Clinical Trial Review

sample for further characterization of immune mechanisms leading to reduced IFNγ responses in ADEH+.

Psoriasis patients are known to be at increased risk for heart disease. This may be due to the increased prevalence of cardiovascular disease risk factors in this population, including high blood pressure, diabetes, obesity, and high cholesterol. Although cholesterol levels are known to be altered in psoriasis, most studies have used standard lipid profiles to measure cholesterol. These tests indirectly measure LDL (bad cholesterol) and become less accurate when triglyceride levels are high, as often seen in individuals with psoriasis. This observational case control study has been designed to use a more specific and detailed cholesterol test to measure serum lipid levels in psoriasis patients, allowing for more accurate determination of LDL and better assessment of the lipid-contribution to cardiovascular risk.

One hundred adults of both sexes between the ages of 18 and 80 years who have a diagnosis of psoriasis as diagnosed by the principal investigator will comprise the psoriasis or case group, while controls will be selected from the same dermatology clinic. Serum lipid levels in the psoriasis patients will be evaluated compared with controls through the use of a relatively new comprehensive lipid profile test that has not been used in previous psoriasis studies.

The study will also measure other markers of inflammation that may contribute to cardiovascular disease.

The purpose of this study is to evaluate the role of angiogenesis in cutaneous disease and, ultimately, facilitate implementation of anti-angiogenic therapy in a wide range of dermatologic diseases including port wine stains, hemangiomas, angiofibromas, Kaposi's sarcoma, angiosarcoma, scars, rosacea, and psoriasis.

The researchers believe that pro-angiogenic factors are upregulated in a wide range of dermatologic diseases. Previously or newly collected biospecimens from various dermatologic diseases including those listed above will be evaluated, along with discarded human skin tissue samples from skin biopsy/surgery sites that are removed for closure but are not submitted for histopathologic analysis.

The researchers will perform immunohistochemistry and/or microarray analysis and/or quantitative polymerase chain reaction to evaluate the expression of various angiogenic factors in these dermatologic diseases. In addition, some of the skin specimens may be used to make cell cultures to study expression of angiogenic factors and interactions of cells in dermatologic disease.

Inflammatory pustular skin diseases are a type of autoinflammatory disease in which the immune system attacks the body’s tissues. These diseases cause painful and itchy skin rashes, eye and mouth irritation, joint pain, and fever. Several drugs for treating these diseases suppress the immune system. However, they can cause severe side effects when taken over a long period of time.

Interleukin-1 (IL-1) is a small protein that may be important in causing the inflammation seen in pustular skin disease. Anakinra is a drug that works by blocking IL-1. It has been effective in treating some inflammatory conditions such as rheumatoid arthritis. However, anakinra has not been studied for use in patients with pustular skin disease. Researchers want to see whether anakinra will be effective in treating pustular skin disease.

Participants will have an initial visit to receive the first dose of anakinra, and be shown how to give themselves daily injections of anakinra. They will then take it for up to 12 weeks,