tetracycline and Psoriasis

New drugs are available for managing several common skin disorders. For psoriasis, topical corticosteroids remain the first-line therapy, but topical vitamin D3 analogs, such as calcipotriene, now have a role. They are as effective as medium-potency topical steroids but without steroid side effects, though they can induce hypercalcemia if the dose exceeds 100 g/week. For more severe cases, methotrexate has been widely used, but other drugs now also are prescribed. They include calcineurin inhibitors, such as cyclosporine, and more recently, biologic agents, such as tumor necrosis factor inhibitors. For children and pregnant women, in whom the previously discussed drugs are not appropriate, narrowband UV-B light often is the first-line treatment. For eczema, patients requiring steroid-sparing topical drugs can be treated with calcineurin inhibitors (ie, pimecrolimus or tacrolimus); between the 2, tacrolimus is the first choice for adults and children older than 2 years. When systemic management is needed, oral calcineurin inhibitors (eg, cyclosporine) are appropriate, though oral steroids often are needed for severe cases. The need for systemic management can sometimes be delayed with use of diluted bleach baths. For acne vulgaris, standard treatments with topical benzoyl peroxide and topical or systemic antibiotics are used widely, as are oral contraceptives, but oral isotretinoin is the most effective treatment.

Topics: Acne Vulgaris; Administration, Oral; Administration, Topical; Adrenal Cortex Hormones; Calcineurin Inhibitors; Child; Dermatologic Agents; Eczema; Female; Histamine Antagonists; Humans; Immunologic Factors; Infant; Middle Aged; Psoriasis; Retinoids; Skin Diseases; Tetracycline

Topics: Acne Vulgaris; Alopecia Areata; Dermatitis, Contact; Humans; Lupus Erythematosus, Systemic; Lymphatic Diseases; Methotrexate; Ointments; Photosensitivity Disorders; Porphyrias; Psoriasis; Rosacea; Skin Diseases; Steroids; Sunscreening Agents; Tetracycline; Tinea; Trichophyton; Urea; Vitiligo

Topics: Acne Vulgaris; Adult; Aged; Child, Preschool; Female; Gonorrhea; Hirsutism; Humans; Ichthyosis; Infant; Male; Melphalan; Middle Aged; Psoriasis; Sarcoidosis; Skin Diseases; Skin Neoplasms; Syphilis; Tetracycline; United States

The use of potassium iodide (KI) to treat palmoplantar pustulosis (PPP) and pustulotic arthro-osteitis (PAO) has not previously been reported. Here, we report the first successful treatment of PPP and PAO with KI.. Among 25 patients with PPP, seven had an associated PAO. All patients were administered 900 mg KI three times per day for 3 months. Overall, 12 patients received this medical treatment for the first time or had >6 months interval since the last therapy for PPP. The other 13 patients who were nonresponsive to tetracycline for >3 months prior to KI treatment were treated with a combination of KI and tetracycline. All seven patients with PAO were included in the tetracycline and KI-treated group.. More than 70% of patients demonstrated complete clearance or ≥50% improvement in palmoplantar pustular psoriasis area and severity index (PPPASI) from baseline. In the group with <50% improvement in PPPASI from baseline, all except one patient were smokers. In the KI with tetracycline treatment group, approximately 80% demonstrated improvement. At the end of 3 months, there was remission of arthralgia in five out of seven PPP patients with PAO.. Treatment with KI and/or its combination with tetracycline may be a useful treatment for PPP/PAO. Smoking may affect the effectiveness of these treatment modalities.

Topics: Adult; Aged; Anti-Bacterial Agents; Arthritis, Psoriatic; Dermatologic Agents; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Potassium Iodide; Psoriasis; Severity of Illness Index; Smoking; Tetracycline; Treatment Outcome

Pityriasis lichenoides is an uncommon, acquired, idiopathic, self-limiting skin disease that poses a challenge to patients and clinicians to diagnose and treat. Several variants exist including pityriasis lichenoides et varioliformis acuta (PLEVA), pityriasis lichenoides chronica (PLC), and febrile ulcer-onecrotic Mucha-Habermann disease. Precise classification can be difficult due to an overlap of clinical and histologic features. In this case report we describe a patient with a rare presentation of PLC exhibiting bilateral palmoplantar involvement and mimicking psoriasis. We review the literature and discuss the clinical course, pathogenesis, and current treatment modalities of PLC.

Topics: Anti-Bacterial Agents; Diagnosis, Differential; Female; Humans; Middle Aged; Pityriasis Lichenoides; Psoriasis; PUVA Therapy; Skin; Tetracycline; Treatment Outcome

Psoriasis is a common, persistent skin disorder characterized by recurrent erythematous lesions thought to arise as a result of inflammatory cell infiltration and activation of keratinocyte proliferation. Unscheduled angiogenic growth has also been proposed to mediate the pathogenesis of psoriasis although the cellular and molecular basis for this response remains unclear. Recently, a role for the angiopoietin signaling system in psoriasis has been suggested by studies that demonstrate an up-regulation of the tyrosine kinase receptor Tie2 (also known as Tek) as well as angiopoietin-1 and angiopoietin-2 in human psoriatic lesions. To examine temporal expression of Tie2, we have developed a binary transgenic approach whereby expression of Tie2 can be conditionally regulated by the presence of tetracycline analogs in double-transgenic mice. A psoriasis-like phenotype developed in double-transgenic animals within 5 days of birth and persisted throughout adulthood. The skin of affected mice exhibited many cardinal features of human psoriasis including epidermal hyperplasia, inflammatory cell accumulation, and altered dermal angiogenesis. These skin abnormalities resolved completely with tetracycline-mediated suppression of transgene expression, thereby illustrating a complete dependence on Tie2 signaling for disease maintenance and progression. Furthermore, the skin lesions in double-transgenic mice markedly improved after administration of the immunosuppressive anti-psoriatic agent cyclosporine, thus demonstrating the clinical significance of this new model.

Topics: Angiopoietins; Animals; Blotting, Western; Cell Line; Cyclosporine; Doxycycline; Enzyme-Linked Immunosorbent Assay; Epidermis; Gene Expression Regulation; Genotype; Humans; Immunohistochemistry; Immunoprecipitation; Immunosuppressive Agents; Inflammation; Keratinocytes; Lac Operon; Lectins; Mice; Mice, Transgenic; Models, Genetic; Phenotype; Psoriasis; Receptor, TIE-2; Signal Transduction; Skin; Tetracycline; Time Factors; Transgenes; Vascular Endothelial Growth Factor A

Acrodermatitis continua of Hallopeau (ACH) is a rare type of localized pustular psoriasis. We report the case of a 65-year-old alcoholic woman who had severe inflammatory ACH for 10 years. Initial therapy with sulfasalazine was unsuccessful. The patient was then treated with oral tetracycline and topical betamethasone valerate with occlusive dressing. Her condition improved dramatically after one week.

Topics: Acrodermatitis; Administration, Oral; Administration, Topical; Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Betamethasone Valerate; Drug Therapy, Combination; Female; Glucocorticoids; Humans; Psoriasis; Tetracycline

A rare, but distinctive chronic eruption in six female black South Africans is reported. The original diagnosis of subcorneal pustular dermatosis of Sneddon and Wilkinson in these patients was refuted by the subsequent histological observation of both spongiform pustules and an underlying vasculitis. This may represent a previously undocumented form of generalized pustular psoriasis.

Topics: Adult; Black People; Child; Dapsone; Female; Humans; Middle Aged; Prednisolone; Psoriasis; Retrospective Studies; Skin; South Africa; Tetracycline; Vasculitis

Topics: Female; Humans; Middle Aged; Psoriasis; Tetracycline

Topics: Adult; Agranulocytosis; Drug Interactions; Gingivitis, Necrotizing Ulcerative; Humans; Male; Methotrexate; Pneumonia, Mycoplasma; Psoriasis; Tetracycline

To determine the potentially adverse effects of photoactive medications taken in conjunction with oral methoxsalen photochemotherapy (PUVA) for psoriasis, we studied the incidence of phototoxic reactions in 1,125 patients treated with PUVA at 15 centers. During the initial (clearing) phase of PUVA therapy, patients using photoactive medications were no more likely to have diffuse delayed erythema than patients who did not use such medications. After clearing, patients 45 years of age or older who used photoactive drugs were 2.3 times as likely to discontinue PUVA therapy for at least one month owing to problems related to UV-induced burns than were those who did not use such drugs. Only 6% of patients older than 45 years who took photoactive medications had problems with phototoxicity sufficiently severe to contribute to permanent discontinuation of PUVA therapy.

Topics: Adult; Chlorothiazide; Demeclocycline; Furosemide; Humans; Methoxsalen; Middle Aged; Nalidixic Acid; Photochemotherapy; Photosensitivity Disorders; Psoriasis; Sulfonamides; Sulfonylurea Compounds; Tetracycline

Patients whose skins are colonized with Staphylococcus aureus resistant to penicillin and/or tetracycline may carry variants that are sensitive to these antibiotics. The skin of most individuals yields the fully resistant type as the predominant flora and the nose harbours the sensitive version. This probably represents plasmid loss in vivo. The plasmid-positive cells were not more resistant to desiccation or more deeply pigmented than plasmid-negative cells. The explanation for such distributions is unknown.

Topics: Anthralin; Anti-Bacterial Agents; Desiccation; Drug Resistance, Microbial; Eczema; Ethidium; Female; Genetic Variation; Humans; Male; Nasal Mucosa; Penicillin Resistance; Perineum; Pigments, Biological; Plasmids; Psoriasis; Skin; Staphylococcus aureus; Tetracycline

Moderately severe tropical sprue was diagnosed in two American servicemen 15 and 19 months after return from Vietnam. Intestinal parasites were not demonstrated, and clinical, laboratory, and jejunal histological abnormalities returned to normal following treatment with tetracycline and folic acid in one patient and folic acid alone in the other. Neither patient was anemic, although one had hypersegmented polymorphonuclear leukocytes and both had macrocytosis and megaloblastic bone marrows. In each of these patients, diagnosis was delayed because of the failure to consider tropical sprue in the differential diagnosis of diarrhea and weight loss. The findings in these patients indicate that individuals from nonendemic areas who reside in Vietnam are at risk of developing overt tropical sprue.

Topics: Adult; Biopsy; Folic Acid; Humans; Intestine, Small; Jejunum; Male; Military Medicine; Psoriasis; Radiography; Sprue, Tropical; Tetracycline; United States; Vietnam

Topics: Administration, Topical; Anti-Inflammatory Agents; Dermatitis; Dermatitis, Seborrheic; Dermatologic Agents; Drug Prescriptions; Eczema; Female; Humans; Hydrocortisone; Male; Neomycin; Ointment Bases; Psoriasis; Salicylates; Skin Diseases; Sulfur; Tetracycline

Topics: Administration, Oral; Adolescent; Adult; Biopsy; Child; Drug Therapy, Combination; Female; Histamine H1 Antagonists; Humans; Male; Middle Aged; Pharynx; Psoriasis; Staphylococcus; Tetracycline

Topics: Adrenal Cortex Hormones; Blood Protein Disorders; Capillaries; Colchicine; Epithelial Cells; Estrogens, Conjugated (USP); Female; Humans; Hydroxyurea; Hypocalcemia; Iodoquinol; Leukocytes; Methotrexate; Microcirculation; Microscopy, Electron; Middle Aged; Psoriasis; Serum Albumin; Skin; Tetracycline

Topics: Adult; Aged; Ampicillin; Anti-Bacterial Agents; Blood; Cephaloridine; Cloxacillin; Erythromycin; Female; Humans; Lichen Planus; Male; Middle Aged; Penicillin G; Penicillins; Psoriasis; Staphylococcal Infections; Sulfamethoxazole; Tetracycline; Trimethoprim

Topics: 17-Ketosteroids; Acne Vulgaris; Adrenal Cortex Hormones; Anti-Bacterial Agents; Betamethasone; Dermatitis; Fludrocortisone; Humans; Hydrocortisone; Intestinal Diseases; Intestine, Small; Ointments; Prednisolone; Psoriasis; Skin Diseases; Tetracycline

Topics: Acne Vulgaris; Animals; Basement Membrane; Female; Humans; Injections, Intramuscular; Keratins; Male; Microscopy, Fluorescence; Psoriasis; Rats; Rosacea; Sebaceous Glands; Skin; Tail; Tetracycline

Topics: Ampicillin; Female; gamma-Globulins; Humans; Methotrexate; Middle Aged; Psoriasis; Smallpox Vaccine; Tetracycline; Vaccinia

Topics: Acne Vulgaris; Anti-Bacterial Agents; Diagnosis; Humans; Pharmacology; Psoriasis; Tetracycline; Ultraviolet Rays

Topics: Blood Chemical Analysis; Darier Disease; Demeclocycline; Dermatitis; Humans; Mycosis Fungoides; Pityriasis; Psoriasis; Skin; Skin Diseases; Sunburn; Tetracycline

Topics: Acrodermatitis; Anti-Bacterial Agents; Diagnosis, Differential; Drug Therapy; Egypt; Finger Injuries; Humans; Oxytetracycline; Pathology; Psoriasis; Staphylococcal Infections; Sulfanilamide; Sulfanilamides; Sulfonamides; Tetracycline