Current scenario in clinical trends of psoriasis in tertiary care hospital

Velappan, Ravichandran; Venu, Sridhar; Subbaiya, Ramasamy; Chellappan, Lakshmanan

doi:10.18203/issn.2455-4529.intjresdermatol20192068

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…The main aim of the treatment of psoriasis is to relieve the symptoms and prevent relapse. 36 Velappan R et al 37 concluded that usage of systemic steroids should be avoided as there is a severe flare, or even development of life-threatening generalised pustular psoriasis when steroids are tapered or stopped. In 2017, Thappa and Munisamy 5 reported that despite the prevalence of psoriasis in the Indian population and progress in research, India still lags in psoriasis research output.…”

Section: Discussionmentioning

confidence: 99%

Homoeopathy in Psoriasis Vulgaris with Special Emphasis on Modified Naranjo Criteria for Homeopathy: An Evidence-Based Case Report

2023

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Background Psoriasis is a chronic multisystem inflammatory disease with predominantly skin and joint involvement. Ample evidences suggest that psoriasis patients improve under homoeopathic treatment. The main objective of this documentation is to find out whether such improvement can be attributable to the homoeopathic treatment. Method A case of psoriasis vulgaris with the complaint of dry, scaly itching eruption on the extensor surface of both legs is presented here. Outcome-related to impact on daily living (ORIDL) was used to evaluate the patient-reported outcome related to his daily living, disease severity in the involved area was assessed by PASI (Psoriasis Area and Severity Index) scale and PDI (Psoriasis Disability Index) scale was used to assess the disease-specific quality of life. Photographs were taken as objective evidence after obtaining consent from the patient. The Modified Naranjo Criteria for Homeopathy (MONARCH) was used to find out the possible causal attribution of the treatment provided. Result The ORIDL score of (+4) showed the major improvement from patient and physician's perspective. PASI score reduced from ‘11.2 to 0’ (documented in photographs) within a plausible timeframe. The duration of remission of the skin lesion continued for six months. Each domain of PDI score reduced (from ‘25 to 3′) imparting improved quality of life. The high total score (+9 in ‘−6 to 13’ scale) of MONARCH suggested the likelihood of improvement was attributable to the homoeopathic intervention. This case has evidently shown its marked improvement with validated outcome measures.

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Section: Discussionmentioning

confidence: 99%

Homoeopathy in Psoriasis Vulgaris with Special Emphasis on Modified Naranjo Criteria for Homeopathy: An Evidence-Based Case Report

2023

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“…EC/CHAF Bangalore/2018/28 and an informed consent of the patients. The study size was calculated based on a previous study conducted by Velappan R et al 5 considering incidence of chronic plaque psoriasis "P" as 63.2%, with 95% confidence interval and permissible error (L) in the estimate of "p" as 10%, the sample size was calculated using the formula…”

Section: Methodsmentioning

confidence: 99%

“…EC/CHAF Bangalore/2018/28 and an informed consent of the patients. The study size was calculated based on a previous study conducted by Velappan R et al 5 considering incidence of chronic plaque psoriasis “P” as 63.2%, with 95% confidence interval and permissible error (L) in the estimate of “p” as 10%, the sample size was calculated using the formula

n goodbreak= ([], ((), z) 2 ((), p) ((), q)) / ((), d) 2

where, n is the sample size, z is the value for the selected alpha level, that is, 1.96 for 95% confidence interval, p is the estimated prevalence of attribute that is present in the population, q is 1‐p, d is the acceptable margin of error of 10% for proportion being estimated.…”

Section: Introductionmentioning

confidence: 99%

Hemorrhagic dot score as a follow up marker in psoriasis on treatment: A prospective observational study

Arora¹,

Paul

Banerjee³

et al. 2022

Dermatologic Therapy

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Context: Psoriasis assessment tools in use presently lack reproducibility and are cumbersome to use. An easily reproducible, objective tool with ability to maintain visual records for follow up is hence desirable. We conducted a study with the aim to assess dermoscopic changes in psoriasis while on treatment by recording the number of hemorrhagic dots (Hemorrhagic Dot Score‐HDS) in a representative plaque and comparing it to the PASI score. Settings and design: A longitudinal prospective study was conducted between October 2018 to March 2020 in a dermatology centre of a tertiary hospital on cases of chronic plaque psoriasis on treatment over 6 months, assessed at baseline and thereafter monthly for 6 months. Methods: Hundred consenting patients of chronic plaque psoriasis were assessed, clinically, PASI and dermoscopically. HDS and other dermoscopic features were noted at every visit. Statistical analysis used: ANOVA and F test of testing of equality of Variance; effect size in terms of Cohen were used to report the strength of an apparent relationship. Results and Interpretation: Percentage improvement in the mean PASI scores and HDS and percentage improvement of mean was found significant in each month on follow up. Systemic therapy as compared to topical therapy showed higher effect size of 6.1 and 1.7, respectively. Conclusion: Hemorrhagic dot score can be used as an objective, definite assessment tool correlating with clinical severity of psoriasis with more accuracy which shows changes early following institution of therapy.

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“…Psoriatic lesions are well-defined erythematous indurated plaques with silvery white scales. Autoimmune diseases like vitiligo, lichen planus, bullous pemphigoid and alopecia areata are also known to be associated in psoriatic patients (Velappan et al 2019).…”

Section: Introductionmentioning

confidence: 99%

Exploring genetic targets of psoriasis using genome wide association studies (GWAS) for drug repurposing

et al. 2020

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Psoriasis is a chronic inflammatory disease causing itching in the body and pain in the joints. Currently, no permanent cure is available at a commercial level for this disease. Genome wide association studies (GWAS) provide a deeper insight that helps in better understanding this disease and further possible cure of this disease. The major goal of the present study is to identify potent genetic targets of psoriasis disease using GWAS approach and identify drugs for repurposing. The methods used include GWAS catalogue, GeneAnalytics, canSAR protein annotation tool, VarElect, Drug bank, Proteomics database, ProTox software. By exploring GWAS catalogue, 126 psoriasis associated genes (PAG) were identified. 68 genes found to be druggable were obtained from canSAR protein annotation tool. Localization results depict that maximum genes are present in cytoplasmic cellular components. The superpathways obtained from GeneAnalytics resulted in involvement of these genes in the immune system, Jak/Stat pathway, Th17 and Wnt pathways. Two genes Interleukin 13 (IL13) and POLI are Food and Drug Administration (FDA) approved targets. Small compounds for these targets were analysed for drug-likeliness, toxicity and mutagenecity properties. The FDA approved drug pandel was found to possess desirable properties. The medications used for psoriasis causes mild to severe side effects and does not work well always. Hence we propose drug repurposing strategy to use existing drugs for new therapies. Therefore, the drug pandel could be explored further and repurposed to treat psoriasis.

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Current scenario in clinical trends of psoriasis in tertiary care hospital

Cited by 5 publications

References 7 publications

Homoeopathy in Psoriasis Vulgaris with Special Emphasis on Modified Naranjo Criteria for Homeopathy: An Evidence-Based Case Report

Homoeopathy in Psoriasis Vulgaris with Special Emphasis on Modified Naranjo Criteria for Homeopathy: An Evidence-Based Case Report

Hemorrhagic dot score as a follow up marker in psoriasis on treatment: A prospective observational study

Exploring genetic targets of psoriasis using genome wide association studies (GWAS) for drug repurposing

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