Psoriasis is a T-cell mediated disease. Recent developments in pathogenesis of this common immun disease suggest that some biological agents have clinical efficacy in treating psoriasis. This agents include chimeric antibodies, fusion proteins and recombinant cytokines. Compared with conventional systemic treatments, these new agents show more safety profile and efficacy because of targeting spesific T cell activity. This article provides information on immunopathogenesis of psoriasis and biological treatments, also reviews the studies about agents use in psoriasis.

Background and Design: Association between lichen planus and hepatitis viruses, mainly hepatitis B virus (HBV) and hepatitis C virus (HCV), has been evaluated in many studies. Hepatitis G virus (HGV) is a RNA virus and its coinfection with HCV is frequently seen. The aim of the study is to determine whether there is an association between HGV and lichen planus.
MATERIAL-METHOD: 73 patients diagnosed as lichen planus with clinical and histopathological findings and 40 healthy controls were enrolled in the study. HGV-RNA, and HBsAg and anti-HCV due to their coinfection with HGV-RNA were investigated in serum samples of both groups. The lichen planus patients and the control group were compared regarding the prevalence rates of each viral marker.
RESULTS: HGV-RNA was not detected in the sera of either group. Only 3 (%4.1) patients in the lichen planus group had anti-HCV antibodies. The control group was negative for HCV antibody. 6 (%8.21) of the patients with lichen planus and 2 (%5) of the controls were positive for HBsAg. There was not statistically significant difference between the results of viral markers of the lichen planus patients and the control group (p>0.05).
CONCLUSION: It was determined that when serologically evaluated, HGV did not seem to be associated with lichen planus.

Background and Design: The frequency of Kaposi’s sarcoma is increased in renal transplantation patients. The prevalence, clinical features and the etiopathological role of human herpesvirus-8 in Kaposi’s sarcoma in renal transplantation patients were investigated in this study.
Patients and METHODS: Files of renal transplantation patients who were diagnosed as Kaposi’s sarcoma have been examined. Human herpesvirus-8 DNA was investigated in the lesional skin of 6 patients.
RESULTS: The prevalence of Kaposi’s sarcoma was 1.2%. Mucocutaneous and visceral involvement was noted in 76.9% and 61.5% of the patients, respectively. In 61.5% of the patients total remission, in 23.1% partial remission was observed. Twent-five percent of the patients with visceral involvement were died. Viral DNA was detected in all of the 6 patients.
CONCLUSION: Visceral involvement is common in Kaposi’s sarcoma developing in renal transplant recipients and increases the mortality. Immunosuppresion with human herpesvirus-8 play roles in etiopathogenesis.

Background and Design: Propylthiouracil (PTU) decreases the synthesis of thyroid hormon as well as having immune modulatory and free radical scavenging effects. Oral PTU has been shown to be effective for the treatment of plaque psoriasis in several studies. This study was performed to determine the efficacy of topical PTU in psoriasis.
MATERIALS-METHODS: Different plaques of 16 patients with plaque psoriasis were treated with 5% topical PTU and placebo, three times daily for 8 weeks in a setting of a double-blind and placebo controlled study. Response to therapy was evaluated by using clinical score, histopathologic score and epidermal thickness.
RESULTS: The clinical scores of both PTU and placebo plaques decreased significantly after the treatment (p<0.001). The epidermal thickness of the psoriatic PTU plaques before and after treatment were 0.57±0.1 mm and 0.46±0.19 mm, respectively. Furthermore, no significant difference was observed between the pre-and post-treatment histopathological findings of plaques treated with PTU.
CONCLUSION: Topical PTU may be viable steroid-sparing agent, since topical corticosteroid as a conventional agent, have many side effects. Since we didn’t observe a significant difference between the plaques treated with PTU and placebo in our group, we concluded that further studies with larger series should be performed to confirm this hypothesis.

Background and Design: Methotrexate (MTX), a folic acid (folate) analog, is used for treatment of severe psoriasis or psoriatic arthritis. It has been reported that the homocysteine (Hcy) and folate levels were affected by low dose MTX treatment. In this study we investigated the effect of low dose MTX treatment on folate, vitamin B12 and plasma Hcy levels of patients with psoriasis vulgaris at early phase.
MATERIAL-METHOD: Sixteen patients (10 males, 6 females) diagnosed as moderate and severe psoriasis vulgaris and age-sex matched twenty healthy subjects (12 males, 8 females) were included in the study. Blood samples were drawn from the both groups before initiation of MTX treatment for folate, vitamin B12 and plasma Hcy measurements. Again, after 48 hours following 20 mg intramuscular MTX injection, blood samples of patients were drawn for folate, vitamin B12 and plasma Hcy level measurements
RESULTS: While there were no significant differences in the folate and plasma Hcy levels between patients and healthy subjects (p>0.05), vitamin B12 levels were significantly lower in the patients than the controls (p<0.001). Although the decrease of folate and the increase of Hcy levels were significant compared to the initiation time of the treatment, there were no differences between the weeks. There was negative correlation between folate and Hcy levels before MTX treatment (rho: -0,54, p>0.05). There was no correlation been folate and Hcy levels after MTX treatment (p>0.05). Negative correlation was found between vitamin B12 and Hcy levels before and after treatment (p<0.05).
CONCLUSION: We concluded that low dose MTX treatment cause transient decrease of serum folate levels and transient increase of plasma Hcy levels that did not increase throughout the MTX treatment.

Lupus panniculitis is a rare and unusual form of lupus erythematosus with subcutaneous inflammation of adipose tissue. Successful use of dapsone in lupus panniculitis was reported in a few cases refractory to systemic corticosteroids and antimalarial agents. A 43-year-old female patient has been suffering from asymptomatic, erythematous, indurated plaques on the forehead, nose and ear started two years ago, which were followed by several subcutaneous nodules on the arms. Diagnosis of lupus panniculitis was confirmed by histopathological findings of the skin biopsy. Dapsone, 100mg/day was administered for 4 weeks and continued 50mg daily for another 18-week-period. This case is presented because of its rarity and responsivity to dapsone treatment.

Partial unilateral lentiginosis (PUL) is an unusual pigmentary disorder characterized by numerous lentigines grouped within an area of normal skin; the pigmented macules are often in a segmental distribution with a sharp demarcation at the midline. We report a 22-year-old woman with PUL affecting the right side of the chest, right axilla and right upper back. To our knowledge, this is the first reported case of a patient with PUL in the Turkish literature.

Behcet’s disease is a chronic relapsing, inflammatory process with clinical features of oral aphthous and genital ulcerations, uveitis, cuteneous vasculitis, arthritis and central nervous system involvement. 48 years old woman who a had burning pain in her lower extremities referred to our pain clinic. Behcet’s disease had been diagnosed 20 years ago. She was treated with tramadol HCL 150 mg and amytriptiline 10 mg. After two months mexilitine HCL 200 mg was given to support to treatment. They were stopped and treatment continued with gabapentin 800 mg after 6 months VAS was O (VAS: visual analog scale 0-10 cm, 0: no pain and 10: worst pain) in the last four months.
Pains in Behcet’s disease are disartrous feeling, but appropriate treatment improves symptoms and outcome.