Open label trial of alefacept in palmoplantar pustular psoriasis.

Background: Palmoplantar pustular psoriasis (PPP) is difficult to treat. We assessed the effectiveness of alefacept in PPP and the safety of a 30 mg/week dose.

Methods: Fifteen individuals with PPP were started on 15 mg/week intramuscularly (IM) alefacept.

Cutaneous blood flow in dermatomyositis and its association with disease severity.

Background: Several studies using nailfold capillary microscopes have demonstrated capillary changes in patients with dermatomyositis (DM); however, no previous study has examined cutaneous blood flow in this disease.

Purpose: To determine cutaneous blood flow in involved and non-involved skin surfaces of patients with DM and to assess possible correlation with clinical measures of disease severity.

Methods: Using a Laser Doppler perfusion imager, cutaneous blood flow was measured at six targeted sites of involved and apparently non-involved skin of 13 DM patients and the corresponding non-involved sites of 13 healthy controls.

Comparison of different compliance behaviors in a clinical trial.

Demographics, regimen complexity, patient attitude, disease severity, and psychology determine a patient's adherence (ie, compliance) behavior. In a study of 30 patients with moderate to severe hand dermatitis, we found 2 extremes of adherence behavior: overusage and underusage. We compared these 2 patients to one patient who engaged in near-ideal usage of medication.

Adherence to topical therapy increases around the time of office visits.

Background: The efficacy of topical medications is limited by non-adherence. Interventions to improve adherence to topical treatments are not well characterized.

Objective: To assess the impact of office visits on patients' adherence to topical treatment.

Tacrolimus: focusing on atopic dermatitis.

Tacrolimus ointment is an effective treatment for atopic dermatitis. As a calcineurin inhibitor, it works through the FK-binding protein, inhibiting calcineurin and preventing dephosphorylation of nuclear factor of activated T cells (NFAT). Systemic absorption from the drug is minimal, allowing a favorable safety profile.

Adherence in dermatology: a review of the last 20 years.

Background: Adherence has been studied in many areas of medicine; however, there are few published articles pertaining to adherence and dermatology.

Objective: The purpose of this review is to summarize the current literature on medical adherence as it specifically applies to dermatology.

Methods: We conducted a PUBMED search between the years of 1985 and 2005 using the following terms: 1-[adherence AND dermatology] and 2-[dermatology AND treatment].

Cutaneous symptoms of dermatomyositis significantly impact patients' quality of life.

Background: Dermatomyositis affects visible skin and causes disease symptoms that can affect patients' quality of life (QOL).

Methods: In all, 71 patients with dermatomyositis or dermatomyositis sine myositis completed two QOL measures (the Skindex-16 and the Dermatology Life Quality Index) and a visual analog scale for pruritus. Disease severity was assessed by Physician's Global Assessment.

An open label study of clobetasol propionate 0.05% and betamethasone valerate 0.12% foams in the treatment of mild to moderate acne keloidalis.

Acne keloidalis (AK) is a disease affecting primarily African American men. Topical steroids are a widely accepted treatment of AK; however, no studies have been published investigating their effectiveness. The purpose of this open-label study was to assess the efficacy and tolerability of clobetasol propionate 0.

The burden of atopic dermatitis: impact on the patient, family, and society.

Atopic dermatitis is a common disease of increasing prevalence. Affected individuals must cope with a significant psychosocial burden, in addition to dealing with the medical aspects of the disease. Furthermore, because this is primarily a disease of childhood, family members, especially parents, are also affected by the condition.

Topical tacrolimus ointment combined with 6% salicylic acid gel for plaque psoriasis treatment.

Background: While oral tacrolimus is effective for the treatment of psoriasis, tacrolimus ointment has shown only spotty efficacy in the treatment of plaque psoriasis. The efficacy of tacrolimus ointment for the treatment of facial and intertriginous psoriasis suggests that if tacrolimus penetration can be increased, the ointment could be used for effective treatment of plaque psoriasis.

Objective: To assess whether tacrolimus ointment is an effective psoriasis treatment when used in a combination regimen with the penetration-enhancer salicylic acid.

Tacrolimus ointment: the treatment of atopic dermatitis and other inflammatory cutaneous disease.

Topical tacrolimus (FK506, Protopic) has been developed and marketed for the treatment of atopic dermatitis (AD). Tacrolimus works as an inhibitor of calcineurin, which creates a downregulation of the inflammatory cascade. Numerous trials have shown the efficacy and safety of tacrolimus in treating AD in both adults and children.

Adherence to topical therapy decreases during the course of an 8-week psoriasis clinical trial: commonly used methods of measuring adherence to topical therapy overestimate actual use.

Introduction: Medication nonadherence is common throughout medicine, and research into this area is increasing; however, knowledge about topical medication adherence is limited.

Methods: A total of 30 patients were enrolled in a clinical trial for psoriasis and followed up for 8 weeks using 3 methods of adherence monitoring: electronic monitoring caps; medication logs; and medication usage by weight.

Results: Adherence rates calculated from the medication logs and medication weights were consistently higher than those of the electronic monitors (P <.

Electronic monitoring of medication adherence in skin disease: results of a pilot study.

Background: Traditional medication adherence monitoring for topical medication use in dermatology relies heavily on measures of self-reporting and ointment tube weight, which are susceptible to various biases.

Methods: We first assessed the feasibility of using medication electronic monitoring system caps with cream, ointment, and gel formulations. We then performed a pilot study using 10 patients given a diagnosis of psoriasis with a weekly follow-up visit.

Effects of an episode of specialist care on the impact of childhood atopic dermatitis on the child's family.

Introduction: Although some preliminary work has examined the impact of atopic dermatitis (AD) on families, no empirical work has examined changes in the impact on families dealing with AD over time. An exploratory analysis of change in impact on families dealing with AD before and after an episode of medical care in a physician office setting was conducted.

Method: Baseline and follow-up surveys were completed by 35 parent caregivers before and 1 month after a dermatologist visit for the child at an academic medical center.