Investigating the therapeutic potential of a probiotic in a clinical population with chronic hand dermatitis

Wayne P Gulliver,1 Andrew S Hutton,1 Noam Ship2 1NewLab Life Sciences Inc., St. John’s, NL, Canada; 2Research and Development, Bio-K Plus International Inc., Laval, QC, Canada Background: Hand dermatitis or hand eczema (HD) is one of the most common dermatologic conditions. Lesions, scaling, pruritus and pain are chronic and relapsing. Improved HD has been reported with the probiotic composed of Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R and Lactobacillus rhamnosus CLR2 (Bio-K+). Purpose: Investigation of the therapeutic potential of this probiotic as the sole systemic treatment for adults with nonacute HD. Subjects and methods: A single-center study documented clinical ratings and patient-reported outcomes in adults with chronic HD. The probiotic was taken orally for 12 weeks, adjunctive to standard topical treatments and preventative measures. Results: Most of the 30 subjects with mild to severe HD were compliant with the probiotic. Around 22 of the 30 subjects were able to complete the study, and of these subjects, an improvement was noted in 19. One required systemic therapy, and one subject was not able to tolerate the probiotic and therefore discontinued the study. 23% of the subjects achieved clear or almost clear hands by the end of 12 weeks. Pruritus, which was a common complaint at baseline, was improved with 59% of symptomatic patients within 2 weeks. Conclusion: It is feasible and safe to administer Bio-K+ for HD. Clinicians saw an improvement in most subjects’ hands, and cases of significant improvement in dermatitis were documented. Pruritus was the most rapidly relieved symptom, as reported by patients. Keywords: hand dermatitis, eczema, CL1285, Lactobacillus, pruritus, Bio-K

Medical Treatments of Hidradenitis Suppurativa: More Options, Less Evidence

Hidradenitis suppurativa is a common debilitating skin disease that has been neglected by science. There is a need for effective treatment. We are still at the beginning of improving care for these patients as demonstrated by the low levels of evidence. The following treatments have a category of evidence of Ill and a strength of recommendation of C. Acitretin, metformin and zinc gluconate. The following treatments have a category of evidence of IV and a strength of recommendation of D. Ustekinumab, steroids (intralesional/systemic), dapsone, cyclosporine, hormones, pain control and dressings, Isotretinoin, alitretinoin, resorcinol, gamma-globulin, colchicine, botulinum toxin, tacorlimusand fumarates

Prognosis after percutaneous coronary intervention in patients with psoriasis: a cohort study using Danish nationwide registries

<p>Abstract</p> <p>Background</p> <p>Psoriasis is an inflammatory disease associated with increased risk of coronary artery disease. However, the potential impact of psoriasis on the prognosis following percutaneous coronary revascularization (PCI) is unknown.</p> <p>Methods</p> <p>The study comprised the entire Danish population undergoing first-time PCI in the period 2002–09. Cox regression models, controlling for age, gender, socioeconomic status, pharmacological treatment, and comorbidity were used to assess the risk of 1) all-cause mortality and 2) a composite endpoint of death, myocardial infarction, and stroke.</p> <p>Results</p> <p>A total of 53,141 patients with first-time PCI in the study period were identified. Of these, 1074 had mild psoriasis and 315 had severe psoriasis. Patients with severe psoriasis, but not those with mild disease had increased risk of both endpoints compared to patients without psoriasis. The incidence rates for all-cause mortality were 30.5 (CI 29.7-31.3), 29.9 (CI 24.7-36.1), and 47.2 (CI 35.0-63.6) per 1000 patient years for patients without psoriasis, with mild psoriasis, and with severe psoriasis, respectively. Hazard ratios were 1.10 (CI 0.91-1.33) and 1.67 (CI 1.24-2.26) for mild and severe psoriasis, respectively. Patients with severe psoriasis were less likely to receive secondary prevention pharmacotherapy with betablockers, statins and platelet inhibitors.</p> <p>Conclusion</p> <p>This first study of the prognosis following PCI in patients with psoriasis demonstrated an increased risk of all-cause mortality and of a composite of death, myocardial infarction and stroke, respectively, in patients with severe psoriasis compared to patients without psoriasis. Further studies of this novel association are needed.</p