BACKGROUNDPsoriasis is a chronic immune-mediated disease, characterized by increased
levels of TNFα. Anti-TNFα agents have revolutionized the treatment of severe
psoriasis by targeting an important molecule involved in its
pathogenesis.OBJECTIVESWe report the experience of a state referral center that uses anti-TNFα
agents for psoriasis.METHODSWe conducted a retrospective case series. Seventy-four out of 120 patients
met the inclusion criteria. Clinical and laboratory data was analyzed using
the chi-squared, Wicoxon and McNemar's tests. Associations were considered
statistically significant when p-value<0.05.RESULTSForty-one subjects (55.40%) were male, with a mean age of 47.69±14.99 years.
Median disease duration and pre-treatment PASI were 14.0 months (IQR
9.0-20.0), and 13.55 points (IQR 8.5-20.32). Sixty patients (81.10%) had
arthropathic psoriasis. Forty-six subjects (62.20%) had comorbidities; the
most frequent was dyslipidemia (25.70%). In 55.40% of patients, insufficient
response to conventional therapies was the principal indication for using
anti-TNFα drugs. Clinical improvement occurred in 93.20% of cases, and the
post-treatment PASI median was 0.0 points (IQR 0.0-0.0). Adverse effects
occurred in 6.80% of patients. Infections and elevation of transaminases
occurred in 28.40% and 8.10% of cases, respectively.CONCLUSIONPost-treatment reduction in PASI was satisfactory and the occurrence of
adverse effects was minor, mostly mild infusion effects and local reactions
at drug administration sites.
SummaryBackground: Hair follicles are produced in a cyclical manner and the machinery involved in the reproduction of these follicles is present since the fetal stage. Although extensive research has been done on the human hair follicle, very little is known about the importance of adhesion molecules in its development. Methods: We analyzed here, the immunoexpression of beta-1 integrin, p-cadherin, e- cadherin, and beta-catenin in hair follicles from 26 formalin-fixed and paraffin-embedded skin samples from human embryos and fetus between 12-23 weeks of gestational age. Findings: The adhesion molecules beta-1 integrin and e-cadherin/p-cadherin were expressed from 12 weeks and seemed to play a role in regulating epidermis invagination. Beta-catenin immuno stainingwas negative in all cases; down regulation of this protein may be necessary for fetal hair development and thus facilitating hair follicle down growth. Conclusion: Adhesion molecules are essential for hair follicle down growth and proliferation; integrins and cadherins play a major role in this process. More studies are needed to describe hair follicle development.
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