M. Makris

Treatment of nail psoriasis with adalimumab: an open label unblinded study

Background  Despite numerous advances in the therapeutic management of cutaneous psoriasis, there is a lack of standardized therapeutic regimens for psoriatic nail disease.

Clinical features and natural history of acquired cold urticaria in a tertiary referral hospital: a 10-year prospective study.

Background  Acquired cold urticaria (ACU) represents a heterogeneous group of disorders that share a common clinical feature: the development of urticaria or angioedema after cold exposure. We present epidemiological and clinical data of subjects with ACU, natural progression and we examine possible parameters that could correlate with disease severity.

A QUERCETIN CONTAINING SUPPLEMENT REDUCES NIACIN-INDUCED FLUSH IN HUMANS

Coronary artery disease is associated with increased serum levels of cholesterol, triglycerides and LDL, but low levels of HDL. The most potent agent capable of reversing this trend is the vitamin nicotinic acid (niacin). However, compliance even with extended-release preparations and addition of acetylsalicylic acid (ASA) is hampered by the development of a feeling of erythema and burning (“flush”), especially on the face. We recently showed that the natural flavonoids quercetin and luteolin can eliminate “flush”, as well as inhibit both niacin-induced plasma prostaglandin D2 (PGD2) and serotonin increase in an animal model. We conducted a pilot clinical study in humans. Four normal male subjects received (a) 1 g immediate release niacin either alone or after (b) the dietary formulation (Algonot-plus®) containing 150 mg quercetin per capsule. Subjects completed a visual scale (1=no, 5=worst response) symptom assessment. Erythema and burning sensation scores were both 4.75±0.50 and lasted for 3.63±1.11 hours. After Algonot-plus® administration, both scores were reduced to 2.5±0.58 and lasted for only 1.68±0.70 hours. Quercetin also inhibited methylnicotinate-induced human mast cell PGD2 release. These preliminary results suggest that quercetin could reduce niacin-induced “flush” in humans.

Efficacy of Ustekinumab in Nail Psoriasis and Improvement in Nail-Associated Quality of Life in a Population Treated with Ustekinumab for Cutaneous Psoriasis: An Open Prospective Unblinded Study

Background: The objective of this open-label prospective unblinded study was to evaluate the efficacy of ustekinumab in nail psoriasis and the improvement of patient quality of life (QoL). Methods: Twenty-seven patients with plaque psoriasis and fingernail involvement were treated with the standard ustekinumab regimen. Outcome measures were assessed at baseline and at weeks 4, 16, 28 and 40 using the nail psoriasis severity index (NAPSI). QoL was evaluated before and after treatment using the international onychomycosis-specific questionnaire. Results: The pairwise comparisons showed statistically significant NAPSI reduction in 4, 16, 28 and 40 weeks compared to the baseline score. The mean NAPSI at week 40 was 2.00 ± 2.337. The international onychomycosis QoL scores were significantly improved at all time points (p < 0.001). No patient reported any adverse events. Conclusions: Even though no control group was used in this study, ustekinumab was effective and safe in the treatment of nail psoriasis.

A randomized, double‐blind, vehicle‐controlled study of a preparation containing undecylenoyl phenylalanine 2% in the treatment of solar lentigines

Background.  Solar lentigines are common, benign, cosmetically disfiguring lesions. Available physical treatments are effective, but they are costly and carry risks of side‐effects.

An internet survey on self‐reported food allergy in Greece: clinical aspects and lack of appropriate medical consultation

Background  Food allergy (FA) represents a common and worldwide disorder but in publications referring to FA the reported diagnosis is rarely confirmed. Consequently, the subjectively assessed FA may negatively affect the quality of life of patients and their families.

Urticaria pigmentosa associated with acute stress and lesional skin mast-cell expression of CRF-R1

A 38‐year‐old woman presented with a pronounced increase in symptoms and proliferation of urticaria pigmentosa (UP) after acute psychological stress, which was quantified using the Spielberger’s State–Trait Anxiety Inventory. Immunohistochemical examination of a skin biopsy from a new UP lesion showed a large number of activated mast cells expressing corticotrophin‐releasing factor receptor‐1 (CRF‐R1) and there was high serum CRF. This is the first documented report to our knowledge of UP worsening associated with acute stress, possibly through activation of skin mast‐cell CRF‐R1.

Theophylline as "add-on" therapy in patients with delayed pressure urticaria: a prospective self-controlled study.

Delayed pressure urticaria (DPU) is a skin condition that involves the gradual development of wheals and edema at sites of physical pressure. Its pathogenesis is not clear and histamine-1 receptor (H-1R) antagonists provide only partial relief. In this prospective, clinical study, we investigated the effect of theophylline, which has a long history of benefit in allergic asthma, added to cetirizine in patients with DPU. Twenty three patients received during period #1 cetirizine (10 mg po QD) and theophylline (200 mg po BID) for 6 months, followed by period #2 of 1 month washout with only rescue medication as needed, and then by period #3 with cetirizine (10 mg QD plus placebo (BID) for 5 more months. The addition of theophylline resulted in statistically significant improvement over cetirizine alone by 2 months and continued for the duration of treatment. Treatment of cultured human mast cells with theophylline (10 μM) did not inhibit allergic histamine release, but the in vivo beneficial effect of theophylline may require significant pretreatment period to manifest itself, or may involve inhibition of other mast cell dependent mediators. A double-blind study, accompanied by serum histamine and tryptase levels, should be in order.

Comparable profiles of serum histamine and IgG4 levels in allergic beekeepers

Growing evidence identifies histamine as a key player in allergic responses, but the reports relating serum histamine to tolerance are scarce and inconclusive. This study investigated the relationship of circulating histamine to the tolerant phenotype in allergic beekeepers. The results showed a positive correlation between the serum levels of histamine and specific immunoglobulin G4 (sIgG4) to honeybee venom, but not with total IgE or sIgE. Interestingly, both sIgG4 and histamine levels were negatively correlated with the time since the last bee sting. In contrast to total IgE and sIgE, serum sIgG4 and histamine levels followed comparable patterns, being higher in tolerant/recently stung individuals and lower in the least frequently stung subgroup. The data obtained in this pilot study associated, for the first time, serum histamine levels with allergen tolerance in allergic individuals and provided the lead for further considering the putative immunomodulatory properties of histamine in allergic responses.

Maculopapular eruption to rivastigmine’s transdermal patch application and successful oral desensitization

chrisis galbana. J Food Sci 2003;68:1144–1148. 2. Laemmli UK. Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature 1970;227:680– 685. 3. Shevchenko A, Wilm M, Vorm O, Jensen ON, Podtelejnikov AV, Neubauer G et al. A strategy for identifying gel-separated proteins in sequence databases by MS alone. Biochem Soc Trans 1996;24:893–896. 4. Wang XQ, Li LN, Chang WR, Zhang JP, Gui LL, Guo BJ et al. Structure of C-phycocyanin from Spirulina platensis at 2.2 Å resolution: a novel monoclinic crystal form for phycobiliproteins in phycobilisomes. Acta Crystallogr D Biol Crystallogr 2001;57: 784–792.