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Biomedical subjects

Richard A Krathen

Publications and source records attributed to Richard A Krathen.

9 recordsLinked to original sources
PubMed2006

Sustained efficacy and safety of infliximab in psoriasis: a retrospective study of 73 patients.

BACKGROUND: Infliximab inhibits T-cell activation by binding tumor necrosis factor-alpha (TNF-alpha). This medication is widely used in the US for treatment of psoriasis as an off-label indication. The durability of its effect is largely unknown. OBJECTIVE: To assess the proportion of patients still on infliximab 12 months after initiation of therapy for psoriasis. METHODS: Retrospective chart review analysis of 73 patients with psoriasis treated with infliximab for at least 12 months or those who experienced treatment failure in less than 12 months. The point where infusions were deemed to no longer be efficacious was determined by physician's global assessment (PGA). RESULTS: Of 73 patients who started infliximab at least 12 months prior to this chart review, 22 (30.1%) had discontinued treatment secondary to loss of efficacy. Thirty seven patients (50.7%) had no loss of efficacy and continued to receive infusions. Two patients (2.7%) discontinued due to loss of efficacy after greater than 12 months. Of the 22 patients who discontinued treatment due to loss of efficacy, 2 were on concomitant methotrexate (5-7.5 mg/wk) therapy. Of the 37 patients still receiving treatment with no loss of efficacy at 12 months, 3 patients were on concomitant methotrexate therapy. Five patients (6.8%) discontinued secondary to minor adverse events: sinus infection (1), acne (1), fever (1), arthralgia (1), and transient rash (1). Three patients (4.1%) discontinued due to major adverse events: reactivation of tuberculosis (1), breast cancer (1), and gastrointestinal bleeding (1). One patient discontinued infliximab secondary to concerns of possible lymphoma risk (though there were no signs of symptoms of disease on examination), and 3 patients discontinued due to insurance concerns. CONCLUSION: Infliximab treatment resulted in significant improvement in psoriasis, with 37 out of 73 patients (50.7%) experiencing no loss of efficacy. This longitudinal retrospective chart review demonstrates continued benefit of infliximab infusions in about half of patients after 1 year, though a notable percentage (30.1%) experienced loss of efficacy as determined by physician's global assessment (PGA) and a number of others discontinued due to adverse events or insurance difficulty.

Adolescent↗
PubMed2004

How I do it. In a pinch.

BACKGROUND: Punch biopsy is a standard method for obtaining tissue sample in dermatology. OBJECTIVE: The objective is to convey the use of towel clips when forceps are not available in performing a punch biopsy. METHODS: After informed consent, a punch biopsy was performed when clinically indicated, using towel clips in place of forceps to aid in removal of the specimen from the patient. RESULTS: The biopsy sample was satisfactory without tissue trauma or crush artifact. CONCLUSIONS: A towel clip is a reasonable alternative when forceps are not available when performing a punch biopsy.

Biopsy↗
PubMed2003

Cutaneous metastasis: a meta-analysis of data.

BACKGROUND: Previous studies of the incidence and the most common causes of cutaneous metastasis have not led to a consensus. We compiled data from many retrospective studies and from patient data registries and autopsies to increase the total number of cases available for a larger analysis of this subject. This study was conducted to gain a better understanding of the true incidence of cutaneous metastasis, the tumors most commonly involved in this presentation, and the locations of such lesions. METHODS: A meta-analysis of cutaneous metastases from patient tumor registries and autopsic studies was performed. RESULTS: The overall incidence of cutaneous metastasis is 5.3%. The most common tumor to metastasize to the skin is breast cancer. The chest is the most common site of cutaneous metastasis. Every practitioner should be highly suspicious of acute-onset, persistent, firm papulonodules, especially when they develop on the chest. CONCLUSION: This meta-analysis greatly increases the total number of cases available for the analysis of cutaneous metastases and provides a better overall view of this topic than was previously possible.

Breast Neoplasms↗
PubMed2003

Bexarotene is a new treatment option for lymphomatoid papulosis.

BACKGROUND: Lymphomatoid papulosis (LyP) is a clonal T cell proliferation with large cell histology, a chronic course, and an increased risk of lymphoma. Bexarotene (Targretin) is an RXR-selective retinoid (rexinoid) approved for the cutaneous manifestations of cutaneous T cell lymphoma. OBJECTIVE: To determine whether bexarotene is effective in treating LyP. METHODS: Ten patients with chronic and symptomatic LyP were prospectively treated with oral (n = 3) or topical gel (n = 7) formulations of bexarotene. RESULTS: A favorable response to bexarotene treatment with decreased numbers or duration of lesions was seen in all with objective responses in 8 patients. CONCLUSIONS: Bexarotene may be an effective palliative treatment for LyP, warranting further controlled studies.

Administration, Oral↗