particular form of psoriasis characterized by lesions on the scalp, which may occur isolated or in association with other skin lesions. The aim of this study was to investigate the efficacy and safeness of an innovative treatment of scalp psoriasis, which is based on the topical application of natural products. Fifty adult subjects with scalp psoriasis (23 females, 27 males) from different European dermatological centres were included in the study. Forty-six patients with severely infiltrated psoriatic lesions were invited to use the products of Dr Michaels® (Soratinex®), according to a three-phase application, twice a day (morning and evening). The other 4 patients followed a different regimen: after a shampoo in the evening, they applied the conditioner in the night and washed it in the morning with the cleansing gel. The application time of Dr Michaels® (Soratinex®) products was 8 weeks. The treatment was evaluated at 0, 1, 2, 3, 4, 5, 6, 7, and 8 weeks. The evaluation was based on the Psoriasis Scalp Severity Index (PSSI) and on a photographic analysis at each of the medical evaluation points. At the end of the study, all patients showed an outstanding improvement. Five patients referred a transient pruritus, which regressed spontaneously without discontinuing the application. No other side effects have been described. We observe that Dr Michaels® (Soratinex®) natural product family can be considered as a valid therapeutic tool for scalp psoriasis when considering the exclusion criteria. The tested products provided an outstanding improvement of lesions in all the patients, without side effects.

An innovative, promising topical treatment for psoriasis: a Romanian clinical study.

Psoriasis is a chronic inflammatory disease with negative impacts both physically and psychologically. It is a common disorder affecting 2-3% of the total world population, in some cases causing changes to the nail and joints as well as skin lesions. The cutaneous manifestations of psoriasis can vary in morphology and severity and therapy should be tailored accordingly. Even if today many therapeutic options are available for psoriasis treatment, none of them provide excellent clinical results without the risk of side effects. The authors investigate the efficacy of Dr. Michaels® (Soratinex®) natural products in the topical treatments of a group of psoriatic patients. Sixty-two patients (34 male/28 female) from Romania, aged 18-70 years (mean age: 52 years), affected by a mild to severe form of chronic plaque psoriasis were included in this study. Each patient has been treated with a triphasic application of Dr. Michaels® (Soratinex®) natural products, twice a day for six weeks. The products were applied on skin and scalp lesions, but not on the face, genital and flexures. The evaluation of the tested products was based on the PASI of each patient at time 0, 1, 2, 3, 4, 5, and 6 weeks. The tested products were ineffective in five of 57 patients. Eleven patients had a moderate improvement (PASI decrease 26-50%); 11 patients had a good improvement (PASI decrease 51-75%) and 30 patients an outstanding one (PASI decrease 76-100%). Twenty-three% of patients developed folliculitis that regressed upon discontinuation of the application. Five patients developed pruritus, which regressed spontaneously. The cosmetic effect was evaluated as indifferent by 44% of patients, as good by 40% of patients and as excellent by 16% of patients. Ninety-five% of patients stated that they would continue to use the tested products, because it was effective and with poor side effects since the products were natural. In our experimental study, the topical application of Dr. Michaels® (Soratinex®) natural products proved to be an effective natural therapeutic option for psoriasis treatment.

Efficacy and safety of Dr Michaels® (Soratinex®) product family for the topical treatment of psoriasis: a monitored status study.

The aim of the study was to investigate the efficacy and safety of Michaels® (Soratinex®) remedies in patients suffering from chronic plaque psoriasis in a Czech population. Seventy-five (34 female/41 male) patients, aged 18-72 years old (mean age: 38.5 years) with mild to severe plaque psoriasis participated in the study. The products, including cleansing gel, ointment and skin conditioner, containing fruit acid complex, herbal oils and emulsifiers, were used twice daily and in the same manner for all the skin lesions. The study period was eight weeks. Histologic variables and various blood picture parameters, including FW, glucose, cholesterol, triacylglyceroles, bilirubin, GMT, ALT, AST, creatinine, uric acid and urea in blood were monitored, before and after therapy with Michaels® (Soratinex®) treatment. Assessment, using the Psoriasis Activity Severity Index (PASI) scores and photographic analysis, was done at time 0, and after 2, 4, 6 and 8 weeks. Patient’s improvement was determined by the percentage reduction of the PASI scores. Side effects and tolerability were also evaluated. After 8 weeks using Dr Michaels® (Soratinex®) treatment course, 5 patients had a moderate improvement, with the resolution of 25-50% of skin lesions; 11 patients showed a good improvement, with the resolution of 51-75% of lesions. Another 50 patients had an outstanding improvement, with the regression of 76-100% of lesions. Only 4 patients did not achieve an improvement of psoriasis. Six patients experienced folliculitis, which resolved without cessation of treatment. Three patients worsened and discontinued treatment. Six patients dropped out because of non-compliance. The blood results and histologic findings were all normal. Our investigation shows that Dr Michaels® (Soratinex®) products can be safely and successfully used in the treatment of chronic plaque psoriasis.

Investigation of the efficacy of Dr Michaels® (Soratinex®) family in maintaining a symptom-free state for patients with psoriasis in remission. A retrospective, comparative study.

Psoriasis is a chronic inflammatory disease, affecting about 3% of the worldwide population. Although there are many therapeutic options available today for psoriasis, none of them can be considered as the gold standard treatment for maintaining a sustained period of remission. The aim of this study was to investigate whether a maintenance dosage of Michaels® Soratinex® product family is effective in maintaining a symptom-free state for patients in remission. Fifty patients (23 male, 27 female), aged 18-58-years-old (mean age: 38.3), affected by mild to severe plaque psoriasis (mean duration: 29.5), were included in this retrospective study. All of them had completed previous treatment and achieved remission. Twenty-eight had been previously treated with an Australian series of herbal skin-care products (Dr. Michaels® Soratinex® skincare products for psoriasis) and 22 treated with biologics. We evaluated the clinical condition of the member of each group every 4 weeks, for 16 times following remission. Maintenance group continued treatment with Dr Michaels® (Soratinex®). Non-Maintenance group discontinued both forms of treatment. The evaluation was based on the PASI score, assuming that at baseline it was zero. Out of 34 patients who continued treatment with Dr Michaels® (Soratinex®) product family in the Maintenance group (22 previously treated with Dr Michaels and 12 previously treated with Biologic), 26 remained symptom free with baseline PASI of zero. Six patients had a mild flare with a PASI increase of 0-25%. Two patients were in the moderate group with a PASI increase of 26-50% and were initially treated with biologic. Out of 6 patients in Dr Michaels non-maintenance group, 3 patients remained symptom free, 1 had a rebound starting on week 36 and 2 rebounded at week 44. Out of 10 patients who were in the non-maintenance from the biologic group, 6 rebounded at week 12, 2 rebounded at week 16, 1 rebounded at week 24 and 1 rebounded at week 32. In the maintenance group no side effects were described, except for a mild form of folliculitis in 3 patients. Treatment did not have to be discontinued and all 3 patients cleared. Based on the results of this study, Dr. Michaels® (Soratinex®) product family can be safely and successfully applied to maintain a symptom-free state, after patients go into remission following treatment with Dr. Michaels® (Soratinex®) product family or biologics in mild to very severe psoriasis, when considering the exclusion criteria.