home *** CD-ROM | disk | FTP | other *** search
| Unknown | 1992-06-05 | 306.8 KB |
open in: 
MacOS 8.1
|
Win98
|
DOS
view JSON data
|
view as text
This file was not able to be converted.
This format is not currently supported by dexvert.
| Confidence | Program | Detection | Match Type | Support
|
|---|
| 66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
| 1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Newton Package (archive/newtonPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
| 100%
| file
| data
| default
|
|
hex view+--------+-------------------------+-------------------------+--------+--------+
|00000000| 1a 44 50 31 2e 31 00 00 | 00 00 00 00 00 05 64 00 |.DP1.1..|......d.|
|00000010| 00 00 16 00 00 00 30 30 | 00 00 00 01 9c 05 00 00 |......00|........|
|00000020| 44 0f 00 00 30 31 00 00 | 00 01 e0 14 00 00 91 0a |D...01..|........|
|00000030| 00 00 30 32 00 00 00 01 | 71 1f 00 00 1d 0d 00 00 |..02....|q.......|
|00000040| 30 33 00 00 00 01 8e 2c | 00 00 84 0c 00 00 30 34 |03.....,|......04|
|00000050| 00 00 00 01 12 39 00 00 | 43 0c 00 00 30 35 00 00 |.....9..|C...05..|
|00000060| 00 01 55 45 00 00 ea 0f | 00 00 30 36 00 00 00 01 |..UE....|..06....|
|00000070| 3f 55 00 00 cd 0a 00 00 | 30 37 00 00 00 01 0c 60 |?U......|07.....`|
|00000080| 00 00 c5 0e 00 00 30 38 | 00 00 00 01 d1 6e 00 00 |......08|.....n..|
|00000090| bf 10 00 00 30 39 00 00 | 00 01 90 7f 00 00 51 0d |....09..|......Q.|
|000000a0| 00 00 31 30 00 00 00 01 | e1 8c 00 00 cb 10 00 00 |..10....|........|
|000000b0| 31 31 00 00 00 01 ac 9d | 00 00 89 0a 00 00 31 32 |11......|......12|
|000000c0| 00 00 00 01 35 a8 00 00 | 0b 0a 00 00 31 33 00 00 |....5...|....13..|
|000000d0| 00 01 40 b2 00 00 43 0b | 00 00 31 34 00 00 00 01 |..@...C.|..14....|
|000000e0| 83 bd 00 00 eb 09 00 00 | 31 35 00 00 00 01 6e c7 |........|15....n.|
|000000f0| 00 00 f7 0b 00 00 31 36 | 00 00 00 01 65 d3 00 00 |......16|....e...|
|00000100| b5 0a 00 00 31 37 00 00 | 00 01 1a de 00 00 88 0b |....17..|........|
|00000110| 00 00 31 38 00 00 00 01 | a2 e9 00 00 bc 08 00 00 |..18....|........|
|00000120| 31 39 00 00 00 01 5e f2 | 00 00 64 0b 00 00 32 30 |19....^.|..d...20|
|00000130| 00 00 00 01 c2 fd 00 00 | 20 0c 00 00 32 31 00 00 |........| ...21..|
|00000140| 00 01 e2 09 01 00 3e 09 | 00 00 32 32 00 00 00 01 |......>.|..22....|
|00000150| 20 13 01 00 6b 0c 00 00 | 32 33 00 00 00 01 8b 1f | ...k...|23......|
|00000160| 01 00 58 0b 00 00 32 34 | 00 00 00 01 e3 2a 01 00 |..X...24|.....*..|
|00000170| a5 0b 00 00 32 35 00 00 | 00 01 88 36 01 00 ca 0a |....25..|...6....|
|00000180| 00 00 32 36 00 00 00 01 | 52 41 01 00 40 0b 00 00 |..26....|RA..@...|
|00000190| 32 37 00 00 00 01 92 4c | 01 00 f0 0a 00 00 32 38 |27.....L|......28|
|000001a0| 00 00 00 01 82 57 01 00 | 41 12 00 00 32 39 00 00 |.....W..|A...29..|
|000001b0| 00 01 c3 69 01 00 a2 0d | 00 00 33 30 00 00 00 01 |...i....|..30....|
|000001c0| 65 77 01 00 85 0a 00 00 | 33 31 00 00 00 01 ea 81 |ew......|31......|
|000001d0| 01 00 6c 0b 00 00 33 32 | 00 00 00 01 56 8d 01 00 |..l...32|....V...|
|000001e0| 5d 0c 00 00 33 33 00 00 | 00 01 b3 99 01 00 d9 0e |]...33..|........|
|000001f0| 00 00 33 34 00 00 00 01 | 8c a8 01 00 2b 0e 00 00 |..34....|....+...|
|00000200| 33 35 00 00 00 01 b7 b6 | 01 00 ee 0c 00 00 33 36 |35......|......36|
|00000210| 00 00 00 01 a5 c3 01 00 | 71 0b 00 00 33 37 00 00 |........|q...37..|
|00000220| 00 01 16 cf 01 00 c2 0a | 00 00 33 38 00 00 00 01 |........|..38....|
|00000230| d8 d9 01 00 3d 0c 00 00 | 33 39 00 00 00 01 15 e6 |....=...|39......|
|00000240| 01 00 f5 0c 00 00 34 30 | 00 00 00 01 0a f3 01 00 |......40|........|
|00000250| 17 0f 00 00 34 31 00 00 | 00 01 21 02 02 00 52 0f |....41..|..!...R.|
|00000260| 00 00 34 32 00 00 00 01 | 73 11 02 00 48 0c 00 00 |..42....|s...H...|
|00000270| 34 33 00 00 00 01 bb 1d | 02 00 e3 0b 00 00 34 34 |43......|......44|
|00000280| 00 00 00 01 9e 29 02 00 | a5 0f 00 00 34 35 00 00 |.....)..|....45..|
|00000290| 00 01 43 39 02 00 8f 0e | 00 00 34 36 00 00 00 01 |..C9....|..46....|
|000002a0| d2 47 02 00 aa 0b 00 00 | 34 37 00 00 00 01 7c 53 |.G......|47....|S|
|000002b0| 02 00 3d 0e 00 00 34 38 | 00 00 00 01 b9 61 02 00 |..=...48|.....a..|
|000002c0| 46 0d 00 00 34 39 00 00 | 00 01 ff 6e 02 00 1a 0f |F...49..|...n....|
|000002d0| 00 00 35 30 00 00 00 01 | 19 7e 02 00 e5 0b 00 00 |..50....|.~......|
|000002e0| 35 31 00 00 00 01 fe 89 | 02 00 05 0f 00 00 35 32 |51......|......52|
|000002f0| 00 00 00 01 03 99 02 00 | 20 26 00 00 35 33 00 00 |........| &..53..|
|00000300| 00 01 23 bf 02 00 c4 0c | 00 00 35 34 00 00 00 01 |..#.....|..54....|
|00000310| e7 cb 02 00 3e 0f 00 00 | 35 35 00 00 00 01 25 db |....>...|55....%.|
|00000320| 02 00 84 08 00 00 35 36 | 00 00 00 01 a9 e3 02 00 |......56|........|
|00000330| c4 0f 00 00 35 37 00 00 | 00 01 6d f3 02 00 15 07 |....57..|..m.....|
|00000340| 00 00 35 38 00 00 00 01 | 82 fa 02 00 aa 08 00 00 |..58....|........|
|00000350| 35 39 00 00 00 01 2c 03 | 03 00 13 0c 00 00 36 30 |59....,.|......60|
|00000360| 00 00 00 01 3f 0f 03 00 | 53 08 00 00 36 31 00 00 |....?...|S...61..|
|00000370| 00 01 92 17 03 00 e1 07 | 00 00 36 32 00 00 00 01 |........|..62....|
|00000380| 73 1f 03 00 fd 0a 00 00 | 36 33 00 00 00 01 70 2a |s.......|63....p*|
|00000390| 03 00 40 09 00 00 36 34 | 00 00 00 01 b0 33 03 00 |..@...64|.....3..|
|000003a0| 3c 0a 00 00 36 35 00 00 | 00 01 ec 3d 03 00 79 09 |<...65..|...=..y.|
|000003b0| 00 00 36 36 00 00 00 01 | 65 47 03 00 55 08 00 00 |..66....|eG..U...|
|000003c0| 36 37 00 00 00 01 ba 4f | 03 00 ab 0a 00 00 36 38 |67.....O|......68|
|000003d0| 00 00 00 01 65 5a 03 00 | c7 0d 00 00 36 39 00 00 |....eZ..|....69..|
|000003e0| 00 01 2c 68 03 00 c7 09 | 00 00 37 30 00 00 00 01 |..,h....|..70....|
|000003f0| f3 71 03 00 1c 0a 00 00 | 37 31 00 00 00 01 0f 7c |.q......|71.....||
|00000400| 03 00 d5 09 00 00 37 32 | 00 00 00 01 e4 85 03 00 |......72|........|
|00000410| a4 0b 00 00 37 33 00 00 | 00 01 88 91 03 00 5b 0b |....73..|......[.|
|00000420| 00 00 37 34 00 00 00 01 | e3 9c 03 00 19 0b 00 00 |..74....|........|
|00000430| 37 35 00 00 00 01 fc a7 | 03 00 03 0a 00 00 37 36 |75......|......76|
|00000440| 00 00 00 01 ff b1 03 00 | 91 0c 00 00 37 37 00 00 |........|....77..|
|00000450| 00 01 90 be 03 00 41 11 | 00 00 37 38 00 00 00 01 |......A.|..78....|
|00000460| d1 cf 03 00 cc 0b 00 00 | 37 39 00 00 00 01 9d db |........|79......|
|00000470| 03 00 c2 0a 00 00 38 30 | 00 00 00 01 5f e6 03 00 |......80|...._...|
|00000480| 8c 0c 00 00 38 31 00 00 | 00 01 eb f2 03 00 93 0f |....81..|........|
|00000490| 00 00 38 32 00 00 00 01 | 7e 02 04 00 26 0c 00 00 |..82....|~...&...|
|000004a0| 38 33 00 00 00 01 a4 0e | 04 00 00 0d 00 00 38 34 |83......|......84|
|000004b0| 00 00 00 01 a4 1b 04 00 | 01 0b 00 00 38 35 00 00 |........|....85..|
|000004c0| 00 01 a5 26 04 00 80 0a | 00 00 38 36 00 00 00 01 |...&....|..86....|
|000004d0| 25 31 04 00 1c 0b 00 00 | 38 37 00 00 00 01 41 3c |%1......|87....A<|
|000004e0| 04 00 47 0a 00 00 38 38 | 00 00 00 01 88 46 04 00 |..G...88|.....F..|
|000004f0| fc 0a 00 00 38 39 00 00 | 00 01 84 51 04 00 09 0c |....89..|...Q....|
|00000500| 00 00 39 30 00 00 00 01 | 8d 5d 04 00 f3 0e 00 00 |..90....|.]......|
|00000510| 39 31 00 00 00 01 80 6c | 04 00 ca 0a 00 00 39 32 |91.....l|......92|
|00000520| 00 00 00 01 4a 77 04 00 | 47 0c 00 00 39 33 00 00 |....Jw..|G...93..|
|00000530| 00 01 91 83 04 00 43 08 | 00 00 39 34 00 00 00 01 |......C.|..94....|
|00000540| d4 8b 04 00 76 09 00 00 | 39 35 00 00 00 01 4a 95 |....v...|95....J.|
|00000550| 04 00 1f 0a 00 00 39 36 | 00 00 00 01 69 9f 04 00 |......96|....i...|
|00000560| e5 07 00 00 39 37 00 00 | 00 01 4e a7 04 00 66 0a |....97..|..N...f.|
|00000570| 00 00 39 38 00 00 00 01 | b4 b1 04 00 d4 0b 00 00 |..98....|........|
|00000580| 39 39 00 00 00 01 88 bd | 04 00 7e 0d 00 00 00 00 |99......|..~.....|
|00000590| 00 00 00 00 06 cb 04 00 | 00 00 00 00 24 55 6e 69 |........|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 30 30 33 30 30 7d |que_ID{Y|RB00300}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 45 66 66 69 63 69 65 |..$Title|{Efficie|
|000005c0| 6e 63 79 20 6f 66 20 41 | 63 69 74 72 65 74 69 6e |ncy of A|citretin|
|000005d0| 20 69 6e 20 43 6f 6d 62 | 69 6e 61 74 69 6f 6e 20 | in Comb|ination |
|000005e0| 57 69 74 68 20 55 56 2d | 42 20 69 6e 20 74 68 65 |With UV-|B in the|
|000005f0| 20 54 72 65 61 74 6d 65 | 6e 74 20 6f 66 0d 0a 53 | Treatme|nt of..S|
|00000600| 65 76 65 72 65 20 50 73 | 6f 72 69 61 73 69 73 7d |evere Ps|oriasis}|
|00000610| 0d 0a 24 41 75 74 68 6f | 72 7b 0d 0a 52 75 7a 69 |..$Autho|r{..Ruzi|
|00000620| 63 6b 61 2c 20 54 0d 0a | 53 6f 6d 6d 65 72 62 75 |cka, T..|Sommerbu|
|00000630| 72 67 2c 20 43 0d 0a 42 | 72 61 75 6e 2d 46 61 6c |rg, C..B|raun-Fal|
|00000640| 63 6f 2c 20 4f 0d 0a 4b | 6f 73 74 65 72 2c 20 57 |co, O..K|oster, W|
|00000650| 0d 0a 4c 65 6e 67 65 6e | 2c 20 57 0d 0a 4c 65 6e |..Lengen|, W..Len|
|00000660| 73 69 6e 67 2c 20 57 0d | 0a 4c 65 74 7a 65 6c 2c |sing, W.|.Letzel,|
|00000670| 20 48 0d 0a 4d 65 69 67 | 65 6c 2c 20 57 4e 0d 0a | H..Meig|el, WN..|
|00000680| 50 61 75 6c 2c 20 45 0d | 0a 50 72 7a 79 62 69 6c |Paul, E.|.Przybil|
|00000690| 6c 61 2c 20 42 0d 0a 53 | 74 65 69 6e 65 72 74 2c |la, B..S|teinert,|
|000006a0| 20 4d 0d 0a 57 69 6e 7a | 65 72 2c 20 4d 0d 0a 57 | M..Winz|er, M..W|
|000006b0| 69 73 6b 65 6d 61 6e 6e | 2c 20 41 7d 0d 0a 24 41 |iskemann|, A}..$A|
|000006c0| 66 66 69 6c 69 61 74 69 | 6f 6e 7b 55 6e 69 76 20 |ffiliati|on{Univ |
|000006d0| 6f 66 20 4d 75 6e 69 63 | 68 3b 20 53 74 61 74 69 |of Munic|h; Stati|
|000006e0| 63 6f 6e 20 47 6d 62 48 | 2c 20 50 6c 61 6e 65 67 |con GmbH|, Planeg|
|000006f0| 67 3b 20 55 6e 69 76 20 | 6f 66 20 48 61 6d 62 75 |g; Univ |of Hambu|
|00000700| 72 67 3b 20 43 69 74 79 | 0d 0a 48 6f 73 70 20 53 |rg; City|..Hosp S|
|00000710| 74 20 47 65 6f 72 67 2c | 20 48 61 6d 62 75 72 67 |t Georg,| Hamburg|
|00000720| 3b 20 4d 65 64 20 53 63 | 68 6f 6f 6c 2c 20 48 61 |; Med Sc|hool, Ha|
|00000730| 6e 6e 6f 76 65 72 2c 20 | 47 65 72 6d 61 6e 79 3b |nnover, |Germany;|
|00000740| 20 65 74 20 61 6c 7d 0d | 0a 24 4a 6f 75 72 6e 61 | et al}.|.$Journa|
|00000750| 6c 7b 41 72 63 68 20 44 | 65 72 6d 61 74 6f 6c 7d |l{Arch D|ermatol}|
|00000760| 0d 0a 24 56 6f 6c 75 6d | 65 7b 31 32 36 7d 0d 0a |..$Volum|e{126}..|
|00000770| 24 50 61 67 65 7b 34 38 | 32 2d 34 38 36 7d 0d 0a |$Page{48|2-486}..|
|00000780| 24 44 61 74 65 7b 31 39 | 39 30 7d 0d 0a 24 59 42 |$Date{19|90}..$YB|
|00000790| 56 6f 6c 7b 31 39 39 31 | 20 59 65 61 72 20 42 6f |Vol{1991| Year Bo|
|000007a0| 6f 6b 20 6f 66 20 44 65 | 72 6d 61 74 6f 6c 6f 67 |ok of De|rmatolog|
|000007b0| 79 7d 0d 0a 24 43 68 61 | 70 74 65 72 7b 31 37 2d |y}..$Cha|pter{17-|
|000007c0| 32 30 7d 0d 0a 24 59 42 | 45 64 69 74 6f 72 7b 44 |20}..$YB|Editor{D|
|000007d0| 72 73 2e 20 20 53 6f 62 | 65 72 20 61 6e 64 20 46 |rs. Sob|er and F|
|000007e0| 69 74 7a 70 61 74 72 69 | 63 6b 7d 0d 0a 24 54 61 |itzpatri|ck}..$Ta|
|000007f0| 62 6c 65 7b 54 61 62 6c | 65 20 4f 6d 69 74 74 65 |ble{Tabl|e Omitte|
|00000800| 64 7d 0d 0a 24 43 6f 6d | 6d 65 6e 74 61 74 6f 72 |d}..$Com|mentator|
|00000810| 7b 53 2e 41 2e 20 20 43 | 6f 6f 70 6d 61 6e 2c 20 |{S.A. C|oopman, |
|00000820| 4d 2e 44 2e 7d 0d 0a 0d | 0a 43 6f 70 79 72 69 67 |M.D.}...|.Copyrig|
|00000830| 68 74 20 28 43 29 20 59 | 65 61 72 20 42 6f 6f 6b |ht (C) Y|ear Book|
|00000840| 20 4d 65 64 69 63 61 6c | 20 50 75 62 6c 69 73 68 | Medical| Publish|
|00000850| 65 72 73 2c 20 49 6e 63 | 2e 20 20 31 39 39 31 0d |ers, Inc|. 1991.|
|00000860| 0a 0d 0a 31 39 39 31 20 | 59 65 61 72 20 42 6f 6f |...1991 |Year Boo|
|00000870| 6b 20 6f 66 20 44 65 72 | 6d 61 74 6f 6c 6f 67 79 |k of Der|matology|
|00000880| 0d 0a 0d 0a 43 68 61 70 | 74 65 72 20 31 37 2d 2d |....Chap|ter 17--|
|00000890| 50 73 6f 72 69 61 73 69 | 73 20 61 6e 64 20 52 65 |Psoriasi|s and Re|
|000008a0| 6c 61 74 65 64 20 44 69 | 73 6f 72 64 65 72 73 0d |lated Di|sorders.|
|000008b0| 0a 0d 0a 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |...-----|--------|
|000008c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000008d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000008e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000008f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000900| 2d 0d 0a 45 66 66 69 63 | 69 65 6e 63 79 20 6f 66 |-..Effic|iency of|
|00000910| 20 41 63 69 74 72 65 74 | 69 6e 20 69 6e 20 43 6f | Acitret|in in Co|
|00000920| 6d 62 69 6e 61 74 69 6f | 6e 20 57 69 74 68 20 55 |mbinatio|n With U|
|00000930| 56 2d 42 20 69 6e 20 74 | 68 65 20 54 72 65 61 74 |V-B in t|he Treat|
|00000940| 6d 65 6e 74 20 6f 66 20 | 53 65 76 65 72 65 0d 0a |ment of |Severe..|
|00000950| 50 73 6f 72 69 61 73 69 | 73 0d 0a 0d 0a 52 75 7a |Psoriasi|s....Ruz|
|00000960| 69 63 6b 61 20 54 3b 20 | 53 6f 6d 6d 65 72 62 75 |icka T; |Sommerbu|
|00000970| 72 67 20 43 3b 20 42 72 | 61 75 6e 2d 46 61 6c 63 |rg C; Br|aun-Falc|
|00000980| 6f 20 4f 3b 20 4b 6f 73 | 74 65 72 20 57 3b 20 4c |o O; Kos|ter W; L|
|00000990| 65 6e 67 65 6e 20 57 3b | 20 4c 65 6e 73 69 6e 67 |engen W;| Lensing|
|000009a0| 20 57 3b 20 4c 65 74 7a | 65 6c 0d 0a 48 3b 20 4d | W; Letz|el..H; M|
|000009b0| 65 69 67 65 6c 20 57 4e | 3b 20 50 61 75 6c 20 45 |eigel WN|; Paul E|
|000009c0| 3b 20 50 72 7a 79 62 69 | 6c 6c 61 20 42 3b 20 53 |; Przybi|lla B; S|
|000009d0| 74 65 69 6e 65 72 74 20 | 4d 3b 20 57 69 6e 7a 65 |teinert |M; Winze|
|000009e0| 72 20 4d 3b 20 57 69 73 | 6b 65 6d 61 6e 6e 20 41 |r M; Wis|kemann A|
|000009f0| 0d 0a 28 55 6e 69 76 20 | 6f 66 20 4d 75 6e 69 63 |..(Univ |of Munic|
|00000a00| 68 3b 20 53 74 61 74 69 | 63 6f 6e 20 47 6d 62 48 |h; Stati|con GmbH|
|00000a10| 2c 20 50 6c 61 6e 65 67 | 67 3b 20 55 6e 69 76 20 |, Planeg|g; Univ |
|00000a20| 6f 66 20 48 61 6d 62 75 | 72 67 3b 20 43 69 74 79 |of Hambu|rg; City|
|00000a30| 20 48 6f 73 70 20 53 74 | 20 47 65 6f 72 67 2c 0d | Hosp St| Georg,.|
|00000a40| 0a 48 61 6d 62 75 72 67 | 3b 20 4d 65 64 20 53 63 |.Hamburg|; Med Sc|
|00000a50| 68 6f 6f 6c 2c 20 48 61 | 6e 6e 6f 76 65 72 2c 20 |hool, Ha|nnover, |
|00000a60| 47 65 72 6d 61 6e 79 3b | 20 65 74 20 61 6c 29 0d |Germany;| et al).|
|00000a70| 0a 41 72 63 68 20 44 65 | 72 6d 61 74 6f 6c 20 31 |.Arch De|rmatol 1|
|00000a80| 32 36 3a 34 38 32 2d 34 | 38 36 2c 20 31 39 39 30 |26:482-4|86, 1990|
|00000a90| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00000aa0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000ab0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000ac0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000ad0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000ae0| 0d 0a 0d 0a 41 62 73 74 | 72 61 63 74 0d 0a 0d 0a |....Abst|ract....|
|00000af0| 20 20 20 20 20 41 63 69 | 74 72 65 74 69 6e 20 28 | Aci|tretin (|
|00000b00| 65 74 72 65 74 69 6e 2c | 20 52 4f 20 31 30 2d 31 |etretin,| RO 10-1|
|00000b10| 36 37 30 29 2c 20 74 68 | 65 20 6d 61 6a 6f 72 20 |670), th|e major |
|00000b20| 6d 65 74 61 62 6f 6c 69 | 74 65 20 6f 66 20 65 74 |metaboli|te of et|
|00000b30| 72 65 74 69 6e 61 74 65 | 2c 0d 0a 6f 66 66 65 72 |retinate|,..offer|
|00000b40| 73 20 61 20 73 69 6d 69 | 6c 61 72 20 74 68 65 72 |s a simi|lar ther|
|00000b50| 61 70 65 75 74 69 63 20 | 70 72 6f 66 69 6c 65 20 |apeutic |profile |
|00000b60| 61 73 20 69 74 73 20 70 | 61 72 65 6e 74 20 63 6f |as its p|arent co|
|00000b70| 6d 70 6f 75 6e 64 20 69 | 6e 20 70 73 6f 72 69 61 |mpound i|n psoria|
|00000b80| 73 69 73 0d 0a 76 75 6c | 67 61 72 69 73 2c 20 62 |sis..vul|garis, b|
|00000b90| 75 74 20 77 69 74 68 20 | 72 61 70 69 64 20 65 6c |ut with |rapid el|
|00000ba0| 69 6d 69 6e 61 74 69 6f | 6e 20 6b 69 6e 65 74 69 |iminatio|n kineti|
|00000bb0| 63 73 2e 20 20 42 65 63 | 61 75 73 65 20 72 65 74 |cs. Bec|ause ret|
|00000bc0| 69 6e 6f 69 64 73 20 69 | 6e 20 70 73 6f 72 69 61 |inoids i|n psoria|
|00000bd0| 73 69 73 0d 0a 76 75 6c | 67 61 72 69 73 20 61 72 |sis..vul|garis ar|
|00000be0| 65 20 75 73 65 64 20 70 | 72 65 64 6f 6d 69 6e 61 |e used p|redomina|
|00000bf0| 6e 74 6c 79 20 69 6e 20 | 63 6f 6d 62 69 6e 61 74 |ntly in |combinat|
|00000c00| 69 6f 6e 20 72 65 67 69 | 6d 65 6e 73 20 77 69 74 |ion regi|mens wit|
|00000c10| 68 20 75 6c 74 72 61 76 | 69 6f 6c 65 74 20 42 0d |h ultrav|iolet B.|
|00000c20| 0a 28 55 56 42 29 2c 20 | 74 68 65 20 61 6e 74 69 |.(UVB), |the anti|
|00000c30| 70 73 6f 72 69 61 74 69 | 63 20 65 66 66 69 63 61 |psoriati|c effica|
|00000c40| 63 79 20 61 6e 64 20 73 | 61 66 65 74 79 20 6f 66 |cy and s|afety of|
|00000c50| 20 61 63 69 74 72 65 74 | 69 6e 20 69 6e 20 63 6f | acitret|in in co|
|00000c60| 6d 62 69 6e 61 74 69 6f | 6e 20 77 69 74 68 0d 0a |mbinatio|n with..|
|00000c70| 55 56 42 20 77 61 73 20 | 65 76 61 6c 75 61 74 65 |UVB was |evaluate|
|00000c80| 64 20 69 6e 20 61 20 64 | 6f 75 62 6c 65 2d 62 6c |d in a d|ouble-bl|
|00000c90| 69 6e 64 2c 20 72 61 6e | 64 6f 6d 69 7a 65 64 2c |ind, ran|domized,|
|00000ca0| 20 70 6c 61 63 65 62 6f | 2d 63 6f 6e 74 72 6f 6c | placebo|-control|
|00000cb0| 6c 65 64 2c 0d 0a 6d 75 | 6c 74 69 63 65 6e 74 65 |led,..mu|lticente|
|00000cc0| 72 20 73 74 75 64 79 20 | 6f 66 20 38 32 20 70 61 |r study |of 82 pa|
|00000cd0| 74 69 65 6e 74 73 20 77 | 69 74 68 20 73 65 76 65 |tients w|ith seve|
|00000ce0| 72 65 20 70 73 6f 72 69 | 61 73 69 73 2e 20 20 54 |re psori|asis. T|
|00000cf0| 68 65 20 64 6f 73 65 20 | 6f 66 0d 0a 6d 65 64 69 |he dose |of..medi|
|00000d00| 63 61 74 69 6f 6e 20 77 | 61 73 20 33 35 20 6d 67 |cation w|as 35 mg|
|00000d10| 20 69 6e 20 74 68 65 20 | 66 69 72 73 74 20 34 20 | in the |first 4 |
|00000d20| 77 65 65 6b 73 20 61 6e | 64 20 32 35 20 6d 67 20 |weeks an|d 25 mg |
|00000d30| 66 6f 72 20 74 68 65 20 | 6e 65 78 74 20 34 2c 20 |for the |next 4, |
|00000d40| 77 69 74 68 20 55 56 42 | 0d 0a 74 72 65 61 74 6d |with UVB|..treatm|
|00000d50| 65 6e 74 20 73 74 61 72 | 74 65 64 20 63 6f 6e 63 |ent star|ted conc|
|00000d60| 6f 6d 69 74 61 6e 74 6c | 79 20 69 6e 20 69 6e 63 |omitantl|y in inc|
|00000d70| 72 65 61 73 69 6e 67 20 | 65 6e 65 72 67 79 20 64 |reasing |energy d|
|00000d80| 6f 73 65 73 2e 20 20 54 | 68 65 20 70 73 6f 72 69 |oses. T|he psori|
|00000d90| 61 73 69 73 0d 0a 73 65 | 76 65 72 69 74 79 20 69 |asis..se|verity i|
|00000da0| 6e 64 65 78 20 28 50 53 | 49 29 20 61 6e 64 20 74 |ndex (PS|I) and t|
|00000db0| 6f 74 61 6c 20 64 6f 73 | 65 20 6f 66 20 55 56 42 |otal dos|e of UVB|
|00000dc0| 20 77 65 72 65 20 6d 65 | 61 73 75 72 65 64 20 61 | were me|asured a|
|00000dd0| 74 20 69 6e 74 65 72 76 | 61 6c 73 20 66 6f 72 20 |t interv|als for |
|00000de0| 38 0d 0a 77 65 65 6b 73 | 2e 0d 0a 20 20 20 20 20 |8..weeks|... |
|00000df0| 41 74 20 74 68 65 20 65 | 6e 64 20 6f 66 20 74 68 |At the e|nd of th|
|00000e00| 65 20 38 2d 77 65 65 6b | 20 74 72 65 61 74 6d 65 |e 8-week| treatme|
|00000e10| 6e 74 20 70 65 72 69 6f | 64 2c 20 74 68 65 20 34 |nt perio|d, the 4|
|00000e20| 30 20 70 61 74 69 65 6e | 74 73 20 74 72 65 61 74 |0 patien|ts treat|
|00000e30| 65 64 20 77 69 74 68 0d | 0a 61 63 69 74 72 65 74 |ed with.|.acitret|
|00000e40| 69 6e 20 61 6e 64 20 55 | 56 2d 42 20 68 61 64 20 |in and U|V-B had |
|00000e50| 61 20 64 65 63 72 65 61 | 73 65 20 69 6e 20 50 53 |a decrea|se in PS|
|00000e60| 49 20 6f 66 20 37 39 25 | 2c 20 63 6f 6d 70 61 72 |I of 79%|, compar|
|00000e70| 65 64 20 77 69 74 68 20 | 33 35 25 20 69 6e 20 74 |ed with |35% in t|
|00000e80| 68 65 20 33 38 0d 0a 70 | 61 74 69 65 6e 74 73 20 |he 38..p|atients |
|00000e90| 74 72 65 61 74 65 64 20 | 77 69 74 68 20 70 6c 61 |treated |with pla|
|00000ea0| 63 65 62 6f 20 61 6e 64 | 20 55 56 42 2c 20 61 20 |cebo and| UVB, a |
|00000eb0| 73 69 67 6e 69 66 69 63 | 61 6e 74 20 64 69 66 66 |signific|ant diff|
|00000ec0| 65 72 65 6e 63 65 20 28 | 46 69 67 20 31 37 2d 34 |erence (|Fig 17-4|
|00000ed0| 29 2e 0d 0a 54 68 65 20 | 72 65 73 70 6f 6e 73 65 |)...The |response|
|00000ee0| 20 72 61 74 65 2c 20 64 | 65 66 69 6e 65 64 20 61 | rate, d|efined a|
|00000ef0| 73 20 61 20 64 65 63 72 | 65 61 73 65 20 69 6e 20 |s a decr|ease in |
|00000f00| 50 53 49 20 6f 72 20 61 | 74 20 6c 65 61 73 74 20 |PSI or a|t least |
|00000f10| 37 35 25 2c 20 77 61 73 | 0d 0a 73 69 67 6e 69 66 |75%, was|..signif|
|00000f20| 69 63 61 6e 74 6c 79 20 | 68 69 67 68 65 72 20 69 |icantly |higher i|
|00000f30| 6e 20 74 68 65 20 61 63 | 69 74 72 65 74 69 6e 20 |n the ac|itretin |
|00000f40| 67 72 6f 75 70 20 28 36 | 30 25 29 20 63 6f 6d 70 |group (6|0%) comp|
|00000f50| 61 72 65 64 20 77 69 74 | 68 20 74 68 65 20 63 6f |ared wit|h the co|
|00000f60| 6e 74 72 6f 6c 0d 0a 67 | 72 6f 75 70 20 28 32 34 |ntrol..g|roup (24|
|00000f70| 25 29 2e 20 20 54 68 65 | 20 63 75 6d 75 6c 61 74 |%). The| cumulat|
|00000f80| 69 76 65 20 64 6f 73 65 | 20 6f 66 20 55 56 42 20 |ive dose| of UVB |
|00000f90| 72 65 71 75 69 72 65 64 | 20 74 6f 20 61 63 68 69 |required| to achi|
|00000fa0| 65 76 65 20 74 68 69 73 | 20 74 72 65 61 74 6d 65 |eve this| treatme|
|00000fb0| 6e 74 0d 0a 72 65 73 70 | 6f 6e 73 65 20 77 61 73 |nt..resp|onse was|
|00000fc0| 20 73 69 67 6e 69 66 69 | 63 61 6e 74 6c 79 20 6c | signifi|cantly l|
|00000fd0| 6f 77 65 72 20 69 6e 20 | 74 68 65 20 61 63 69 74 |ower in |the acit|
|00000fe0| 72 65 74 69 6e 20 67 72 | 6f 75 70 20 74 68 61 6e |retin gr|oup than|
|00000ff0| 20 69 6e 20 74 68 65 20 | 63 6f 6e 74 72 6f 6c 0d | in the |control.|
|00001000| 0a 67 72 6f 75 70 2c 20 | 73 75 67 67 65 73 74 69 |.group, |suggesti|
|00001010| 6e 67 20 61 20 55 56 42 | 20 73 70 61 72 69 6e 67 |ng a UVB| sparing|
|00001020| 20 65 66 66 65 63 74 20 | 6f 66 20 74 68 65 20 72 | effect |of the r|
|00001030| 65 74 69 6e 6f 69 64 2e | 20 20 4e 6f 20 75 6e 65 |etinoid.| No une|
|00001040| 78 70 65 63 74 65 64 20 | 6f 72 0d 0a 73 65 76 65 |xpected |or..seve|
|00001050| 72 65 20 73 69 64 65 20 | 65 66 66 65 63 74 73 20 |re side |effects |
|00001060| 74 6f 20 61 63 69 74 72 | 65 74 69 6e 20 77 65 72 |to acitr|etin wer|
|00001070| 65 20 6e 6f 74 65 64 2c | 20 61 6e 64 20 74 68 65 |e noted,| and the|
|00001080| 20 73 69 64 65 20 65 66 | 66 65 63 74 20 70 72 6f | side ef|fect pro|
|00001090| 66 69 6c 65 73 20 77 65 | 72 65 0d 0a 73 69 6d 69 |files we|re..simi|
|000010a0| 6c 61 72 20 69 6e 20 62 | 6f 74 68 20 67 72 6f 75 |lar in b|oth grou|
|000010b0| 70 73 2e 0d 0a 20 20 20 | 20 20 41 63 69 74 72 65 |ps... | Acitre|
|000010c0| 74 69 6e 20 69 6e 20 63 | 6f 6d 62 69 6e 61 74 69 |tin in c|ombinati|
|000010d0| 6f 6e 20 77 69 74 68 20 | 55 56 42 20 64 72 61 6d |on with |UVB dram|
|000010e0| 61 74 69 63 61 6c 6c 79 | 20 69 6d 70 72 6f 76 65 |atically| improve|
|000010f0| 73 20 74 68 65 72 61 70 | 65 75 74 69 63 0d 0a 72 |s therap|eutic..r|
|00001100| 65 73 70 6f 6e 73 65 20 | 69 6e 20 73 65 76 65 72 |esponse |in sever|
|00001110| 65 20 70 73 6f 72 69 61 | 73 69 73 2e 20 20 49 6e |e psoria|sis. In|
|00001120| 20 61 64 64 69 74 69 6f | 6e 2c 20 61 63 69 74 72 | additio|n, acitr|
|00001130| 65 74 69 6e 20 6d 61 72 | 6b 65 64 6c 79 20 72 65 |etin mar|kedly re|
|00001140| 64 75 63 65 73 20 74 68 | 65 0d 0a 65 66 66 65 63 |duces th|e..effec|
|00001150| 74 69 76 65 20 63 75 6d | 75 6c 61 74 69 76 65 20 |tive cum|ulative |
|00001160| 64 6f 73 65 20 6f 66 20 | 55 56 42 2c 20 74 68 65 |dose of |UVB, the|
|00001170| 72 65 62 79 20 72 65 64 | 75 63 69 6e 67 20 74 68 |reby red|ucing th|
|00001180| 65 20 70 6f 74 65 6e 74 | 69 61 6c 20 6c 6f 6e 67 |e potent|ial long|
|00001190| 2d 74 65 72 6d 0d 0a 63 | 61 72 63 69 6e 6f 67 65 |-term..c|arcinoge|
|000011a0| 6e 69 63 20 72 69 73 6b | 20 6f 66 20 55 56 20 69 |nic risk| of UV i|
|000011b0| 72 72 61 64 69 61 74 69 | 6f 6e 2e 20 20 54 68 65 |rradiati|on. The|
|000011c0| 20 63 6f 6e 76 65 6e 69 | 65 6e 63 65 2c 20 65 66 | conveni|ence, ef|
|000011d0| 66 69 63 69 65 6e 63 79 | 2c 20 61 6e 64 0d 0a 72 |ficiency|, and..r|
|000011e0| 65 6c 61 74 69 76 65 20 | 73 61 66 65 74 79 20 6f |elative |safety o|
|000011f0| 66 20 74 68 65 20 63 6f | 6d 62 69 6e 61 74 69 6f |f the co|mbinatio|
|00001200| 6e 20 74 68 65 72 61 70 | 79 20 6d 61 6b 65 20 69 |n therap|y make i|
|00001210| 74 20 61 6e 20 61 70 70 | 65 61 6c 69 6e 67 20 61 |t an app|ealing a|
|00001220| 6c 74 65 72 6e 61 74 69 | 76 65 20 74 6f 0d 0a 6f |lternati|ve to..o|
|00001230| 74 68 65 72 20 63 75 72 | 72 65 6e 74 6c 79 20 61 |ther cur|rently a|
|00001240| 76 61 69 6c 61 62 6c 65 | 20 61 6e 74 69 70 73 6f |vailable| antipso|
|00001250| 72 69 61 74 69 63 20 72 | 65 67 69 6d 65 6e 73 2e |riatic r|egimens.|
|00001260| 0d 0a 0d 0a 50 6f 73 74 | 2d 43 6f 6d 6d 65 6e 74 |....Post|-Comment|
|00001270| 0d 0a 0d 0a 20 20 20 20 | 20 54 68 69 73 20 6e 65 |.... | This ne|
|00001280| 77 20 76 61 72 69 61 6e | 74 20 6f 66 20 65 74 72 |w varian|t of etr|
|00001290| 65 74 69 6e 61 74 65 2d | 55 56 42 20 63 6f 6d 62 |etinate-|UVB comb|
|000012a0| 69 6e 61 74 69 6f 6e 20 | 74 72 65 61 74 6d 65 6e |ination |treatmen|
|000012b0| 74 20 77 69 74 68 20 74 | 68 65 0d 0a 61 72 6f 6d |t with t|he..arom|
|000012c0| 61 74 69 63 20 72 65 74 | 69 6e 6f 69 64 20 61 63 |atic ret|inoid ac|
|000012d0| 69 74 72 65 74 69 6e 20 | 63 6c 65 61 72 6c 79 20 |itretin |clearly |
|000012e0| 72 65 70 72 65 73 65 6e | 74 73 20 61 6e 20 65 66 |represen|ts an ef|
|000012f0| 66 65 63 74 69 76 65 20 | 74 68 65 72 61 70 65 75 |fective |therapeu|
|00001300| 74 69 63 0d 0a 72 65 67 | 69 6d 65 6e 20 66 6f 72 |tic..reg|imen for|
|00001310| 20 70 73 6f 72 69 61 73 | 69 73 2e 20 20 41 74 20 | psorias|is. At |
|00001320| 74 68 69 73 20 74 69 6d | 65 2c 20 68 6f 77 65 76 |this tim|e, howev|
|00001330| 65 72 2c 20 74 68 65 20 | 70 68 61 72 6d 61 63 6f |er, the |pharmaco|
|00001340| 6b 69 6e 65 74 69 63 20 | 61 64 76 61 6e 74 61 67 |kinetic |advantag|
|00001350| 65 73 0d 0a 6f 66 66 65 | 72 65 64 20 62 79 20 61 |es..offe|red by a|
|00001360| 63 69 74 72 65 74 69 6e | 20 6f 76 65 72 20 69 74 |citretin| over it|
|00001370| 73 20 70 72 65 63 75 72 | 73 6f 72 20 63 6f 6d 70 |s precur|sor comp|
|00001380| 6f 75 6e 64 20 65 74 72 | 65 74 69 6e 61 74 65 20 |ound etr|etinate |
|00001390| 61 72 65 20 6c 65 73 73 | 20 6f 62 76 69 6f 75 73 |are less| obvious|
|000013a0| 2e 0d 0a 54 68 65 20 72 | 65 63 65 6e 74 20 65 78 |...The r|ecent ex|
|000013b0| 70 65 72 69 65 6e 63 65 | 73 20 69 6e 20 73 65 76 |perience|s in sev|
|000013c0| 65 72 61 6c 20 45 75 72 | 6f 70 65 61 6e 20 63 6f |eral Eur|opean co|
|000013d0| 75 6e 74 72 69 65 73 2c | 20 77 68 65 72 65 20 61 |untries,| where a|
|000013e0| 63 69 74 72 65 74 69 6e | 20 77 61 73 0d 0a 74 65 |citretin| was..te|
|000013f0| 6d 70 6f 72 61 72 69 6c | 79 20 77 69 74 68 64 72 |mporaril|y withdr|
|00001400| 61 77 6e 20 66 72 6f 6d | 20 74 68 65 20 6d 61 72 |awn from| the mar|
|00001410| 6b 65 74 20 62 79 20 69 | 74 73 20 6d 61 6e 75 66 |ket by i|ts manuf|
|00001420| 61 63 74 75 72 65 72 20 | 61 6e 64 20 72 65 69 6e |acturer |and rein|
|00001430| 74 72 6f 64 75 63 65 64 | 0d 0a 77 69 74 68 20 6e |troduced|..with n|
|00001440| 65 77 20 67 75 69 64 65 | 6c 69 6e 65 73 20 66 6f |ew guide|lines fo|
|00001450| 72 20 65 78 74 65 6e 64 | 65 64 20 70 6f 73 74 74 |r extend|ed postt|
|00001460| 68 65 72 61 70 79 20 63 | 6f 6e 74 72 61 63 65 70 |herapy c|ontracep|
|00001470| 74 69 6f 6e 2c 20 68 61 | 76 65 20 73 65 72 69 6f |tion, ha|ve serio|
|00001480| 75 73 6c 79 0d 0a 63 68 | 61 6c 6c 65 6e 67 65 64 |usly..ch|allenged|
|00001490| 20 74 68 65 20 63 6c 61 | 69 6d 73 20 6f 66 20 74 | the cla|ims of t|
|000014a0| 68 65 20 74 68 65 72 61 | 70 65 75 74 69 63 20 69 |he thera|peutic i|
|000014b0| 6e 6e 6f 76 61 74 69 6f | 6e 20 77 69 74 68 20 74 |nnovatio|n with t|
|000014c0| 68 69 73 20 64 72 75 67 | 2e 2d 2d 53 2e 41 2e 0d |his drug|.--S.A..|
|000014d0| 0a 43 6f 6f 70 6d 61 6e | 2c 20 4d 2e 44 2e 0d 0a |.Coopman|, M.D...|
|000014e0| 24 55 6e 69 71 75 65 5f | 49 44 7b 59 52 42 30 30 |$Unique_|ID{YRB00|
|000014f0| 33 30 31 7d 0d 0a 24 54 | 69 74 6c 65 7b 55 73 65 |301}..$T|itle{Use|
|00001500| 20 6f 66 20 43 79 63 6c | 6f 73 70 6f 72 69 6e 20 | of Cycl|osporin |
|00001510| 69 6e 20 50 73 6f 72 69 | 61 73 69 73 7d 0d 0a 24 |in Psori|asis}..$|
|00001520| 41 75 74 68 6f 72 7b 0d | 0a 42 6f 73 2c 20 4a 44 |Author{.|.Bos, JD|
|00001530| 0d 0a 4d 65 69 6e 61 72 | 64 69 2c 20 4d 4d 48 4d |..Meinar|di, MMHM|
|00001540| 0d 0a 76 61 6e 20 4a 6f | 6f 73 74 2c 20 54 0d 0a |..van Jo|ost, T..|
|00001550| 48 65 75 6c 65 2c 20 46 | 0d 0a 50 6f 77 6c 65 73 |Heule, F|..Powles|
|00001560| 2c 20 41 56 0d 0a 46 72 | 79 2c 20 4c 7d 0d 0a 24 |, AV..Fr|y, L}..$|
|00001570| 41 66 66 69 6c 69 61 74 | 69 6f 6e 7b 55 6e 69 76 |Affiliat|ion{Univ|
|00001580| 20 6f 66 20 41 6d 73 74 | 65 72 64 61 6d 3b 20 45 | of Amst|erdam; E|
|00001590| 72 61 73 6d 75 73 20 55 | 6e 69 76 2c 20 52 6f 74 |rasmus U|niv, Rot|
|000015a0| 74 65 72 64 61 6d 3b 20 | 53 74 20 4d 61 72 79 27 |terdam; |St Mary'|
|000015b0| 73 20 48 6f 73 70 2c 0d | 0a 4c 6f 6e 64 6f 6e 7d |s Hosp,.|.London}|
|000015c0| 0d 0a 24 4a 6f 75 72 6e | 61 6c 7b 4c 61 6e 63 65 |..$Journ|al{Lance|
|000015d0| 74 7d 0d 0a 24 56 6f 6c | 75 6d 65 7b 32 7d 0d 0a |t}..$Vol|ume{2}..|
|000015e0| 24 50 61 67 65 7b 31 35 | 30 30 2d 31 35 30 32 7d |$Page{15|00-1502}|
|000015f0| 0d 0a 24 44 61 74 65 7b | 31 39 38 39 7d 0d 0a 24 |..$Date{|1989}..$|
|00001600| 59 42 56 6f 6c 7b 31 39 | 39 31 20 59 65 61 72 20 |YBVol{19|91 Year |
|00001610| 42 6f 6f 6b 20 6f 66 20 | 44 65 72 6d 61 74 6f 6c |Book of |Dermatol|
|00001620| 6f 67 79 7d 0d 0a 24 43 | 68 61 70 74 65 72 7b 31 |ogy}..$C|hapter{1|
|00001630| 37 2d 32 31 7d 0d 0a 24 | 59 42 45 64 69 74 6f 72 |7-21}..$|YBEditor|
|00001640| 7b 44 72 73 2e 20 20 53 | 6f 62 65 72 20 61 6e 64 |{Drs. S|ober and|
|00001650| 20 46 69 74 7a 70 61 74 | 72 69 63 6b 7d 0d 0a 24 | Fitzpat|rick}..$|
|00001660| 54 61 62 6c 65 7b 7d 0d | 0a 24 43 6f 6d 6d 65 6e |Table{}.|.$Commen|
|00001670| 74 61 74 6f 72 7b 52 2e | 53 2e 20 20 53 74 65 72 |tator{R.|S. Ster|
|00001680| 6e 2c 20 4d 2e 44 2e 7d | 0d 0a 0d 0a 43 6f 70 79 |n, M.D.}|....Copy|
|00001690| 72 69 67 68 74 20 28 43 | 29 20 59 65 61 72 20 42 |right (C|) Year B|
|000016a0| 6f 6f 6b 20 4d 65 64 69 | 63 61 6c 20 50 75 62 6c |ook Medi|cal Publ|
|000016b0| 69 73 68 65 72 73 2c 20 | 49 6e 63 2e 20 20 31 39 |ishers, |Inc. 19|
|000016c0| 39 31 0d 0a 0d 0a 31 39 | 39 31 20 59 65 61 72 20 |91....19|91 Year |
|000016d0| 42 6f 6f 6b 20 6f 66 20 | 44 65 72 6d 61 74 6f 6c |Book of |Dermatol|
|000016e0| 6f 67 79 0d 0a 0d 0a 43 | 68 61 70 74 65 72 20 31 |ogy....C|hapter 1|
|000016f0| 37 2d 2d 50 73 6f 72 69 | 61 73 69 73 20 61 6e 64 |7--Psori|asis and|
|00001700| 20 52 65 6c 61 74 65 64 | 20 44 69 73 6f 72 64 65 | Related| Disorde|
|00001710| 72 73 0d 0a 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |rs....--|--------|
|00001720| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001730| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001740| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001750| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001760| 2d 2d 2d 2d 0d 0a 55 73 | 65 20 6f 66 20 43 79 63 |----..Us|e of Cyc|
|00001770| 6c 6f 73 70 6f 72 69 6e | 20 69 6e 20 50 73 6f 72 |losporin| in Psor|
|00001780| 69 61 73 69 73 0d 0a 0d | 0a 42 6f 73 20 4a 44 3b |iasis...|.Bos JD;|
|00001790| 20 4d 65 69 6e 61 72 64 | 69 20 4d 4d 48 4d 3b 20 | Meinard|i MMHM; |
|000017a0| 76 61 6e 20 4a 6f 6f 73 | 74 20 54 3b 20 48 65 75 |van Joos|t T; Heu|
|000017b0| 6c 65 20 46 3b 20 50 6f | 77 6c 65 73 20 41 56 3b |le F; Po|wles AV;|
|000017c0| 20 46 72 79 20 4c 0d 0a | 28 55 6e 69 76 20 6f 66 | Fry L..|(Univ of|
|000017d0| 20 41 6d 73 74 65 72 64 | 61 6d 3b 20 45 72 61 73 | Amsterd|am; Eras|
|000017e0| 6d 75 73 20 55 6e 69 76 | 2c 20 52 6f 74 74 65 72 |mus Univ|, Rotter|
|000017f0| 64 61 6d 3b 20 53 74 20 | 4d 61 72 79 27 73 20 48 |dam; St |Mary's H|
|00001800| 6f 73 70 2c 20 4c 6f 6e | 64 6f 6e 29 0d 0a 4c 61 |osp, Lon|don)..La|
|00001810| 6e 63 65 74 20 32 3a 31 | 35 30 30 2d 31 35 30 32 |ncet 2:1|500-1502|
|00001820| 2c 20 31 39 38 39 0d 0a | 2d 2d 2d 2d 2d 2d 2d 2d |, 1989..|--------|
|00001830| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001840| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001850| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001860| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001870| 2d 2d 2d 2d 2d 2d 0d 0a | 0d 0a 41 62 73 74 72 61 |------..|..Abstra|
|00001880| 63 74 0d 0a 0d 0a 20 20 | 20 20 20 43 79 63 6c 6f |ct.... | Cyclo|
|00001890| 73 70 6f 72 69 6e 65 20 | 69 73 20 77 69 64 65 6c |sporine |is widel|
|000018a0| 79 20 75 73 65 64 20 69 | 6e 20 74 68 65 20 70 72 |y used i|n the pr|
|000018b0| 65 76 65 6e 74 69 6f 6e | 20 6f 66 20 67 72 61 66 |evention| of graf|
|000018c0| 74 20 72 65 6a 65 63 74 | 69 6f 6e 20 61 6e 64 20 |t reject|ion and |
|000018d0| 68 61 73 0d 0a 62 65 63 | 6f 6d 65 20 61 6e 20 65 |has..bec|ome an e|
|000018e0| 73 74 61 62 6c 69 73 68 | 65 64 20 74 72 65 61 74 |stablish|ed treat|
|000018f0| 6d 65 6e 74 20 66 6f 72 | 20 73 65 76 65 72 65 20 |ment for| severe |
|00001900| 70 73 6f 72 69 61 73 69 | 73 2e 20 20 48 6f 77 65 |psoriasi|s. Howe|
|00001910| 76 65 72 2c 20 77 68 65 | 6e 20 74 68 65 0d 0a 69 |ver, whe|n the..i|
|00001920| 6d 6d 75 6e 6f 73 75 70 | 70 72 65 73 73 61 6e 74 |mmunosup|pressant|
|00001930| 20 69 73 20 64 69 73 63 | 6f 6e 74 69 6e 75 65 64 | is disc|ontinued|
|00001940| 2c 20 70 73 6f 72 69 61 | 73 69 73 20 74 65 6e 64 |, psoria|sis tend|
|00001950| 73 20 74 6f 20 72 65 6c | 61 70 73 65 20 74 6f 20 |s to rel|apse to |
|00001960| 69 74 73 20 70 72 65 76 | 69 6f 75 73 0d 0a 73 65 |its prev|ious..se|
|00001970| 76 65 72 69 74 79 2e 20 | 20 50 72 6f 6c 6f 6e 67 |verity. | Prolong|
|00001980| 65 64 20 63 79 63 6c 6f | 73 70 6f 72 69 6e 65 20 |ed cyclo|sporine |
|00001990| 74 68 65 72 61 70 79 20 | 69 73 20 61 73 73 6f 63 |therapy |is assoc|
|000019a0| 69 61 74 65 64 20 77 69 | 74 68 20 73 65 72 69 6f |iated wi|th serio|
|000019b0| 75 73 20 73 69 64 65 0d | 0a 65 66 66 65 63 74 73 |us side.|.effects|
|000019c0| 2e 0d 0a 20 20 20 20 20 | 50 61 74 69 65 6e 74 73 |... |Patients|
|000019d0| 20 77 69 74 68 20 70 73 | 6f 72 69 61 73 69 73 20 | with ps|oriasis |
|000019e0| 6d 75 73 74 20 75 6e 64 | 65 72 67 6f 20 61 20 63 |must und|ergo a c|
|000019f0| 6f 6d 70 6c 65 74 65 20 | 70 68 79 73 69 63 61 6c |omplete |physical|
|00001a00| 20 65 78 61 6d 69 6e 61 | 74 69 6f 6e 0d 0a 69 6e | examina|tion..in|
|00001a10| 63 6c 75 64 69 6e 67 20 | 74 68 6f 72 6f 75 67 68 |cluding |thorough|
|00001a20| 20 6c 61 62 6f 72 61 74 | 6f 72 79 20 74 65 73 74 | laborat|ory test|
|00001a30| 73 20 62 65 66 6f 72 65 | 20 73 74 61 72 74 69 6e |s before| startin|
|00001a40| 67 20 63 79 63 6c 6f 73 | 70 6f 72 69 6e 65 20 74 |g cyclos|porine t|
|00001a50| 68 65 72 61 70 79 2e 20 | 20 54 68 65 0d 0a 70 68 |herapy. | The..ph|
|00001a60| 79 73 69 63 69 61 6e 20 | 73 68 6f 75 6c 64 20 74 |ysician |should t|
|00001a70| 61 6b 65 20 61 20 64 65 | 74 61 69 6c 65 64 20 66 |ake a de|tailed f|
|00001a80| 61 6d 69 6c 79 20 61 6e | 64 20 70 65 72 73 6f 6e |amily an|d person|
|00001a90| 61 6c 20 68 69 73 74 6f | 72 79 20 61 6e 64 20 65 |al histo|ry and e|
|00001aa0| 6d 70 68 61 73 69 7a 65 | 20 74 68 65 0d 0a 6b 6e |mphasize| the..kn|
|00001ab0| 6f 77 6e 20 72 69 73 6b | 73 20 6f 66 20 63 79 63 |own risk|s of cyc|
|00001ac0| 6c 6f 73 70 6f 72 69 6e | 65 20 74 72 65 61 74 6d |losporin|e treatm|
|00001ad0| 65 6e 74 2c 20 6e 65 70 | 68 72 6f 74 6f 78 69 63 |ent, nep|hrotoxic|
|00001ae0| 69 74 79 2c 20 68 79 70 | 65 72 74 65 6e 73 69 6f |ity, hyp|ertensio|
|00001af0| 6e 2c 20 61 6e 64 0d 0a | 6d 61 6c 69 67 6e 61 6e |n, and..|malignan|
|00001b00| 63 79 2e 0d 0a 20 20 20 | 20 20 54 68 65 20 61 69 |cy... | The ai|
|00001b10| 6d 20 6f 66 20 74 68 65 | 72 61 70 79 20 73 68 6f |m of the|rapy sho|
|00001b20| 75 6c 64 20 62 65 20 69 | 6d 70 72 6f 76 65 6d 65 |uld be i|mproveme|
|00001b30| 6e 74 2c 20 72 61 74 68 | 65 72 20 74 68 61 6e 20 |nt, rath|er than |
|00001b40| 74 6f 74 61 6c 20 63 6c | 65 61 72 61 6e 63 65 2c |total cl|earance,|
|00001b50| 20 6f 66 0d 0a 74 68 65 | 20 70 73 6f 72 69 61 73 | of..the| psorias|
|00001b60| 69 73 2e 20 20 41 20 73 | 75 67 67 65 73 74 65 64 |is. A s|uggested|
|00001b70| 20 69 6e 69 74 69 61 6c | 20 6f 72 61 6c 20 72 65 | initial| oral re|
|00001b80| 67 69 6d 65 6e 20 6f 66 | 20 63 79 63 6c 6f 73 70 |gimen of| cyclosp|
|00001b90| 6f 72 69 6e 65 20 69 73 | 20 33 20 6d 67 2f 20 6b |orine is| 3 mg/ k|
|00001ba0| 67 2f 0d 0a 64 61 79 2c | 20 64 69 76 69 64 65 64 |g/..day,| divided|
|00001bb0| 20 69 6e 20 32 20 64 6f | 73 65 73 2e 20 20 44 6f | in 2 do|ses. Do|
|00001bc0| 73 65 73 20 67 72 65 61 | 74 65 72 20 74 68 61 6e |ses grea|ter than|
|00001bd0| 20 35 20 6d 67 2f 6b 67 | 2f 64 61 79 20 63 61 72 | 5 mg/kg|/day car|
|00001be0| 72 79 20 61 6e 20 69 6e | 63 72 65 61 73 65 64 0d |ry an in|creased.|
|00001bf0| 0a 72 69 73 6b 20 6f 66 | 20 73 69 64 65 20 65 66 |.risk of| side ef|
|00001c00| 66 65 63 74 73 2e 20 20 | 49 66 20 74 68 65 20 69 |fects. |If the i|
|00001c10| 6e 69 74 69 61 6c 20 64 | 6f 73 65 20 62 72 69 6e |nitial d|ose brin|
|00001c20| 67 73 20 63 6f 6d 70 6c | 65 74 65 20 72 65 6d 69 |gs compl|ete remi|
|00001c30| 73 73 69 6f 6e 2c 20 61 | 20 6c 6f 77 65 72 0d 0a |ssion, a| lower..|
|00001c40| 64 6f 73 65 20 63 61 6e | 20 62 65 20 74 72 69 65 |dose can| be trie|
|00001c50| 64 2e 20 20 43 61 72 65 | 66 75 6c 20 6d 6f 6e 69 |d. Care|ful moni|
|00001c60| 74 6f 72 69 6e 67 20 6f | 66 20 70 61 74 69 65 6e |toring o|f patien|
|00001c70| 74 73 20 69 73 20 6e 65 | 63 65 73 73 61 72 79 20 |ts is ne|cessary |
|00001c80| 64 75 72 69 6e 67 0d 0a | 63 79 63 6c 6f 73 70 6f |during..|cyclospo|
|00001c90| 72 69 6e 65 20 74 68 65 | 72 61 70 79 2e 20 20 45 |rine the|rapy. E|
|00001ca0| 6d 6f 6c 6c 69 65 6e 74 | 73 20 61 6e 64 20 74 6f |mollient|s and to|
|00001cb0| 70 69 63 61 6c 6c 79 20 | 61 70 70 6c 69 65 64 20 |pically |applied |
|00001cc0| 63 6f 72 74 69 63 6f 73 | 74 65 72 6f 69 64 73 20 |corticos|teroids |
|00001cd0| 6d 61 79 0d 0a 61 6c 73 | 6f 20 62 65 20 75 73 65 |may..als|o be use|
|00001ce0| 64 2c 20 62 75 74 20 6f | 74 68 65 72 20 61 64 6a |d, but o|ther adj|
|00001cf0| 75 76 61 6e 74 20 74 72 | 65 61 74 6d 65 6e 74 73 |uvant tr|eatments|
|00001d00| 20 66 6f 72 20 70 73 6f | 72 69 61 73 69 73 20 6d | for pso|riasis m|
|00001d10| 75 73 74 20 6e 6f 74 20 | 62 65 20 67 69 76 65 6e |ust not |be given|
|00001d20| 0d 0a 64 75 72 69 6e 67 | 20 63 79 63 6c 6f 73 70 |..during| cyclosp|
|00001d30| 6f 72 69 6e 65 20 74 68 | 65 72 61 70 79 2e 0d 0a |orine th|erapy...|
|00001d40| 0d 0a 50 6f 73 74 2d 43 | 6f 6d 6d 65 6e 74 0d 0a |..Post-C|omment..|
|00001d50| 0d 0a 20 20 20 20 20 54 | 68 69 73 20 73 74 75 64 |.. T|his stud|
|00001d60| 79 20 68 61 73 20 62 65 | 65 6e 20 73 75 70 65 72 |y has be|en super|
|00001d70| 73 65 64 65 64 20 62 79 | 20 74 68 65 20 63 61 72 |seded by| the car|
|00001d80| 65 66 75 6c 20 72 61 6e | 64 6f 6d 69 7a 65 64 20 |eful ran|domized |
|00001d90| 73 74 75 64 79 20 6f 66 | 20 45 6c 6c 69 73 0d 0a |study of| Ellis..|
|00001da0| 65 74 20 61 6c 2e 20 28 | 31 29 2c 20 77 68 69 63 |et al. (|1), whic|
|00001db0| 68 20 73 68 6f 77 65 64 | 20 74 68 61 74 20 69 6e |h showed| that in|
|00001dc0| 20 74 68 65 20 4d 69 63 | 68 69 67 61 6e 20 73 74 | the Mic|higan st|
|00001dd0| 75 64 79 20 67 72 6f 75 | 70 2c 20 64 6f 73 65 73 |udy grou|p, doses|
|00001de0| 20 6c 65 73 73 20 74 68 | 61 6e 20 35 0d 0a 6d 67 | less th|an 5..mg|
|00001df0| 2f 6b 67 20 68 61 64 20 | 6f 6e 6c 79 20 6d 6f 64 |/kg had |only mod|
|00001e00| 65 73 74 20 73 75 63 63 | 65 73 73 20 69 6e 20 63 |est succ|ess in c|
|00001e10| 6c 65 61 72 69 6e 67 20 | 73 65 76 65 72 65 20 70 |learing |severe p|
|00001e20| 73 6f 72 69 61 73 69 73 | 2e 20 20 57 68 65 74 68 |soriasis|. Wheth|
|00001e30| 65 72 20 61 6e 79 20 64 | 6f 73 65 0d 0a 6f 66 20 |er any d|ose..of |
|00001e40| 63 79 63 6c 6f 73 70 6f | 72 69 6e 65 20 69 73 20 |cyclospo|rine is |
|00001e50| 73 61 66 65 20 69 6e 20 | 74 68 65 20 6c 6f 6e 67 |safe in |the long|
|00001e60| 2d 74 65 72 6d 20 74 68 | 65 72 61 70 79 20 6f 66 |-term th|erapy of|
|00001e70| 20 70 73 6f 72 69 61 73 | 69 73 20 69 73 20 73 75 | psorias|is is su|
|00001e80| 62 6a 65 63 74 20 74 6f | 0d 0a 73 65 72 69 6f 75 |bject to|..seriou|
|00001e90| 73 20 71 75 65 73 74 69 | 6f 6e 2e 20 20 43 6c 65 |s questi|on. Cle|
|00001ea0| 61 72 6c 79 2c 20 74 68 | 69 73 20 69 73 73 75 65 |arly, th|is issue|
|00001eb0| 20 6e 65 65 64 73 20 74 | 6f 20 62 65 20 61 64 64 | needs t|o be add|
|00001ec0| 72 65 73 73 65 64 20 62 | 65 66 6f 72 65 20 74 68 |ressed b|efore th|
|00001ed0| 69 73 20 64 72 75 67 0d | 0a 63 61 6e 20 62 65 20 |is drug.|.can be |
|00001ee0| 63 6f 6e 73 69 64 65 72 | 65 64 20 61 73 20 6f 74 |consider|ed as ot|
|00001ef0| 68 65 72 20 74 68 61 6e | 20 61 6e 20 65 78 70 65 |her than| an expe|
|00001f00| 72 69 6d 65 6e 74 61 6c | 20 74 68 65 72 61 70 79 |rimental| therapy|
|00001f10| 20 74 6f 20 62 65 20 75 | 73 65 64 20 6f 6e 6c 79 | to be u|sed only|
|00001f20| 20 69 6e 0d 0a 65 78 63 | 65 70 74 69 6f 6e 61 6c | in..exc|eptional|
|00001f30| 20 63 69 72 63 75 6d 73 | 74 61 6e 63 65 73 20 69 | circums|tances i|
|00001f40| 6e 20 74 68 65 20 74 72 | 65 61 74 6d 65 6e 74 20 |n the tr|eatment |
|00001f50| 6f 66 20 70 73 6f 72 69 | 61 73 69 73 2e 2d 2d 52 |of psori|asis.--R|
|00001f60| 2e 53 2e 20 53 74 65 72 | 6e 2c 20 4d 2e 44 2e 0d |.S. Ster|n, M.D..|
|00001f70| 0a 24 55 6e 69 71 75 65 | 5f 49 44 7b 59 52 42 30 |.$Unique|_ID{YRB0|
|00001f80| 30 33 30 32 7d 0d 0a 24 | 54 69 74 6c 65 7b 49 6e |0302}..$|Title{In|
|00001f90| 74 72 61 6c 65 73 69 6f | 6e 61 6c 20 43 79 63 6c |tralesio|nal Cycl|
|00001fa0| 6f 73 70 6f 72 69 6e 65 | 20 69 6e 20 74 68 65 20 |osporine| in the |
|00001fb0| 54 72 65 61 74 6d 65 6e | 74 20 6f 66 20 50 73 6f |Treatmen|t of Pso|
|00001fc0| 72 69 61 73 69 73 3a 20 | 20 41 20 43 6c 69 6e 69 |riasis: | A Clini|
|00001fd0| 63 61 6c 2c 0d 0a 49 6d | 6d 75 6e 6f 6c 6f 67 69 |cal,..Im|munologi|
|00001fe0| 63 2c 20 61 6e 64 20 50 | 68 61 72 6d 61 63 6f 6b |c, and P|harmacok|
|00001ff0| 69 6e 65 74 69 63 20 53 | 74 75 64 79 7d 0d 0a 24 |inetic S|tudy}..$|
|00002000| 41 75 74 68 6f 72 7b 0d | 0a 48 6f 2c 20 56 43 0d |Author{.|.Ho, VC.|
|00002010| 0a 47 72 69 66 66 69 74 | 68 73 2c 20 43 45 4d 0d |.Griffit|hs, CEM.|
|00002020| 0a 45 6c 6c 69 73 2c 20 | 43 4e 0d 0a 47 75 70 74 |.Ellis, |CN..Gupt|
|00002030| 61 2c 20 41 4b 0d 0a 4d | 63 43 75 61 69 67 2c 20 |a, AK..M|cCuaig, |
|00002040| 43 43 0d 0a 4e 69 63 6b | 6f 6c 6f 66 66 2c 20 42 |CC..Nick|oloff, B|
|00002050| 4a 0d 0a 43 6f 6f 70 65 | 72 2c 20 4b 44 0d 0a 48 |J..Coope|r, KD..H|
|00002060| 61 6d 69 6c 74 6f 6e 2c | 20 54 41 0d 0a 56 6f 6f |amilton,| TA..Voo|
|00002070| 72 68 65 65 73 2c 20 4a | 4a 7d 0d 0a 24 41 66 66 |rhees, J|J}..$Aff|
|00002080| 69 6c 69 61 74 69 6f 6e | 7b 55 6e 69 76 20 6f 66 |iliation|{Univ of|
|00002090| 20 4d 69 63 68 69 67 61 | 6e 2c 20 41 6e 6e 20 41 | Michiga|n, Ann A|
|000020a0| 72 62 6f 72 7d 0d 0a 24 | 4a 6f 75 72 6e 61 6c 7b |rbor}..$|Journal{|
|000020b0| 4a 20 41 6d 20 41 63 61 | 64 20 44 65 72 6d 61 74 |J Am Aca|d Dermat|
|000020c0| 6f 6c 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 32 32 7d |ol}..$Vo|lume{22}|
|000020d0| 0d 0a 24 50 61 67 65 7b | 39 34 2d 31 30 30 7d 0d |..$Page{|94-100}.|
|000020e0| 0a 24 44 61 74 65 7b 31 | 39 39 30 7d 0d 0a 24 59 |.$Date{1|990}..$Y|
|000020f0| 42 56 6f 6c 7b 31 39 39 | 31 20 59 65 61 72 20 42 |BVol{199|1 Year B|
|00002100| 6f 6f 6b 20 6f 66 20 44 | 65 72 6d 61 74 6f 6c 6f |ook of D|ermatolo|
|00002110| 67 79 7d 0d 0a 24 43 68 | 61 70 74 65 72 7b 31 37 |gy}..$Ch|apter{17|
|00002120| 2d 32 32 7d 0d 0a 24 59 | 42 45 64 69 74 6f 72 7b |-22}..$Y|BEditor{|
|00002130| 44 72 73 2e 20 20 53 6f | 62 65 72 20 61 6e 64 20 |Drs. So|ber and |
|00002140| 46 69 74 7a 70 61 74 72 | 69 63 6b 7d 0d 0a 24 54 |Fitzpatr|ick}..$T|
|00002150| 61 62 6c 65 7b 7d 0d 0a | 24 43 6f 6d 6d 65 6e 74 |able{}..|$Comment|
|00002160| 61 74 6f 72 7b 7d 0d 0a | 0d 0a 43 6f 70 79 72 69 |ator{}..|..Copyri|
|00002170| 67 68 74 20 28 43 29 20 | 59 65 61 72 20 42 6f 6f |ght (C) |Year Boo|
|00002180| 6b 20 4d 65 64 69 63 61 | 6c 20 50 75 62 6c 69 73 |k Medica|l Publis|
|00002190| 68 65 72 73 2c 20 49 6e | 63 2e 20 20 31 39 39 31 |hers, In|c. 1991|
|000021a0| 0d 0a 0d 0a 31 39 39 31 | 20 59 65 61 72 20 42 6f |....1991| Year Bo|
|000021b0| 6f 6b 20 6f 66 20 44 65 | 72 6d 61 74 6f 6c 6f 67 |ok of De|rmatolog|
|000021c0| 79 0d 0a 0d 0a 43 68 61 | 70 74 65 72 20 31 37 2d |y....Cha|pter 17-|
|000021d0| 2d 50 73 6f 72 69 61 73 | 69 73 20 61 6e 64 20 52 |-Psorias|is and R|
|000021e0| 65 6c 61 74 65 64 20 44 | 69 73 6f 72 64 65 72 73 |elated D|isorders|
|000021f0| 0d 0a 0d 0a 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |....----|--------|
|00002200| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002210| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002220| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002230| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002240| 2d 2d 0d 0a 49 6e 74 72 | 61 6c 65 73 69 6f 6e 61 |--..Intr|alesiona|
|00002250| 6c 20 43 79 63 6c 6f 73 | 70 6f 72 69 6e 65 20 69 |l Cyclos|porine i|
|00002260| 6e 20 74 68 65 20 54 72 | 65 61 74 6d 65 6e 74 20 |n the Tr|eatment |
|00002270| 6f 66 20 50 73 6f 72 69 | 61 73 69 73 3a 20 20 41 |of Psori|asis: A|
|00002280| 20 43 6c 69 6e 69 63 61 | 6c 2c 0d 0a 49 6d 6d 75 | Clinica|l,..Immu|
|00002290| 6e 6f 6c 6f 67 69 63 2c | 20 61 6e 64 20 50 68 61 |nologic,| and Pha|
|000022a0| 72 6d 61 63 6f 6b 69 6e | 65 74 69 63 20 53 74 75 |rmacokin|etic Stu|
|000022b0| 64 79 0d 0a 0d 0a 48 6f | 20 56 43 3b 20 47 72 69 |dy....Ho| VC; Gri|
|000022c0| 66 66 69 74 68 73 20 43 | 45 4d 3b 20 45 6c 6c 69 |ffiths C|EM; Elli|
|000022d0| 73 20 43 4e 3b 20 47 75 | 70 74 61 20 41 4b 3b 20 |s CN; Gu|pta AK; |
|000022e0| 4d 63 43 75 61 69 67 20 | 43 43 3b 20 4e 69 63 6b |McCuaig |CC; Nick|
|000022f0| 6f 6c 6f 66 66 20 42 4a | 3b 20 43 6f 6f 70 65 72 |oloff BJ|; Cooper|
|00002300| 20 4b 44 3b 0d 0a 48 61 | 6d 69 6c 74 6f 6e 20 54 | KD;..Ha|milton T|
|00002310| 41 3b 20 56 6f 6f 72 68 | 65 65 73 20 4a 4a 0d 0a |A; Voorh|ees JJ..|
|00002320| 28 55 6e 69 76 20 6f 66 | 20 4d 69 63 68 69 67 61 |(Univ of| Michiga|
|00002330| 6e 2c 20 41 6e 6e 20 41 | 72 62 6f 72 29 0d 0a 4a |n, Ann A|rbor)..J|
|00002340| 20 41 6d 20 41 63 61 64 | 20 44 65 72 6d 61 74 6f | Am Acad| Dermato|
|00002350| 6c 20 32 32 3a 39 34 2d | 31 30 30 2c 20 31 39 39 |l 22:94-|100, 199|
|00002360| 30 0d 0a 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |0..-----|--------|
|00002370| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002380| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002390| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000023a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000023b0| 2d 0d 0a 0d 0a 41 62 73 | 74 72 61 63 74 0d 0a 0d |-....Abs|tract...|
|000023c0| 0a 20 20 20 20 20 4f 72 | 61 6c 2c 20 62 75 74 20 |. Or|al, but |
|000023d0| 6e 6f 74 20 74 6f 70 69 | 63 61 6c 2c 20 63 79 63 |not topi|cal, cyc|
|000023e0| 6c 6f 73 70 6f 72 69 6e | 65 20 74 68 65 72 61 70 |losporin|e therap|
|000023f0| 79 20 68 61 73 20 62 65 | 65 6e 20 65 66 66 65 63 |y has be|en effec|
|00002400| 74 69 76 65 20 69 6e 20 | 74 68 65 0d 0a 74 72 65 |tive in |the..tre|
|00002410| 61 74 6d 65 6e 74 20 6f | 66 20 70 73 6f 72 69 61 |atment o|f psoria|
|00002420| 73 69 73 2e 20 20 49 74 | 20 69 73 20 70 6f 73 74 |sis. It| is post|
|00002430| 75 6c 61 74 65 64 20 74 | 68 61 74 20 73 79 73 74 |ulated t|hat syst|
|00002440| 65 6d 69 63 20 6d 65 74 | 61 62 6f 6c 69 73 6d 20 |emic met|abolism |
|00002450| 6f 66 0d 0a 63 79 63 6c | 6f 73 70 6f 72 69 6e 65 |of..cycl|osporine|
|00002460| 20 74 6f 20 61 63 74 69 | 76 65 20 6d 65 74 61 62 | to acti|ve metab|
|00002470| 6f 6c 69 74 65 73 20 6d | 61 79 20 62 65 20 72 65 |olites m|ay be re|
|00002480| 71 75 69 72 65 64 20 6f | 72 20 74 68 61 74 20 70 |quired o|r that p|
|00002490| 65 72 63 75 74 61 6e 65 | 6f 75 73 0d 0a 61 62 73 |ercutane|ous..abs|
|000024a0| 6f 72 70 74 69 6f 6e 20 | 6f 66 20 74 6f 70 69 63 |orption |of topic|
|000024b0| 61 6c 6c 79 20 61 70 70 | 6c 69 65 64 20 63 79 63 |ally app|lied cyc|
|000024c0| 6c 6f 73 70 6f 72 69 6e | 65 20 69 73 20 69 6e 61 |losporin|e is ina|
|000024d0| 64 65 71 75 61 74 65 2e | 20 20 41 20 64 6f 75 62 |dequate.| A doub|
|000024e0| 6c 65 2d 62 6c 69 6e 64 | 2c 0d 0a 76 65 68 69 63 |le-blind|,..vehic|
|000024f0| 6c 65 2d 63 6f 6e 74 72 | 6f 6c 6c 65 64 2c 20 72 |le-contr|olled, r|
|00002500| 61 6e 64 6f 6d 69 7a 65 | 64 20 73 74 75 64 79 20 |andomize|d study |
|00002510| 77 61 73 20 75 6e 64 65 | 72 74 61 6b 65 6e 20 74 |was unde|rtaken t|
|00002520| 6f 20 64 65 74 65 72 6d | 69 6e 65 20 77 68 65 74 |o determ|ine whet|
|00002530| 68 65 72 0d 0a 63 79 63 | 6c 6f 73 70 6f 72 69 6e |her..cyc|losporin|
|00002540| 65 20 61 63 74 73 20 73 | 79 73 74 65 6d 69 63 61 |e acts s|ystemica|
|00002550| 6c 6c 79 20 6f 72 20 6c | 6f 63 61 6c 6c 79 20 69 |lly or l|ocally i|
|00002560| 6e 20 70 73 6f 72 69 61 | 73 69 73 2e 0d 0a 20 20 |n psoria|sis... |
|00002570| 20 20 20 49 6e 20 70 68 | 61 73 65 20 49 2c 20 33 | In ph|ase I, 3|
|00002580| 20 63 6f 6d 70 61 72 61 | 62 6c 65 20 70 73 6f 72 | compara|ble psor|
|00002590| 69 61 74 69 63 20 70 6c | 61 71 75 65 73 20 66 72 |iatic pl|aques fr|
|000025a0| 6f 6d 20 36 20 70 61 74 | 69 65 6e 74 73 20 77 65 |om 6 pat|ients we|
|000025b0| 72 65 20 74 72 65 61 74 | 65 64 0d 0a 77 69 74 68 |re treat|ed..with|
|000025c0| 20 69 6e 74 72 61 6c 65 | 73 69 6f 6e 61 6c 6c 79 | intrale|sionally|
|000025d0| 20 61 64 6d 69 6e 69 73 | 74 65 72 65 64 20 63 79 | adminis|tered cy|
|000025e0| 63 6c 6f 73 70 6f 72 69 | 6e 65 2c 20 76 65 68 69 |clospori|ne, vehi|
|000025f0| 63 6c 65 2c 20 6f 72 20 | 73 61 6c 69 6e 65 20 73 |cle, or |saline s|
|00002600| 6f 6c 75 74 69 6f 6e 20 | 33 0d 0a 74 69 6d 65 73 |olution |3..times|
|00002610| 20 77 65 65 6b 6c 79 20 | 66 6f 72 20 34 20 77 65 | weekly |for 4 we|
|00002620| 65 6b 73 2e 20 20 49 6e | 20 70 68 61 73 65 20 49 |eks. In| phase I|
|00002630| 49 2c 20 32 20 63 6f 6d | 70 61 72 61 62 6c 65 20 |I, 2 com|parable |
|00002640| 70 73 6f 72 69 61 74 69 | 63 20 70 6c 61 71 75 65 |psoriati|c plaque|
|00002650| 73 20 66 72 6f 6d 20 36 | 0d 0a 70 61 74 69 65 6e |s from 6|..patien|
|00002660| 74 73 20 77 65 72 65 20 | 74 72 65 61 74 65 64 20 |ts were |treated |
|00002670| 77 69 74 68 20 65 69 74 | 68 65 72 20 69 6e 74 72 |with eit|her intr|
|00002680| 61 6c 65 73 69 6f 6e 61 | 6c 6c 79 20 61 64 6d 69 |alesiona|lly admi|
|00002690| 6e 69 73 74 65 72 65 64 | 20 63 79 63 6c 6f 73 70 |nistered| cyclosp|
|000026a0| 6f 72 69 6e 65 20 6f 72 | 0d 0a 76 65 68 69 63 6c |orine or|..vehicl|
|000026b0| 65 20 6f 6e 63 65 20 77 | 65 65 6b 6c 79 20 66 6f |e once w|eekly fo|
|000026c0| 72 20 34 20 77 65 65 6b | 73 2e 0d 0a 20 20 20 20 |r 4 week|s... |
|000026d0| 20 54 68 65 20 63 79 63 | 6c 6f 73 70 6f 72 69 6e | The cyc|losporin|
|000026e0| 65 2d 74 72 65 61 74 65 | 64 20 70 73 6f 72 69 61 |e-treate|d psoria|
|000026f0| 74 69 63 20 70 6c 61 71 | 75 65 73 20 66 72 6f 6d |tic plaq|ues from|
|00002700| 20 61 6c 6c 20 70 61 74 | 69 65 6e 74 73 20 69 6e | all pat|ients in|
|00002710| 20 70 68 61 73 65 20 49 | 0d 0a 73 68 6f 77 65 64 | phase I|..showed|
|00002720| 20 63 6f 6d 70 6c 65 74 | 65 20 63 6c 65 61 72 69 | complet|e cleari|
|00002730| 6e 67 20 6f 72 20 69 6e | 63 6f 6d 70 6c 65 74 65 |ng or in|complete|
|00002740| 20 62 75 74 20 73 69 67 | 6e 69 66 69 63 61 6e 74 | but sig|nificant|
|00002750| 20 63 6c 65 61 72 69 6e | 67 20 63 6f 6d 70 61 72 | clearin|g compar|
|00002760| 65 64 20 77 69 74 68 0d | 0a 76 65 68 69 63 6c 65 |ed with.|.vehicle|
|00002770| 2d 74 72 65 61 74 65 64 | 20 70 6c 61 71 75 65 73 |-treated| plaques|
|00002780| 2e 20 20 54 68 65 20 6d | 65 61 6e 20 67 6c 6f 62 |. The m|ean glob|
|00002790| 61 6c 20 73 63 6f 72 65 | 2c 20 62 61 73 65 64 20 |al score|, based |
|000027a0| 6f 6e 20 74 68 65 20 64 | 65 67 72 65 65 20 6f 66 |on the d|egree of|
|000027b0| 0d 0a 65 72 79 74 68 65 | 6d 61 2c 20 73 63 61 6c |..erythe|ma, scal|
|000027c0| 69 6e 67 2c 20 69 6e 64 | 75 72 61 74 69 6f 6e 2c |ing, ind|uration,|
|000027d0| 20 61 6e 64 20 70 75 73 | 74 75 6c 61 74 69 6f 6e | and pus|tulation|
|000027e0| 2c 20 77 61 73 20 72 65 | 64 75 63 65 64 20 73 69 |, was re|duced si|
|000027f0| 67 6e 69 66 69 63 61 6e | 74 6c 79 2e 0d 0a 53 74 |gnifican|tly...St|
|00002800| 65 61 64 79 2d 73 74 61 | 74 65 20 62 6c 6f 6f 64 |eady-sta|te blood|
|00002810| 20 63 79 63 6c 6f 73 70 | 6f 72 69 6e 65 20 6c 65 | cyclosp|orine le|
|00002820| 76 65 6c 73 20 72 61 6e | 67 65 64 20 66 72 6f 6d |vels ran|ged from|
|00002830| 20 32 30 20 74 6f 20 33 | 30 20 6e 67 2f 6d 4c 20 | 20 to 3|0 ng/mL |
|00002840| 64 75 72 69 6e 67 20 74 | 68 65 0d 0a 66 69 72 73 |during t|he..firs|
|00002850| 74 20 31 32 20 68 6f 75 | 72 73 20 61 66 74 65 72 |t 12 hou|rs after|
|00002860| 20 69 6e 6a 65 63 74 69 | 6f 6e 20 61 6e 64 20 62 | injecti|on and b|
|00002870| 65 63 61 6d 65 20 75 6e | 64 65 74 65 63 74 61 62 |ecame un|detectab|
|00002880| 6c 65 20 61 74 20 34 38 | 20 68 6f 75 72 73 2e 20 |le at 48| hours. |
|00002890| 20 50 61 69 6e 20 61 74 | 0d 0a 74 68 65 20 69 6e | Pain at|..the in|
|000028a0| 6a 65 63 74 69 6f 6e 20 | 73 69 74 65 20 77 61 73 |jection |site was|
|000028b0| 20 63 6f 6d 6d 6f 6e 2e | 20 20 49 6e 20 63 6f 6e | common.| In con|
|000028c0| 74 72 61 73 74 20 74 6f | 20 70 68 61 73 65 20 49 |trast to| phase I|
|000028d0| 20 72 65 73 75 6c 74 73 | 2c 20 74 68 65 20 72 65 | results|, the re|
|000028e0| 73 70 6f 6e 73 65 0d 0a | 77 61 73 20 6d 69 6e 69 |sponse..|was mini|
|000028f0| 6d 61 6c 20 69 6e 20 63 | 79 63 6c 6f 73 70 6f 72 |mal in c|yclospor|
|00002900| 69 6e 65 2d 74 72 65 61 | 74 65 64 20 70 61 74 69 |ine-trea|ted pati|
|00002910| 65 6e 74 73 20 69 6e 20 | 70 68 61 73 65 20 49 49 |ents in |phase II|
|00002920| 2e 0d 0a 20 20 20 20 20 | 49 6e 20 63 79 63 6c 6f |... |In cyclo|
|00002930| 73 70 6f 72 69 6e 65 2d | 74 72 65 61 74 65 64 20 |sporine-|treated |
|00002940| 70 6c 61 71 75 65 73 2c | 20 74 68 65 72 65 20 77 |plaques,| there w|
|00002950| 61 73 20 61 20 73 69 67 | 6e 69 66 69 63 61 6e 74 |as a sig|nificant|
|00002960| 20 72 65 64 75 63 74 69 | 6f 6e 20 69 6e 0d 0a 65 | reducti|on in..e|
|00002970| 70 69 64 65 72 6d 61 6c | 20 74 68 69 63 6b 6e 65 |pidermal| thickne|
|00002980| 73 73 2c 20 66 72 6f 6d | 20 61 20 6d 65 61 6e 20 |ss, from| a mean |
|00002990| 2e 34 32 20 74 6f 20 2e | 32 37 20 6d 6d 2e 20 20 |.42 to .|27 mm. |
|000029a0| 42 69 6f 70 73 79 20 73 | 70 65 63 69 6d 65 6e 73 |Biopsy s|pecimens|
|000029b0| 20 6f 62 74 61 69 6e 65 | 64 20 6f 6e 0d 0a 64 61 | obtaine|d on..da|
|000029c0| 79 20 35 20 73 68 6f 77 | 65 64 20 61 20 73 69 67 |y 5 show|ed a sig|
|000029d0| 6e 69 66 69 63 61 6e 74 | 20 72 65 64 75 63 74 69 |nificant| reducti|
|000029e0| 6f 6e 20 6f 66 20 65 70 | 69 64 65 72 6d 61 6c 20 |on of ep|idermal |
|000029f0| 44 52 28 2b 29 20 43 44 | 49 28 2d 29 0d 0a 61 6e |DR(+) CD|I(-)..an|
|00002a00| 74 69 67 65 6e 2d 70 72 | 65 73 65 6e 74 69 6e 67 |tigen-pr|esenting|
|00002a10| 20 63 65 6c 6c 73 2c 20 | 65 70 69 64 65 72 6d 61 | cells, |epiderma|
|00002a20| 6c 20 61 6e 64 20 64 65 | 72 6d 61 6c 20 6d 6f 6e |l and de|rmal mon|
|00002a30| 6f 63 79 74 65 73 2c 20 | 61 6e 64 20 6b 65 72 61 |ocytes, |and kera|
|00002a40| 74 69 6e 6f 63 79 74 65 | 0d 0a 69 6e 74 65 72 63 |tinocyte|..interc|
|00002a50| 65 6c 6c 75 6c 61 72 20 | 61 64 68 65 73 69 6f 6e |ellular |adhesion|
|00002a60| 20 6d 6f 6c 65 63 75 6c | 65 2d 31 20 65 78 70 72 | molecul|e-1 expr|
|00002a70| 65 73 73 69 6f 6e 2e 20 | 20 49 6e 20 61 64 64 69 |ession. | In addi|
|00002a80| 74 69 6f 6e 2c 20 74 68 | 65 20 70 61 72 61 6b 65 |tion, th|e parake|
|00002a90| 72 61 74 6f 74 69 63 0d | 0a 73 74 72 61 74 75 6d |ratotic.|.stratum|
|00002aa0| 20 63 6f 72 6e 65 75 6d | 20 72 65 76 65 72 74 65 | corneum| reverte|
|00002ab0| 64 20 74 6f 20 61 20 6e | 6f 72 6d 61 6c 20 6f 72 |d to a n|ormal or|
|00002ac0| 74 68 6f 6b 65 72 61 74 | 6f 74 69 63 20 70 61 74 |thokerat|otic pat|
|00002ad0| 74 65 72 6e 2e 20 20 54 | 68 65 20 68 69 73 74 6f |tern. T|he histo|
|00002ae0| 6c 6f 67 69 63 0d 0a 61 | 6e 64 20 69 6d 6d 75 6e |logic..a|nd immun|
|00002af0| 6f 70 68 65 6e 6f 74 79 | 70 69 63 20 63 68 61 6e |ophenoty|pic chan|
|00002b00| 67 3b 65 73 20 62 65 63 | 61 6d 65 20 65 76 69 64 |g;es bec|ame evid|
|00002b10| 65 6e 74 20 61 74 20 64 | 61 79 20 35 2c 20 62 65 |ent at d|ay 5, be|
|00002b20| 66 6f 72 65 20 63 6c 69 | 6e 69 63 61 6c 0d 0a 69 |fore cli|nical..i|
|00002b30| 6d 70 72 6f 76 65 6d 65 | 6e 74 20 77 61 73 20 61 |mproveme|nt was a|
|00002b40| 70 70 61 72 65 6e 74 2e | 0d 0a 20 20 20 20 20 49 |pparent.|.. I|
|00002b50| 6e 20 70 73 6f 72 69 61 | 73 69 73 2c 20 63 79 63 |n psoria|sis, cyc|
|00002b60| 6c 6f 73 70 6f 72 69 6e | 65 20 61 70 70 61 72 65 |losporin|e appare|
|00002b70| 6e 74 6c 79 20 64 6f 65 | 73 20 6e 6f 74 20 68 61 |ntly doe|s not ha|
|00002b80| 76 65 20 74 6f 20 62 65 | 20 6d 65 74 61 62 6f 6c |ve to be| metabol|
|00002b90| 69 7a 65 64 0d 0a 73 79 | 73 74 65 6d 69 63 61 6c |ized..sy|stemical|
|00002ba0| 6c 79 20 74 6f 20 62 65 | 20 74 68 65 72 61 70 65 |ly to be| therape|
|00002bb0| 75 74 69 63 61 6c 6c 79 | 20 61 63 74 69 76 65 2c |utically| active,|
|00002bc0| 20 62 75 74 20 61 63 74 | 73 20 74 68 72 6f 75 67 | but act|s throug|
|00002bd0| 68 20 61 20 6c 6f 63 61 | 6c 20 6d 65 63 68 61 6e |h a loca|l mechan|
|00002be0| 69 73 6d 2e 0d 0a 54 68 | 65 20 66 61 69 6c 75 72 |ism...Th|e failur|
|00002bf0| 65 20 6f 66 20 74 6f 70 | 69 63 61 6c 6c 79 20 61 |e of top|ically a|
|00002c00| 70 70 6c 69 65 64 20 63 | 79 63 6c 6f 73 70 6f 72 |pplied c|yclospor|
|00002c10| 69 6e 65 20 6d 61 79 20 | 62 65 20 62 65 63 61 75 |ine may |be becau|
|00002c20| 73 65 20 6f 66 20 69 6e | 61 64 65 71 75 61 74 65 |se of in|adequate|
|00002c30| 0d 0a 70 65 6e 65 74 72 | 61 74 69 6f 6e 2c 20 72 |..penetr|ation, r|
|00002c40| 61 70 69 64 20 72 65 64 | 69 73 74 72 69 62 75 74 |apid red|istribut|
|00002c50| 69 6f 6e 2c 20 6f 72 20 | 63 79 74 6f 63 68 72 6f |ion, or |cytochro|
|00002c60| 6d 65 20 50 2d 34 35 30 | 2d 6d 65 64 69 61 74 65 |me P-450|-mediate|
|00002c70| 64 20 69 6e 61 63 74 69 | 76 61 74 69 6f 6e 0d 0a |d inacti|vation..|
|00002c80| 69 6e 20 74 68 65 20 73 | 6b 69 6e 2e 0d 0a 24 55 |in the s|kin...$U|
|00002c90| 6e 69 71 75 65 5f 49 44 | 7b 59 52 42 30 30 33 30 |nique_ID|{YRB0030|
|00002ca0| 33 7d 0d 0a 24 54 69 74 | 6c 65 7b 49 6e 74 72 61 |3}..$Tit|le{Intra|
|00002cb0| 6c 65 73 69 6f 6e 61 6c | 20 43 79 63 6c 6f 73 70 |lesional| Cyclosp|
|00002cc0| 6f 72 69 6e 20 69 6e 20 | 50 73 6f 72 69 61 73 69 |orin in |Psoriasi|
|00002cd0| 73 7d 0d 0a 24 41 75 74 | 68 6f 72 7b 0d 0a 50 6f |s}..$Aut|hor{..Po|
|00002ce0| 77 6c 65 73 2c 20 41 56 | 0d 0a 42 61 6b 65 72 2c |wles, AV|..Baker,|
|00002cf0| 20 42 53 0d 0a 4d 63 46 | 61 64 64 65 6e 2c 20 4a | BS..McF|adden, J|
|00002d00| 50 0d 0a 56 61 6c 64 69 | 6d 61 72 73 73 6f 6e 2c |P..Valdi|marsson,|
|00002d10| 20 48 0d 0a 46 72 79 2c | 20 4c 7d 0d 0a 24 41 66 | H..Fry,| L}..$Af|
|00002d20| 66 69 6c 69 61 74 69 6f | 6e 7b 53 74 20 4d 61 72 |filiatio|n{St Mar|
|00002d30| 79 27 73 20 48 6f 73 70 | 3b 20 53 74 20 4d 61 72 |y's Hosp|; St Mar|
|00002d40| 79 27 73 20 48 6f 73 70 | 20 4d 65 64 20 53 63 68 |y's Hosp| Med Sch|
|00002d50| 6f 6f 6c 2c 20 4c 6f 6e | 64 6f 6e 3b 20 4c 61 6e |ool, Lon|don; Lan|
|00002d60| 73 70 69 74 61 6c 69 6e | 6e 2c 0d 0a 52 65 79 6b |spitalin|n,..Reyk|
|00002d70| 6a 61 76 69 6b 2c 20 49 | 63 65 6c 61 6e 64 7d 0d |javik, I|celand}.|
|00002d80| 0a 24 4a 6f 75 72 6e 61 | 6c 7b 41 63 74 61 20 44 |.$Journa|l{Acta D|
|00002d90| 65 72 6d 20 56 65 6e 65 | 72 65 6f 6c 20 28 53 74 |erm Vene|reol (St|
|00002da0| 6f 63 6b 68 29 20 5b 53 | 75 70 70 6c 5d 7d 0d 0a |ockh) [S|uppl]}..|
|00002db0| 24 56 6f 6c 75 6d 65 7b | 31 34 36 7d 0d 0a 24 50 |$Volume{|146}..$P|
|00002dc0| 61 67 65 7b 31 34 38 2d | 31 35 30 7d 0d 0a 24 44 |age{148-|150}..$D|
|00002dd0| 61 74 65 7b 31 39 38 39 | 7d 0d 0a 24 59 42 56 6f |ate{1989|}..$YBVo|
|00002de0| 6c 7b 31 39 39 31 20 59 | 65 61 72 20 42 6f 6f 6b |l{1991 Y|ear Book|
|00002df0| 20 6f 66 20 44 65 72 6d | 61 74 6f 6c 6f 67 79 7d | of Derm|atology}|
|00002e00| 0d 0a 24 43 68 61 70 74 | 65 72 7b 31 37 2d 32 33 |..$Chapt|er{17-23|
|00002e10| 7d 0d 0a 24 59 42 45 64 | 69 74 6f 72 7b 44 72 73 |}..$YBEd|itor{Drs|
|00002e20| 2e 20 20 53 6f 62 65 72 | 20 61 6e 64 20 46 69 74 |. Sober| and Fit|
|00002e30| 7a 70 61 74 72 69 63 6b | 7d 0d 0a 24 54 61 62 6c |zpatrick|}..$Tabl|
|00002e40| 65 7b 7d 0d 0a 24 43 6f | 6d 6d 65 6e 74 61 74 6f |e{}..$Co|mmentato|
|00002e50| 72 7b 52 2e 53 2e 20 20 | 53 74 65 72 6e 2c 20 4d |r{R.S. |Stern, M|
|00002e60| 2e 44 2e 7d 0d 0a 0d 0a | 43 6f 70 79 72 69 67 68 |.D.}....|Copyrigh|
|00002e70| 74 20 28 43 29 20 59 65 | 61 72 20 42 6f 6f 6b 20 |t (C) Ye|ar Book |
|00002e80| 4d 65 64 69 63 61 6c 20 | 50 75 62 6c 69 73 68 65 |Medical |Publishe|
|00002e90| 72 73 2c 20 49 6e 63 2e | 20 20 31 39 39 31 0d 0a |rs, Inc.| 1991..|
|00002ea0| 0d 0a 31 39 39 31 20 59 | 65 61 72 20 42 6f 6f 6b |..1991 Y|ear Book|
|00002eb0| 20 6f 66 20 44 65 72 6d | 61 74 6f 6c 6f 67 79 0d | of Derm|atology.|
|00002ec0| 0a 0d 0a 43 68 61 70 74 | 65 72 20 31 37 2d 2d 50 |...Chapt|er 17--P|
|00002ed0| 73 6f 72 69 61 73 69 73 | 20 61 6e 64 20 52 65 6c |soriasis| and Rel|
|00002ee0| 61 74 65 64 20 44 69 73 | 6f 72 64 65 72 73 0d 0a |ated Dis|orders..|
|00002ef0| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00002f00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002f40| 0d 0a 49 6e 74 72 61 6c | 65 73 69 6f 6e 61 6c 20 |..Intral|esional |
|00002f50| 43 79 63 6c 6f 73 70 6f | 72 69 6e 20 69 6e 20 50 |Cyclospo|rin in P|
|00002f60| 73 6f 72 69 61 73 69 73 | 0d 0a 0d 0a 50 6f 77 6c |soriasis|....Powl|
|00002f70| 65 73 20 41 56 3b 20 42 | 61 6b 65 72 20 42 53 3b |es AV; B|aker BS;|
|00002f80| 20 4d 63 46 61 64 64 65 | 6e 20 4a 50 3b 20 56 61 | McFadde|n JP; Va|
|00002f90| 6c 64 69 6d 61 72 73 73 | 6f 6e 20 48 3b 20 46 72 |ldimarss|on H; Fr|
|00002fa0| 79 20 4c 0d 0a 28 53 74 | 20 4d 61 72 79 27 73 20 |y L..(St| Mary's |
|00002fb0| 48 6f 73 70 3b 20 53 74 | 20 4d 61 72 79 27 73 20 |Hosp; St| Mary's |
|00002fc0| 48 6f 73 70 20 4d 65 64 | 20 53 63 68 6f 6f 6c 2c |Hosp Med| School,|
|00002fd0| 20 4c 6f 6e 64 6f 6e 3b | 20 4c 61 6e 73 70 69 74 | London;| Lanspit|
|00002fe0| 61 6c 69 6e 6e 2c 20 52 | 65 79 6b 6a 61 76 69 6b |alinn, R|eykjavik|
|00002ff0| 2c 0d 0a 49 63 65 6c 61 | 6e 64 29 0d 0a 41 63 74 |,..Icela|nd)..Act|
|00003000| 61 20 44 65 72 6d 20 56 | 65 6e 65 72 65 6f 6c 20 |a Derm V|enereol |
|00003010| 28 53 74 6f 63 6b 68 29 | 20 5b 53 75 70 70 6c 5d |(Stockh)| [Suppl]|
|00003020| 20 31 34 36 3a 31 34 38 | 2d 31 35 30 2c 20 31 39 | 146:148|-150, 19|
|00003030| 38 39 0d 0a 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |89..----|--------|
|00003040| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003050| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003060| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003070| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003080| 2d 2d 0d 0a 0d 0a 41 62 | 73 74 72 61 63 74 0d 0a |--....Ab|stract..|
|00003090| 0d 0a 20 20 20 20 20 4f | 72 61 6c 2c 20 62 75 74 |.. O|ral, but|
|000030a0| 20 6e 6f 74 20 74 6f 70 | 69 63 61 6c 20 63 79 63 | not top|ical cyc|
|000030b0| 6c 6f 73 70 6f 72 69 6e | 65 20 69 73 20 65 66 66 |losporin|e is eff|
|000030c0| 65 63 74 69 76 65 20 69 | 6e 20 74 72 65 61 74 69 |ective i|n treati|
|000030d0| 6e 67 20 70 73 6f 72 69 | 61 73 69 73 2e 0d 0a 54 |ng psori|asis...T|
|000030e0| 6f 20 64 65 74 65 72 6d | 69 6e 65 20 77 68 65 74 |o determ|ine whet|
|000030f0| 68 65 72 20 74 68 69 73 | 20 6f 63 63 75 72 73 20 |her this| occurs |
|00003100| 62 65 63 61 75 73 65 20 | 6f 66 20 61 20 6c 61 63 |because |of a lac|
|00003110| 6b 20 6f 66 20 61 62 73 | 6f 72 70 74 69 6f 6e 20 |k of abs|orption |
|00003120| 6f 72 20 62 65 63 61 75 | 73 65 20 61 0d 0a 6d 65 |or becau|se a..me|
|00003130| 74 61 62 6f 6c 69 74 65 | 20 6f 66 20 63 79 63 6c |tabolite| of cycl|
|00003140| 6f 73 70 6f 72 69 6e 65 | 20 69 73 20 6e 65 63 65 |osporine| is nece|
|00003150| 73 73 61 72 79 20 66 6f | 72 20 69 74 73 20 69 6d |ssary fo|r its im|
|00003160| 6d 75 6e 6f 73 75 70 70 | 72 65 73 73 69 76 65 20 |munosupp|ressive |
|00003170| 65 66 66 65 63 74 2c 0d | 0a 63 79 63 6c 6f 73 70 |effect,.|.cyclosp|
|00003180| 6f 72 69 6e 65 20 77 61 | 73 20 67 69 76 65 6e 20 |orine wa|s given |
|00003190| 69 6e 74 72 61 6c 65 73 | 69 6f 6e 61 6c 6c 79 20 |intrales|ionally |
|000031a0| 74 6f 20 31 30 20 70 61 | 74 69 65 6e 74 73 20 77 |to 10 pa|tients w|
|000031b0| 69 74 68 20 63 68 72 6f | 6e 69 63 20 70 6c 61 71 |ith chro|nic plaq|
|000031c0| 75 65 0d 0a 70 73 6f 72 | 69 61 73 69 73 2e 20 20 |ue..psor|iasis. |
|000031d0| 49 6e 20 61 20 64 6f 75 | 62 6c 65 2d 62 6c 69 6e |In a dou|ble-blin|
|000031e0| 64 20 66 61 73 68 69 6f | 6e 2c 20 32 20 73 79 6d |d fashio|n, 2 sym|
|000031f0| 6d 65 74 72 69 63 20 70 | 6c 61 71 75 65 73 20 69 |metric p|laques i|
|00003200| 6e 20 65 61 63 68 20 70 | 61 74 69 65 6e 74 0d 0a |n each p|atient..|
|00003210| 77 65 72 65 20 69 6e 6a | 65 63 74 65 64 20 77 69 |were inj|ected wi|
|00003220| 74 68 20 65 69 74 68 65 | 72 20 61 63 74 69 76 65 |th eithe|r active|
|00003230| 20 64 72 75 67 20 6f 72 | 20 76 65 68 69 63 6c 65 | drug or| vehicle|
|00003240| 20 61 6c 6f 6e 65 20 6f | 6e 20 36 20 6f 63 63 61 | alone o|n 6 occa|
|00003250| 73 69 6f 6e 73 20 6f 76 | 65 72 20 31 32 0d 0a 64 |sions ov|er 12..d|
|00003260| 61 79 73 2e 20 20 52 65 | 73 70 6f 6e 73 65 20 77 |ays. Re|sponse w|
|00003270| 61 73 20 61 73 73 65 73 | 73 65 64 20 75 73 69 6e |as asses|sed usin|
|00003280| 67 20 74 68 65 20 63 6c | 69 6e 69 63 61 6c 20 63 |g the cl|inical c|
|00003290| 72 69 74 65 72 69 61 20 | 6f 66 20 65 72 79 74 68 |riteria |of eryth|
|000032a0| 65 6d 61 2c 0d 0a 64 65 | 73 71 75 61 6d 61 74 69 |ema,..de|squamati|
|000032b0| 6f 6e 2c 20 61 6e 64 20 | 74 68 69 63 6b 6e 65 73 |on, and |thicknes|
|000032c0| 73 2e 20 20 50 73 6f 72 | 69 61 74 69 63 20 70 6c |s. Psor|iatic pl|
|000032d0| 61 71 75 65 73 20 77 65 | 72 65 20 73 74 75 64 69 |aques we|re studi|
|000032e0| 65 64 20 68 69 73 74 6f | 6c 6f 67 69 63 61 6c 6c |ed histo|logicall|
|000032f0| 79 0d 0a 66 6f 72 20 48 | 4c 41 2d 44 52 20 65 78 |y..for H|LA-DR ex|
|00003300| 70 72 65 73 73 69 6f 6e | 20 6f 66 20 54 20 6c 79 |pression| of T ly|
|00003310| 6d 70 68 6f 63 79 74 65 | 73 20 61 6e 64 20 64 65 |mphocyte|s and de|
|00003320| 6e 64 72 69 74 69 63 20 | 63 65 6c 6c 73 2e 0d 0a |ndritic |cells...|
|00003330| 20 20 20 20 20 49 6e 20 | 61 6c 6c 20 31 30 20 70 | In |all 10 p|
|00003340| 61 74 69 65 6e 74 73 20 | 74 68 65 20 70 6c 61 71 |atients |the plaq|
|00003350| 75 65 73 20 69 6e 6a 65 | 63 74 65 64 20 77 69 74 |ues inje|cted wit|
|00003360| 68 20 63 79 63 6c 6f 73 | 70 6f 72 69 6e 65 20 73 |h cyclos|porine s|
|00003370| 68 6f 77 65 64 0d 0a 73 | 69 67 6e 69 66 69 63 61 |howed..s|ignifica|
|00003380| 6e 74 20 69 6d 70 72 6f | 76 65 6d 65 6e 74 2c 20 |nt impro|vement, |
|00003390| 77 69 74 68 20 61 20 72 | 65 64 75 63 74 69 6f 6e |with a r|eduction|
|000033a0| 20 69 6e 20 6d 65 61 6e | 20 73 63 6f 72 65 20 66 | in mean| score f|
|000033b0| 72 6f 6d 20 39 20 74 6f | 20 32 2e 35 2e 20 20 49 |rom 9 to| 2.5. I|
|000033c0| 6e 0d 0a 63 6f 6e 74 72 | 61 73 74 2c 20 74 68 65 |n..contr|ast, the|
|000033d0| 72 65 20 77 61 73 20 6e | 6f 20 73 69 67 6e 69 66 |re was n|o signif|
|000033e0| 69 63 61 6e 74 20 69 6d | 70 72 6f 76 65 6d 65 6e |icant im|provemen|
|000033f0| 74 20 69 6e 20 74 68 65 | 20 63 6f 6e 74 72 6f 6c |t in the| control|
|00003400| 20 70 6c 61 71 75 65 73 | 2c 20 77 69 74 68 20 61 | plaques|, with a|
|00003410| 0d 0a 72 65 64 75 63 74 | 69 6f 6e 20 69 6e 20 6d |..reduct|ion in m|
|00003420| 65 61 6e 20 73 63 6f 72 | 65 20 66 72 6f 6d 20 39 |ean scor|e from 9|
|00003430| 20 74 6f 20 37 2e 39 2e | 0d 0a 20 20 20 20 20 48 | to 7.9.|.. H|
|00003440| 69 73 74 6f 6c 6f 67 69 | 63 61 6c 6c 79 2c 20 63 |istologi|cally, c|
|00003450| 68 61 6e 67 65 73 20 69 | 6e 20 74 68 65 20 73 75 |hanges i|n the su|
|00003460| 62 70 6f 70 75 6c 61 74 | 69 6f 6e 20 6f 66 20 54 |bpopulat|ion of T|
|00003470| 20 6c 79 6d 70 68 6f 63 | 79 74 65 73 20 61 6e 64 | lymphoc|ytes and|
|00003480| 0d 0a 64 65 6e 64 72 69 | 74 69 63 20 63 65 6c 6c |..dendri|tic cell|
|00003490| 73 20 77 65 72 65 20 73 | 69 6d 69 6c 61 72 20 74 |s were s|imilar t|
|000034a0| 6f 20 74 68 6f 73 65 20 | 6f 62 73 65 72 76 65 64 |o those |observed|
|000034b0| 20 69 6e 20 61 20 70 72 | 65 76 69 6f 75 73 20 73 | in a pr|evious s|
|000034c0| 74 75 64 79 20 6f 66 20 | 70 61 74 69 65 6e 74 73 |tudy of |patients|
|000034d0| 0d 0a 74 72 65 61 74 65 | 64 20 6f 72 61 6c 6c 79 |..treate|d orally|
|000034e0| 20 77 69 74 68 20 63 79 | 63 6c 6f 73 70 6f 72 69 | with cy|clospori|
|000034f0| 6e 65 2c 20 62 75 74 20 | 64 69 66 66 65 72 65 64 |ne, but |differed|
|00003500| 20 69 6e 20 32 20 61 73 | 70 65 63 74 73 2e 0d 0a | in 2 as|pects...|
|00003510| 43 79 63 6c 6f 73 70 6f | 72 69 6e 65 2d 74 72 65 |Cyclospo|rine-tre|
|00003520| 61 74 65 64 20 70 6c 61 | 71 75 65 73 20 73 68 6f |ated pla|ques sho|
|00003530| 77 65 64 20 72 65 64 75 | 63 65 64 20 65 70 69 64 |wed redu|ced epid|
|00003540| 65 72 6d 61 6c 20 44 52 | 20 2b 20 43 44 34 20 54 |ermal DR| + CD4 T|
|00003550| 20 6c 79 6d 70 68 6f 63 | 79 74 65 73 2c 0d 0a 62 | lymphoc|ytes,..b|
|00003560| 75 74 20 74 68 65 73 65 | 20 77 65 72 65 20 6c 61 |ut these| were la|
|00003570| 72 67 65 6c 79 20 75 6e | 63 68 61 6e 67 65 64 20 |rgely un|changed |
|00003580| 69 6e 20 70 61 74 69 65 | 6e 74 73 20 74 72 65 61 |in patie|nts trea|
|00003590| 74 65 64 20 73 79 73 74 | 65 6d 69 63 61 6c 6c 79 |ted syst|emically|
|000035a0| 2e 20 20 54 68 65 72 65 | 20 77 61 73 0d 0a 61 6e |. There| was..an|
|000035b0| 20 69 6e 63 72 65 61 73 | 65 20 69 6e 20 44 52 20 | increas|e in DR |
|000035c0| 2d 20 54 36 20 2b 20 64 | 65 6e 64 72 69 74 69 63 |- T6 + d|endritic|
|000035d0| 20 63 65 6c 6c 73 20 69 | 6e 20 74 68 65 20 65 70 | cells i|n the ep|
|000035e0| 69 64 65 72 6d 69 73 20 | 6f 66 0d 0a 63 79 63 6c |idermis |of..cycl|
|000035f0| 6f 73 70 6f 72 69 6e 65 | 2d 74 72 65 61 74 65 64 |osporine|-treated|
|00003600| 20 70 6c 61 71 75 65 73 | 2c 20 62 75 74 20 74 68 | plaques|, but th|
|00003610| 69 73 20 77 61 73 20 6e | 6f 74 20 6f 62 73 65 72 |is was n|ot obser|
|00003620| 76 65 64 20 69 6e 20 70 | 61 74 69 65 6e 74 73 20 |ved in p|atients |
|00003630| 74 72 65 61 74 65 64 0d | 0a 73 79 73 74 65 6d 69 |treated.|.systemi|
|00003640| 63 61 6c 6c 79 2e 20 20 | 49 6e 74 72 61 6c 65 73 |cally. |Intrales|
|00003650| 69 6f 6e 61 6c 20 63 79 | 63 6c 6f 73 70 6f 72 69 |ional cy|clospori|
|00003660| 6e 65 20 74 68 65 72 61 | 70 79 20 69 73 20 65 66 |ne thera|py is ef|
|00003670| 66 65 63 74 69 76 65 20 | 69 6e 20 63 6c 65 61 72 |fective |in clear|
|00003680| 69 6e 67 0d 0a 70 73 6f | 72 69 61 73 69 73 2e 20 |ing..pso|riasis. |
|00003690| 20 54 6f 70 69 63 61 6c | 20 74 72 65 61 74 6d 65 | Topical| treatme|
|000036a0| 6e 74 20 77 69 74 68 20 | 63 79 63 6c 6f 73 70 6f |nt with |cyclospo|
|000036b0| 72 69 6e 65 20 68 61 73 | 20 6e 6f 74 20 62 65 65 |rine has| not bee|
|000036c0| 6e 20 65 66 66 65 63 74 | 69 76 65 2c 0d 0a 70 6f |n effect|ive,..po|
|000036d0| 73 73 69 62 6c 79 20 62 | 65 63 61 75 73 65 20 6f |ssibly b|ecause o|
|000036e0| 66 20 6c 61 63 6b 20 6f | 66 20 61 62 73 6f 72 70 |f lack o|f absorp|
|000036f0| 74 69 6f 6e 2e 0d 0a 0d | 0a 50 6f 73 74 2d 43 6f |tion....|.Post-Co|
|00003700| 6d 6d 65 6e 74 0d 0a 0d | 0a 20 20 20 20 20 54 68 |mment...|. Th|
|00003710| 65 73 65 20 73 74 75 64 | 69 65 73 20 64 65 6d 6f |ese stud|ies demo|
|00003720| 6e 73 74 72 61 74 65 20 | 74 68 61 74 20 66 72 65 |nstrate |that fre|
|00003730| 71 75 65 6e 74 20 68 69 | 67 68 20 6c 6f 63 61 6c |quent hi|gh local|
|00003740| 20 74 69 73 73 75 65 20 | 6c 65 76 65 6c 73 20 61 | tissue |levels a|
|00003750| 63 68 69 65 76 65 64 0d | 0a 62 79 20 69 6e 74 72 |chieved.|.by intr|
|00003760| 61 6c 65 73 69 6f 6e 61 | 6c 20 69 6e 6a 65 63 74 |alesiona|l inject|
|00003770| 69 6f 6e 20 6f 66 20 63 | 79 63 6c 6f 73 70 6f 72 |ion of c|yclospor|
|00003780| 69 6e 65 20 33 20 74 69 | 6d 65 73 20 70 65 72 20 |ine 3 ti|mes per |
|00003790| 77 65 65 6b 20 63 61 6e | 20 69 6d 70 72 6f 76 65 |week can| improve|
|000037a0| 0d 0a 6c 6f 63 61 6c 69 | 7a 65 64 20 70 6c 61 71 |..locali|zed plaq|
|000037b0| 75 65 73 20 6f 66 20 70 | 73 6f 72 69 61 73 69 73 |ues of p|soriasis|
|000037c0| 2e 20 20 47 69 76 65 6e | 20 74 68 65 20 64 69 73 |. Given| the dis|
|000037d0| 63 6f 6d 66 6f 72 74 20 | 61 73 73 6f 63 69 61 74 |comfort |associat|
|000037e0| 65 64 20 77 69 74 68 20 | 74 68 65 73 65 0d 0a 69 |ed with |these..i|
|000037f0| 6e 6a 65 63 74 69 6f 6e | 73 2c 20 74 68 65 20 6e |njection|s, the n|
|00003800| 65 65 64 20 66 6f 72 20 | 6d 75 6c 74 69 70 6c 65 |eed for |multiple|
|00003810| 20 69 6e 6a 65 63 74 69 | 6f 6e 73 20 70 65 72 20 | injecti|ons per |
|00003820| 77 65 65 6b 2c 20 61 6e | 64 20 74 68 65 20 6c 69 |week, an|d the li|
|00003830| 6b 65 6c 69 68 6f 6f 64 | 20 6f 66 0d 0a 70 72 6f |kelihood| of..pro|
|00003840| 6d 70 74 20 72 65 74 75 | 72 6e 20 6f 66 20 6c 65 |mpt retu|rn of le|
|00003850| 73 69 6f 6e 73 2c 20 74 | 68 69 73 20 69 73 20 61 |sions, t|his is a|
|00003860| 6e 20 61 6c 74 6f 67 65 | 74 68 65 72 20 69 6d 70 |n altoge|ther imp|
|00003870| 72 61 63 74 69 63 61 6c | 20 74 68 65 72 61 70 79 |ractical| therapy|
|00003880| 2e 20 20 54 68 65 0d 0a | 73 74 75 64 79 20 73 75 |. The..|study su|
|00003890| 67 67 65 73 74 73 20 74 | 68 61 74 20 63 79 63 6c |ggests t|hat cycl|
|000038a0| 6f 73 70 6f 72 69 6e 65 | 20 64 6f 65 73 20 6e 6f |osporine| does no|
|000038b0| 74 20 68 61 76 65 20 74 | 6f 20 62 65 20 73 79 73 |t have t|o be sys|
|000038c0| 74 65 6d 69 63 61 6c 6c | 79 20 6d 65 74 61 62 6f |temicall|y metabo|
|000038d0| 6c 69 7a 65 64 0d 0a 74 | 6f 20 68 61 76 65 20 74 |lized..t|o have t|
|000038e0| 68 65 72 61 70 65 75 74 | 69 63 20 65 66 66 65 63 |herapeut|ic effec|
|000038f0| 74 20 69 6e 20 74 68 65 | 20 73 6b 69 6e 2e 2d 2d |t in the| skin.--|
|00003900| 52 2e 53 2e 20 53 74 65 | 72 6e 2c 20 4d 2e 44 2e |R.S. Ste|rn, M.D.|
|00003910| 0d 0a 24 55 6e 69 71 75 | 65 5f 49 44 7b 59 52 42 |..$Uniqu|e_ID{YRB|
|00003920| 30 30 33 30 34 7d 0d 0a | 24 54 69 74 6c 65 7b 41 |00304}..|$Title{A|
|00003930| 6e 61 6c 79 73 69 73 20 | 6f 66 20 53 69 64 65 2d |nalysis |of Side-|
|00003940| 45 66 66 65 63 74 73 20 | 6f 66 20 4d 65 64 69 75 |Effects |of Mediu|
|00003950| 6d 2d 20 61 6e 64 20 4c | 6f 77 2d 44 6f 73 65 20 |m- and L|ow-Dose |
|00003960| 43 79 63 6c 6f 73 70 6f | 72 69 6e 0d 0a 4d 61 69 |Cyclospo|rin..Mai|
|00003970| 6e 74 65 6e 61 6e 63 65 | 20 54 68 65 72 61 70 79 |ntenance| Therapy|
|00003980| 20 69 6e 20 50 73 6f 72 | 69 61 73 69 73 7d 0d 0a | in Psor|iasis}..|
|00003990| 24 41 75 74 68 6f 72 7b | 0d 0a 44 65 20 52 69 65 |$Author{|..De Rie|
|000039a0| 2c 20 4d 41 0d 0a 4d 65 | 69 6e 61 72 64 69 2c 20 |, MA..Me|inardi, |
|000039b0| 4d 4d 48 4d 0d 0a 42 6f | 73 2c 20 4a 44 7d 0d 0a |MMHM..Bo|s, JD}..|
|000039c0| 24 41 66 66 69 6c 69 61 | 74 69 6f 6e 7b 55 6e 69 |$Affilia|tion{Uni|
|000039d0| 76 20 6f 66 20 41 6d 73 | 74 65 72 64 61 6d 7d 0d |v of Ams|terdam}.|
|000039e0| 0a 24 4a 6f 75 72 6e 61 | 6c 7b 42 72 20 4a 20 44 |.$Journa|l{Br J D|
|000039f0| 65 72 6d 61 74 6f 6c 7d | 0d 0a 24 56 6f 6c 75 6d |ermatol}|..$Volum|
|00003a00| 65 7b 31 32 33 7d 0d 0a | 24 50 61 67 65 7b 33 34 |e{123}..|$Page{34|
|00003a10| 37 2d 33 35 33 7d 0d 0a | 24 44 61 74 65 7b 31 39 |7-353}..|$Date{19|
|00003a20| 39 30 7d 0d 0a 24 59 42 | 56 6f 6c 7b 31 39 39 31 |90}..$YB|Vol{1991|
|00003a30| 20 59 65 61 72 20 42 6f | 6f 6b 20 6f 66 20 44 65 | Year Bo|ok of De|
|00003a40| 72 6d 61 74 6f 6c 6f 67 | 79 7d 0d 0a 24 43 68 61 |rmatolog|y}..$Cha|
|00003a50| 70 74 65 72 7b 31 37 2d | 32 34 7d 0d 0a 24 59 42 |pter{17-|24}..$YB|
|00003a60| 45 64 69 74 6f 72 7b 44 | 72 73 2e 20 20 53 6f 62 |Editor{D|rs. Sob|
|00003a70| 65 72 20 61 6e 64 20 46 | 69 74 7a 70 61 74 72 69 |er and F|itzpatri|
|00003a80| 63 6b 7d 0d 0a 24 54 61 | 62 6c 65 7b 7d 0d 0a 24 |ck}..$Ta|ble{}..$|
|00003a90| 43 6f 6d 6d 65 6e 74 61 | 74 6f 72 7b 52 2e 53 2e |Commenta|tor{R.S.|
|00003aa0| 20 20 53 74 65 72 6e 2c | 20 4d 2e 44 2e 7d 0d 0a | Stern,| M.D.}..|
|00003ab0| 0d 0a 43 6f 70 79 72 69 | 67 68 74 20 28 43 29 20 |..Copyri|ght (C) |
|00003ac0| 59 65 61 72 20 42 6f 6f | 6b 20 4d 65 64 69 63 61 |Year Boo|k Medica|
|00003ad0| 6c 20 50 75 62 6c 69 73 | 68 65 72 73 2c 20 49 6e |l Publis|hers, In|
|00003ae0| 63 2e 20 20 31 39 39 31 | 0d 0a 0d 0a 31 39 39 31 |c. 1991|....1991|
|00003af0| 20 59 65 61 72 20 42 6f | 6f 6b 20 6f 66 20 44 65 | Year Bo|ok of De|
|00003b00| 72 6d 61 74 6f 6c 6f 67 | 79 0d 0a 0d 0a 43 68 61 |rmatolog|y....Cha|
|00003b10| 70 74 65 72 20 31 37 2d | 2d 50 73 6f 72 69 61 73 |pter 17-|-Psorias|
|00003b20| 69 73 20 61 6e 64 20 52 | 65 6c 61 74 65 64 20 44 |is and R|elated D|
|00003b30| 69 73 6f 72 64 65 72 73 | 0d 0a 0d 0a 2d 2d 2d 2d |isorders|....----|
|00003b40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003b80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 0d 0a 41 6e 61 6c |--------|--..Anal|
|00003b90| 79 73 69 73 20 6f 66 20 | 53 69 64 65 2d 45 66 66 |ysis of |Side-Eff|
|00003ba0| 65 63 74 73 20 6f 66 20 | 4d 65 64 69 75 6d 2d 20 |ects of |Medium- |
|00003bb0| 61 6e 64 20 4c 6f 77 2d | 44 6f 73 65 20 43 79 63 |and Low-|Dose Cyc|
|00003bc0| 6c 6f 73 70 6f 72 69 6e | 20 4d 61 69 6e 74 65 6e |losporin| Mainten|
|00003bd0| 61 6e 63 65 0d 0a 54 68 | 65 72 61 70 79 20 69 6e |ance..Th|erapy in|
|00003be0| 20 50 73 6f 72 69 61 73 | 69 73 0d 0a 0d 0a 44 65 | Psorias|is....De|
|00003bf0| 20 52 69 65 20 4d 41 3b | 20 4d 65 69 6e 61 72 64 | Rie MA;| Meinard|
|00003c00| 69 20 4d 4d 48 4d 3b 20 | 42 6f 73 20 4a 44 0d 0a |i MMHM; |Bos JD..|
|00003c10| 28 55 6e 69 76 20 6f 66 | 20 41 6d 73 74 65 72 64 |(Univ of| Amsterd|
|00003c20| 61 6d 29 0d 0a 42 72 20 | 4a 20 44 65 72 6d 61 74 |am)..Br |J Dermat|
|00003c30| 6f 6c 20 31 32 33 3a 33 | 34 37 2d 33 35 33 2c 20 |ol 123:3|47-353, |
|00003c40| 31 39 39 30 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1990..--|--------|
|00003c50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003c60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003c70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003c80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003c90| 2d 2d 2d 2d 0d 0a 0d 0a | 41 62 73 74 72 61 63 74 |----....|Abstract|
|00003ca0| 0d 0a 0d 0a 20 20 20 20 | 20 50 73 6f 72 69 61 73 |.... | Psorias|
|00003cb0| 69 73 2c 20 70 6f 73 73 | 69 62 6c 79 20 61 20 54 |is, poss|ibly a T|
|00003cc0| 2d 63 65 6c 6c 2d 6d 65 | 64 69 61 74 65 64 20 64 |-cell-me|diated d|
|00003cd0| 69 73 6f 72 64 65 72 2c | 20 68 61 73 20 62 65 65 |isorder,| has bee|
|00003ce0| 6e 20 65 66 66 65 63 74 | 69 76 65 6c 79 0d 0a 74 |n effect|ively..t|
|00003cf0| 72 65 61 74 65 64 20 77 | 69 74 68 20 63 79 63 6c |reated w|ith cycl|
|00003d00| 6f 73 70 6f 72 69 6e 65 | 20 41 2e 20 20 4c 6f 6e |osporine| A. Lon|
|00003d10| 67 2d 74 65 72 6d 20 73 | 69 64 65 20 65 66 66 65 |g-term s|ide effe|
|00003d20| 63 74 73 20 77 65 72 65 | 20 72 65 76 69 65 77 65 |cts were| reviewe|
|00003d30| 64 20 69 6e 20 32 36 0d | 0a 70 61 74 69 65 6e 74 |d in 26.|.patient|
|00003d40| 73 20 77 68 6f 20 72 65 | 63 65 69 76 65 64 20 74 |s who re|ceived t|
|00003d50| 68 65 20 64 72 75 67 20 | 66 6f 72 20 61 20 6d 65 |he drug |for a me|
|00003d60| 61 6e 20 6f 66 20 31 39 | 2e 35 20 6d 6f 6e 74 68 |an of 19|.5 month|
|00003d70| 73 2e 20 20 41 6c 6c 20 | 6f 66 20 74 68 65 20 70 |s. All |of the p|
|00003d80| 61 74 69 65 6e 74 73 0d | 0a 68 61 64 20 73 65 76 |atients.|.had sev|
|00003d90| 65 72 65 20 70 73 6f 72 | 69 61 73 69 73 20 69 6e |ere psor|iasis in|
|00003da0| 20 70 6c 61 71 75 65 20 | 66 6f 72 6d 3b 20 31 20 | plaque |form; 1 |
|00003db0| 68 61 64 20 70 61 6c 6d | 6f 70 6c 61 6e 74 61 72 |had palm|oplantar|
|00003dc0| 20 70 75 73 74 75 6c 6f | 73 69 73 20 61 73 20 77 | pustulo|sis as w|
|00003dd0| 65 6c 6c 2e 0d 0a 43 79 | 63 6c 6f 73 70 6f 72 69 |ell...Cy|clospori|
|00003de0| 6e 65 20 41 20 77 61 73 | 20 67 69 76 65 6e 20 66 |ne A was| given f|
|00003df0| 6f 72 20 61 74 20 6c 65 | 61 73 74 20 37 20 6d 6f |or at le|ast 7 mo|
|00003e00| 6e 74 68 73 20 77 69 74 | 68 6f 75 74 20 69 6e 74 |nths wit|hout int|
|00003e10| 65 72 72 75 70 74 69 6f | 6e 2c 20 69 6e 20 61 6e |erruptio|n, in an|
|00003e20| 0d 0a 69 6e 69 74 69 61 | 6c 20 64 6f 73 65 20 6f |..initia|l dose o|
|00003e30| 66 20 33 20 6d 67 2f 6b | 67 2f 64 61 79 2e 0d 0a |f 3 mg/k|g/day...|
|00003e40| 20 20 20 20 20 41 20 64 | 6f 73 65 2d 72 65 6c 61 | A d|ose-rela|
|00003e50| 74 65 64 20 65 66 66 65 | 63 74 20 6f 6e 20 64 69 |ted effe|ct on di|
|00003e60| 61 73 74 6f 6c 69 63 20 | 62 6c 6f 6f 64 20 70 72 |astolic |blood pr|
|00003e70| 65 73 73 75 72 65 20 77 | 61 73 20 6e 6f 74 65 64 |essure w|as noted|
|00003e80| 3b 20 35 20 70 61 74 69 | 65 6e 74 73 0d 0a 62 65 |; 5 pati|ents..be|
|00003e90| 63 61 6d 65 20 68 79 70 | 65 72 74 65 6e 73 69 76 |came hyp|ertensiv|
|00003ea0| 65 20 77 68 65 6e 20 74 | 72 65 61 74 65 64 20 77 |e when t|reated w|
|00003eb0| 69 74 68 20 6d 6f 72 65 | 20 74 68 61 6e 20 33 20 |ith more| than 3 |
|00003ec0| 6d 67 2f 6b 67 2f 64 61 | 79 2e 20 20 54 68 65 20 |mg/kg/da|y. The |
|00003ed0| 73 65 72 75 6d 0d 0a 63 | 72 65 61 74 69 6e 69 6e |serum..c|reatinin|
|00003ee0| 65 20 6c 65 76 65 6c 20 | 63 6f 6e 73 69 73 74 65 |e level |consiste|
|00003ef0| 6e 74 6c 79 20 69 6e 63 | 72 65 61 73 65 64 20 69 |ntly inc|reased i|
|00003f00| 6e 20 70 61 74 69 65 6e | 74 73 20 74 72 65 61 74 |n patien|ts treat|
|00003f10| 65 64 20 6c 6f 6e 67 65 | 72 20 74 68 61 6e 20 32 |ed longe|r than 2|
|00003f20| 0d 0a 79 65 61 72 73 2c | 20 6d 6f 73 74 20 6d 61 |..years,| most ma|
|00003f30| 72 6b 65 64 6c 79 20 69 | 6e 20 74 68 6f 73 65 20 |rkedly i|n those |
|00003f40| 67 69 76 65 6e 20 6d 6f | 72 65 20 74 68 61 6e 20 |given mo|re than |
|00003f50| 32 20 6d 67 2f 6b 67 2f | 64 61 79 2e 20 20 42 6c |2 mg/kg/|day. Bl|
|00003f60| 6f 6f 64 20 70 6f 74 61 | 73 73 69 75 6d 0d 0a 61 |ood pota|ssium..a|
|00003f70| 6e 64 20 61 6c 6b 61 6c | 69 6e 65 20 70 68 6f 73 |nd alkal|ine phos|
|00003f80| 70 68 61 74 61 73 65 20 | 6c 65 76 65 6c 73 20 61 |phatase |levels a|
|00003f90| 6c 73 6f 20 69 6e 63 72 | 65 61 73 65 64 20 69 6e |lso incr|eased in|
|00003fa0| 20 6d 6f 73 74 20 70 61 | 74 69 65 6e 74 73 2e 20 | most pa|tients. |
|00003fb0| 20 54 72 65 61 74 6d 65 | 6e 74 0d 0a 77 61 73 20 | Treatme|nt..was |
|00003fc0| 77 69 74 68 64 72 61 77 | 6e 20 66 72 6f 6d 20 31 |withdraw|n from 1|
|00003fd0| 32 20 70 61 74 69 65 6e | 74 73 20 62 65 63 61 75 |2 patien|ts becau|
|00003fe0| 73 65 20 6f 66 20 6e 65 | 70 68 72 6f 74 6f 78 69 |se of ne|phrotoxi|
|00003ff0| 63 69 74 79 20 61 6e 64 | 2f 6f 72 20 68 79 70 65 |city and|/or hype|
|00004000| 72 74 65 6e 73 69 6f 6e | 2e 0d 0a 4f 74 68 65 72 |rtension|...Other|
|00004010| 20 73 69 64 65 20 65 66 | 66 65 63 74 73 20 69 6e | side ef|fects in|
|00004020| 63 6c 75 64 65 64 20 68 | 79 70 65 72 74 72 69 63 |cluded h|ypertric|
|00004030| 68 6f 73 69 73 2c 20 67 | 61 73 74 72 6f 69 6e 74 |hosis, g|astroint|
|00004040| 65 73 74 69 6e 61 6c 20 | 74 72 61 63 74 20 64 69 |estinal |tract di|
|00004050| 73 6f 72 64 65 72 73 2c | 0d 0a 61 6e 64 20 74 72 |sorders,|..and tr|
|00004060| 65 6d 6f 72 2e 20 20 53 | 65 76 65 72 61 6c 20 70 |emor. S|everal p|
|00004070| 61 74 69 65 6e 74 73 20 | 68 61 64 20 6d 79 61 6c |atients |had myal|
|00004080| 67 69 61 20 61 6e 64 20 | 66 61 74 69 67 75 65 2e |gia and |fatigue.|
|00004090| 20 20 43 79 63 6c 6f 73 | 70 6f 72 69 6e 65 20 41 | Cyclos|porine A|
|000040a0| 20 69 73 20 6d 6f 73 74 | 0d 0a 65 66 66 65 63 74 | is most|..effect|
|000040b0| 69 76 65 20 69 6e 20 63 | 6c 65 61 72 69 6e 67 20 |ive in c|learing |
|000040c0| 73 65 76 65 72 65 20 70 | 6c 61 71 75 65 2d 74 79 |severe p|laque-ty|
|000040d0| 70 65 20 70 73 6f 72 69 | 61 73 69 73 20 61 6e 64 |pe psori|asis and|
|000040e0| 20 69 6e 20 6d 61 69 6e | 74 61 69 6e 69 6e 67 0d | in main|taining.|
|000040f0| 0a 72 65 6d 69 73 73 69 | 6f 6e 2e 20 20 54 72 65 |.remissi|on. Tre|
|00004100| 61 74 6d 65 6e 74 20 69 | 73 2c 20 68 6f 77 65 76 |atment i|s, howev|
|00004110| 65 72 2c 20 66 72 65 71 | 75 65 6e 74 6c 79 20 6c |er, freq|uently l|
|00004120| 69 6d 69 74 65 64 20 62 | 79 20 6e 65 70 68 72 6f |imited b|y nephro|
|00004130| 74 6f 78 69 63 69 74 79 | 2c 0d 0a 68 79 70 65 72 |toxicity|,..hyper|
|00004140| 74 65 6e 73 69 6f 6e 2c | 20 61 6e 64 20 68 79 70 |tension,| and hyp|
|00004150| 65 72 6b 61 6c 65 6d 69 | 61 2e 0d 0a 0d 0a 50 6f |erkalemi|a.....Po|
|00004160| 73 74 2d 43 6f 6d 6d 65 | 6e 74 0d 0a 0d 0a 20 20 |st-Comme|nt.... |
|00004170| 20 20 20 54 68 65 73 65 | 20 61 75 74 68 6f 72 73 | These| authors|
|00004180| 20 77 65 72 65 20 61 62 | 6c 65 20 74 6f 20 63 6c | were ab|le to cl|
|00004190| 65 61 72 20 74 68 65 20 | 70 73 6f 72 69 61 73 69 |ear the |psoriasi|
|000041a0| 73 20 69 6e 20 6d 61 6e | 79 20 6d 6f 72 65 20 70 |s in man|y more p|
|000041b0| 61 74 69 65 6e 74 73 0d | 0a 75 73 69 6e 67 20 63 |atients.|.using c|
|000041c0| 79 63 6c 6f 73 70 6f 72 | 69 6e 65 20 61 74 20 64 |yclospor|ine at d|
|000041d0| 6f 73 65 73 20 6c 65 73 | 73 20 74 68 61 6e 20 35 |oses les|s than 5|
|000041e0| 20 6d 67 2f 6b 67 20 74 | 68 61 6e 20 74 68 65 20 | mg/kg t|han the |
|000041f0| 72 61 6e 64 6f 6d 69 7a | 65 64 0d 0a 70 6c 61 63 |randomiz|ed..plac|
|00004200| 65 62 6f 2d 63 6f 6e 74 | 72 6f 6c 6c 65 64 20 74 |ebo-cont|rolled t|
|00004210| 72 69 61 6c 20 6f 66 20 | 74 68 65 20 4d 69 63 68 |rial of |the Mich|
|00004220| 69 67 61 6e 20 67 72 6f | 75 70 20 28 31 29 2e 20 |igan gro|up (1). |
|00004230| 20 49 6e 20 66 6f 6c 6c | 6f 77 69 6e 67 20 75 70 | In foll|owing up|
|00004240| 20 32 36 0d 0a 70 61 74 | 69 65 6e 74 73 20 77 69 | 26..pat|ients wi|
|00004250| 74 68 20 73 65 76 65 72 | 65 20 70 73 6f 72 69 61 |th sever|e psoria|
|00004260| 73 69 73 20 77 68 6f 20 | 72 65 63 65 69 76 65 64 |sis who |received|
|00004270| 20 63 79 63 6c 6f 73 70 | 6f 72 69 6e 65 20 66 6f | cyclosp|orine fo|
|00004280| 72 20 61 6e 20 61 76 65 | 72 61 67 65 20 6f 66 0d |r an ave|rage of.|
|00004290| 0a 31 39 2e 35 20 6d 6f | 6e 74 68 73 2c 20 74 68 |.19.5 mo|nths, th|
|000042a0| 65 20 61 75 74 68 6f 72 | 73 20 64 65 6d 6f 6e 73 |e author|s demons|
|000042b0| 74 72 61 74 65 20 74 68 | 61 74 20 65 76 65 6e 20 |trate th|at even |
|000042c0| 61 74 20 65 78 74 72 65 | 6d 65 6c 79 20 6c 6f 77 |at extre|mely low|
|000042d0| 20 64 6f 73 65 73 20 28 | 31 35 20 6f 66 0d 0a 74 | doses (|15 of..t|
|000042e0| 68 65 20 32 36 20 70 61 | 74 69 65 6e 74 73 20 77 |he 26 pa|tients w|
|000042f0| 65 72 65 20 74 72 65 61 | 74 65 64 20 77 69 74 68 |ere trea|ted with|
|00004300| 20 61 20 6d 65 61 6e 20 | 64 61 69 6c 79 20 64 6f | a mean |daily do|
|00004310| 73 65 20 6f 66 20 33 20 | 6d 67 2f 6b 67 20 6f 72 |se of 3 |mg/kg or|
|00004320| 20 6c 65 73 73 29 2c 20 | 74 68 65 72 65 0d 0a 77 | less), |there..w|
|00004330| 65 72 65 20 66 72 65 71 | 75 65 6e 74 20 69 6d 70 |ere freq|uent imp|
|00004340| 6f 72 74 61 6e 74 20 73 | 69 64 65 20 65 66 66 65 |ortant s|ide effe|
|00004350| 63 74 73 20 69 6e 63 6c | 75 64 69 6e 67 20 68 79 |cts incl|uding hy|
|00004360| 70 65 72 74 65 6e 73 69 | 6f 6e 2c 20 73 75 62 73 |pertensi|on, subs|
|00004370| 74 61 6e 74 69 61 6c 0d | 0a 64 65 63 72 65 61 73 |tantial.|.decreas|
|00004380| 65 73 20 69 6e 20 72 65 | 6e 61 6c 20 66 75 6e 63 |es in re|nal func|
|00004390| 74 69 6f 6e 2c 20 68 79 | 70 65 72 6b 61 6c 65 6d |tion, hy|perkalem|
|000043a0| 69 61 2c 20 74 72 65 6d | 6f 72 2c 20 67 69 6e 67 |ia, trem|or, ging|
|000043b0| 69 76 61 6c 20 68 79 70 | 65 72 70 6c 61 73 69 61 |ival hyp|erplasia|
|000043c0| 2c 0d 0a 68 79 70 65 72 | 74 72 69 63 68 6f 73 69 |,..hyper|trichosi|
|000043d0| 73 2e 20 20 49 6e 20 61 | 64 64 69 74 69 6f 6e 2c |s. In a|ddition,|
|000043e0| 20 32 20 73 71 75 61 6d | 6f 75 73 20 63 65 6c 6c | 2 squam|ous cell|
|000043f0| 20 63 61 72 63 69 6e 6f | 6d 61 73 20 64 65 76 65 | carcino|mas deve|
|00004400| 6c 6f 70 65 64 20 69 6e | 20 31 0d 0a 70 61 74 69 |loped in| 1..pati|
|00004410| 65 6e 74 2e 20 20 54 68 | 69 73 20 70 61 74 69 65 |ent. Th|is patie|
|00004420| 6e 74 20 68 61 64 20 70 | 72 65 76 69 6f 75 73 20 |nt had p|revious |
|00004430| 74 72 65 61 74 6d 65 6e | 74 20 77 69 74 68 20 70 |treatmen|t with p|
|00004440| 73 6f 72 61 6c 65 6e 20 | 70 6c 75 73 20 75 6c 74 |soralen |plus ult|
|00004450| 72 61 76 69 6f 6c 65 74 | 20 41 0d 0a 28 50 55 56 |raviolet| A..(PUV|
|00004460| 41 29 20 73 75 67 67 65 | 73 74 69 6e 67 20 74 68 |A) sugge|sting th|
|00004470| 61 74 20 63 79 63 6c 6f | 73 70 6f 72 69 6e 65 20 |at cyclo|sporine |
|00004480| 6d 61 79 20 62 65 20 65 | 73 70 65 63 69 61 6c 6c |may be e|speciall|
|00004490| 79 20 68 61 7a 61 72 64 | 6f 75 73 20 77 69 74 68 |y hazard|ous with|
|000044a0| 20 72 65 73 70 65 63 74 | 0d 0a 74 6f 20 63 61 72 | respect|..to car|
|000044b0| 63 69 6e 6f 67 65 6e 65 | 73 69 73 20 69 6e 20 74 |cinogene|sis in t|
|000044c0| 68 65 20 6d 61 6e 79 20 | 70 61 74 69 65 6e 74 73 |he many |patients|
|000044d0| 20 77 69 74 68 20 70 73 | 6f 72 69 61 73 69 73 20 | with ps|oriasis |
|000044e0| 77 68 6f 20 68 61 76 65 | 20 68 61 64 20 70 72 65 |who have| had pre|
|000044f0| 76 69 6f 75 73 0d 0a 74 | 68 65 72 61 70 79 20 77 |vious..t|herapy w|
|00004500| 69 74 68 20 50 55 56 41 | 2c 20 73 75 62 73 74 61 |ith PUVA|, substa|
|00004510| 6e 74 69 61 6c 20 65 78 | 70 6f 73 75 72 65 20 74 |ntial ex|posure t|
|00004520| 6f 20 73 75 6e 6c 69 67 | 68 74 2c 20 6f 72 20 55 |o sunlig|ht, or U|
|00004530| 56 42 0d 0a 70 68 6f 74 | 6f 74 68 65 72 61 70 79 |VB..phot|otherapy|
|00004540| 2e 2d 2d 52 2e 53 2e 20 | 53 74 65 72 6e 2c 20 4d |.--R.S. |Stern, M|
|00004550| 2e 44 2e 0d 0a 24 55 6e | 69 71 75 65 5f 49 44 7b |.D...$Un|ique_ID{|
|00004560| 59 52 42 30 30 33 30 35 | 7d 0d 0a 24 54 69 74 6c |YRB00305|}..$Titl|
|00004570| 65 7b 54 68 72 65 65 20 | 4c 6f 6e 67 2d 54 65 72 |e{Three |Long-Ter|
|00004580| 6d 20 52 65 67 69 6d 65 | 6e 73 20 57 69 74 68 20 |m Regime|ns With |
|00004590| 43 79 63 6c 6f 73 70 6f | 72 69 6e 20 66 6f 72 20 |Cyclospo|rin for |
|000045a0| 50 73 6f 72 69 61 73 69 | 73 20 56 75 6c 67 61 72 |Psoriasi|s Vulgar|
|000045b0| 69 73 7d 0d 0a 24 41 75 | 74 68 6f 72 7b 0d 0a 48 |is}..$Au|thor{..H|
|000045c0| 65 75 6c 65 2c 20 46 0d | 0a 42 6f 75 73 65 6d 61 |eule, F.|.Bousema|
|000045d0| 2c 20 4d 54 0d 0a 4c 61 | 65 69 6a 65 6e 64 65 63 |, MT..La|eijendec|
|000045e0| 6b 65 72 2c 20 52 0d 0a | 76 61 6e 20 4a 6f 6f 73 |ker, R..|van Joos|
|000045f0| 74 2c 20 54 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 |t, T}..$|Affiliat|
|00004600| 69 6f 6e 7b 55 6e 69 76 | 20 48 6f 73 70 20 52 6f |ion{Univ| Hosp Ro|
|00004610| 74 74 65 72 64 61 6d 2f | 44 69 6a 6b 7a 69 67 74 |tterdam/|Dijkzigt|
|00004620| 2c 20 52 6f 74 74 65 72 | 64 61 6d 7d 0d 0a 24 4a |, Rotter|dam}..$J|
|00004630| 6f 75 72 6e 61 6c 7b 41 | 63 74 61 20 44 65 72 6d |ournal{A|cta Derm|
|00004640| 20 56 65 6e 65 72 65 6f | 6c 20 28 53 74 6f 63 6b | Venereo|l (Stock|
|00004650| 68 29 20 5b 53 75 70 70 | 6c 5d 7d 0d 0a 24 56 6f |h) [Supp|l]}..$Vo|
|00004660| 6c 75 6d 65 7b 31 34 36 | 7d 0d 0a 24 50 61 67 65 |lume{146|}..$Page|
|00004670| 7b 31 37 31 2d 31 37 35 | 7d 0d 0a 24 44 61 74 65 |{171-175|}..$Date|
|00004680| 7b 31 39 38 39 7d 0d 0a | 24 59 42 56 6f 6c 7b 31 |{1989}..|$YBVol{1|
|00004690| 39 39 31 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |991 Year| Book of|
|000046a0| 20 44 65 72 6d 61 74 6f | 6c 6f 67 79 7d 0d 0a 24 | Dermato|logy}..$|
|000046b0| 43 68 61 70 74 65 72 7b | 31 37 2d 32 35 7d 0d 0a |Chapter{|17-25}..|
|000046c0| 24 59 42 45 64 69 74 6f | 72 7b 44 72 73 2e 20 20 |$YBEdito|r{Drs. |
|000046d0| 53 6f 62 65 72 20 61 6e | 64 20 46 69 74 7a 70 61 |Sober an|d Fitzpa|
|000046e0| 74 72 69 63 6b 7d 0d 0a | 24 54 61 62 6c 65 7b 7d |trick}..|$Table{}|
|000046f0| 0d 0a 24 43 6f 6d 6d 65 | 6e 74 61 74 6f 72 7b 52 |..$Comme|ntator{R|
|00004700| 2e 53 2e 20 20 53 74 65 | 72 6e 2c 20 4d 2e 44 2e |.S. Ste|rn, M.D.|
|00004710| 7d 0d 0a 0d 0a 43 6f 70 | 79 72 69 67 68 74 20 28 |}....Cop|yright (|
|00004720| 43 29 20 59 65 61 72 20 | 42 6f 6f 6b 20 4d 65 64 |C) Year |Book Med|
|00004730| 69 63 61 6c 20 50 75 62 | 6c 69 73 68 65 72 73 2c |ical Pub|lishers,|
|00004740| 20 49 6e 63 2e 20 20 31 | 39 39 31 0d 0a 0d 0a 31 | Inc. 1|991....1|
|00004750| 39 39 31 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |991 Year| Book of|
|00004760| 20 44 65 72 6d 61 74 6f | 6c 6f 67 79 0d 0a 0d 0a | Dermato|logy....|
|00004770| 43 68 61 70 74 65 72 20 | 31 37 2d 2d 50 73 6f 72 |Chapter |17--Psor|
|00004780| 69 61 73 69 73 20 61 6e | 64 20 52 65 6c 61 74 65 |iasis an|d Relate|
|00004790| 64 20 44 69 73 6f 72 64 | 65 72 73 0d 0a 0d 0a 2d |d Disord|ers....-|
|000047a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 54 |--------|-----..T|
|000047f0| 68 72 65 65 20 4c 6f 6e | 67 2d 54 65 72 6d 20 52 |hree Lon|g-Term R|
|00004800| 65 67 69 6d 65 6e 73 20 | 57 69 74 68 20 43 79 63 |egimens |With Cyc|
|00004810| 6c 6f 73 70 6f 72 69 6e | 20 66 6f 72 20 50 73 6f |losporin| for Pso|
|00004820| 72 69 61 73 69 73 20 56 | 75 6c 67 61 72 69 73 0d |riasis V|ulgaris.|
|00004830| 0a 0d 0a 48 65 75 6c 65 | 20 46 3b 20 42 6f 75 73 |...Heule| F; Bous|
|00004840| 65 6d 61 20 4d 54 3b 20 | 4c 61 65 69 6a 65 6e 64 |ema MT; |Laeijend|
|00004850| 65 63 6b 65 72 20 52 3b | 20 76 61 6e 20 4a 6f 6f |ecker R;| van Joo|
|00004860| 73 74 20 54 0d 0a 28 55 | 6e 69 76 20 48 6f 73 70 |st T..(U|niv Hosp|
|00004870| 20 52 6f 74 74 65 72 64 | 61 6d 2f 44 69 6a 6b 7a | Rotterd|am/Dijkz|
|00004880| 69 67 74 2c 20 52 6f 74 | 74 65 72 64 61 6d 29 0d |igt, Rot|terdam).|
|00004890| 0a 41 63 74 61 20 44 65 | 72 6d 20 56 65 6e 65 72 |.Acta De|rm Vener|
|000048a0| 65 6f 6c 20 28 53 74 6f | 63 6b 68 29 20 5b 53 75 |eol (Sto|ckh) [Su|
|000048b0| 70 70 6c 5d 20 31 34 36 | 3a 31 37 31 2d 31 37 35 |ppl] 146|:171-175|
|000048c0| 2c 20 31 39 38 39 0d 0a | 2d 2d 2d 2d 2d 2d 2d 2d |, 1989..|--------|
|000048d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000048e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000048f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004900| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004910| 2d 2d 2d 2d 2d 2d 0d 0a | 0d 0a 41 62 73 74 72 61 |------..|..Abstra|
|00004920| 63 74 0d 0a 0d 0a 20 20 | 20 20 20 54 68 65 20 72 |ct.... | The r|
|00004930| 65 73 75 6c 74 73 20 6f | 66 20 33 20 6c 6f 6e 67 |esults o|f 3 long|
|00004940| 2d 74 65 72 6d 20 72 65 | 67 69 6d 65 6e 73 20 77 |-term re|gimens w|
|00004950| 69 74 68 20 63 79 63 6c | 6f 73 70 6f 72 69 6e 65 |ith cycl|osporine|
|00004960| 20 41 20 66 6f 72 20 74 | 68 65 20 74 72 65 61 74 | A for t|he treat|
|00004970| 6d 65 6e 74 0d 0a 6f 66 | 20 70 73 6f 72 69 61 73 |ment..of| psorias|
|00004980| 69 73 20 76 75 6c 67 61 | 72 69 73 20 77 65 72 65 |is vulga|ris were|
|00004990| 20 65 76 61 6c 75 61 74 | 65 64 20 72 65 74 72 6f | evaluat|ed retro|
|000049a0| 73 70 65 63 74 69 76 65 | 6c 79 20 74 6f 20 6f 70 |spective|ly to op|
|000049b0| 74 69 6d 69 7a 65 20 64 | 72 75 67 0d 0a 65 66 66 |timize d|rug..eff|
|000049c0| 65 63 74 69 76 65 6e 65 | 73 73 20 77 69 74 68 20 |ectivene|ss with |
|000049d0| 6d 69 6e 69 6d 61 6c 20 | 73 69 64 65 20 65 66 66 |minimal |side eff|
|000049e0| 65 63 74 73 2e 20 20 4f | 66 20 31 39 20 70 61 74 |ects. O|f 19 pat|
|000049f0| 69 65 6e 74 73 20 77 69 | 74 68 20 73 65 76 65 72 |ients wi|th sever|
|00004a00| 65 20 70 6c 61 71 75 65 | 0d 0a 70 73 6f 72 69 61 |e plaque|..psoria|
|00004a10| 73 69 73 2c 20 74 68 65 | 20 39 20 70 61 74 69 65 |sis, the| 9 patie|
|00004a20| 6e 74 73 20 69 6e 20 67 | 72 6f 75 70 20 31 20 72 |nts in g|roup 1 r|
|00004a30| 65 63 65 69 76 65 64 20 | 63 6f 6e 74 69 6e 75 6f |eceived |continuo|
|00004a40| 75 73 20 74 72 65 61 74 | 6d 65 6e 74 20 77 69 74 |us treat|ment wit|
|00004a50| 68 0d 0a 63 79 63 6c 6f | 73 70 6f 72 69 6e 65 20 |h..cyclo|sporine |
|00004a60| 41 20 61 74 20 74 68 65 | 20 6c 6f 77 65 73 74 20 |A at the| lowest |
|00004a70| 70 6f 73 73 69 62 6c 65 | 20 64 6f 73 65 20 74 6f |possible| dose to|
|00004a80| 20 6d 61 69 6e 74 61 69 | 6e 20 73 63 6f 72 65 73 | maintai|n scores|
|00004a90| 20 6f 6e 20 74 68 65 20 | 50 73 6f 72 69 61 74 69 | on the |Psoriati|
|00004aa0| 63 0d 0a 41 63 74 69 76 | 69 74 79 20 61 6e 64 20 |c..Activ|ity and |
|00004ab0| 53 65 76 65 72 69 74 79 | 20 49 6e 64 65 78 20 6f |Severity| Index o|
|00004ac0| 66 20 6e 6f 20 6d 6f 72 | 65 20 74 68 61 6e 20 35 |f no mor|e than 5|
|00004ad0| 2e 20 20 54 68 65 20 31 | 30 20 70 61 74 69 65 6e |. The 1|0 patien|
|00004ae0| 74 73 20 69 6e 20 67 72 | 6f 75 70 20 32 0d 0a 72 |ts in gr|oup 2..r|
|00004af0| 65 63 65 69 76 65 64 20 | 69 6e 74 65 72 6d 69 74 |eceived |intermit|
|00004b00| 74 65 6e 74 20 63 79 63 | 6c 6f 73 70 6f 72 69 6e |tent cyc|losporin|
|00004b10| 65 20 41 20 74 72 65 61 | 74 6d 65 6e 74 2c 20 61 |e A trea|tment, a|
|00004b20| 6e 64 20 61 66 74 65 72 | 20 72 65 6d 69 73 73 69 |nd after| remissi|
|00004b30| 6f 6e 20 77 61 73 0d 0a | 69 6e 64 75 63 65 64 2c |on was..|induced,|
|00004b40| 20 74 68 65 20 64 6f 73 | 65 20 77 61 73 20 77 65 | the dos|e was we|
|00004b50| 61 6e 65 64 20 74 6f 20 | 30 20 61 6e 64 20 70 72 |aned to |0 and pr|
|00004b60| 65 73 63 72 69 62 65 64 | 20 61 67 61 69 6e 20 64 |escribed| again d|
|00004b70| 75 72 69 6e 67 20 61 6e | 20 65 78 61 63 65 72 62 |uring an| exacerb|
|00004b80| 61 74 69 6f 6e 2e 0d 0a | 49 6e 20 61 64 64 69 74 |ation...|In addit|
|00004b90| 69 6f 6e 20 74 6f 20 63 | 79 63 6c 6f 73 70 6f 72 |ion to c|yclospor|
|00004ba0| 69 6e 65 20 41 2c 20 74 | 68 65 20 34 20 70 61 74 |ine A, t|he 4 pat|
|00004bb0| 69 65 6e 74 73 20 69 6e | 20 67 72 6f 75 70 20 33 |ients in| group 3|
|00004bc0| 20 72 65 63 65 69 76 65 | 64 20 54 69 67 61 73 6f | receive|d Tigaso|
|00004bd0| 6e 20 74 6f 0d 0a 61 63 | 68 69 65 76 65 20 72 65 |n to..ac|hieve re|
|00004be0| 6d 69 73 73 69 6f 6e 20 | 77 68 65 6e 20 63 79 63 |mission |when cyc|
|00004bf0| 6c 6f 73 70 6f 72 69 6e | 65 20 41 2c 20 35 20 6d |losporin|e A, 5 m|
|00004c00| 67 2f 6b 67 2f 64 61 79 | 2c 20 66 61 69 6c 65 64 |g/kg/day|, failed|
|00004c10| 20 74 6f 20 73 75 70 70 | 72 65 73 73 0d 0a 70 73 | to supp|ress..ps|
|00004c20| 6f 72 69 61 74 69 63 20 | 64 69 73 65 61 73 65 20 |oriatic |disease |
|00004c30| 61 74 20 61 20 50 73 6f | 72 69 61 74 69 63 20 41 |at a Pso|riatic A|
|00004c40| 63 74 69 76 69 74 79 20 | 61 6e 64 20 53 65 76 65 |ctivity |and Seve|
|00004c50| 72 69 74 79 20 49 6e 64 | 65 78 20 73 63 6f 72 65 |rity Ind|ex score|
|00004c60| 20 6f 66 20 6e 6f 20 6d | 6f 72 65 0d 0a 74 68 61 | of no m|ore..tha|
|00004c70| 6e 20 35 20 6f 72 20 69 | 6e 20 35 30 25 20 6f 66 |n 5 or i|n 50% of|
|00004c80| 20 74 68 65 20 65 70 69 | 73 6f 64 65 73 2e 20 20 | the epi|sodes. |
|00004c90| 54 68 65 20 6d 65 61 6e | 20 66 6f 6c 6c 6f 77 2d |The mean| follow-|
|00004ca0| 75 70 20 70 65 72 69 6f | 64 20 66 6f 72 20 61 6c |up perio|d for al|
|00004cb0| 6c 20 70 61 74 69 65 6e | 74 73 0d 0a 77 61 73 20 |l patien|ts..was |
|00004cc0| 35 38 20 77 65 65 6b 73 | 2e 0d 0a 20 20 20 20 20 |58 weeks|... |
|00004cd0| 54 68 65 20 6d 65 61 6e | 20 64 6f 73 65 20 6f 66 |The mean| dose of|
|00004ce0| 20 63 79 63 6c 6f 73 70 | 6f 72 69 6e 65 20 41 20 | cyclosp|orine A |
|00004cf0| 6e 65 65 64 65 64 20 74 | 6f 20 69 6e 64 75 63 65 |needed t|o induce|
|00004d00| 20 61 20 72 65 6d 69 73 | 73 69 6f 6e 20 69 6e 20 | a remis|sion in |
|00004d10| 67 72 6f 75 70 73 20 31 | 0d 0a 61 6e 64 20 32 20 |groups 1|..and 2 |
|00004d20| 77 61 73 20 35 2e 34 20 | 6d 67 2f 6b 67 2f 64 61 |was 5.4 |mg/kg/da|
|00004d30| 79 20 28 72 61 6e 67 65 | 2c 20 32 2e 39 2d 38 2e |y (range|, 2.9-8.|
|00004d40| 34 20 6d 67 2f 6b 67 2f | 64 61 79 29 2e 20 20 54 |4 mg/kg/|day). T|
|00004d50| 68 65 20 73 61 6d 65 20 | 62 65 6e 65 66 69 63 69 |he same |benefici|
|00004d60| 61 6c 0d 0a 65 66 66 65 | 63 74 20 6f 6e 20 74 68 |al..effe|ct on th|
|00004d70| 65 20 73 6b 69 6e 20 77 | 61 73 20 6d 61 69 6e 74 |e skin w|as maint|
|00004d80| 61 69 6e 65 64 20 66 6f | 72 20 61 20 70 65 72 69 |ained fo|r a peri|
|00004d90| 6f 64 20 6f 66 20 32 34 | 2e 33 20 77 65 65 6b 73 |od of 24|.3 weeks|
|00004da0| 20 69 6e 20 67 72 6f 75 | 70 20 31 20 61 6e 64 0d | in grou|p 1 and.|
|00004db0| 0a 32 33 2e 34 20 77 65 | 65 6b 73 20 69 6e 20 67 |.23.4 we|eks in g|
|00004dc0| 72 6f 75 70 20 32 2c 20 | 62 75 74 20 32 35 25 20 |roup 2, |but 25% |
|00004dd0| 6c 65 73 73 20 63 79 63 | 6c 6f 73 70 6f 72 69 6e |less cyc|losporin|
|00004de0| 65 20 41 20 77 61 73 20 | 75 73 65 64 20 69 6e 20 |e A was |used in |
|00004df0| 67 72 6f 75 70 20 32 20 | 74 6f 0d 0a 61 63 68 69 |group 2 |to..achi|
|00004e00| 65 76 65 20 74 68 69 73 | 20 72 65 73 75 6c 74 2e |eve this| result.|
|00004e10| 20 20 41 20 63 6f 6d 62 | 69 6e 61 74 69 6f 6e 20 | A comb|ination |
|00004e20| 6f 66 20 54 69 67 61 73 | 6f 6e 20 61 6e 64 20 63 |of Tigas|on and c|
|00004e30| 79 63 6c 6f 73 70 6f 72 | 69 6e 65 20 41 20 77 61 |yclospor|ine A wa|
|00004e40| 73 20 67 69 76 65 6e 20 | 74 6f 0d 0a 32 20 70 61 |s given |to..2 pa|
|00004e50| 74 69 65 6e 74 73 20 69 | 6e 20 67 72 6f 75 70 20 |tients i|n group |
|00004e60| 31 20 61 6e 64 20 32 20 | 70 61 74 69 65 6e 74 73 |1 and 2 |patients|
|00004e70| 20 69 6e 20 67 72 6f 75 | 70 20 32 2e 20 20 43 6f | in grou|p 2. Co|
|00004e80| 6d 70 61 72 65 64 20 77 | 69 74 68 20 67 72 6f 75 |mpared w|ith grou|
|00004e90| 70 20 32 0d 0a 70 61 74 | 69 65 6e 74 73 2c 20 74 |p 2..pat|ients, t|
|00004ea0| 68 65 73 65 20 70 61 74 | 69 65 6e 74 73 20 6e 65 |hese pat|ients ne|
|00004eb0| 65 64 65 64 20 6c 65 73 | 73 20 63 79 63 6c 6f 73 |eded les|s cyclos|
|00004ec0| 70 6f 72 69 6e 65 20 41 | 20 74 6f 20 63 6c 65 61 |porine A| to clea|
|00004ed0| 72 20 74 68 65 20 73 6b | 69 6e 2c 20 62 75 74 20 |r the sk|in, but |
|00004ee0| 69 74 0d 0a 74 6f 6f 6b | 20 61 20 73 6c 69 67 68 |it..took| a sligh|
|00004ef0| 74 6c 79 20 6c 6f 6e 67 | 65 72 20 74 69 6d 65 20 |tly long|er time |
|00004f00| 74 6f 20 61 63 68 69 65 | 76 65 20 72 65 6d 69 73 |to achie|ve remis|
|00004f10| 73 69 6f 6e 2e 0d 0a 20 | 20 20 20 20 53 69 64 65 |sion... | Side|
|00004f20| 20 65 66 66 65 63 74 73 | 20 77 65 72 65 20 6d 6f | effects| were mo|
|00004f30| 72 65 20 63 6f 6d 6d 6f | 6e 20 69 6e 20 67 72 6f |re commo|n in gro|
|00004f40| 75 70 73 20 31 20 61 6e | 64 20 32 20 74 68 61 6e |ups 1 an|d 2 than|
|00004f50| 20 69 6e 20 67 72 6f 75 | 70 20 33 2e 0d 0a 48 79 | in grou|p 3...Hy|
|00004f60| 70 65 72 74 65 6e 73 69 | 6f 6e 20 6f 63 63 75 72 |pertensi|on occur|
|00004f70| 72 65 64 20 69 6e 20 34 | 39 25 20 6f 66 20 70 61 |red in 4|9% of pa|
|00004f80| 74 69 65 6e 74 73 20 61 | 6e 64 20 61 6e 20 69 6e |tients a|nd an in|
|00004f90| 63 72 65 61 73 65 20 69 | 6e 20 73 65 72 75 6d 20 |crease i|n serum |
|00004fa0| 63 72 65 61 74 69 6e 69 | 6e 65 0d 0a 6c 65 76 65 |creatini|ne..leve|
|00004fb0| 6c 73 20 77 61 73 20 6e | 6f 74 65 64 20 69 6e 20 |ls was n|oted in |
|00004fc0| 34 32 25 20 6f 66 20 70 | 61 74 69 65 6e 74 73 20 |42% of p|atients |
|00004fd0| 69 6e 63 6c 75 64 69 6e | 67 20 34 20 77 68 6f 20 |includin|g 4 who |
|00004fe0| 72 65 63 65 69 76 65 64 | 20 50 72 6f 6c 69 78 61 |received| Prolixa|
|00004ff0| 6e 2c 20 61 0d 0a 6e 6f | 6e 73 74 65 72 6f 69 64 |n, a..no|nsteroid|
|00005000| 61 6c 20 61 6e 74 69 2d | 69 6e 66 6c 61 6d 6d 61 |al anti-|inflamma|
|00005010| 74 6f 72 79 20 64 72 75 | 67 2e 20 20 47 61 73 74 |tory dru|g. Gast|
|00005020| 72 6f 69 6e 74 65 73 74 | 69 6e 61 6c 20 74 72 61 |rointest|inal tra|
|00005030| 63 74 20 63 6f 6d 70 6c | 61 69 6e 74 73 20 61 6e |ct compl|aints an|
|00005040| 64 0d 0a 77 65 69 67 68 | 74 20 69 6e 63 72 65 61 |d..weigh|t increa|
|00005050| 73 65 20 77 65 72 65 20 | 6d 6f 72 65 20 63 6f 6d |se were |more com|
|00005060| 6d 6f 6e 20 69 6e 20 67 | 72 6f 75 70 20 31 20 74 |mon in g|roup 1 t|
|00005070| 68 61 6e 20 69 6e 20 67 | 72 6f 75 70 20 32 20 70 |han in g|roup 2 p|
|00005080| 61 74 69 65 6e 74 73 2e | 20 20 41 6c 6c 0d 0a 73 |atients.| All..s|
|00005090| 69 64 65 20 65 66 66 65 | 63 74 73 20 74 65 6e 64 |ide effe|cts tend|
|000050a0| 65 64 20 74 6f 20 6e 6f | 72 6d 61 6c 69 7a 65 20 |ed to no|rmalize |
|000050b0| 6f 6e 20 72 65 64 75 63 | 74 69 6f 6e 20 6f 66 20 |on reduc|tion of |
|000050c0| 74 68 65 20 64 6f 73 65 | 20 6f 66 20 63 79 63 6c |the dose| of cycl|
|000050d0| 6f 73 70 6f 72 69 6e 65 | 20 41 20 6f 72 0d 0a 64 |osporine| A or..d|
|000050e0| 69 73 61 70 70 65 61 72 | 65 64 20 6f 6e 20 73 74 |isappear|ed on st|
|000050f0| 6f 70 70 69 6e 67 20 74 | 68 65 20 64 72 75 67 2e |opping t|he drug.|
|00005100| 20 20 54 68 65 73 65 20 | 64 61 74 61 20 73 75 67 | These |data sug|
|00005110| 67 65 73 74 20 74 68 61 | 74 20 61 6e 20 69 6e 74 |gest tha|t an int|
|00005120| 65 72 6d 69 74 74 65 6e | 74 0d 0a 72 65 67 69 6d |ermitten|t..regim|
|00005130| 65 6e 20 6f 66 20 63 79 | 63 6c 6f 73 70 6f 72 69 |en of cy|clospori|
|00005140| 6e 65 20 41 20 69 73 20 | 73 75 70 65 72 69 6f 72 |ne A is |superior|
|00005150| 20 74 6f 20 61 20 63 6f | 6e 74 69 6e 75 6f 75 73 | to a co|ntinuous|
|00005160| 20 72 65 67 69 6d 65 6e | 20 69 6e 20 74 68 65 20 | regimen| in the |
|00005170| 74 72 65 61 74 6d 65 6e | 74 0d 0a 6f 66 20 70 73 |treatmen|t..of ps|
|00005180| 6f 72 69 61 73 69 73 2e | 20 20 49 6e 74 65 72 6d |oriasis.| Interm|
|00005190| 69 74 74 65 6e 74 20 74 | 68 65 72 61 70 79 20 61 |ittent t|herapy a|
|000051a0| 6c 6c 6f 77 73 20 66 6f | 72 20 74 68 65 20 6e 65 |llows fo|r the ne|
|000051b0| 67 61 74 69 76 65 20 65 | 66 66 65 63 74 73 20 6f |gative e|ffects o|
|000051c0| 66 0d 0a 74 72 65 61 74 | 6d 65 6e 74 20 28 64 65 |f..treat|ment (de|
|000051d0| 74 65 72 69 6f 72 61 74 | 69 6f 6e 20 6f 66 20 72 |teriorat|ion of r|
|000051e0| 65 6e 61 6c 20 66 75 6e | 63 74 69 6f 6e 20 61 6e |enal fun|ction an|
|000051f0| 64 20 68 79 70 65 72 74 | 65 6e 73 69 6f 6e 29 20 |d hypert|ension) |
|00005200| 74 6f 20 6e 6f 72 6d 61 | 6c 69 7a 65 0d 0a 64 75 |to norma|lize..du|
|00005210| 72 69 6e 67 20 74 68 65 | 20 64 72 75 67 2d 66 72 |ring the| drug-fr|
|00005220| 65 65 20 70 65 72 69 6f | 64 2e 0d 0a 0d 0a 50 6f |ee perio|d.....Po|
|00005230| 73 74 2d 43 6f 6d 6d 65 | 6e 74 0d 0a 0d 0a 20 20 |st-Comme|nt.... |
|00005240| 20 20 20 42 65 63 61 75 | 73 65 20 6f 66 20 74 68 | Becau|se of th|
|00005250| 65 20 6c 61 63 6b 20 6f | 66 20 72 61 6e 64 6f 6d |e lack o|f random|
|00005260| 69 7a 61 74 69 6f 6e 20 | 69 6e 20 74 68 65 20 33 |ization |in the 3|
|00005270| 20 74 72 65 61 74 6d 65 | 6e 74 20 67 72 6f 75 70 | treatme|nt group|
|00005280| 73 2c 20 31 20 6f 66 0d | 0a 77 68 69 63 68 20 77 |s, 1 of.|.which w|
|00005290| 61 73 20 61 20 73 75 62 | 67 72 6f 75 70 20 6f 66 |as a sub|group of|
|000052a0| 20 61 6e 6f 74 68 65 72 | 2c 20 69 74 20 69 73 20 | another|, it is |
|000052b0| 69 6d 70 6f 73 73 69 62 | 6c 65 20 74 6f 20 6d 61 |impossib|le to ma|
|000052c0| 6b 65 20 69 6e 66 65 72 | 65 6e 63 65 73 20 61 62 |ke infer|ences ab|
|000052d0| 6f 75 74 0d 0a 77 68 61 | 74 20 69 73 20 74 68 65 |out..wha|t is the|
|000052e0| 20 6f 70 74 69 6d 61 6c | 20 6d 61 69 6e 74 65 6e | optimal| mainten|
|000052f0| 61 6e 63 65 20 74 68 65 | 72 61 70 79 20 66 6f 72 |ance the|rapy for|
|00005300| 20 70 61 74 69 65 6e 74 | 73 20 74 72 65 61 74 65 | patient|s treate|
|00005310| 64 20 77 69 74 68 20 63 | 79 63 6c 6f 73 70 6f 72 |d with c|yclospor|
|00005320| 69 6e 65 0d 0a 41 20 66 | 72 6f 6d 20 74 68 65 73 |ine..A f|rom thes|
|00005330| 65 20 64 61 74 61 2e 20 | 20 49 74 20 69 73 20 63 |e data. | It is c|
|00005340| 6c 65 61 72 2c 20 68 6f | 77 65 76 65 72 2c 20 74 |lear, ho|wever, t|
|00005350| 68 61 74 20 63 6f 6e 74 | 69 6e 75 65 64 20 6d 61 |hat cont|inued ma|
|00005360| 69 6e 74 65 6e 61 6e 63 | 65 20 69 73 0d 0a 72 65 |intenanc|e is..re|
|00005370| 71 75 69 72 65 64 2c 20 | 6f 72 20 70 73 6f 72 69 |quired, |or psori|
|00005380| 61 73 69 73 20 77 69 6c | 6c 20 70 72 6f 6d 70 74 |asis wil|l prompt|
|00005390| 6c 79 20 72 65 74 75 72 | 6e 20 61 66 74 65 72 20 |ly retur|n after |
|000053a0| 73 74 6f 70 70 69 6e 67 | 20 63 79 63 6c 6f 73 70 |stopping| cyclosp|
|000053b0| 6f 72 69 6e 65 2e 0d 0a | 41 6c 73 6f 2c 20 74 68 |orine...|Also, th|
|000053c0| 65 20 6e 75 6d 62 65 72 | 20 6f 66 20 63 6c 69 6e |e number| of clin|
|000053d0| 69 63 61 6c 6c 79 20 69 | 6d 70 6f 72 74 61 6e 74 |ically i|mportant|
|000053e0| 20 73 69 64 65 20 65 66 | 66 65 63 74 73 2c 20 65 | side ef|fects, e|
|000053f0| 76 65 6e 20 69 6e 20 6c | 65 73 73 20 74 68 61 6e |ven in l|ess than|
|00005400| 20 36 0d 0a 6d 6f 6e 74 | 68 73 20 6f 66 20 6d 61 | 6..mont|hs of ma|
|00005410| 69 6e 74 65 6e 61 6e 63 | 65 2c 20 61 72 65 20 73 |intenanc|e, are s|
|00005420| 6f 20 67 72 65 61 74 20 | 74 68 61 74 20 69 74 20 |o great |that it |
|00005430| 69 73 20 64 69 66 66 69 | 63 75 6c 74 20 74 6f 20 |is diffi|cult to |
|00005440| 69 6d 61 67 69 6e 65 20 | 74 68 61 74 0d 0a 6c 6f |imagine |that..lo|
|00005450| 6e 67 2d 74 65 72 6d 20 | 74 68 65 72 61 70 79 20 |ng-term |therapy |
|00005460| 77 69 74 68 20 63 79 63 | 6c 6f 73 70 6f 72 69 6e |with cyc|losporin|
|00005470| 65 20 63 6f 75 6c 64 20 | 62 65 20 6a 75 73 74 69 |e could |be justi|
|00005480| 66 69 65 64 2c 20 65 78 | 63 65 70 74 20 69 6e 20 |fied, ex|cept in |
|00005490| 70 61 74 69 65 6e 74 73 | 0d 0a 77 69 74 68 20 70 |patients|..with p|
|000054a0| 73 6f 72 69 61 73 69 73 | 20 74 68 61 74 20 77 61 |soriasis| that wa|
|000054b0| 73 20 62 6f 74 68 20 65 | 78 74 72 65 6d 65 6c 79 |s both e|xtremely|
|000054c0| 20 64 69 73 61 62 6c 69 | 6e 67 20 61 6e 64 20 72 | disabli|ng and r|
|000054d0| 65 66 72 61 63 74 6f 72 | 79 20 74 6f 20 63 75 72 |efractor|y to cur|
|000054e0| 72 65 6e 74 6c 79 0d 0a | 61 70 70 72 6f 76 65 64 |rently..|approved|
|000054f0| 20 74 68 65 72 61 70 69 | 65 73 2c 20 74 68 65 72 | therapi|es, ther|
|00005500| 61 70 69 65 73 20 75 73 | 65 64 20 65 69 74 68 65 |apies us|ed eithe|
|00005510| 72 20 61 6c 6f 6e 65 20 | 6f 72 20 69 6e 20 63 6f |r alone |or in co|
|00005520| 6d 62 69 6e 61 74 69 6f | 6e 2e 2d 2d 52 2e 53 2e |mbinatio|n.--R.S.|
|00005530| 0d 0a 53 74 65 72 6e 2c | 20 4d 2e 44 2e 0d 0a 24 |..Stern,| M.D...$|
|00005540| 55 6e 69 71 75 65 5f 49 | 44 7b 59 52 42 30 30 33 |Unique_I|D{YRB003|
|00005550| 30 36 7d 0d 0a 24 54 69 | 74 6c 65 7b 48 79 64 72 |06}..$Ti|tle{Hydr|
|00005560| 6f 78 79 75 72 65 61 20 | 69 6e 20 74 68 65 20 4d |oxyurea |in the M|
|00005570| 61 6e 61 67 65 6d 65 6e | 74 20 6f 66 20 54 68 65 |anagemen|t of The|
|00005580| 72 61 70 79 20 52 65 73 | 69 73 74 61 6e 74 20 50 |rapy Res|istant P|
|00005590| 73 6f 72 69 61 73 69 73 | 7d 0d 0a 24 41 75 74 68 |soriasis|}..$Auth|
|000055a0| 6f 72 7b 0d 0a 4c 61 79 | 74 6f 6e 2c 20 41 4d 0d |or{..Lay|ton, AM.|
|000055b0| 0a 53 68 65 65 68 61 6e | 2d 44 61 72 65 2c 20 52 |.Sheehan|-Dare, R|
|000055c0| 41 0d 0a 47 6f 6f 64 66 | 69 65 6c 64 2c 20 4d 4a |A..Goodf|ield, MJ|
|000055d0| 44 0d 0a 43 6f 74 74 65 | 72 69 6c 6c 2c 20 4a 41 |D..Cotte|rill, JA|
|000055e0| 7d 0d 0a 24 41 66 66 69 | 6c 69 61 74 69 6f 6e 7b |}..$Affi|liation{|
|000055f0| 54 68 65 20 47 65 6e 20 | 49 6e 66 69 72 6d 61 72 |The Gen |Infirmar|
|00005600| 79 2c 20 4c 65 65 64 73 | 2c 20 45 6e 67 6c 61 6e |y, Leeds|, Englan|
|00005610| 64 7d 0d 0a 24 4a 6f 75 | 72 6e 61 6c 7b 42 72 20 |d}..$Jou|rnal{Br |
|00005620| 4a 20 44 65 72 6d 61 74 | 6f 6c 7d 0d 0a 24 56 6f |J Dermat|ol}..$Vo|
|00005630| 6c 75 6d 65 7b 31 32 31 | 7d 0d 0a 24 50 61 67 65 |lume{121|}..$Page|
|00005640| 7b 36 34 37 2d 36 35 33 | 7d 0d 0a 24 44 61 74 65 |{647-653|}..$Date|
|00005650| 7b 31 39 38 39 7d 0d 0a | 24 59 42 56 6f 6c 7b 31 |{1989}..|$YBVol{1|
|00005660| 39 39 31 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |991 Year| Book of|
|00005670| 20 44 65 72 6d 61 74 6f | 6c 6f 67 79 7d 0d 0a 24 | Dermato|logy}..$|
|00005680| 43 68 61 70 74 65 72 7b | 31 37 2d 32 36 7d 0d 0a |Chapter{|17-26}..|
|00005690| 24 59 42 45 64 69 74 6f | 72 7b 44 72 73 2e 20 20 |$YBEdito|r{Drs. |
|000056a0| 53 6f 62 65 72 20 61 6e | 64 20 46 69 74 7a 70 61 |Sober an|d Fitzpa|
|000056b0| 74 72 69 63 6b 7d 0d 0a | 24 54 61 62 6c 65 7b 54 |trick}..|$Table{T|
|000056c0| 61 62 6c 65 20 4f 6d 69 | 74 74 65 64 7d 0d 0a 24 |able Omi|tted}..$|
|000056d0| 43 6f 6d 6d 65 6e 74 61 | 74 6f 72 7b 53 2e 41 2e |Commenta|tor{S.A.|
|000056e0| 20 20 43 6f 6f 70 6d 61 | 6e 2c 20 4d 2e 44 2e 7d | Coopma|n, M.D.}|
|000056f0| 0d 0a 0d 0a 43 6f 70 79 | 72 69 67 68 74 20 28 43 |....Copy|right (C|
|00005700| 29 20 59 65 61 72 20 42 | 6f 6f 6b 20 4d 65 64 69 |) Year B|ook Medi|
|00005710| 63 61 6c 20 50 75 62 6c | 69 73 68 65 72 73 2c 20 |cal Publ|ishers, |
|00005720| 49 6e 63 2e 20 20 31 39 | 39 31 0d 0a 0d 0a 31 39 |Inc. 19|91....19|
|00005730| 39 31 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |91 Year |Book of |
|00005740| 44 65 72 6d 61 74 6f 6c | 6f 67 79 0d 0a 0d 0a 43 |Dermatol|ogy....C|
|00005750| 68 61 70 74 65 72 20 31 | 37 2d 2d 50 73 6f 72 69 |hapter 1|7--Psori|
|00005760| 61 73 69 73 20 61 6e 64 | 20 52 65 6c 61 74 65 64 |asis and| Related|
|00005770| 20 44 69 73 6f 72 64 65 | 72 73 0d 0a 0d 0a 2d 2d | Disorde|rs....--|
|00005780| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005790| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000057a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000057b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000057c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 48 79 |--------|----..Hy|
|000057d0| 64 72 6f 78 79 75 72 65 | 61 20 69 6e 20 74 68 65 |droxyure|a in the|
|000057e0| 20 4d 61 6e 61 67 65 6d | 65 6e 74 20 6f 66 20 54 | Managem|ent of T|
|000057f0| 68 65 72 61 70 79 20 52 | 65 73 69 73 74 61 6e 74 |herapy R|esistant|
|00005800| 20 50 73 6f 72 69 61 73 | 69 73 0d 0a 0d 0a 4c 61 | Psorias|is....La|
|00005810| 79 74 6f 6e 20 41 4d 3b | 20 53 68 65 65 68 61 6e |yton AM;| Sheehan|
|00005820| 2d 44 61 72 65 20 52 41 | 3b 20 47 6f 6f 64 66 69 |-Dare RA|; Goodfi|
|00005830| 65 6c 64 20 4d 4a 44 3b | 20 43 6f 74 74 65 72 69 |eld MJD;| Cotteri|
|00005840| 6c 6c 20 4a 41 0d 0a 28 | 54 68 65 20 47 65 6e 20 |ll JA..(|The Gen |
|00005850| 49 6e 66 69 72 6d 61 72 | 79 2c 20 4c 65 65 64 73 |Infirmar|y, Leeds|
|00005860| 2c 20 45 6e 67 6c 61 6e | 64 29 0d 0a 42 72 20 4a |, Englan|d)..Br J|
|00005870| 20 44 65 72 6d 61 74 6f | 6c 20 31 32 31 3a 36 34 | Dermato|l 121:64|
|00005880| 37 2d 36 35 33 2c 20 31 | 39 38 39 0d 0a 2d 2d 2d |7-653, 1|989..---|
|00005890| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000058a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000058b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000058c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000058d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 0d 0a 41 |--------|---....A|
|000058e0| 62 73 74 72 61 63 74 0d | 0a 0d 0a 20 20 20 20 20 |bstract.|... |
|000058f0| 48 79 64 72 6f 78 79 75 | 72 65 61 20 69 73 20 61 |Hydroxyu|rea is a|
|00005900| 6e 20 61 6e 74 69 6d 65 | 74 61 62 6f 6c 69 74 65 |n antime|tabolite|
|00005910| 20 74 68 61 74 20 69 73 | 20 65 66 66 65 63 74 69 | that is| effecti|
|00005920| 76 65 20 73 68 6f 72 74 | 2d 74 65 72 6d 20 74 72 |ve short|-term tr|
|00005930| 65 61 74 6d 65 6e 74 0d | 0a 66 6f 72 20 72 65 63 |eatment.|.for rec|
|00005940| 61 6c 63 69 74 72 61 6e | 74 20 70 73 6f 72 69 61 |alcitran|t psoria|
|00005950| 73 69 73 20 77 68 65 6e | 20 67 69 76 65 6e 20 63 |sis when| given c|
|00005960| 6f 6e 74 69 6e 75 6f 75 | 73 6c 79 20 61 6e 64 20 |ontinuou|sly and |
|00005970| 69 6e 74 65 72 6d 69 74 | 74 65 6e 74 6c 79 2e 20 |intermit|tently. |
|00005980| 20 54 68 65 0d 0a 6c 6f | 6e 67 2d 74 65 72 6d 20 | The..lo|ng-term |
|00005990| 65 66 66 69 63 61 63 79 | 20 6f 66 20 68 79 64 72 |efficacy| of hydr|
|000059a0| 6f 78 79 75 72 65 61 2c | 20 2e 35 2d 31 2e 35 20 |oxyurea,| .5-1.5 |
|000059b0| 67 2f 64 61 79 2c 20 77 | 61 73 20 61 73 73 65 73 |g/day, w|as asses|
|000059c0| 73 65 64 20 69 6e 20 38 | 35 20 70 61 74 69 65 6e |sed in 8|5 patien|
|000059d0| 74 73 0d 0a 77 69 74 68 | 20 65 78 74 65 6e 73 69 |ts..with| extensi|
|000059e0| 76 65 20 63 68 72 6f 6e | 69 63 20 70 6c 61 71 75 |ve chron|ic plaqu|
|000059f0| 65 20 70 73 6f 72 69 61 | 73 69 73 20 75 6e 72 65 |e psoria|sis unre|
|00005a00| 73 70 6f 6e 73 69 76 65 | 20 74 6f 20 63 6f 6e 76 |sponsive| to conv|
|00005a10| 65 6e 74 69 6f 6e 61 6c | 20 74 6f 70 69 63 61 6c |entional| topical|
|00005a20| 0d 0a 74 68 65 72 61 70 | 79 2e 0d 0a 20 20 20 20 |..therap|y... |
|00005a30| 20 41 20 67 6f 6f 64 20 | 6f 72 20 6d 6f 64 65 72 | A good |or moder|
|00005a40| 61 74 65 20 72 65 73 70 | 6f 6e 73 65 20 77 61 73 |ate resp|onse was|
|00005a50| 20 61 63 68 69 65 76 65 | 64 20 69 6e 20 36 38 20 | achieve|d in 68 |
|00005a60| 28 38 30 25 29 20 70 61 | 74 69 65 6e 74 73 2c 20 |(80%) pa|tients, |
|00005a70| 77 69 74 68 20 61 0d 0a | 63 6f 6d 70 6c 65 74 65 |with a..|complete|
|00005a80| 20 6f 72 20 61 6c 6d 6f | 73 74 20 63 6f 6d 70 6c | or almo|st compl|
|00005a90| 65 74 65 20 72 65 6d 69 | 73 73 69 6f 6e 20 69 6e |ete remi|ssion in|
|00005aa0| 20 35 31 20 28 36 30 25 | 29 20 70 61 74 69 65 6e | 51 (60%|) patien|
|00005ab0| 74 73 2e 20 20 49 6e 20 | 74 68 65 20 72 65 6d 61 |ts. In |the rema|
|00005ac0| 69 6e 69 6e 67 0d 0a 31 | 37 20 70 61 74 69 65 6e |ining..1|7 patien|
|00005ad0| 74 73 2c 20 68 79 64 72 | 6f 78 79 75 72 65 61 20 |ts, hydr|oxyurea |
|00005ae0| 74 72 65 61 74 6d 65 6e | 74 20 77 61 73 20 73 74 |treatmen|t was st|
|00005af0| 6f 70 70 65 64 20 62 65 | 63 61 75 73 65 20 6f 66 |opped be|cause of|
|00005b00| 20 69 6e 61 64 65 71 75 | 61 74 65 20 74 72 65 61 | inadequ|ate trea|
|00005b10| 74 6d 65 6e 74 0d 0a 72 | 65 73 70 6f 6e 73 65 2e |tment..r|esponse.|
|00005b20| 20 20 4f 6e 6c 79 20 31 | 20 28 36 25 29 20 70 61 | Only 1| (6%) pa|
|00005b30| 74 69 65 6e 74 20 68 61 | 64 20 61 6e 20 61 63 75 |tient ha|d an acu|
|00005b40| 74 65 20 66 6c 61 72 65 | 20 6f 66 20 70 73 6f 72 |te flare| of psor|
|00005b50| 69 61 73 69 73 20 6f 6e | 20 73 74 6f 70 70 69 6e |iasis on| stoppin|
|00005b60| 67 0d 0a 74 68 65 72 61 | 70 79 2e 20 20 41 64 76 |g..thera|py. Adv|
|00005b70| 65 72 73 65 20 72 65 61 | 63 74 69 6f 6e 73 20 77 |erse rea|ctions w|
|00005b80| 65 72 65 20 6f 62 73 65 | 72 76 65 64 20 69 6e 20 |ere obse|rved in |
|00005b90| 33 37 20 28 34 33 25 29 | 20 70 61 74 69 65 6e 74 |37 (43%)| patient|
|00005ba0| 73 2c 20 69 6e 63 6c 75 | 64 69 6e 67 20 31 36 0d |s, inclu|ding 16.|
|00005bb0| 0a 28 31 39 25 29 20 69 | 6e 20 77 68 6f 6d 20 68 |.(19%) i|n whom h|
|00005bc0| 79 64 72 6f 78 79 75 72 | 65 61 20 74 72 65 61 74 |ydroxyur|ea treat|
|00005bd0| 6d 65 6e 74 20 77 61 73 | 20 73 74 6f 70 70 65 64 |ment was| stopped|
|00005be0| 20 28 74 61 62 6c 65 29 | 2e 20 20 53 69 67 6e 69 | (table)|. Signi|
|00005bf0| 66 69 63 61 6e 74 0d 0a | 68 65 6d 61 74 6f 6c 6f |ficant..|hematolo|
|00005c00| 67 69 63 20 63 68 61 6e | 67 65 73 20 6f 63 63 75 |gic chan|ges occu|
|00005c10| 72 72 65 64 20 69 6e 20 | 33 30 20 28 33 35 25 29 |rred in |30 (35%)|
|00005c20| 20 70 61 74 69 65 6e 74 | 73 2c 20 77 68 69 63 68 | patient|s, which|
|00005c30| 20 77 65 72 65 20 63 6f | 72 72 65 63 74 65 64 20 | were co|rrected |
|00005c40| 61 66 74 65 72 0d 0a 72 | 65 64 75 63 69 6e 67 20 |after..r|educing |
|00005c50| 74 68 65 20 64 6f 73 65 | 20 6f 66 20 68 79 64 72 |the dose| of hydr|
|00005c60| 6f 78 79 75 72 65 61 20 | 6f 72 20 74 65 6d 70 6f |oxyurea |or tempo|
|00005c70| 72 61 72 69 6c 79 20 73 | 74 6f 70 70 69 6e 67 20 |rarily s|topping |
|00005c80| 74 72 65 61 74 6d 65 6e | 74 2e 20 20 54 72 65 61 |treatmen|t. Trea|
|00005c90| 74 6d 65 6e 74 0d 0a 77 | 61 73 20 64 69 73 63 6f |tment..w|as disco|
|00005ca0| 6e 74 69 6e 75 65 64 20 | 62 65 63 61 75 73 65 20 |ntinued |because |
|00005cb0| 6f 66 20 62 6f 6e 65 20 | 6d 61 72 72 6f 77 20 73 |of bone |marrow s|
|00005cc0| 75 70 70 72 65 73 73 69 | 6f 6e 20 69 6e 20 36 20 |uppressi|on in 6 |
|00005cd0| 70 61 74 69 65 6e 74 73 | 2e 20 20 44 75 72 69 6e |patients|. Durin|
|00005ce0| 67 0d 0a 74 72 65 61 74 | 6d 65 6e 74 2c 20 61 63 |g..treat|ment, ac|
|00005cf0| 74 69 6e 69 63 20 70 73 | 6f 72 69 61 73 69 73 20 |tinic ps|oriasis |
|00005d00| 64 65 76 65 6c 6f 70 65 | 64 20 69 6e 20 34 20 28 |develope|d in 4 (|
|00005d10| 34 2e 37 25 29 20 70 61 | 74 69 65 6e 74 73 2c 20 |4.7%) pa|tients, |
|00005d20| 68 65 70 61 74 69 63 0d | 0a 64 79 73 66 75 6e 63 |hepatic.|.dysfunc|
|00005d30| 74 69 6f 6e 20 64 65 76 | 65 6c 6f 70 65 64 20 69 |tion dev|eloped i|
|00005d40| 6e 20 33 2c 20 61 6e 64 | 20 65 6e 64 6f 63 72 69 |n 3, and| endocri|
|00005d50| 6e 65 20 64 79 73 66 75 | 6e 63 74 69 6f 6e 20 28 |ne dysfu|nction (|
|00005d60| 68 79 70 6f 74 68 79 72 | 6f 69 64 69 73 6d 20 61 |hypothyr|oidism a|
|00005d70| 6e 64 0d 0a 64 69 61 62 | 65 74 65 73 20 6d 65 6c |nd..diab|etes mel|
|00005d80| 6c 69 74 75 73 29 20 64 | 65 76 65 6c 6f 70 65 64 |litus) d|eveloped|
|00005d90| 20 69 6e 20 32 2e 0d 0a | 20 20 20 20 20 48 79 64 | in 2...| Hyd|
|00005da0| 6f 78 79 75 72 65 61 20 | 69 73 20 61 6e 20 65 66 |oxyurea |is an ef|
|00005db0| 66 65 63 74 69 76 65 20 | 6c 6f 6e 67 2d 74 65 72 |fective |long-ter|
|00005dc0| 6d 20 74 72 65 61 74 6d | 65 6e 74 20 66 6f 72 20 |m treatm|ent for |
|00005dd0| 72 65 66 72 61 63 74 6f | 72 79 20 70 73 6f 72 69 |refracto|ry psori|
|00005de0| 61 73 69 73 2e 0d 0a 53 | 65 72 69 6f 75 73 20 6c |asis...S|erious l|
|00005df0| 6f 6e 67 2d 74 65 72 6d | 20 61 64 76 65 72 73 65 |ong-term| adverse|
|00005e00| 20 65 66 66 65 63 74 73 | 20 61 72 65 20 72 61 72 | effects| are rar|
|00005e10| 65 20 61 74 20 64 6f 73 | 65 73 20 6f 66 20 6c 65 |e at dos|es of le|
|00005e20| 73 73 20 74 68 61 6e 20 | 31 2e 35 20 67 20 64 61 |ss than |1.5 g da|
|00005e30| 69 6c 79 2c 0d 0a 61 6e | 64 20 74 68 65 20 69 6e |ily,..an|d the in|
|00005e40| 63 69 64 65 6e 63 65 20 | 63 6f 6d 70 61 72 65 73 |cidence |compares|
|00005e50| 20 66 61 76 6f 72 61 62 | 6c 79 20 77 69 74 68 20 | favorab|ly with |
|00005e60| 74 68 6f 73 65 20 6f 66 | 20 6d 65 74 68 6f 74 72 |those of| methotr|
|00005e70| 65 78 61 74 65 20 6f 72 | 0d 0a 63 79 63 6c 6f 73 |exate or|..cyclos|
|00005e80| 70 6f 72 69 6e 65 20 41 | 2e 0d 0a 0d 0a 50 6f 73 |porine A|.....Pos|
|00005e90| 74 2d 43 6f 6d 6d 65 6e | 74 0d 0a 0d 0a 20 20 20 |t-Commen|t.... |
|00005ea0| 20 20 54 68 69 73 20 61 | 72 74 69 63 6c 65 20 72 | This a|rticle r|
|00005eb0| 65 70 72 65 73 65 6e 74 | 73 20 61 20 73 6f 62 65 |epresent|s a sobe|
|00005ec0| 72 20 61 6e 64 20 72 65 | 61 6c 69 73 74 69 63 20 |r and re|alistic |
|00005ed0| 61 70 70 72 61 69 73 61 | 6c 20 6f 66 20 74 68 65 |appraisa|l of the|
|00005ee0| 20 75 73 65 20 6f 66 0d | 0a 68 79 64 72 6f 78 79 | use of.|.hydroxy|
|00005ef0| 75 72 65 61 20 69 6e 20 | 74 68 65 20 74 72 65 61 |urea in |the trea|
|00005f00| 74 6d 65 6e 74 20 6f 66 | 20 70 73 6f 72 69 61 73 |tment of| psorias|
|00005f10| 69 73 2e 20 20 44 65 73 | 70 69 74 65 20 61 20 68 |is. Des|pite a h|
|00005f20| 69 67 68 20 69 6e 63 69 | 64 65 6e 63 65 20 6f 66 |igh inci|dence of|
|00005f30| 20 62 6f 6e 65 0d 0a 6d | 61 72 72 6f 77 20 73 75 | bone..m|arrow su|
|00005f40| 70 70 72 65 73 73 69 6f | 6e 2c 20 73 69 67 6e 69 |ppressio|n, signi|
|00005f50| 66 69 63 61 6e 74 20 68 | 65 6d 61 74 6f 6c 6f 67 |ficant h|ematolog|
|00005f60| 69 63 20 70 72 6f 62 6c | 65 6d 73 20 73 65 65 6d |ic probl|ems seem|
|00005f70| 20 74 6f 20 62 65 20 72 | 65 6c 61 74 69 76 65 6c | to be r|elativel|
|00005f80| 79 0d 0a 75 6e 63 6f 6d | 6d 6f 6e 2c 20 70 72 6f |y..uncom|mon, pro|
|00005f90| 76 69 64 65 64 20 74 68 | 65 72 65 20 69 73 20 72 |vided th|ere is r|
|00005fa0| 65 67 75 6c 61 72 20 6d | 6f 6e 69 74 6f 72 69 6e |egular m|onitorin|
|00005fb0| 67 20 6f 66 20 62 6c 6f | 6f 64 20 63 6f 75 6e 74 |g of blo|od count|
|00005fc0| 73 20 61 6e 64 20 61 70 | 70 72 6f 70 72 69 61 74 |s and ap|propriat|
|00005fd0| 65 0d 0a 72 65 67 75 6c | 61 74 69 6f 6e 20 6f 66 |e..regul|ation of|
|00005fe0| 20 74 68 65 20 64 6f 73 | 65 20 6f 66 20 74 68 65 | the dos|e of the|
|00005ff0| 20 64 72 75 67 2e 2d 2d | 53 2e 41 2e 20 43 6f 6f | drug.--|S.A. Coo|
|00006000| 70 6d 61 6e 2c 20 4d 2e | 44 2e 0d 0a 24 55 6e 69 |pman, M.|D...$Uni|
|00006010| 71 75 65 5f 49 44 7b 59 | 52 42 30 30 33 30 37 7d |que_ID{Y|RB00307}|
|00006020| 0d 0a 24 54 69 74 6c 65 | 7b 53 75 6c 66 61 73 61 |..$Title|{Sulfasa|
|00006030| 6c 61 7a 69 6e 65 20 49 | 6d 70 72 6f 76 65 73 20 |lazine I|mproves |
|00006040| 50 73 6f 72 69 61 73 69 | 73 3a 20 20 41 20 44 6f |Psoriasi|s: A Do|
|00006050| 75 62 6c 65 2d 42 6c 69 | 6e 64 20 41 6e 61 6c 79 |uble-Bli|nd Analy|
|00006060| 73 69 73 7d 0d 0a 24 41 | 75 74 68 6f 72 7b 0d 0a |sis}..$A|uthor{..|
|00006070| 47 75 70 74 61 2c 20 41 | 4b 0d 0a 45 6c 6c 69 73 |Gupta, A|K..Ellis|
|00006080| 2c 20 43 4e 0d 0a 53 69 | 65 67 65 6c 2c 20 4d 54 |, CN..Si|egel, MT|
|00006090| 0d 0a 44 75 65 6c 6c 2c | 20 45 41 0d 0a 47 72 69 |..Duell,| EA..Gri|
|000060a0| 66 66 69 74 68 73 2c 20 | 43 45 4d 0d 0a 48 61 6d |ffiths, |CEM..Ham|
|000060b0| 69 6c 74 6f 6e 2c 20 54 | 41 0d 0a 4e 69 63 6b 6f |ilton, T|A..Nicko|
|000060c0| 6c 6f 66 66 2c 20 42 4a | 0d 0a 56 6f 6f 72 68 65 |loff, BJ|..Voorhe|
|000060d0| 65 73 2c 20 4a 4a 7d 0d | 0a 24 41 66 66 69 6c 69 |es, JJ}.|.$Affili|
|000060e0| 61 74 69 6f 6e 7b 55 6e | 69 76 20 6f 66 20 4d 69 |ation{Un|iv of Mi|
|000060f0| 63 68 69 67 61 6e 2c 20 | 41 6e 6e 20 41 72 62 6f |chigan, |Ann Arbo|
|00006100| 72 7d 0d 0a 24 4a 6f 75 | 72 6e 61 6c 7b 41 72 63 |r}..$Jou|rnal{Arc|
|00006110| 68 20 44 65 72 6d 61 74 | 6f 6c 7d 0d 0a 24 56 6f |h Dermat|ol}..$Vo|
|00006120| 6c 75 6d 65 7b 31 32 36 | 7d 0d 0a 24 50 61 67 65 |lume{126|}..$Page|
|00006130| 7b 34 38 37 2d 34 39 33 | 7d 0d 0a 24 44 61 74 65 |{487-493|}..$Date|
|00006140| 7b 31 39 39 30 7d 0d 0a | 24 59 42 56 6f 6c 7b 31 |{1990}..|$YBVol{1|
|00006150| 39 39 31 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |991 Year| Book of|
|00006160| 20 44 65 72 6d 61 74 6f | 6c 6f 67 79 7d 0d 0a 24 | Dermato|logy}..$|
|00006170| 43 68 61 70 74 65 72 7b | 31 37 2d 32 37 7d 0d 0a |Chapter{|17-27}..|
|00006180| 24 59 42 45 64 69 74 6f | 72 7b 44 72 73 2e 20 20 |$YBEdito|r{Drs. |
|00006190| 53 6f 62 65 72 20 61 6e | 64 20 46 69 74 7a 70 61 |Sober an|d Fitzpa|
|000061a0| 74 72 69 63 6b 7d 0d 0a | 24 54 61 62 6c 65 7b 7d |trick}..|$Table{}|
|000061b0| 0d 0a 24 43 6f 6d 6d 65 | 6e 74 61 74 6f 72 7b 53 |..$Comme|ntator{S|
|000061c0| 2e 41 2e 20 20 43 6f 6f | 70 6d 61 6e 2c 20 4d 2e |.A. Coo|pman, M.|
|000061d0| 44 2e 7d 0d 0a 0d 0a 43 | 6f 70 79 72 69 67 68 74 |D.}....C|opyright|
|000061e0| 20 28 43 29 20 59 65 61 | 72 20 42 6f 6f 6b 20 4d | (C) Yea|r Book M|
|000061f0| 65 64 69 63 61 6c 20 50 | 75 62 6c 69 73 68 65 72 |edical P|ublisher|
|00006200| 73 2c 20 49 6e 63 2e 20 | 20 31 39 39 31 0d 0a 0d |s, Inc. | 1991...|
|00006210| 0a 31 39 39 31 20 59 65 | 61 72 20 42 6f 6f 6b 20 |.1991 Ye|ar Book |
|00006220| 6f 66 20 44 65 72 6d 61 | 74 6f 6c 6f 67 79 0d 0a |of Derma|tology..|
|00006230| 0d 0a 43 68 61 70 74 65 | 72 20 31 37 2d 2d 50 73 |..Chapte|r 17--Ps|
|00006240| 6f 72 69 61 73 69 73 20 | 61 6e 64 20 52 65 6c 61 |oriasis |and Rela|
|00006250| 74 65 64 20 44 69 73 6f | 72 64 65 72 73 0d 0a 0d |ted Diso|rders...|
|00006260| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|00006270| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006280| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006290| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000062a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|000062b0| 0a 53 75 6c 66 61 73 61 | 6c 61 7a 69 6e 65 20 49 |.Sulfasa|lazine I|
|000062c0| 6d 70 72 6f 76 65 73 20 | 50 73 6f 72 69 61 73 69 |mproves |Psoriasi|
|000062d0| 73 3a 20 20 41 20 44 6f | 75 62 6c 65 2d 42 6c 69 |s: A Do|uble-Bli|
|000062e0| 6e 64 20 41 6e 61 6c 79 | 73 69 73 0d 0a 0d 0a 47 |nd Analy|sis....G|
|000062f0| 75 70 74 61 20 41 4b 3b | 20 45 6c 6c 69 73 20 43 |upta AK;| Ellis C|
|00006300| 4e 3b 20 53 69 65 67 65 | 6c 20 4d 54 3b 20 44 75 |N; Siege|l MT; Du|
|00006310| 65 6c 6c 20 45 41 3b 20 | 47 72 69 66 66 69 74 68 |ell EA; |Griffith|
|00006320| 73 20 43 45 4d 3b 20 48 | 61 6d 69 6c 74 6f 6e 20 |s CEM; H|amilton |
|00006330| 54 41 3b 20 4e 69 63 6b | 6f 6c 6f 66 66 0d 0a 42 |TA; Nick|oloff..B|
|00006340| 4a 3b 20 56 6f 6f 72 68 | 65 65 73 20 4a 4a 0d 0a |J; Voorh|ees JJ..|
|00006350| 28 55 6e 69 76 20 6f 66 | 20 4d 69 63 68 69 67 61 |(Univ of| Michiga|
|00006360| 6e 2c 20 41 6e 6e 20 41 | 72 62 6f 72 29 0d 0a 41 |n, Ann A|rbor)..A|
|00006370| 72 63 68 20 44 65 72 6d | 61 74 6f 6c 20 31 32 36 |rch Derm|atol 126|
|00006380| 3a 34 38 37 2d 34 39 33 | 2c 20 31 39 39 30 0d 0a |:487-493|, 1990..|
|00006390| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000063a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000063b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000063c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000063d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|000063e0| 0d 0a 41 62 73 74 72 61 | 63 74 0d 0a 0d 0a 20 20 |..Abstra|ct.... |
|000063f0| 20 20 20 49 6e 20 61 6e | 20 6f 70 65 6e 2d 6c 61 | In an| open-la|
+--------+-------------------------+-------------------------+--------+--------+
Only 25.0 KB of data is shown above.
