This clinicopathological study shows that anti-E-selectin (CDP850), although a well-tolerated, logical and safe therapy, does not appear to possess a therapeutic role in the treatment of chronic plaque psoriasis.

These findings suggest that at PDAI ≥ 7, every incremental increase in PDAI had a smaller detrimental impact on QoL. For the ABSIS, there was no significant difference in slopes before and after a given score, along with a higher P-value overall. Our results support previous findings 6 that the PDAI is superior to the ABSIS at capturing disease severity, especially at the lower end of disease activity (Figure 1c,d).To significantly improve QoL for patients with mucosal and nonmucosal PV, complete disease clearance may be necessary. Small amounts of worsening activity have an increasingly significant impact on QoL at the lower end of the spectrum. Above mild levels of activity, increasing activity has linear but detrimental smaller effects on QoL. The findings for patients with mucosal PV further support this, likely because oral erosions are painful and impact eating. Consistent with prior findings, 2 the Skindex-S best correlates with PDAI score in all patients.A notable limitation of this study is that our population had milder disease, with a median PDAI of 6Á75 and ABSIS of 11Á75. However, we are still able to show a change in QoL as the PDAI decreases, even at lower PDAI levels. Our findings have important clinical implications in determining appropriate outcomes for therapies. 7 Unlike dermatomyositis and systemic lupus erythematosus, 4 in patients with PV, complete clearance should be the goal.

The cardinal effects of cytotoxic drugs found in this study were tapering of the proximal hair shaft and premature entry of the follicle into telogen, conflicting with the conventional view that affected hair follicles continue in anagen. There was a resulting effluvium of a mixture of tapering telogen hairs and fractured hairs. As entry into telogen is an integral part of the process, cytotoxic hair loss may be regarded as a variant of the conventional 'telogen effluvium' and we propose the term 'atrophic telogen effluvium'. There was no obvious protective effect on the hair loss of prior treatment with topical calcipotriol.

Psoralen in conjunction with UVA (PUVA) is perhaps the most effective treatment for psoriasis. It is, however, a risk factor for skin cancer in these patients and there is a need to develop non-invasive assays reflective of treatment-induced DNA damage. We report here the assessment of two important lesions, thymine dimer (TG Gf fT) and 8-oxo-2P P-deoxyguanosine (8-OHdG), in the urine of psoriasis patients. It was found that, once corrected for urine concentration, the psoriatic group had significantly higher (P6 6 0.0001) urinary levels of thymine dimers compared to the control group. No significant differences in urinary 8-OHdG levels were noted between the psoriatic, atopic dermatitis and control groups. Therefore biomonitoring of therapy from the very start with this simple and non-invasive assay could perhaps be an effective measure of the risk involved with the treatment allowing optimization for minimal-risk therapy.z 1999 Federation of European Biochemical Societies.