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J Cutan Pathol ; 34(1): 15-21, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17214849

RESUMO

BACKGROUND: Cyclosporine is a potent immunosupressor, which induces cytokeratin expression pattern changes and dermal dendrocytes number increase. OBJECTIVES: To evaluate its clinical effect in psoriasis, on keratinocytic proliferation and differentiation, and on dermal dendrocytes proliferation. METHODS: Thirty patients with psoriasis were treated and evaluated for 8 weeks. Clinical improvement was evaluated by Psoriasis Area and Severity Index (PASI). Biopsies were performed initially and after 8 weeks. Immunohistochemistry [CK markers 10, 14, and 16, and factor XIIIa+ (FXIIIa+)] was performed. RESULTS: Mean PASI before treatment was 26.32 and 3.71 after. Mean initial and final PASI difference was 22.61 (p < 0.001). Two patients had serum creatinine and six uric acid increase. Before and after treatment, mean numbers per field of dermal dendrocytes were 7.07 and 3.68, respectively. Mean difference was 3.39, with p < 0.001. CK10 immunohistochemical pattern demonstrated recovery of normal expression pattern in 26 patients, while CK14 pattern demonstrated improvement in 21 patients. CONCLUSIONS: Cyclosporine was effective and safe for psoriasis in low doses, with significant decrease of PASI and dermal dendrocytes number after 8 weeks of therapy. CK10 and 14 pattern changed and, less prominently, CK16 expression. These modifications occur later than the PASI and dermal dendrocytes variation.


Assuntos
Ciclosporina/uso terapêutico , Células Dendríticas/patologia , Derme/patologia , Imunossupressores/uso terapêutico , Queratinócitos/patologia , Psoríase/tratamento farmacológico , Psoríase/patologia , Adulto , Idoso , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Ciclosporina/administração & dosagem , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Imunossupressores/administração & dosagem , Queratina-10/metabolismo , Queratina-14/metabolismo , Queratina-16/metabolismo , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do Tratamento
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