Acta dermatovenerologica Croatica : ADC
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Acta Dermatovenerol Croat · Jan 2012
Randomized Controlled Trial Comparative StudyComparative study of clinical efficacy of amitriptyline and pregabalin in postherpetic neuralgia.
The most common complication of herpes zoster in immunocompetent patients is postherpetic neuralgia, which is very difficult to treat. Significant beneficial effects have been found for amitriptyline, gabapentin, pregabalin, carbamazepine, sodium valproate, oxycodone, corticosteroid, topical capsaicin, tramadol, etc. The aim of this open randomized comparative study was to demonstrate clinical efficacy of amitriptyline and pregabalin. ⋯ More importantly, none of the patients stopped treatment due to adverse reaction. In conclusion, therapy with pregabalin is better compared to amitriptyline in postherpetic neuralgia patients. However, a similar study in a larger sample is required to validate the present findings.
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Acta Dermatovenerol Croat · Jan 2011
Review Case ReportsDelusion of parasitosis: case report and current concept of management.
Delusions of parasitosis (DP) is a primary psychiatric disorder, a type of monosymptomatic hypochondriac psychosis in which patients believe that 'bugs' or 'parasites' have infested their skin or that they have even spread into their visceral organs. Patients with DP usually approach different medical specialists, mostly dermatologists and primary care physicians because of symptoms presenting as crawling under their skin. Therefore, the exact prevalence of DP is unknown. ⋯ It is essential to distinguish primary from secondary disorder since the approach to these patients is different. Dermatologists who have good knowledge in diagnosis, both dermatologic and psychodermatologic, and who dare prescribe antipsychotics after consulting liaison-psychiatrist, can have good results in treating patients with DP. When treating patients with DP, multidisciplinary approach by collaboration between a dermatologist and a psychiatrist is necessary to provide complete and meaningful treatment for these patients.
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Acta Dermatovenerol Croat · Jan 2011
ReviewPhototherapy of psoriasis in the era of biologics: still in.
This article reviews recent literature on phototherapy for psoriasis, particularly narrowband UVB. The efficacy, safety, tolerability and acceptance of phototherapy are discussed. It focuses in detail on how to improve the efficacy and safety in practice by trying to optimize the protocols, using combination therapy, monitoring the cumulative dose and providing skin cancer surveillance. ⋯ It represents a valuable treatment, which deserves more utilization and research. Although not so dynamic as in systemic drugs, research into phototherapy is ongoing. Even in the era of biologics, phototherapy remains an important therapeutic modality for psoriasis and other dermatoses and represents an essential part of modern dermatological therapy.
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Psoriasis is a chronic inflammatory, immune-mediated skin disease, which affects 2%-3% of the population worldwide. Chronic plaque psoriasis is frequently associated with metabolic diseases including diabetes, obesity, dyslipidemia, metabolic syndrome and nonalcoholic fatty liver disease. Although the causal relationship between metabolic comorbidities and psoriasis has not yet been completely proven, it appears that shared genetic links, common environmental factors and/or common inflammatory pathways may underlie the development of psoriasis and comorbidities. ⋯ Traditional systemic anti-psoriatic agents could negatively affect cardio-metabolic comorbidities, and may have important interactions with drugs commonly used by psoriatic patients. In contrast, the recent findings that the risk of myocardial infarction is reduced in patients with rheumatoid arthritis who respond to anti-TNF-α therapy compared to non-responders, supports the hypothesis that the anti-inflammatory effect of TNF-α blockers might reduce the cardiovascular risk potentially also in psoriasis patients. Finally, patients with moderate to severe psoriasis should be treated promptly and effectively, and should be encouraged to drastically correct their modifiable cardiovascular risk factors, in particular obesity and smoking habit.