Poster abstracts
therapy opened new windows for treatment of nail psoriasis (1,2).
Objective:The aim of this study was to evaluate the efficacy of
different pulse durations in the treatment of nail psoriasis with the
595-nm PDL to determine the optimal pulse duration.
Methods: In this clinical trial study, 120 patients with bilateral fing-
ernail psoriasis were evaluated. PDL was applied on the proximal
and lateral nailfolds based on random assignment. 240 nails were
treated with 6-millisecond pulse duration and 9 J/cm(2) whereas
240 nails were treated with 0.45-millisecond pulse duration and 6 J/
cm(2). Nail Psoriasis Severity Index (NAPSI) was used to assess the
clinical outcome from pretreatment and posttreatment photographs.
Results: After 6 months of first treatment, there was a signifi-
cant reduction in overall NAPSI, nail matrix NAPSI, and nail
bed NAPSI scores from baseline in both groups; however, no
significant difference was found between the two pulse duration
groups. Side effects were mild including transient petechiae and
hyperpigmentation.
Conclusion: PDL was found to be an effective and well-tolerated
option in the treatment of nail psoriasis. This study demonstrated
that both the longer 6-millisecond and shorter 0.45-millisecond
pulses of PDL (595 nm) have been clinically proven to be effective
for the treatment of nail matrix and nail bed psoriasis.
References:
1. Al-Mutairi N, Nour T, Al-Rqobah D. Onychomycosis in patients of
nail psoriasis on biologic therapy: a randomized, prospective open label
study comparing Etanercept, Infliximab and Adalimumab. Expert Opin
Biol Ther 2013;13(5):625-629.
2. Radtke MA, Beikert FC, Augustin M. Nail psoriasis - a treatment chal-
lenge. J Dtsch Dermatol Ges 2013;11(3):203-219.
P145
NEUTROPENIA IN A PSORIASIS PATIENT: SECU
KINUMAB OR MICRONUTRIENT DEFICIENCY?
Maruska Marovt, Katarina Trcko, Pij B. Marko
University Medical Centre Maribor, Maribor, Slovenia
We report a case of severe neutropenia in a psoriasis patient, which
developed three months after discontinuation of secukinumab. She
had gastric bypass surgery a few years ago and was intermittently
treated due to iron deficiency anemia. According to the suggested
approach to the adult with unexplained neutropenia (1) a range
of diagnostic tests were performed and no abnormalities were
noticed. Neutropenia still persists, however the patient hasn’t
had any complications. Neutropenia was reported infrequently in
subjects with moderate to severe psoriasis receiving secukinumab
in a pooled analysis of 10 phase II and III clinical studies (2). Most
were grades 1 or 2. Grade 3 neutropenia was uncommon and not
associated with serious infections, and no grade 4 neutropenia was
recorded. Deficiencies of dietary vitamins and minerals typically
cause neutropenia in association with other cytopenias. Patients
who have undergone bariatric surgery require lifelong vitamin
and mineral supplementation. Severe neutropenia in our patient
could be due to combination of secukinumab and micronutrient
deficiency, however exact etiology remains unclear.
Berliner N (2018). Approach to the adult with unexplained neutropenia. In
Newburger P (Ed.), UpToDate. Retrieved February 19, 2018, from https://
www.uptodate.com/contents/approach-to-the-adult-with-unexplained-
neutropenia
Van de Kerkhof PC, Griffiths CE, Reich K, Leonardi CL, Blauvelt A, Tsai
TF, et al. Secukinumab long-term safety experience: A pooled analysis of 10
phase II and III clinical studies in patients with moderate to severe plaque
psoriasis. J Am Acad Dermatol 2016 Jul;75(1):83-98.e4.
P146
ESTABLISHMENT OF A PSORIATIC SKIN MODEL FOR
Α-IRRADIATION
Julia Wiedemann 1 , Valeria Grünebaum 1 , Claudius Witzler 1 , Maxi-
milian Dornhecker 1 , Sylvie Lerchl, Claudia Fournier 1,2
59
GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany,
University of Applied Sciences, Darmstadt, Germany
1
2
Introduction: Psoriasis is on the indication list for therapy in radon
galleries (1). Radon is a radioactive noble gas evaporating from
rocks. It is absorbed through skin or lung epithelium during inha-
lation. Radon decays in the tissue under emission of α-particles.
The estimated dose received during a radon therapy is in the
order of 1.2 mSv which corresponds to the annual background
irradiation caused by radon. Chronic inflammatory diseases such
as rheumatoid arthritis are treated with radon and pain reduction
and improvement of mobility are reported (2). Positive effects
are also reported for psoriasis, but sparely documented. However,
for both diseases the mechanisms underlying the clinical benefit
are unknown.
Objectives: To investigate effects of radon treatment we have
established a cellular model for psoriasis which can be used for
irradiation with α-particles. The requirements in using α-particles
are specific due to their short range.
Methods: Special rings stringed with a 2 µm oxygen plasma
treated boPET foil are used to facilitate α-irradiation and growth
of NHEK (normal human epidermal keratinocytes). Cells were
cultured in rings or culture dishes for 24 hours and induced with
IL-17, IL-22 and TNF-α. Supernatants and cells for protein and
mRNA extraction were collected 24 hours after induction. ELISA,
qPCR and Western Blot analysis was performed.
Results: We could show that it is possible to culture primary
keratinocytes on plasma treated boPET foil with a similar morp-
hology to cells cultured in cell culture dishes. Furthermore, the
selected cytokines are able to significantly induce psoriasis-related
markers like IL-19 and BDEF2 on mRNA level and the release
of the cytokine IL-6. Testing if culturing of NHEK on the treated
boPET foil alone has an inflammatory effect revealed no si gnificant
differences in the expression or release of markers compared to
cells cultured in cell culture dishes.
Conclusion: We conclude that the plasma treated boPET foil is a
promising tool for a setup, which enables α-irradiation of mono-
layer cell cultures. The induction of a psoriasis-like phenotype with
cytokines leads to an enhancement of relevant markers.
References:
Gasteiner Kur- Reha- und Heilstollen-Betriebsges.m.b.H. www.gasteiner-
heilstollen.com
Cucu et al; Front Immunol. 2017; 8: 882.; doi: 10.3389/fimmu.2017.00882
This work is supported by the Forschungsinstitut Bad Gastein (FOI-15/08-
031WIE), EURADON, the Radon Gallery of Bad Gastein and GREWIS
(02NUK017A)
P147
THE HISTORY OF PSORIASIS
Selma Poparic
Dermatology Department University Clinical Center of Sarajevo
Many ancient texts, including the Bible, mention people afflicted
with diseases and symptoms very much like psoriasis. Ancient
Egyptians wrote about a salve made with various herbs that would
be spread on the skin, after which the afflicted person would be
instructed to sit in the sun to bring relief to symptoms that seem
to point to psoriasis. The Arabian physicians perhaps first dis-
tinguished psoriasis from other skin diseases already in the 8th
century A.D., but the first written description of psoriasis appears
during the Roman Empire in the 1st century AD in the books of A.
Cornelius Celsus » De re medica libri octo». Galen (131–201 AD)
of Pergamon, physician of some Roman imperators, was the first
who used the term psoriasis, but only for an itchy, scaly eruption of
the eyelids and scrotum, that was probably seborrheic dermatitis.
Unfortunately, little was known about the origin of the disease for
hundreds of years, in the darkness of the Middle Age - a period of
stagnation, and many psoriasis sufferers were thought at the time
to have leprosy. Because so little was known about contraction
Acta Derm Venereol 2018