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Biomedical subjects

C Guzzo

Publications and source records attributed to C Guzzo.

11 recordsLinked to original sources
PubMed1992

Alterations in renal function in psoriasis patients treated with cyclosporine, 5 mg/kg/day.

BACKGROUND: Cyclosporine has been used to treat a variety of cutaneous and immune-mediated diseases. Nephrotoxicity is the most common major adverse side effect. OBJECTIVE: The study was designed to investigate the frequency of alterations in serum creatinine in patients with psoriasis receiving 5 mg/kg/day of cyclosporine. METHODS: Sixteen patients with severe refractory psoriasis received cyclosporine, 5 mg/kg/day, for 12 weeks. Serum creatinine was evaluated with respect to each patient's baseline. RESULTS: Serum creatinine levels remained in the normal range, but 10 of 16 patients had a 30% elevation and 5 of 16 patients had a 50% elevation of serum creatinine compared with the patient's baseline value. CONCLUSION: These results indicate that a significant elevation in serum creatinine occurs in many patients who receive cyclosporine for psoriasis.

Adult↗
PubMed1991

Urticaria pigmentosa. Systemic evaluation and successful treatment with topical steroids.

Nine patients with adult-onset urticaria pigmentosa were studied for the incidence of extracutaneous mast cell involvement and the efficacy of potent topical corticosteroid therapy for cutaneous lesions. Seven of the nine patients had increased mast cells in the marrow biopsy specimens, and five patients had focal aggregates of mast cells. The bone scan was abnormal in one patient. Liver-spleen scans revealed a shift of colloid uptake from liver to spleen in four patients. No abnormal gastrointestinal tract roentgenograms were obtained. Urinary histamine metabolites correlated with nodular bone marrow involvement, but not with other parameters. Results of the psychoneurologic testing revealed significant deviation from the norm with a verbal memory deficit in all nine patients and abnormalities on the Minnesota Multiphasic Personality Inventory in four patients. All nine patients were treated with 0.05% betamethasone dipropionate ointment under occlusion over half of the body nightly for 6 weeks. Seven of nine patients treated responded with almost complete resolution of their lesions. Hypothalamic pituitary adrenal axis suppression was evaluated with intramuscular cosyntropin stimulation and metyrapone administration during treatment. Only two patients, both of whom used the medication improperly, developed transient abnormalities. Slow return of lesions was noted 6 months after completion of therapy. Remissions could be lengthened with single weekly applications of topical steroids. Systemic involvement is frequent in patients with cutaneous mast cell disease and it is best demonstrated by bone marrow biopsy. Mast cell lesions can be safely and effectively treated with topical steroids in motivated patients.

Administration, Topical↗
PubMed1991

Evaluation of halobetasol propionate ointment in the treatment of plaque psoriasis: report on two double-blind, vehicle-controlled studies.

The results of two studies are presented that reveal the efficacy and safety of 0.05% halobetasol ointment in the treatment of patients with plaque psoriasis of at least moderate severity. Both multicenter studies were randomized, double-blind, and vehicle controlled, and study medications were applied twice daily for 2 weeks. One study was a paired-comparison (PC); the other study was of parallel-group (PG) design. Both studies called for evaluations at entry (week 0) and after 1 and 2 weeks of treatment. The PC study enrolled 100 patients; the PG study enrolled 110 patients; 204 patients provided efficacy data over both studies. In the PC study, plaque elevation, erythema, and scaling, at least moderately severe at entry, showed at the end of treatment both statistical (p less than or equal to 0.0003) and clinical significance (all greater than 1-unit difference on the rating scale) favoring 0.05% halobetasol ointment over vehicle. Pruritus (initially mild) and total score also showed statistically significant treatment differences favoring halobetasol at the final evaluation. Patient global responses for "effectiveness" and "overall rating" favored 0.05% halobetasol ointment over vehicle. In the PG study, induration, erythema, and scaling, at least moderately severe at entry, showed at the end of treatment both statistically and clinically significant differences favoring 0.05% halobetasol ointment over vehicle. Physician's global evaluation favored 0.05% halobetasol ointment over vehicle after 2 weeks of use. No patients were released from either study because of adverse events. No systemic adverse events or findings of skin atrophy were reported in these studies. Reports of "stings" or "burns" were equally divided between halobetasol and its vehicle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Treatment of psoriasis with piritrexim, a lipid-soluble folate antagonist.

Methotrexate is an effective and convenient treatment for severe psoriasis whose use is limited by the development of hepatic fibrosis and cirrhosis in a small number of patients. The mechanism of hepatotoxicity is unknown, but it is believed to be the result of intracellular polyglutamation and prolonged retention of methotrexate within the cell. Piritrexim isethionate is a lipid-soluble antifolate that has a mechanism of action similar to that of methotrexate. Since it is not polyglutamated, piritrexim could be effective in the treatment of psoriasis without the associated long-term hepatotoxicity. A 12-week phase I/II clinical trial of severe chronic plaque psoriasis assessed the safety and efficacy of oral piritrexim therapy. Based on experience gained from oncologic trials, each patient received a twice-daily dosage for 5 consecutive days every 2 weeks. Dosages ranged from 25 to 100 mg twice a day. Improvement in both lesion scores and percentage of body involvement was significant at a dose of 50 mg or more twice daily. Fifteen of 19 patients who completed 12 weeks of therapy demonstrated greater than 50% improvement in lesion scores. Improvement was limited by recrudescence of lesions over the 9-day rest period. Adverse experiences were minimal and dose related. Piritrexim is efficacious in the treatment of psoriasis.

Adult↗
PubMed1990

Persistent light reactivity from systemic quinine.

A 41-year-old black female with psoriasis developed photosensitivity and a Koebner reaction while receiving phototherapy. She had been receiving oral quinine intermittently for muscle cramps. Photobiological evaluation revealed a strongly positive photopatch test to quinine sulfate and a marked persistent reduction in the minimal erythema dose to solar-simulated radiation in the uninvolved skin. There were no abnormal reactions to UVA. The photosensitivity is still present 3 years after the withdrawal of quinine. These features are similar to those observed previously in persistent light reactors to topical photosensitizers.

Adult↗
PubMed1988

Cockarde nevus: a case report and review of the literature.

Benign acquired melanocytic nevi usually display an even and uniform architecture and coloration easily recognized by the dermatologist. The cockarde nevus, a variant of the melanocytic nevus, is an exception. It displays a targetlike morphology with histologic characteristics of a compound nevus. We believe because the lesion has been rarely reported in the American literature, it is often mistaken in this country for a dysplastic nevus.

Child↗
PubMed1987

Aggressive topical corticosteroid therapy: a novel approach to mast-cell-dependent cutaneous disorders.

Topical corticosteroids are utilized in the treatment of a wide variety of skin diseases, primarily those involving an inflammatory component. Recent investigations have revealed that one of the effects of long-term usage of steroids is the depletion of skin mast cells. This led to the treatment of patients with urticaria pigmentosa with topical high potency corticosteroids for 6 weeks. At the end of treatment there was a marked reduction in tissue histamine and an absence of mast cells as well as a disappearance of pruritus and Darier's sign. Treated areas remained clinically improved for at least 9-12 months. Observations that corticosteroids profoundly affect mast cells in vivo provides a rationale to devise new treatment regimens for mast-cell-related diseases.

Administration, Topical↗