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Videocapillaroscopic findings in the microcirculation of the psoriatic plaque during etanercept therapy.
Clin Exp Dermatol. 2013 Aug; 38(6):633-7.CE

Abstract

BACKGROUND

Vascular endothelial growth factor (VEGF) is a pivotal cytokine in the pathogenesis of psoriasis, and upregulation of VEGF by tumour necrosis factor (TNF)-α and inflammatory factors causes marked alterations in the cutaneous microcirculation. Etanercept is a fully soluble TNF receptor fusion protein that primarily binds soluble TNF-α, thus blocking its pro-angiogenic function.

AIM

To assess the modifications in the superficial capillary bed in psoriatic plaques during treatment with etanercept.

METHODS

The study enrolled 22 patients (13 men, 9 women; age range 31-74 years) with plaque psoriasis resistant to conventional therapy. The patients were stated on etanercept 50 mg/week, which was continued for 24 weeks. At the beginning of the study (baseline), and at weeks 6, 12, 18 and 24, in vivo videocapillaroscopy analysis of a selected plaque was performed. Levels of erythema, scaling and infiltration were assessed using a four-point plaque severity score, with an overall score obtained by the sum of these three scores. The Psoriasis Activity and Severity Index (PASI) was also determined.

RESULTS

Etanercept produced a significant reduction in PASI, plaque severity score and diameter of the basket-weave area at every time point. Four patients had complete remission, although none of the patients regained a normal capillaroscopic pattern.

CONCLUSIONS

Similar to other conventional therapies, etanercept is able to improve PASI, plaque severity score and basket-weave area diameter, but it is unable to induce normalization of the microcirculation in psoriatic plaques.

Authors+Show Affiliations

Department of Experimental and Clinical Medicine, University of Udine, Udine, Italy. giuseppe.stinco@uniud.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23763515

Citation

Stinco, G, et al. "Videocapillaroscopic Findings in the Microcirculation of the Psoriatic Plaque During Etanercept Therapy." Clinical and Experimental Dermatology, vol. 38, no. 6, 2013, pp. 633-7.
Stinco G, Buligan C, Maione V, et al. Videocapillaroscopic findings in the microcirculation of the psoriatic plaque during etanercept therapy. Clin Exp Dermatol. 2013;38(6):633-7.
Stinco, G., Buligan, C., Maione, V., Valent, F., & Patrone, P. (2013). Videocapillaroscopic findings in the microcirculation of the psoriatic plaque during etanercept therapy. Clinical and Experimental Dermatology, 38(6), 633-7. https://doi.org/10.1111/ced.12036
Stinco G, et al. Videocapillaroscopic Findings in the Microcirculation of the Psoriatic Plaque During Etanercept Therapy. Clin Exp Dermatol. 2013;38(6):633-7. PubMed PMID: 23763515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Videocapillaroscopic findings in the microcirculation of the psoriatic plaque during etanercept therapy. AU - Stinco,G, AU - Buligan,C, AU - Maione,V, AU - Valent,F, AU - Patrone,P, Y1 - 2013/06/13/ PY - 2012/08/03/accepted PY - 2013/6/15/entrez PY - 2013/6/15/pubmed PY - 2014/2/6/medline SP - 633 EP - 7 JF - Clinical and experimental dermatology JO - Clin Exp Dermatol VL - 38 IS - 6 N2 - BACKGROUND: Vascular endothelial growth factor (VEGF) is a pivotal cytokine in the pathogenesis of psoriasis, and upregulation of VEGF by tumour necrosis factor (TNF)-α and inflammatory factors causes marked alterations in the cutaneous microcirculation. Etanercept is a fully soluble TNF receptor fusion protein that primarily binds soluble TNF-α, thus blocking its pro-angiogenic function. AIM: To assess the modifications in the superficial capillary bed in psoriatic plaques during treatment with etanercept. METHODS: The study enrolled 22 patients (13 men, 9 women; age range 31-74 years) with plaque psoriasis resistant to conventional therapy. The patients were stated on etanercept 50 mg/week, which was continued for 24 weeks. At the beginning of the study (baseline), and at weeks 6, 12, 18 and 24, in vivo videocapillaroscopy analysis of a selected plaque was performed. Levels of erythema, scaling and infiltration were assessed using a four-point plaque severity score, with an overall score obtained by the sum of these three scores. The Psoriasis Activity and Severity Index (PASI) was also determined. RESULTS: Etanercept produced a significant reduction in PASI, plaque severity score and diameter of the basket-weave area at every time point. Four patients had complete remission, although none of the patients regained a normal capillaroscopic pattern. CONCLUSIONS: Similar to other conventional therapies, etanercept is able to improve PASI, plaque severity score and basket-weave area diameter, but it is unable to induce normalization of the microcirculation in psoriatic plaques. SN - 1365-2230 UR - https://www.unboundmedicine.com/medline/citation/23763515/Videocapillaroscopic_findings_in_the_microcirculation_of_the_psoriatic_plaque_during_etanercept_therapy_ DB - PRIME DP - Unbound Medicine ER -