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AHS 1001 Cardiology and Dermatology Department

AHS 1001 Cardiology and Dermatology Department

 

Cardiovascular disorders and therapies are often associated with a variety of dermatologic manifestations. Frequently, these cutaneous signs can be used in facilitating a diagnosis of the underlying cardiac disease. For example, the diagnosis of acute rheumatic fever in patients presenting with acute carditis includes 2 skin signs out of the 5 classic Jones criteria (ie, arthritis, carditis, erythema marginatum, subcutaneous nodules, and chorea). [1Certain congenital cardiac defects are associated with unique skin manifestations, such as coarctation of the aorta associated with external features of Turner syndrome or atrioventricular (AV) septal defects associated with skin features of Down syndrome. In some patients, the dermatologic manifestations represent a component of a full systemic or vascular disorder that also involves defects in the cardiovascular system as another accompanying component.

Advanced medical and invasive therapies have led to recognition of many new dermatologic manifestations, for example, angioedema from ACE inhibitors, ankle swelling due to calcium channel blockers, or radiation skin burns following prolonged angioplasty and radiation exposure. [2] Calcium channel blockers and ACE inhibitors have also been reported to cause drug-induced cutaneous lupus erythematosus.

AHS 1001 Cardiology and Dermatology Department

 

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Clinical responses to ixekizumab treatment over 52 weeks in an open-label extension trial were maintained in a high proportion of patients with plaque psoriasis. The proportion, Dr. Gordon reported, was similar to that observed in the prior randomized treatment period.

NUR 590 Benchmark – EBP Project Framework or Model for Change

AHS 1001 Cardiology and Dermatology Department

Ixekizumab is a monoclonal antibody that neutralizes inter-leukin-17A (IL-17A), a pro-inflammatory cytokine that plays a critical role in the pathogenesis of psoriasis. In the prior randomized, placebo-controlled phase 2 study, IL-17A was shown to produce positive responses in patients with moderate-to-severe chronic plaque psoriasis.

The 20-week randomized, blinded portion of the trial was followed by a washout period extending to week 32. The 129 patients completing the 20 weeks of treatment could enter the open-label extension (OLE) period at week 32 and receive subcutaneous ixekizumab 120 mg given every four weeks. If their clinical response fell below PASI (Psoriasis Area and Severity Index) 75, they could enter the OLE before week 32. PASI scores are calculated based on psoriatic plaque redness, scaling, and thickness and the extent of involvement of various regions of the body. A PASI 75 response indicates a 75% improvement in PASI score from baseline.

Dr. Gordon presented data on four groups: all patients enrolled in the OLE; those initially assigned to placebo; week 20 responders (at PASI 75, 90, or 100 levels); and week 20 nonresponders.

At week 20, 51 patients had less than a PASI 75 response, as did 24 additional patients between weeks 24 and 32. Forty-five patients maintained PASI 75 and entered the OLE at week 32.

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: AHS 1001 Cardiology and Dermatology Department

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