title: Cyclosporine is superior to tacrolimus in liver transplant recipients with recurrent psoriasis.
abstract: BACKGROUND
  Psoriasis (PS) is one of the most frequent dermatologic diseases and occurs in approximately 2% of the population. It is believed to be an autoimmune disease (AID) that is potentially mediated by pro-inflammatory cytokines produced by lesional T cells. Infections are considered a key factor for triggering or even inducing PS flare-ups. Liver transplant recipients (LTR) with co-existing PS are unique to follow because their T cells are subject to long-term immunosuppression (IS) and they experience infections more frequently than the general population.
  
  
  METHODS
  Our 7.6 ± 3.5-year follow-up aimed to determine the clinical course of PS in 10 patients out of 591 LTR (1.69%). Demographic data, IS protocols, signs of infections, and viral status were analyzed. The PS clinical course was assessed retrospectively by measuring the PS area and severity index.
  
  
  RESULTS
  Remission was observed in all patients 2-6 weeks after liver transplantation (LT). Three patients had PS flare-ups within 2 years. Multivariant analysis did not reveal any correlations between recurrent PS (rPS) and cytomegalovirus (CMV), Epstein-Barr, human papilloma, hepatitis B and C viral status, or interferon treatment. rPS was only observed in LTR with co-existing AID. Response to therapy was variable, but cyclosporine (CsA) seemed to have a better effect than tacrolimus (TAC).
  
  
  CONCLUSIONS
  PS may relapse after LT despite IS, concomitant AID may be the main predisposing factor to disease relapses, and CsA seems to be more potent than TAC for treating rPS in LTR.
authors.affiliation: Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Foroncewicz
authors.affiliation: Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Mucha
authors.affiliation: Starzl Unit of Abdominal Transplantation, Department of Abdominal and Transplantation Surgery, Université Catholique de Louvain-UCL, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Lerut
authors.affiliation: Department of Dermatology and Venereology, Center of Diagnostics and Treatment of Sexually Transmitted Diseases, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Majewski
authors.affiliation: Department of General, Liver and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Krawczyk
authors.affiliation: Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Leszek
authors.initials: L
authors.lastname: Pączek
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use*; D058625:End Stage Liver Disease / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D012008:Recurrence; D012307:Risk Factors; D016559:Tacrolimus / Q000627:therapeutic use*; D066027:Transplant Recipients; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus