Abstract:
BACKGROUND:Psoralen plus ultraviolet A (PUVA) for the treatment of psoriasis has never been evaluated using the Psoriasis Area Severity Index (PASI) in a randomized, double-blind, placebo-controlled trial. The lack of such data limits our capacity to estimate PUVA's efficacy relative to other treatment options that are available today. OBJECTIVES:The purpose of this study was to evaluate the efficacy of PUVA therapy for patients with plaque-type psoriasis. METHODS:This study involved 40 patients with psoriasis; 30 received PUVA and 10 received UVA with placebo. PASI scores were assessed at baseline and every 4 weeks thereafter for 12 weeks. RESULTS:By nonresponder imputation, 60% (18 of 30) in the PUVA group achieved 75% or more improvement in PASI score after 12 weeks of treatment compared with 0% (0 of 10) in the UVA plus placebo group (P < .0001). Using intent to treat with last observation carried forward analysis, 63% (19 of 30) in the PUVA group achieved 75% or more improvement in PASI score compared with 0% (0 of 10) in the UVA plus placebo group (P < .0001). By per protocol analysis, 86% (18 of 21) in the PUVA group as compared with 0% (0 of 7) in the UVA plus placebo group reached 75% or more improvement in PASI score after 12 weeks (P < .0001). LIMITATIONS:The study was relatively small with only 40 patients enrolled and 28 patients who completed the protocol. Further studies that involve head-to-head comparison of PUVA with other treatment modalities are needed. Nonresponder imputation, last observation carried forward with intent to treat, and per protocol analyses each have separate advantages and limitations when determining clinical significance. CONCLUSIONS:This study supports the observation that PUVA is a highly efficacious treatment for chronic plaque psoriasis.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Sivanesan SP,Gattu S,Hong J,Chavez-Frazier A,Bandow GD,Malick F,Kricorian G,Koo Jdoi
10.1016/j.jaad.2009.04.053subject
Has Abstractpub_date
2009-11-01 00:00:00pages
793-8issue
5eissn
0190-9622issn
1097-6787pii
S0190-9622(09)00533-7journal_volume
61pub_type
杂志文章,随机对照试验abstract::Five of seven patients with acquired immunodeficiency syndrome (AIDS) who had pruritus and a chronic, nonspecific-appearing skin eruption had increased antibody titers to antigens in the salivary glands of Aedes taeniorhynchus, a salt marsh mosquito common to South Florida. We hypothesize that the pruritus and skin le...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/s0190-9622(89)80051-9
更新日期:1989-08-01 00:00:00
abstract:BACKGROUND:Condyloma acuminatum are common lesions caused by human papillomavirus (HPV). HPV is associated with many human cancers, and a vaccine now prevents infection with high-risk HPV. However, eradication of established disease is difficult, indicating that these lesions are capable of local immunosuppression. OB...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2008.08.011
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abstract:BACKGROUND:A radiofrequency-controlled electrosurgical device (ESD) has been adapted for skin peeling. A high-voltage, low-amperage current converts an irrigant into an ionized vapor, causing molecular dissociation and superficial damage in adjacent tissue. OBJECTIVE:We compared the clinical and histologic effects of ...
journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mjd.2001.109856
更新日期:2001-03-01 00:00:00
abstract::The monoclonal gammopathies are characterized by clonal proliferation of plasma cells and other clonally related cells in the B-cell lineage. These disorders include monoclonal gammopathy of undetermined significance, multiple myeloma, Waldenström macroglobulinemia, heavy chain diseases, plasmacytoma, and primary amyl...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
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更新日期:1999-04-01 00:00:00
abstract::Tissue resistance to insulin is a major feature underlying the development of acanthosis nigricans in many patients. We report two unusual cases of acanthosis nigricans with contrasting forms of insulin resistance and propose an algorithm for the evaluation of patients with acanthosis nigricans. Further, we present a ...
journal_title:Journal of the American Academy of Dermatology
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abstract:BACKGROUND:Numerous studies have analyzed the influence of psoriasis on the quality of life and psychosocial health of patients. However, few studies have addressed the effect of this disease on individuals living with these patients (cohabitants). OBJECTIVE:To analyze the influence of psoriasis on the levels of anxie...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:10.1016/j.jaad.2014.03.039
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journal_title:Journal of the American Academy of Dermatology
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abstract:BACKGROUND:Early specialist evaluation during rapid proliferative growth of complicated infantile hemangiomas (IH) is crucial. Health disparities and barriers of access-to-care for children with IH have not been examined. OBJECTIVE:Investigate whether socioeconomic status (SES) is associated with age at subspecialist ...
journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
doi:
更新日期:2000-04-01 00:00:00
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
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journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
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abstract::We describe a 3-year-old male patient with an unusual congenital lesion on the plantar surface of the left foot that had been asymptomatic until shortly before presentation. Histologic examination of the plaque revealed a thinner keratin layer, increased pigmentation, and a pilosebaceous unit with a visible vellus hai...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
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journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
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abstract::A 65-year-old man with insulin-dependent diabetes developed intractable pruritus preceding weight loss and increasing fatiguability. Esophagogastroduodenoscopy revealed infection with Candida, cytomegalovirus, and Cryptosporidium. His T cell helper/suppressor ratio was inverted, and the serum human immunodeficiency vi...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
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更新日期:1987-05-01 00:00:00
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journal_title:Journal of the American Academy of Dermatology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1987-05-01 00:00:00
abstract::Myospherulosis is an uncommon subcutaneous disorder believed initially to be caused by an endosporulating fungus. Recently investigators have disproved an infectious cause and have shown that the disease represents an alteration in red blood cells, usually produced by petrolatum or lanolin, with an accompanying foreig...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章,评审
doi:10.1016/s0190-9622(89)80045-3
更新日期:1989-08-01 00:00:00
abstract::During 64 months (1977 to 1983), twelve dermatologists from various sections of the United States studied a total of 713 patients with cosmetic dermatitis out of an estimated total of 13,216 patients with contact dermatitis. The number of patients seen for all causes during this period was 281,100. An important findin...
journal_title:Journal of the American Academy of Dermatology
pub_type: 杂志文章
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更新日期:1985-12-01 00:00:00