BACKGROUND: Psoriasis is a chronic inflammatory disease occurs worldwide. At the Philippine General Hospital dermatology clinic, psoriasis accounted for 2.2% -2.4 % of new consults seen in 2004-2010. Its pathogenesis remains obscure but current studies indicate that activated Thai and Thai response mechanisms mediate inflammation and are implicated as key players in psoriasis genesis. Ustekinumab is a fully human monoclonal antibody that targets two interleukins (IL): IL-12 and IL-23 which influence T-cell differentiation into Thi and Thai, respectively. These naturally occurring proteins help regulate the immune system secondary to their role in linking innate and adaptive immune responses.
CASE SERIES: This is a retrospective chart review on the use of ustekinumab in 22 adult Filipinos (10 males and 12 females) conducted at six (6) dermatologists' clinics in 2010. Included were patients enrolled in the Named Patient Program (NPP) of Janssen Pharmaceutical Companies of Johnson & Johnson Philippines, diagnosed with moderate to severe long-standing plaque psoriasis and contraindicated for, or with inadequate response to, conventional systemic treatment. Patients received ustekinumab subcutaneously at loading doses of 45mg during the initial visit and at four weeks. Subsequently, it was given every twelve weeks. For patients who weighed 100 kg or more, 90mg of ustekinumab was administered. Clinical responses to the drug were assessed using Psoriasis Area and Severity Index (PASI) at initial visit and at the end of the program (52 weeks). At the end of the one-year program period, the median (range) PASI score of patients was 1.50 (0-29.2). Sixteen of the twenty-two subjects (72.73%) were able to achieve ±75% improvement from baseline (PASI 75). There was a significant (94.52%) reduction in median PASI scores of the patients from baseline to end visit (p < 0.0001). Overall, 27% (6/22) of patients with plaque psoriasis achieved complete clearance. Adverse events reported were relatively mild, including increased appetite, weight gain and body weakness/fatigue.
CONCLUSION: Ustekinumab was shown to significantly reduce the median PASI scores of 22 adult Filipino patients with moderate to severe plaque psoriasis. It was also shown to be well tolerated, with relatively mild adverse events.

Human ; Male ; Female ; Ustekinumab ; Psoriasis ; Dermatology ; Philippines

OBJECTIVES: The primary objectives of this study were to identify the demographic profiles and clinical characteristics of herpes zoster patients seen at the University of the Philippines-Philippine General Hospital, Section of Dermatology from 2003-2007, and to identify the predictors of persistent pain in patients with post-herpetic neuralgia.

METHODS: Medical records of patients clinically diagnosed ho have herpes zoster and a positive Tzanck smear were retrieved. Dermatology distribution, common presenting symptoms, characteristics of pain, duration of symptoms, co-morbidities, compliance in using antiviral therapies and complications were recorded. Univariate logistic regression analysis was performed to correlate possible predictors for development of zoster-associated pain.

RESULTS AND CONCLUSION: A total of 221 patients were included in this retrospective study. Pain was the most common presenting symptom of herpes zoster. The three most common complications observed were secondary bacterial infection, herpes zoster ophthalmicus and postherpetic neuralgia. Among the potential risk indicators examined, increasing age and duration of symptoms prior to consultation contributed independently to the incidence of zoster-associated pain.

Human ; Male ; Female ; Aged 80 And Over ; Herpes Zoster ; Neuralgia, Postherpetic