acyclovir and Psoriasis

The aim of the study was to estimate the efficacy of liniment cycloferon included in combined therapy of herpetic infection in 30 patients with psoriasis divided into 2 groups. Combined treatment of patients with recurrent herpetic infection promoted elimination of general infection syndrome, shortened duration of eruption and local inflammation, accelerated epithelization of herpetic erosion, and decreased the frequency of relapses during the follow-up.

Topics: Acridines; Acyclovir; Adult; Anti-Infective Agents, Local; Antiviral Agents; Comorbidity; Drug Therapy, Combination; Female; Herpesviridae Infections; Herpesvirus 1, Human; Humans; Immunomodulation; Interferon Inducers; Liniments; Male; Psoriasis; Re-Epithelialization; Recurrence; Treatment Outcome

The aim: Is to increase effectiveness and assess safety of the antiviral therapy in complex treatment of patients with psoriasis with activated chronic herpes virus infection of types 1 and 2.. Matherials and methods: 120 patients and 25 practically healthy persons were examined.. Results: It has been studied an effect of antiviral therapy on the background of basic therapy in patients with P+HSV 1,2: the percentage of HSV 1,2 DNA detection after the use of acyclovir and/or inosine pranobex was decreased in saliva from 22.0±3.43 % to 6.7±1.32 % (р<0.01) and in epithelium - from 33.3±4.23 % to 6.7±1.8 % (р<0.01); The use of antiviral therapy has showed a decrease in the expression of miR 155 molecules from 126.3 ±10.5 U/6 to 62.4±5.48 U/6 (р<0.05), an increase in the number of T-regulatory lymphocytes from 6.8±1.25% to 9.1±1.41% (p=0.0503); a decrease of IFN-α level in saliva from10.1±1.84 ng/ml to 8.2±1.27 ng/ml (р1=0.0398); in the serum IL-23 level was significantly decreased from14.9±2.11 pg/ml to 8.8±2.03 pg/ml (р<0.05) and TGF-β synthesis was increased from 3.9±1.23 pg/ml to 9.3±2.21 pg/ml (р<0.01).. Conclusions: An improved method of treatment and evaluation of its clinical and immunological effectiveness based on an integral criterion was suggested as a result of conducted antiviral therapy amid basic therapy in patients with psoriasis with activated HSV-1 and HSV-2.

Topics: Acyclovir; Antiviral Agents; Herpesvirus 1, Human; Herpesvirus 2, Human; Humans; Psoriasis

Herpes simplex virus (HSV) encephalitis affects 2-4 people per million/year. Immunocompomised patients can have atypical presentations of HSV encephalitis, including a lack of cerebrospinal fluid (CSF) pleocytosis. We present the case of a patient who was receiving ustekinumab therapy for psoriasis which inhibits interleukin (IL)-12 and IL-23 signalling pathways. The initial presentation was suggestive of encephalitis, but he was discharged prior to the reporting of HSV positivity due to the lack of CSF pleocytosis. On representation, he had worsening symptoms and imaging showed midline shift, indicating cerebral oedema despite the immunosupressant effects of ustekinumab. He required intensive care unit support and treatment with high dose aciclovir and dexamethasone; after a month of treatment he made a good recovery. This case is the first to report a link between ustekinumab and HSV encephalitis, and also emphasises that imunocompromised patients can lack CSF pleocytosis and develop significant cerebral oedema which responds to immune suppression.

Topics: Acyclovir; Adult; Anti-Inflammatory Agents; Antiviral Agents; Brain Edema; Dermatologic Agents; Dexamethasone; Diagnosis, Differential; Encephalitis, Herpes Simplex; Humans; Immunocompromised Host; Male; Psoriasis; Ustekinumab

Psoriasis is a common skin disease, which is associated with multiple extracutaneous manifestations. This article presents a case report of a rare ocular manifestation of psoriasis; psoriasis-associated keratitis. In a 37-year-old man we could show that systemic immunomodulatory therapy led to a rapid improvement of the ocular symptoms.

Topics: Acyclovir; Administration, Intravaginal; Administration, Topical; Adult; Drug Therapy, Combination; Humans; Immunologic Factors; Immunosuppressive Agents; Keratitis; Male; Psoriasis; Treatment Outcome

TNF-α antagonists may increase the risk of herpes zoster (HZ), as well as the duration and severity. Recently, the monoclonal antibody ustekinumab, blocking the p40 subunit of IL-12 and IL-23, has been introduced for treating moderate to severe plaque psoriasis. There are no PubMed reports of HZ occurring in people receiving ustekinumab treatment. Common HZ was reported in clinical trials.. Two patients with severe psoriasis treated with ustekinumab developed severe contiguous multidermatomal HZ 1 and 9 months after treatment initiation.. The occurrence of HZ after the instauration of ustekinumab suggests a causal relationship. Indeed, the inhibition of the p40 subunit of IL-12 shifts the immune response towards a Th1 profile with diminished IFN-γ and TNF-α expression, decreasing the antiviral immune response.. Ustekinumab is probably a risk factor for developing HZ. Anti-HZ vaccination prior to ustekinumab treatment should be considered.

Topics: Acyclovir; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antiviral Agents; Dermatologic Agents; Herpes Zoster; Humans; Male; Middle Aged; Pain; Psoriasis; Severity of Illness Index; Treatment Outcome; Ustekinumab

Ninety percent of varicella infections are seen in children under the age of ten and usually follow a benign clinical course with complete resolution of symptoms in one to three weeks. Herpes zoster an acute vesicular eruption due to the varicella-zoster virus (VZV), occurs mostly in adults. Biologic agents include tumor necrosis factor alpha (TNF-alpha) inhibitors that have significantly impacted the treatment of autoimmune and inflammatory conditions. Therapy with TNF-alpha inhibitors poses a potential risk of serious infections secondary to their immunomodulating properties; however multiple studies have demonstrated acceptable safety and tolerability profiles. A case of documented VZV infection (varicella) in an adult receiving the TNF-alpha inhibitor etanercept is described here.

Topics: Acyclovir; Antiviral Agents; Arthritis, Psoriatic; Chickenpox; Etanercept; Hawaii; Herpesvirus 3, Human; Humans; Immunocompetence; Immunoglobulin G; Immunosuppressive Agents; Male; Middle Aged; Psoriasis; Receptors, Tumor Necrosis Factor; Risk Factors; Tumor Necrosis Factor-alpha

Topics: Acyclovir; Antiviral Agents; Diagnosis, Differential; Female; Forearm; Hand; Herpes Simplex; Humans; Middle Aged; Psoriasis

Topics: Acyclovir; Adult; Biopsy, Needle; Female; Follow-Up Studies; Herpes Genitalis; Humans; Psoriasis; Recurrence; Simplexvirus; Tamoxifen; Treatment Outcome

We report a 29-year-old female OKT4 epitope deficiency patient with primary Sjögren's syndrome and psoriasis vulgaris. Immunological investigations during the prolonged clinical course of her herpes zoster revealed that she has OKT4 epitope deficiency and primary Sjögren's syndrome. She had been treated for psoriasis vulgaris for 17 years without systemic immunosuppressive therapy. Flow cytometric study revealed that her OKT4 deficiency is heterogeneous and excluded interference with the OKT4 epitope by anti OKT4 autoantibodies. The rare coexistence of primary Sjögren's syndrome and psoriasis implicates an immune disturbance due to an unusual phenotype of CD4.

Topics: Acyclovir; Adult; Biopsy; CD4 Antigens; Epitopes; Female; Flow Cytometry; Herpes Zoster; Humans; Psoriasis; Sjogren's Syndrome; Skin

Topics: Acyclovir; Aged; Dermatitis, Exfoliative; Female; Herpes Simplex; Humans; Psoriasis