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Thương tổn do bệnh vảy nến cần phân biệt với các bệnh ký sinh trùng

            Về mặt thực hành lâm sàng dường như có thể dễ dàng chẩn đoán bệnh vảy nến trên các bệnh nhân, tuy nhiên các giai đoạn sớm thì một số thầy thuốc lâm sàng vẫn có thể nhầm lẫn bệnh lý da do vảy nến với một số bệnh ngoài da khác, bao gồm cả căn bệnh thương tổn da do ký sinh trùng, đặc biệt là viêm da do ấu trùng giun sán (cercarial dermatitis). Ngoài ra, một số tiến bộ gần đây trong nghiên cứu đã cho thấy nhiều thành quả trong điều trị và kiểm soát tốt bệnh vảy nến.

Các thông tin dưới đây muốn cập nhật các nghiên cứu đó, xin chia sẻ cùng bạn đọc:

Effect of treatment o­n prolactin levels in patients with psoriasis vulgaris.

Rathika S, Rajappa M, Chandrashekar L, Munisamy M, Thappa DM.

Clin Chim Acta. 2014 Feb 15;429:212-4. doi: 10.1016/j.cca.2013.12.021. Epub 2013 Dec 25. No abstract available.

Serum prolactin levels in psoriasis and correlation with cutaneous disease activity.

Dilmé-Carreras E, Martín-Ezquerra G, Sánchez-Regaña M, Umbert-Millet P.

Clin Exp Dermatol. 2011 Jan;36(1):29-32. doi: 10.1111/j.1365-2230.2010.03871.x.

Effect of methotrexate o­n serum levels of IL-22 in patients with psoriasis.

Meephansan J, Ruchusatsawat K, Sindhupak W, Thorner PS, Wongpiyabovorn J.

Eur J Dermatol. 2011 Jul-Aug;21(4):501-4. doi: 10.1684/ejd.2011.1335.


Hình 1

Clinical efficacy of propylthiouracil and its influence o­n prolactin in psoriatic patients.

Malligarjunan H, Gnanaraj P, Subramanian S, Elango T, Dayalan H.

Clin Biochem. 2011 Oct;44(14-15):1209-13. doi: 10.1016/j.clinbiochem.2011.07.009. Epub 2011 Jul 28.

Nitric oxide levels in patients with psoriasis treated with methotrexate.

Tekin NS, Ilter N, Sancak B, Ozden MG, Gurer MA.

Mediators Inflamm. 2006;2006(3):16043.

[72 cases of psoriasis treated by methotrexate].

Rollier MR.

Bull Soc Fr Dermatol Syphiligr. 1969;76(5):671-5. French. No abstract available.

[Vitamin A content of blood in patients with psoriasis during treatment with group B vitamins, pyrogenal and methotrexate].

Tishchenko LD, Mal'kevich VV.

Vestn Dermatol Venerol. 1975 Jan;(1):55-8. Russian. No abstract available.

Fasting plasma homocysteine as a sensitive parameter of antifolate effect: a study of psoriasis patients receiving low-dose methotrexate treatment.

Refsum H, Helland S, Ueland PM.

Clin Pharmacol Ther. 1989 Nov;46(5):510-20.



Hình 2-3

Association of disease severity with IL-1 levels in methotrexate-treated psoriasis patients.

Tamilselvi E, Haripriya D, Hemamalini M, Pushpa G, Swapna S.

Scand J Immunol. 2013 Dec;78(6):545-53. doi: 10.1111/sji.12117.

[Therapy with bromocriptine and behavior of various hormones in psoriasis patients].

Valentino A, Fimiani M, Bilenchi R, Castelli A, Francini G, Gonnelli S, Gennari C, Andreassi L.

Boll Soc Ital Biol Sper. 1984 Oct 30;60(10):1841-4. Italian.

Impact of methotrexate therapy o­n the folate status of psoriatic patients.

Hendel J, Nyfors A.

Clin Exp Dermatol. 1985 Jan;10(1):30-5. No abstract available.

[Methotrexate in Psoriasis vulgaris].

Braun-Falco O.

Hautarzt. 1971 Mar;22(3):135-6. German. No abstract available.

Prolactin level is significantly elevated in lesional skin of patients with psoriasis.

El-Khateeb EA, Zuel-Fakkar NM, Eid SM, Abdul-Wahab SE.

Int J Dermatol. 2011 Jun;50(6):693-6. doi: 10.1111/j.1365-4632.2010.04752.x.

Peroxisome proliferator receptor (PPAR) β/δ in psoriatic patients before and after two conventional therapeutic modalities: methotrexate and PUVA.

El Eishi N, Hegazy R, Abou Zeid O, Shaker O.

Eur J Dermatol. 2011 Sep-Oct;21(5):691-5. doi: 10.1684/ejd.2011.1422.

Serum interleukin-6 levels in response to methotrexate treatment in psoriatic patients.

Elango T, Dayalan H, Subramanian S, Gnanaraj P, Malligarjunan H.

Clin Chim Acta. 2012 Oct 9;413(19-20):1652-6. doi: 10.1016/j.cca.2012.05.007. Epub 2012 May 16.


Hình 4

The treatment of psoriasis vulgaris: 1% topical methotrexate gel.

Eskicirak B, Zemheri E, Cerkezoglu A.

Int J Dermatol. 2006 Aug;45(8):965-9.

Serum prolactin levels in patients with psoriasis: Results of a pilot study.

Khatri G, Mahajan VK, Mehta KS, Sharma KK, Bhushan S, Chauhan PS.

Indian J Med Res. 2017 Feb;145(2):250-252. doi: 10.4103/ijmr.IJMR_814_15. No abstract available.

Plasma endothelin in psoriasis: possible relations to therapy and toxicity.

Zachariae H, Heickendorff L, Bjerring P.

Acta Derm Venereol. 1996 Nov;76(6):442-3.

The use of folic acid supplementation in psoriasis patients receiving methotrexate: a survey in the United Kingdom.

Kirby B, Lyon CC, Griffiths CE, Chalmers RJ.

Clin Exp Dermatol. 2000 Jun;25(4):265-8.

A clinical study to determine the efficacy and safety of 1% methotrexate/Azone (MAZ) gel applied topically o­nce daily in patients with psoriasis vulgaris.

Sutton L, Swinehart JM, Cato A, Kaplan AS.

Int J Dermatol. 2001 Jul;40(7):464-7. No abstract available.

Radioimmunoassayable methotrexate concentrations in plasma and skin exudate of patients with psoriasis.

Boomla K, Aherne GW, Greaves MW, Quinton M.

Clin Exp Dermatol. 1979 Dec;4(4):457-63. No abstract available.

Interleukin 4 plasma levels in psoriasis vulgaris patients.

Zalewska A, Wyczółkowska J, Dziankowska-Bartkowiak B, Sysa-Jedrzejowska A.

Med Sci Monit. 2004 Apr;10(4):CR156-62.

[Alpha 1-fetoprotein--a marker of potential PUVA side-effects in psoriasis?].

Wollina U, Schulze M, Schaarschmidt H, Barta U, Pfeiffer L, Knopf B, Horn A.

Z Hautkr. 1985 Mar 15;60(6):527-30. German.

[Analysis of serum proteins among psoriatics during methotrexate therapy].

Müller-Sutter T, Schwarz M, Schwarz K.

Dermatologica. 1968;137(4):202-7. German. No abstract available.

Intestinal folate absorption in methotrexate treated psoriatic patients.

Duhra P, Hodgson C, Martin JA, Stableforth PJ.

Br J Dermatol. 1988 Sep;119(3):327-32.

[Multiple primary malignant melanomas in psoriasis vulgaris under long-term methotrexate therapy].

Wemmer U.

Z Hautkr. 1984 May 15;59(10):665-8. German. No abstract available.

Methotrexate hepatotoxicity and concentrations of methotrexate and folate in erythrocytes--relation to liver fibrosis and cirrhosis.

Zachariae H, Schrøder H, Foged E, Søgaard H.

Acta Derm Venereol. 1987;67(4):336-40.

The efficacy of methotrexate in psoriasis--a review of 40 cases.

Collins P, Rogers S.

Clin Exp Dermatol. 1992 Jul;17(4):257-60.

Serum aminoterminal propeptide of type III procollagen in psoriasis and psoriatic arthritis: relation to liver fibrosis.

Kanzler MH, Gorsulowsky D.

J Am Acad Dermatol. 1992 Mar;26(3 Pt 2):509. No abstract available.

Methotrexate treatment of psoriatic arthritis.

Zachariae H, Zachariae E.

Acta Derm Venereol. 1987;67(3):270-3.

Methotrexate serum-level determinations during low-dose therapy of rheumatoid and psoriatic arthritis.

Leeb B, Dunky A, Ogris E, Wohanka A, Schenk G, Gaismayer K, Eberl R.

Int J Clin Pharmacol Res. 1989;9(3):209-15.



Hình 5-6

Circulating adipokine levels in Portuguese patients with psoriasis vulgaris according to body mass index, severity and therapy.

Coimbra S, Oliveira H, Reis F, Belo L, Rocha S, Quintanilha A, Figueiredo A, Teixeira F, Castro E, Rocha-Pereira P, Santos-Silva A.

J Eur Acad Dermatol Venereol. 2010 Dec;24(12):1386-94. doi: 10.1111/j.1468-3083.2010.03647.x.

[Use of methotrexate in the treatment of patients with psoriasis under ambulatory conditions].

Lipskaia MI.

Vestn Dermatol Venerol. 1972 Sep;46(9):65-8. Russian. No abstract available.

[Methotrexate in treatment of psoriasis].

Shakhmeĭster IIa, Ivanov LV, Voronovitskaia LA.

Sov Med. 1977 Jul;(7):79-81. Russian. No abstract available.

[Treatment of pustulous and erythrodermic psoriasis with PUVA therapy and methotrexate].

Leković B, Dostanić I, Konstantinović K, Kneitner I.

Hautarzt. 1982 May;33(5):284-5. German.

Methotrexate in the treatment of psoriasis.

Bright RD.

Cutis. 1999 Nov;64(5):332-4.

The combination of etanercept and methotrexate increases the effectiveness of treatment in active psoriasis despite inadequate effect of methotrexate therapy.

Zachariae C, Mørk NJ, Reunala T, Lorentzen H, Falk E, Karvonen SL, Johannesson A, Claréus B, Skov L, Mørk G, Walker S, Qvitzau S.

Acta Derm Venereol. 2008;88(5):495-501. doi: 10.2340/00015555-0511.

[Treatment of psoriasis with methotrexate].

Vukas A, Kopajtić B.

Lijec Vjesn. 1968;90(2):145-53. Croatian. No abstract available.


Hình 7

Treatment of psoriasis by methotrexate.

Kraus Z.

Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove. 1976;19(3-4):353-60. No abstract available.

Treatment of chronic psoriasis vulgaris.

Morrow NE, Anderson PC.

Mo Med. 1982 Jun;79(6):335-8, 345. No abstract available.

Interruption of long-term methotrexate treatment in psoriasis. Evaluation of clinical course and laboratory parameters after discontinuation and reintroduction of weekly oral methotrexate.

van Dooren-Greebe RJ, Kuijpers AL, Termorshuizen F, van de Kerkhof PC.

Acta Derm Venereol. 1995 Sep;75(5):393-6.

Methotrexate treatment of psoriasis.

Shelmire DS.

Tex Med. 1970 Feb;66(2):88-91. No abstract available.




Hình 8-9

Methotrexate in the treatment of various forms of psoriasis].

Korolev IuF.

Vestn Dermatol Venerol. 1973 May;47(5):71-4. Russian. No abstract available.

[Psoriasis-cytostatic treatment with amethopterin (methotrexate)].

Rassner G.

Fortschr Med. 1973 Mar 22;91(9):381-8. German. No abstract available.

[Treatment of psoriasis by methotrexate in the era of biotherapies: a study in 21 Tunisian patients].

Khaled A, Ben Hamida M, Zeglaoui F, Kharfi M, Ezzine N, Fazaa B.

Therapie. 2012 Jan-Feb;67(1):49-52. doi: 10.2515/therapie/2012004. Epub 2012 Apr 11. French.

Effective continuous systemic therapy of severe plaque-type psoriasis is accompanied by amelioration of biomarkers of cardiovascular risk: results of a prospective longitudinal observational study.

Boehncke S, Salgo R, Garbaraviciene J, Beschmann H, Hardt K, Diehl S, Fichtlscherer S, Thaçi D, Boehncke WH.

J Eur Acad Dermatol Venereol. 2011 Oct;25(10):1187-93. doi: 10.1111/j.1468-3083.2010.03947.x. Epub 2011 Jan 17.

Methotrexate versus cyclosporine in moderate-to-severe chronic plaque psoriasis.

Heydendael VM, Spuls PI, Opmeer BC, de Borgie CA, Reitsma JB, Goldschmidt WF, Bossuyt PM, Bos JD, de Rie MA.

N Engl J Med. 2003 Aug 14;349(7):658-65.

Methotrexate and cyclosporine in psoriasis revisited.

Strober BE.

Semin Cutan Med Surg. 2014 Mar;33(2 Suppl 2):S27-30. doi: 10.12788/j.sder.0066.


Hình 10

Systemic therapy of psoriasis using methotrexate.

Smith KC.

Skin Therapy Lett. 2000;6(3):1-2; 5. Review.

Topical methotrexate therapy for psoriasis.

Weinstein GD, McCullough JL, Olsen E.

Arch Dermatol. 1989 Feb;125(2):227-30.

Clinical observations o­n the treatment of psoriasis with methotrexate. Conclusive notes].

Beltrani G, Armentano E.

Minerva Dermatol. 1966 May;41(5):170-5. Italian. No abstract available.

Psoriasis and methotrexate. Treatment of 50 cases].

Carrillo Casaux D, Carrillo Montesinos JM.

Actas Dermosifiliogr. 1974 May-Jun;65(5-6):265-70. Spanish. No abstract available.

Soluble tumor-necrosis-factor-alpha receptor type-1 as a marker of activity of psoriasis vulgaris and effects of its treatment.

Serwin AB, Sokołowska M, Chodynicka B.

Przegl Lek. 2005;62(2):95-7. Polish.

Coexistence of psoriasis and bullous pemphigoid: remission with low-dose methotrexate.

Gunay U, Gunduz K, Ermertcan AT, Kandiloğlu AR.

Cutan Ocul Toxicol. 2013 Jun;32(2):168-9. doi: 10.3109/15569527.2012.667030. Epub 2012 Mar 20.

Urinary adenosine and aminoimidazolecarboxamide excretion in methotrexate-treated patients with psoriasis.

Baggott JE, Morgan SL, Sams WM, Linden J.

Arch Dermatol. 1999 Jul;135(7):813-7.

Methotrexate and psoriasis: 2009 National Psoriasis Foundation Consensus Conference.

Kalb RE, Strober B, Weinstein G, Lebwohl M.

J Am Acad Dermatol. 2009 May;60(5):824-37. doi: 10.1016/j.jaad.2008.11.906.

Liver ultrastructure in methotrexate treatment of psoriasis.

Horvath E, Kovacs K, Ross RC.

Arch Dermatol. 1973 Sep;108(3):427-8. No abstract available.

Methotrexate inhibits polymorphonuclear leucocyte chemotaxis in psoriasis.

Walsdorfer U, Christophers E, Schröder JM.

Br J Dermatol. 1983 Apr;108(4):451-6.

Folinic acid rescue used routinely in psoriatic patients with known methotrexate "sensitivity".

Hills RJ, Ive FA.

Acta Derm Venereol. 1992 Nov;72(6):438-40.

Methotrexate treatment in 13 children with severe plaque psoriasis.

Collin B, Vani A, Ogboli M, Moss C.

Clin Exp Dermatol. 2009 Apr;34(3):295-8. doi: 10.1111/j.1365-2230.2008.02907.x. Epub 2008 Oct 30.

Psoriasis therapy with methotrexate.

Jaqueti G, Gonzalez P, Gallego J, Corripio F.

Actas Dermosifiliogr. 1968 Nov-Dec;59(11):603-18. Spanish. No abstract available.



Hình 11-12

Studies o­n vitamin A, carotin, and lipid blood levels in patients with psoriasis vulgaris].

Forck G, Rudel K.

Arch Dermatol Forsch. 1972;244:553-6. German. No abstract available.

Treatment of erythrodermic and pustulous psoriasis with a combination of methotrexate and etretinate].

Allegue Rodriguez F, Sendagorta Gomendio E, Freire Murgueytio P, Moreno Izquierdo R, Ledo Pozueta A.

Med Cutan Ibero Lat Am. 1988;16(1):43-9. Review. Spanish.

Epidermal calmodulin levels in psoriasis before & after therapy.

Kaur I, Kaur S, Vaishnavi C, Ganguly NK, Garg J, Kohli M.

Indian J Med Res. 1991 Apr;94:130-3.

Pulmonary function changes in patients with psoriasis o­n methotrexate therapy.

Bedi GK, Kaur I, Behera D.

J Dermatol. 1999 Jul;26(7):423-7.

Short-term methotrexate administration by low-dose infusion--does it influence clearance of psoriasis?

Harrison PV, Orrell DH, James R, Peat M, Stones RN.

Clin Exp Dermatol. 1989 Jul;14(4):291-4.

[Our experience of psoriatic arthritis and psoriasis treatment with methotrexate (author's transl)].

Zbojanová M, Vlcek F, Trnavský K.

Cesk Dermatol. 1980 Feb;55(1):39-44. Slovak. No abstract available.

Methotrexate/narrowband UVB phototherapy combination vs. narrowband UVB phototherapy in the treatment of chronic plaque-type psoriasis--a randomized single-blinded placebo-controlled study.

Mahajan R, Kaur I, Kanwar AJ.

J Eur Acad Dermatol Venereol. 2010 May;24(5):595-600. doi: 10.1111/j.1468-3083.2009.03486.x. Epub 2009 Dec 15.

Topical methotrexate in psoriasis.

Fry L, McMinn RM.

Arch Dermatol. 1967 Nov;96(5):483-8. No abstract available.



Hình 13

Contribution to the therapy of psoriasis with methotrexate].

La Rosa P.

Minerva Dermatol. 1968 Dec;43(12):859-65. Italian. No abstract available.

[Treatment of psoriasis arthropathy with either azathioprine or methotrexate (author's transl)].

Feldges DH, Barnes CG.

Schweiz Rundsch Med Prax. 1976 May 25;65(21):652-4. German. No abstract available.

Neutrophil and monocyte chemotaxis in methotrexate-treated psoriasis patients.

Ternowitz T, Herlin T.

Acta Derm Venereol Suppl (Stockh). 1985;120:23-6.

[Surprisingly rapid effect of methotrexate in the psoriasis of an 82-year-old patient with simultaneous side-effect in the eye].

Lischka G.

Hautarzt. 1968 Oct;19(10):473. German. No abstract available.

Methotrexate for psoriasis. A preliminary report.

Roenigk HH Jr, Haserick JR, Curtis GH.

Cleve Clin Q. 1965 Oct;32(4):211-5. No abstract available.

[Histological picture report No. 197. Psoriasis vulgaris of the vulva].

Grimmer H.

Z Haut Geschlechtskr. 1967 Dec 15;42(24):147-52. German. No abstract available.


Hình 14

Combination methotrexate, PUVA and UVB therapy in the treatment of psoriasis.

Bronner AK, Morison WL.

Photodermatol. 1986 Aug;3(4):245-6. No abstract available.

Partial reversal of androgenetic alopecia with methotrexate therapy for psoriasis.

Famenini S, Wu JJ.

Cutis. 2013 Sep;92(3):127-8.

Methotrexate and etretinate in the treatment of psoriasis.

Vanderveen EE, Ellis CN.

Arch Dermatol. 1984 Dec;120(12):1555-6. No abstract available.

Arthropathic pustulent psoriasis. Result of treatment with methotrexate].

Grupper C.

Bull Soc Fr Dermatol Syphiligr. 1968;75(2):160-7. French. No abstract available.

Generalized pustular psoriasis precipitated by lithium carbonate.

Lowe NJ, Ridgway HB.

Arch Dermatol. 1978 Dec;114(12):1788-9.

Treatment of generalized pustular psoriasis with methotrexate and colchicine.

Horiguchi M, Takigawa M, Imamura S.

Arch Dermatol. 1981 Dec;117(12):760. No abstract available.

Effects of dextran sulfate o­n blood cholesterol in psoriasis vulgaris.

Takenaka I.

Iryo. 1969 Mar;23(3):343-7. Japanese. No abstract available.


Hình 15

[Content of acetalphosphatide in psoriasis vulgaris, with a contribution to the problem of psoriasis vulgaris as a lipoidosis].

Braun-Falco O, Theisen H, Seckfort H.

Klin Wochenschr. 1958 Aug 15;36(16):763-6. German. No abstract available.

Acute methotrexate toxicity presenting as ulcers in plaques of psoriasis vulgaris.

Bhatnagar A, Verma R, Vasudevan B, Saraswat N.

Indian Dermatol o­nline J. 2015 May-Jun;6(3):232-3. doi: 10.4103/2229-5178.156442.

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