A Six-Year Analysis of Biological Therapy for Severe Psoriasis in a Lithuanian Reference Centre of Dermatovenereology.

Background and Objectives: Biological therapy is widely used for the treatment of severe psoriasis. The objective of this study was to evaluate the efficacy and safety of biological therapy for patients with severe psoriasis. Materials and Methods: A retrospective study of 79 patients with severe psoriasis, who have been treated with biological therapy between 2012 and 2018, was conducted. During this study, the following data were collected and evaluated: sex, age, body mass index (BMI), duration of illness, the results of treatment with biological therapy, concomitant therapy, Psoriasis Area and Severity Index (PASI) and adverse events. Results: In total, 74.7% (n = 59) of subjects were male. Their overall average age was 47.4 ± 11.4 (range: 18-73) years. Their baseline BMI was 27.6 ± 5.9, which increased to 29.6 ± 4.5 after 6 years of treatment. The mean duration of psoriasis was 25.7 ± 12.5 years. In total, 39.2% (n = 31) of subjects received infliximab, 36.7% (n = 29)-etanercept, 24.1% (n = 19)-ustekinumab. The treatment duration for infliximab, etanercept and ustekinumab was 201.6 ± 86.8, 156.2 ± 137.4 and 219.1 ± 95.7 weeks (p < 0.01), respectively. Overall, 65.8% (n = 52) of subjects were also on methotrexate; 30.8% (n = 16) of them discontinued it due to clinical improvement (31.3% (n = 5)), impaired liver function (31.3% (n = 5)), and intolerance (25% (n = 4)). Baseline PASI was 20.8 ± 8.8. PASI 50 was achieved by 96.2% (n = 76) of patients at week 11, PASI 75 by 86.1% (n = 68) at week 16, PASI 90 by 54.4% (n = 43) at week 35, and PASI 100 by 13.9% (n = 11) at week 33. The overall incidence rate of adverse events was 0.362 per patient year of follow-up. Conclusion: Biological therapy is an effective and safe treatment for patients with severe psoriasis.

Contact Sensitization in Patients with Chronic Leg Ulcers: Results of a 5-Year Retrospective Analysis.

OBJECTIVES: To determine the frequency of contact sensitization among patients with chronic leg ulcers; to identify the most common allergens; and to examine possible relationships to ulcer duration, itching, exudate, and leg eczema. METHODS: Researchers conducted a 5-year retrospective analysis of 145 patients diagnosed with chronic leg ulcers who underwent skin patch testing with S-1000, LU-1000, and the commonly used dressing and antiseptic series. RESULTS: Investigators included 88 females (60.7%) aged 64 ± 15.1 years and 57 males (39.3%) aged 61 ± 16.4 years. Of these, 62.8% (n = 91) of patients were sensitized to at least one substance (2.6 ± 1.4 allergens on average). The most common allergens were benzalkonium chloride (18.6% [n = 27]), balsam of Peru (17.9% [n = 26]), and povidone-iodine 10% (17.2% [n = 25]). Finally, 40% (n = 58) of patients presented with pruritus around the ulcer, which was strongly associated with a positive patch test reaction (74.1% [n = 43] vs 55.2% [n = 48]; P = .021) and polysensitization (3.5 sensitivities [95% confidence interval, 2.4-4.6] vs 2 [95% confidence interval, 1.2-2.8]). CONCLUSIONS: Contact sensitization is very common in patients with chronic leg ulcers, and pruritus around the ulcer is associated with contact allergy as well as polysensitization.

A 12-Year Experience of Hidradenitis Suppurativa Management.

BACKGROUND: Although treatment recommendations for hidradenitis suppurativa (HS) are well known, practical experience implementing them in Lithuania has not been reported yet. OBJECTIVE: To review clinical findings and treatment options used in patients with HS in the largest center of dermatology and venereology in Lithuania from 2005 to 2016. METHODS: A retrospective single-center medical file analysis was conducted on 46 patients with HS. Demographic information, patient history, and treatment results were included in the final analysis. χ Tests were used. Statistical significance was set at P ≤ .05. MAIN RESULTS: Of the 46 patients, 52.2% were male. Percentages of patients with Hurley stages I, II, and III were 41.3%, 30.4%, and 28.3%, respectively. Patients with Hurley III HS were more likely to be smokers and obese. The most commonly prescribed medications were systemic antibiotics (76.1%) and systemic retinoids (37.0%). Systemic corticosteroids (19.6%) were more often prescribed to patients with Hurley III. Surgical procedures were performed in 54.3% of patients. The most common complication of the disease was contracture (13.0%). CONCLUSIONS: This study revealed an association between smoking and obesity and the most severe stage of HS. Results showed that traditional medications used in this study were not effective for severe HS.