Gottlieb S L, Heftler N S, Gilleaudeau P, Johnson R, Vallat V P, Wolfe J, Gottlieb A B, Krueger J G
Laboratory for Investigative Dermatology, Rockefeller University, New York, NY 10021-6399, USA.
J Am Acad Dermatol. 1995 Oct;33(4):637-45. doi: 10.1016/0190-9622(95)91286-x.
Psoriasis is characterized by immune activation and increased epidermal proliferation. Cyclosporine acts by reducing T lymphocyte numbers and lymphokine production. Anthralin inhibits keratinocyte proliferation.
We investigated whether topical anthralin would augment clearing of psoriasis produced by systemic cyclosporine.
Twelve patients with psoriasis were treated with cyclosporine (5 mg/kg per day). Patients applied anthralin only to plaques on half of their body. They were treated until a remission or maximum benefit was achieved. Disease activity was assessed by a severity index and quantitative histopathologic markers.
Of the 12 patients, the skin of five cleared within 10 weeks irrespective of anthralin use. The other seven (slow responders) continued treatment for a mean of 18 weeks. Slow responders had a significantly lower severity index, a thinner epidermis, fewer CD8+ cells, and fewer proliferating keratinocytes on the anthralin-treated side than on the non-anthralin-treated side.
The combination of cyclosporine and topical anthralin is effective in patients who are slow to respond to cyclosporine alone.
银屑病的特征是免疫激活和表皮增殖增加。环孢素通过减少T淋巴细胞数量和淋巴因子产生发挥作用。蒽林可抑制角质形成细胞增殖。
我们研究了局部应用蒽林是否会增强全身应用环孢素对银屑病的清除作用。
12例银屑病患者接受环孢素治疗（每天5mg/kg）。患者仅将蒽林应用于身体一侧的斑块。治疗直至病情缓解或达到最大疗效。通过严重程度指数和定量组织病理学指标评估疾病活动度。
12例患者中，5例患者的皮肤在10周内清除，无论是否使用蒽林。另外7例（反应缓慢者）平均继续治疗18周。与未使用蒽林治疗的一侧相比，反应缓慢者使用蒽林治疗一侧的严重程度指数显著更低，表皮更薄，CD8 +细胞更少，增殖的角质形成细胞更少。
对于单独使用环孢素反应缓慢的患者，环孢素与局部应用蒽林联合使用有效。
