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• W1520831640 abstract "The pathogenesis of psoriasis involves abnormal differentiation and hyperproliferation of keratinocytes, angiogenesis, lymphocyte activation, activation of dermal macrophages, and neutrophil infiltration. The primary defect(s) in psoriasis may reside in epidermal keratinocytes that when triggered secrete the cytokines responsible for initial recruitment of the inflammatory cells of the immune system. Thus, pathogenesis of psoriasis suggests that this disease can be treated by agents that either modulate the immune system or affect the differentiation program of keratinocytes. Calcipotriol and tazarotene are significant new topical anti-psoriatic drugs. However, it would be desirable to decrease the side effects associated with these drugs and increase their efficacy. Calcipotriol has been identified during systematic effort to synthesize noncalcipotropic vitamin D3 receptor (VDR) agonists. The clinical efficacy of calcipotriol is well established through a number of studies. Calcipotriol ointment has also been compared with betamethasone 17-valerate and is slightly superior to the steroid. Tazarotenean, a retinoic acid receptors (RAR b/g) selective synthetic analog of retinoic acid (RA), is effective as a topical anti-psoriatic agent and is suitable for the treatment of mild to moderate plaque psoriasis. In the case of retinoids, the activity through retinoic acid receptor gamma (RARg) is desirable because it constitutes more than 90% of the total RAR repertoire in the skin. Therefore, RARg selective retinoids may exhibit an increased therapeutic index. Alternatively, function selective compounds, such as retinoids, with only AP1 inhibitory activities but lacking in transactivation capabilities may exhibit fewer side effects. As retinoids, steroids, vitamin D3 analogs, and immuno-suppressive agents affect psoriasis by different mechanisms, a combination of some of these agents at low doses may give a synergistic therapeutic effect. It may also be possible to significantly decrease the toxic side effects associated with each of these therapies by such a combination approach. Larger, well-controlled clinical trials are required to judge the usefulness of the newer agents." @default.
• W1520831640 created "2016-06-24" @default.
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• W1520831640 date "1997-01-01" @default.
• W1520831640 modified "2023-10-17" @default.
• W1520831640 title "Chapter 20. New Dermatological Agents for the Treatment of Psoriasis" @default.
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• W1520831640 doi "https://doi.org/10.1016/s0065-7743(08)61478-5" @default.
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