PubMed Health⌕ Search

Biomedical subjects

A F Finzi

Publications and source records attributed to A F Finzi.

At least 19 recordsLinked to original sources
PubMed1999

Optimising the use of tazarotene in clinical practice: consensus statement from the European advisory panel for tazarotene (Zorac TM).

BACKGROUND: This paper reports the proceedings of the European Advisory Panel Meeting for tazarotene (Zoractrade mark), which took place in Cologne on May 7, 1998. AIM: The aim of this meeting was to discuss recommendations for the use of tazarotene based on the clinical data available and on the clinical experience of the Advisory Panel members, and to identify future research needs. RECOMMENDATIONS: Based on currently available data, tazarotene can be used for the treatment of chronic, stable, plaque-type psoriasis, on the trunk or limbs covering up to 20% of the body surface area. In clinical trials, patients generally experienced a clinical response within 4 weeks of starting tazarotene treatment, and improvement was maintained for up to 12 weeks after stopping therapy. Results from published and not yet published clinical trials show that the efficacy and tolerability of tazarotene can be enhanced by the addition of topical corticosteroids to the treatment regimen and that, when used in combination with broad-band UVB phototherapy, tazarotene reduces the amount of UV light required to treat plaques. Tazarotene gel is available in two concentrations, 0.05 and 0.1%. The Advisory Panel recommends that the choice of concentration should be based on factors such as the irritability of the patient's skin and the thickness of plaques. Irritation can be managed by reducing the concentration or frequency of application, or by adding a topical corticosteroid to therapy. Tazarotene shows promise as a treatment for psoriasis in special localisations, such as the scalp, face and skin folds, although clinical studies are required.

Humans↗
PubMed1998

A clinical survey of psoriasis in Italy: 1st AISP report. Interdisciplinary Association for the Study of Psoriasis.

BACKGROUND: Psoriasis is present all over the world and its prevalence varies in the different populations and different geographical areas. For example, Northern European countries seem to have rates of incidence which are greater than those known for Southern Europe. However, today there is still a lack of adequate data to allow comparisons at an international level. METHODS: In Italy in 1994 the AISP (Interdisciplinary Association for the Study of Psoriasis) co-ordinated the recording of monthly case histories and clinical results relating to psoriasis in patients observed in dermatology centres homogeneously distributed throughout Italy. The results were extrapolated from the overall case series. RESULTS: A sample of nearly 8000 cases was collected, most presenting psoriasis vulgaris. This pathology, prevalent in males, first appears at an age somewhere between the teens and twenties. Numerous factors may be involved, and onset is mainly attributed to stress, viral or bacterial infections and pharmacological therapy. Over 90% of cases lost between 1 and 7 working days in the course of the year. Local anti-psoriasis treatment in monotherapy was administered more frequently than systemic therapy or combined therapy. CONCLUSIONS: The results of this first Italian epidemiological study confirm that psoriasis is homogeneously distributed throughout the country. About 50% of patients avail themselves of specialist cures, even several times in the course of the year, and use a wide range of therapies which may be more or less demanding. The internal socio-economic cost of the disease is evident, particularly in terms of working days lost and/or medical expenses.

Adolescent↗
PubMed1997

Vinorelbine therapy for Kaposi's sarcoma in a kidney transplant patient.

We report the case of a patient with Kaposi's sarcoma after kidney transplantation. Despite the discontinuation of azathioprine and a reduction in the cyclosporin dosage, the disease continued to evolve, and antineoplastic treatment became necessary. After 14 cycles of vinorelbine chemotherapy, there was a 75% regression of the initial lesions, despite the continuation of cyclosporin A.

Antineoplastic Agents, Phytogenic↗
PubMed1997

Posttransplantation cutaneous B-cell lymphoma with monoclonal Epstein-Barr virus infection, responding to acyclovir and reduction in immunosuppression.

Posttransplantation lymphoproliferative disorders (PTLDs) represent an important complication of solid organ transplantation. The main causative factor of PTLDs seems to be the intensity and type of immunosuppressive therapy and the frequent occurrence of Epstein-Barr virus infection. PTLDs that are disseminated at diagnosis or present late after transplantation generally share an unfavorable prognosis and are unlikely to regress in response to reduction in immunosuppressive therapy. We describe a case of cutaneous B-cell lymphoma occurring 4 years after heart transplantation in which molecular analysis revealed a monoclonal pattern of Epstein-Barr virus infection and immunoglobulin gene rearrangement. In spite of its monoclonal nature and late occurrence, the lymphomatous lesions regressed completely after antiviral treatment and a reduction in immunosuppressive therapy.

Acyclovir↗
PubMed1996

Individualized short-course cyclosporin therapy in psoriasis.

The efficacy and side-effects of cyclosporin in psoriasis, namely hypertension and renal dysfunction, are dose-related. An initial dose of 3 mg/kg per day has a better risk/benefit ratio than 5 mg/kg per day. Maximum efficacy is usually reached after 2-3 months, and effects of the drug remain even after treatment stops. We therefore suggest that periodic short-term use of cyclosporin in order to combine persisting therapeutic effect with safety. Psoriatic erythroderma and arthropathy also respond rapidly to oral cyclosporin. Once patients have been successfully treated, the drug should be discontinued. Treatment must not exceed 6 months, but in the case of relapse a new cycle of the previously effective and tolerated dose can be given. The concomitant use of other therapies has been assessed in an attempt to reduce the dose of cyclosporin. There are no significant cyclosporin-sparing effects when etretinate or UVB are used adjunctively, and currently no convincing data on the risk of combining low-dose cyclosporin with immunosuppressive therapy (including methotrexate, UVB, and PUVA) in dermatological indications. The addition of topical corticosteroids or calcipotriol leads to more rapid clearing of psoriasis plaques, although relapse rates remain unchanged. Individualized short-course cyclosporin therapy is useful in controlling acute psoriasis flares and/or inducing remission; less potent agents can then be used for maintenance therapy. Short courses of low-dose cyclosporin may almost completely eliminate the risks of renal dysfunction from this drug.

Cyclosporine↗
PubMed1995

Production of type-1 and type-2 cytokines by peripheral blood mononuclear cells of psoriatic patients.

We investigated the function of peripheral blood mononuclear cells (PBMC) in 16 patients with active psoriasis, in 15 patients with static psoriasis and in 27 healthy volunteers, by examining in vitro proliferation and antigen- and mitogen-stimulated production of interleukin-2 (IL-2) and IL-4. Plasma levels of the neuropeptide substance P were also determined. Defective alloantigen (ALLO)- and phytohaemagglutinin (PHA)-stimulated IL-2 production was detected in 42% and in 45% of psoriatic patients, respectively. The number of defective IL-2 responders was higher in static (60%) than in active (25%) psoriasis. The reduction of IL-2 responses in the former group was associated with an increase of IL-4 production. Thus PBMC of 66% of patients with static psoriasis but none of the patients with active psoriasis produced elevated amounts of PHA-stimulated IL-4. Variations of plasma substance P levels followed the same pattern of IL-4, being higher in static than in active psoriasis. These observations suggest a co-ordinated action of IL-4 and substance P as modulators of the clinical course of psoriasis. Our data show a possible correlation between the clinical evolution of psoriasis and the production of type-1 and type-2 cytokines, suggesting that the former may have a prominent role in the activation of psoriasis, while the latter may play a protective role.

Acute Disease↗
PubMed1994

Mediterranean Kaposi's sarcoma in the elderly. A randomized study of oral etoposide versus vinblastine.

BACKGROUND: This Phase III trial was performed to compare the roles of oral etoposide and intravenous (i.v.) vinblastine in the treatment of Mediterranean Kaposi's Sarcoma (MEKS) in elderly patients with severe disease (Stages II, Ac/B, III, and IV). PATIENTS AND METHODS: Sixty-five patients were randomized to receive either oral etoposide (60 mg/m2 on Days 1-3 during the first course; 60 mg/m2 on Days 1-4 during the second course, and 60 mg/m2 on Days 1-4 during the second course, and 60 mg/m2 on Days 1-5 during the third course; the courses were recycled every 3 weeks) or an i.v. bolus of vinblastine (3 mg/m2 weekly for 3 weeks, and then 6 mg/m2 every 3 weeks). RESULTS: No significant difference between the two drugs was observed in terms of response rates (etoposide, 73.5% vs. vinblastine, 58%; P = 0.3), duration of response, or survival (median not yet reached at a median follow-up of 38 months). Side effects of both treatments were limited, although myelotoxicity was more evident in the vinblastine arm. CONCLUSIONS: Although it is feasible and well tolerated, the oral administration of etoposide at these doses and in this regimen does not appear superior to vinblastine in the treatment of MEKS. Further evaluation of a more intensive schedule in large cooperative clinical trials is needed to establish the role of this drug in comparison with reference treatments.

Administration, Oral↗
PubMed1994

Experience with psoriasis in a psychosomatic dermatology clinic.

We studied 179 psoriatic patients by semistructured colloquia and psychometric tests and determined their cutaneous psycho-neurophysiological profiles by biofeedback methods. The Paykel scale for stressful events showed that 72% of psoriatics had experienced significant stressful events about one month before the appearance of the psoriasis. The Zung test for anxiety and depression showed a high level of anxiety in the psoriatic patients. 64% of the patients who were treated by BFBtraining had a decrease in their PASI index for severity and the extent of the disease and also fewer recurrences at the one-year follow-up. The results of the World Experience Inventory indicated difficulties related to body image and to relationships with others. Psoriasis influenced the sexuality of the patients. It is always difficult when one is afflicted by ill health to enjoy life and the general scores of SWL (Satisfaction with Life), were significantly lower than those of a control group.

Adult↗
PubMed1994

Topical calcipotriol for psoriasis--an immunohistologic study.

The aim of the present study was to investigate the distribution of Langerhans cells and T cells in the lesions and also the phenotypic expression of markers of activation on lesional T cells and keratinocytes, before and after 2 weeks of topical treatment of 7 psoriatic patients with calcipotriol. Before treatment, the infiltrate was composed mainly of T cells and there was decreased expression of CD1 on the intra-epidermal Langerhans cells. ICAM-1 and EGF receptor were present throughout the epidermis, but keratinocytes expressing Transferrin receptor were detected only in the basal layer. After 14 days of calcipotriol therapy, there were significantly fewer CD4T cells in the dermis and an increased number of intraepidermal CD1 + Langerhans cells. ICAM-1 expression on lesional keratinocytes was reduced in all patients, but the expression of EGF receptor was decreased in 3 patients only, and Transferrin receptor expression on keratinocytes had not changed. All these changes were concurrent with moderate clinical improvement of the lesions. The results suggest that in the early stages of the clinical response to calcipotriol there is an immunomodulating effect of the drug associated with variable decreases in keratinocyte expression of markers of activation.

Administration, Topical↗
PubMed1994

Topical calcipotriol (MC 903) for psoriasis: a clinical study.

Calcipotriol, a non-calcemic vitamin D3 analogue, inhibits the proliferation and is necessary for final differentiation of keratinocytes. The aim of the present study was to determine the efficacy and tolerability of calcipotriol ointment in patients treated for 6 weeks. Twenty patients with chronic plaque-type psoriasis were treated twice daily with calcipotriol ointment 50 ng/g. After 6 weeks' treatment there was a marked and statistically significant decrease in the PASI score values for 17 patients, no improvement was seen in 1 patient and local adverse events occurred in 2. Hypercalcemia or other laboratory abnormalities did not develop in any patient.

Administration, Topical↗
PubMed1993

Intramuscular low dose alpha-2B interferon and etretinate for treatment of mycosis fungoides.

BACKGROUND: Mycosis fungoides is a lymphoma of cutaneous origin characterized by a proliferation of cells with a T phenotype. METHODS: In this pilot study, 13 men with mycosis fungoides in various stages were treated with alpha-2b interferon and etretinate. RESULTS: In ten of them, such a therapy proved to be effective (7 complete responses, 3 partial responses), sometimes with prolonged remissions (up to 20 months, and still persistent) after suspension of the drugs. CONCLUSIONS: We chose low-dose interferon administration in order to prevent side effects, which are said to be dose-dependent. In our experience this is not true, but this drawback seems to be overcome by the very good, sometimes spectacular, response to this combination therapy, particularly in low stage forms of the disease. This fact, compared with results provided by other groups, prompts us to plan new research protocols based on associations of retinoids with different interferon types (or even associations of different interferons), because we believe they will have an important place in treatment of cutaneous T-cell lymphoma in future.

Adult↗
PubMed1993

Cyclosporin in psoriasis: pathophysiology and experimental data.

Cyclosporin has been used efficaciously in recent years for the management of severe psoriasis. The remarkable efficacy of this drug and its known immunosuppressive properties have indicated even more strongly the involvement of the immune system in the induction and maintenance of psoriasis. The present review summarizes the role of cellular immunity in the pathogenesis of psoriasis and possible mechanisms of action of cyclosporin in psoriasis, and describes the laboratory studies performed in our Department under two headings, changes in lesional immune infiltrate (evaluated immunohistologically) and changes in neutrophil chemotaxis during cyclosporin treatment. Our immunohistological study showed that the psoriatic plaques contained an infiltrate composed mainly of activated CD4+ T cells. Cyclosporin treatment significantly decreased T cells and normalized the distribution and antigen expression of intraepidermal Langerhans cells, increasing the number of CD1+ dendritic cells. Our studies on neutrophil chemotaxis showed that cyclosporin reduced the chemotactic activity of neutrophilic polymorphonuclear leukocytes (in vivo but not in vitro), seemingly as a consequence of blocking the production of chemoattracting cytokines by psoriatic monocytes.

CD4-Positive T-Lymphocytes↗