The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology (한방안이비인후피부과학회지)

The Society of Korean Medicine Ophthalmology, Otolaryngology & Dermatology (대한한방안이비인후피부과학회)
권호 표지
DOI QR코드

DOI QR Code

A Proposal and Considerations for Treatment Approaches of Psoriasis

건선의 치료 접근법에 대한 고찰 및 제언

  • Kang, Dong-Won (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Han, Chang-Yi (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kim, Jun-Dong (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kim, Kyu-Seok (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kim, Yoon-Bum (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, College of Korean Medicine, Kyung Hee University)
  • 강동원 (경희대학교 한의과대학 안이비인후피부과) ;
  • 한창이 (경희대학교 한의과대학 안이비인후피부과) ;
  • 김준동 (경희대학교 한의과대학 안이비인후피부과) ;
  • 김규석 (경희대학교 한의과대학 안이비인후피부과) ;
  • 김윤범 (경희대학교 한의과대학 안이비인후피부과)
  • Received : 2020.07.03
  • Accepted : 2020.08.03
  • Published : 2020.08.25
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives : To investigate treatment approaches of psoriasis, and to provide universal and holistic standards to assist in optimizing patient care and future research. Methods : Review articles of psoriasis regarding pathophysiology, risk factor or treatment were searched from Pubmed (January 2016 to June 2020). Treatment approaches were investigated based on the searched articles. Additional data collecting was done for further discussion by searching Pubmed and Google scholar with keywords relevant to the approaches, and the relevant references of articles retrieved were manually inspected to be included. Results : Modalities to directly regulate the relevant helper T cell or inflammatory cytokines can constitute the treatment approaches of psoriasis. Modalities to treat gastrointestinal tract inflammation, to correct metabolic syndrome and to improve epidermal lipid abnormality via whole body lipid metabolism can also constitute the treatment approaches of psoriasis. Probable adverse effects of long term use of western medication should be addressed carefully, and alleviating the hazards of western medication can be a treatment approach of psoriasis. Conclusion : Treatment of psoriasis should take account of systemic aspects such as gastrointestinal tract and lipid metabolism. Treatment approaches of psoriasis established on the pathophysiological basis can serve as universal standards.

Keywords

References

  1. The Society of Korean Dermatology. Textbook of Dermatology. 6th ed. Seoul: Daehan Med. 2015:299, 867-91.
  2. Kamiya K, Kishimoto M, Sugai J, Komine M, Ohtsuki M. Risk Factors for the Development of Psoriasis. Int J Mol Sci. 2019;20(18):4347. https://doi.org/10.3390/ijms20184347
  3. Lee JY, Kang S, Park JS, Jo SJ. Prevalence of Psoriasis in Korea: A Population-Based Epidemiological Study Using the Korean National Health Insurance Database. Ann Dermatol. 2017;29(6):761-7. https://doi.org/10.5021/ad.2017.29.6.761
  4. Greb JE, Goldminz AM, Elder JT, Lebwohl MG, Gladman DD, Wu JJ, et al. Psoriasis. Nat Rev Dis Primers. 2016;2:16082. https://doi.org/10.1038/nrdp.2016.82
  5. Kim BH, Kim KI, Kang SH, Park JG, Kang DW, Nam HJ, et al. Explanation and Elaboration of the Clinical Trial Guidelines for Psoriasis Using Herbal Medicine. J Korean Med Ophthalmol Otolaryngol Dermatol. 2018;31(2):40-59. https://doi.org/10.6114/JKOOD.2018.31.2.040
  6. Canavese M, Altruda F, Ruzicka T, Schauber J. Vascular endothelial growth factor (VEGF) in the pathogenesis of psoriasis-a possible target for novel therapies? J Dermatol Sci. 2010;58(3):171-6. https://doi.org/10.1016/j.jdermsci.2010.03.023
  7. Luan L, Han S, Wang H, Liu X. Down-regulation of the Th1, Th17, and Th22 pathways due to anti-TNF-${\alpha}$ treatment in psoriasis. Int Immunopharmacol. 2015;29(2):278-84. https://doi.org/10.1016/j.intimp.2015.11.005
  8. Lynde CW, Poulin Y, Vender R, Bourcier M, Khalil S. Interleukin 17A: toward a new understanding of psoriasis pathogenesis. J Am Acad Dermatol. 2014;71(1):141-50. https://doi.org/10.1016/j.jaad.2013.12.036
  9. Lizzul PF, Aphale A, Malaviya R, Sun Y, Masud S, Dombrovskiy V, et al. Differential expression of phosphorylated $NF-{\kappa}B$/RelA in normal and psoriatic epidermis and downregulation of $NF-{\kappa}B$ in response to treatment with etanercept. J Invest Dermatol. 2005;124(6):1275-83. https://doi.org/10.1111/j.0022-202X.2005.23735.x
  10. Lin Y, See L, Huang Y, Chi C, Hui RC. Comparison of indirubin concentrations in indigo naturalis ointment for psoriasis treatment: a randomized, double-blind, dosage-controlled trial. British Journal of Dermatology. 2018;178(1):124-31. https://doi.org/10.1111/bjd.15894
  11. Yan Y, Liu W, Andres P, Pernin C, Chantalat L, Briantais P, et al. Exploratory clinical trial to evaluate the efficacy of a topical traditional Chinese herbal medicine in psoriasis vulgaris. Evidence-Based Complementary and Alternative Medicine. 2015;2015:719641. https://doi.org/10.1155/2015/719641
  12. Lin Y, Chang Y, Hui RC, See L, Chang C, Yang C, et al. A Chinese herb, indigo naturalis, extracted in oil (Lindioil) used topically to treat psoriatic nails: a randomized clinical trial. Jama Dermatology. 2015;151(6):672-4. https://doi.org/10.1001/jamadermatol.2014.5460
  13. Cheng H, Wu Y, Wang Q, Song M, Wu J, Chen D, et al. Clinical efficacy and IL-17 targeting mechanism of Indigo naturalis as a topical agent in moderate psoriasis. BMC complementary and alternative medicine. 2017;17(1):1-11. https://doi.org/10.1186/s12906-016-1505-2
  14. Wu M, Deng Y, Li S, Chen Y, Guo D, Jin X, et al. The immunoregulatory effects of traditional Chinese medicine on psoriasis via its action on interleukin: advances and considerations. The American journal of Chinese medicine. 2018;46(04):739-50. https://doi.org/10.1142/S0192415X18500386
  15. Wang D, Gu J, Zhu W, Luo F, Chen L, Xu X, et al. PDTCM: a systems pharmacology platform of traditional Chinese medicine for psoriasis. Annals of medicine. 2017;49(8):652-60. https://doi.org/10.1080/07853890.2017.1364417
  16. Lu C, Liu H, Jin X, Chen Y, Liang C, Qiu F, et al. Herbal components of a novel formula PSORI-CM02 interdependently suppress allograft rejection and induce CD8+ CD122+ PD-1+ regulatory T cells. Frontiers in pharmacology. 2018;9:88. https://doi.org/10.3389/fphar.2018.00088
  17. Sun W, Gao Y, Yu X, Yuan Y, Yi J, Zhang Z, et al. 'Psoriasis 1'reduces psoriasis-like skin inflammation by inhibiting the VDR-mediated nuclear $NF-{\kappa}B$ and STAT signaling pathways. Molecular medicine reports. 2018;18(3):2733-43.
  18. Eppinga H, Konstantinov SR, Peppelenbosch MP, Thio HB. The microbiome and psoriatic arthritis. Curr Rheumatol Rep. 2014;16(3):407. https://doi.org/10.1007/s11926-013-0407-2
  19. Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, et al. Psoriasis and comorbid diseases: Epidemiology. J Am Acad Dermatol. 2017;76(3):377-90. https://doi.org/10.1016/j.jaad.2016.07.064
  20. Huang BL, Chandra S, Shih DQ. Skin manifestations of inflammatory bowel disease. Front Physiol. 2012;3:13. https://doi.org/10.3389/fphys.2012.00013
  21. Cohen AD, Dreiher J, Birkenfeld S. Psoriasis associated with ulcerative colitis and Crohn's disease. J Eur Acad Dermatol Venereol. 2009;23(5):561-5. https://doi.org/10.1111/j.1468-3083.2008.03031.x
  22. Pietrzak D, Pietrzak A, Krasowska D, Borzecki A, Franciszkiewicz-Pietrzak K, Polkowska-Pruszynska B, et al. Digestive system in psoriasis: an update. Arch Dermatol Res. 2017;309(9):679-93. https://doi.org/10.1007/s00403-017-1775-7
  23. van Schaik FD, Oldenburg B, Hart AR, Siersema PD, Lindgren S, Grip O, et al. Serological markers predict inflammatory bowel disease years before the diagnosis. Gut. 2013;62(5):683-8. https://doi.org/10.1136/gutjnl-2012-302717
  24. Li WQ, Han JL, Chan AT, Qureshi AA. Psoriasis, psoriatic arthritis and increased risk of incident Crohn's disease in US women. Ann Rheum Dis. 2013;72(7):1200-5. https://doi.org/10.1136/annrheumdis-2012-202143
  25. Juzlova K, Votrubova J, Dzambova M, Gopfertova D, Hercogova J, Smerhovsky Z. Gastrointestinal comorbidities in patients with psoriasis in the Czech Republic: The results of 189 patients with psoriasis and 378 controls. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2016;160(1):100-5. https://doi.org/10.5507/bp.2015.048
  26. Scarpa R, Manguso F, D'Arienzo A, D'Armiento FP, Astarita C, Mazzacca G, et al. Microscopic inflammatory changes in colon of patients with both active psoriasis and psoriatic arthritis without bowel symptoms. J Rheumatol. 2000;27(5):1241-6.
  27. Michaelsson G, Kraaz W, Hagforsen E, Pihl-Lundin I, Loof L, Scheynius A. The skin and the gut in psoriasis: the number of mast cells and CD3+ lymphocytes is increased in non-involved skin and correlated to the number of intraepithelial lymphocytes and mast cells in the duodenum. Acta Derm Venereol. 1997;77(5):343-6.
  28. Sikora M, Chrabaszcz M, Maciejewski C, Zaremba M, Waskiel A, Olszewska M, et al. Intestinal barrier integrity in patients with plaque psoriasis. J Dermatol. 2018;45(12):1468-70. https://doi.org/10.1111/1346-8138.14647
  29. Atkins D, Furuta GT. Mucosal immunology, eosinophilic esophagitis, and other intestinal inflammatory diseases. J Allergy Clin Immunol. 2010;125(2 Suppl 2):S255-61. https://doi.org/10.1016/j.jaci.2009.11.037
  30. Mowat AM, Agace WW. Regional specialization within the intestinal immune system. Nat Rev Immunol. 2014;14(10):667-85. https://doi.org/10.1038/nri3738
  31. Pietrzak A, Michalak-Stoma A, Chodorowska G, Szepietowski JC. Lipid disturbances in psoriasis: an update. Mediators Inflamm. 2010;2010:535612. https://doi.org/10.1155/2010/535612
  32. Singh S, Young P, Armstrong AW. An update on psoriasis and metabolic syndrome: A meta-analysis of observational studies. PLoS One. 2017;12(7):e0181039. https://doi.org/10.1371/journal.pone.0181039
  33. Langan SM, Seminara NM, Shin DB, Troxel AB, Kimmel SE, Mehta NN, et al. Prevalence of metabolic syndrome in patients with psoriasis: a population-based study in the United Kingdom. J Invest Dermatol. 2012;132(3 Pt 1):556-62. https://doi.org/10.1038/jid.2011.365
  34. Itani S, Arabi A, Harb D, Hamzeh D, Kibbi AG. High prevalence of metabolic syndrome in patients with psoriasis in Lebanon: a prospective study. Int J Dermatol. 2016;55(4):390-5. https://doi.org/10.1111/ijd.12811
  35. Parodi A, Aste N, Calvieri C, Cantoresi F, Carlesimo M, Fabbri P, et al. Metabolic syndrome prevalence in psoriasis: a cross-sectional study in the Italian population. Am J Clin Dermatol. 2014;15(4):371-7. https://doi.org/10.1007/s40257-014-0074-8
  36. Karoli R, Fatima J, Shukla V, Dhillon KS, Khanduri S, Maini S, et al. A study of cardio-metabolic risk profile in patients with psoriasis. J Assoc Physicians India. 2013;61(11):798-803.
  37. Sommer DM, Jenisch S, Suchan M, Christophers E, Weichenthal M. Increased prevalence of the metabolic syndrome in patients with moderate to severe psoriasis. Arch Dermatol Res. 2006;298(7):321-8. https://doi.org/10.1007/s00403-006-0703-z
  38. Al-Mutairi N, Nour T. The effect of weight reduction on treatment outcomes in obese patients with psoriasis on biologic therapy: a randomized controlled prospective trial. Expert Opin Biol Ther. 2014;14(6):749-56. https://doi.org/10.1517/14712598.2014.900541
  39. Snekvik I, Nilsen TIL, Romundstad PR, Saunes M. Metabolic syndrome and risk of incident psoriasis: prospective data from the HUNT Study, Norway. Br J Dermatol. 2019;180(1):94-9. https://doi.org/10.1111/bjd.16885
  40. Akhyani M, Ehsani AH, Robati RM, Robati AM. The lipid profile in psoriasis: a controlled study. J Eur Acad Dermatol Venereol. 2007;21(10):1330-2. https://doi.org/10.1111/j.1468-3083.2007.02260.x
  41. Amin T, Saied E, Abdou SH. Atherosclerotic risk in psoriasis. Journal of Pan Arab League of Dermatologists. 2005;16(2):39-45.
  42. Bajaj DR, Mahesar SM, Devrajani BR, Iqbal MP. Lipid profile in patients with psoriasis presenting at Liaquat University Hospital Hyderabad. J Pak Med Assoc. 2009;59(8):512.
  43. Cohen AD, Sherf M, Vidavsky L, Vardy DA, Shapiro J, Meyerovitch J. Association between psoriasis and the metabolic syndrome. A cross-sectional study. Dermatology. 2008;216(2):152-5. https://doi.org/10.1159/000111512
  44. Coimbra S, Oliveira H, Reis F, Belo L, Rocha S, Quintanilha A, et al. Circulating levels of adiponectin, oxidized LDL and C-reactive protein in Portuguese patients with psoriasis vulgaris, according to body mass index, severity and duration of the disease. J Dermatol Sci. 2009;55(3):202-4. https://doi.org/10.1016/j.jdermsci.2009.05.008
  45. Gisondi P, Tessari G, Conti A, Piaserico S, Schianchi S, Peserico A, et al. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. Br J Dermatol. 2007;157(1):68-73. https://doi.org/10.1111/j.1365-2133.2007.07986.x
  46. Javidi Z, Meibodi NT, Nahidi Y. Serum lipids abnormalities and psoriasis. Indian J Dermatol. 2007;52(2):89. https://doi.org/10.4103/0019-5154.33285
  47. Kural BV, Orem A, Cimsit G, Yandi YE, Calapoglu M. Evaluation of the atherogenic tendency of lipids and lipoprotein content and their relationships with oxidant- antioxidant system in patients with psoriasis. Clinica chimica acta. 2003;328(1-2):71-82. https://doi.org/10.1016/S0009-8981(02)00373-X
  48. Mallbris L, Granath F, Hamsten A, Stahle M. Psoriasis is associated with lipid abnormalities at the onset of skin disease. J Am Acad Dermatol. 2006;54(4):614-21. https://doi.org/10.1016/j.jaad.2005.11.1079
  49. Orem A, Cimsit G, Deger O, Orem C, Vanizor B. The significance of autoantibodies against oxidatively modified low-density lipoprotein (LDL) in patients with psoriasis. Clinica chimica acta. 1999;284(1):81-8. https://doi.org/10.1016/S0009-8981(99)00062-5
  50. Pietrzak A, Jastrzebska I, Krasowska D, Chodorowska G, Tabarkiewicz J, Tomasiewicz K, et al. Serum pancreatic lipase [EC 3.1. 1.3] activity, serum lipid profile and peripheral blood dendritic cell populations in normolipidemic males with psoriasis. J Mol Catal. 2006;40(3-4):144-54. https://doi.org/10.1016/j.molcatb.2006.02.005
  51. Piskin S, Gurkok F, Ekuklu G, Senol M. Serum lipid levels in psoriasis. Yonsei Med J. 2003;44(1):24-6. https://doi.org/10.3349/ymj.2003.44.1.24
  52. Rocha-Pereira P, Santos-Silva A, Rebelo I, Figueiredo A, Quintanilha A, Teixeira F. Dislipidemia and oxidative stress in mild and in severe psoriasis as a risk for cardiovascular disease. Clin Chim Acta. 2001;303(1-2):33-9. https://doi.org/10.1016/S0009-8981(00)00358-2
  53. Tekin NS, Tekin IO, Barut F, Sipahi EY. Accumulation of oxidized low-density lipoprotein in psoriatic skin and changes of plasma lipid levels in psoriatic patients. Mediators Inflamm. 2007;2007:78454.
  54. Hadas E, Bozek A, Jarzab J. Impact of phototherapy on selected lipid profile indices in psoriatic patients allowing. Postepy Dermatol Alergol. 2007;24(5):215.
  55. Reynoso-von Drateln C, Martinez-Abundis E, Balcazar-Munoz BR, Bustos-Saldana R, Gonzalez-Ortiz M. Lipid profile, insulin secretion, and insulin sensitivity in psoriasis. J Am Acad Dermatol. 2003;48(6):882-5. https://doi.org/10.1067/mjd.2003.446
  56. Abedini R, Salehi M, Lajevardi V, Beygi S. Patients with psoriasis are at a higher risk of developing nonalcoholic fatty liver disease. Clin Exp Dermatol. 2015;40(7):722-7. https://doi.org/10.1111/ced.12672
  57. Gisondi P, Targher G, Zoppini G, Girolomoni G. Non-alcoholic fatty liver disease in patients with chronic plaque psoriasis. J Hepatol. 2009;51(4):758-64. https://doi.org/10.1016/j.jhep.2009.04.020
  58. van der Voort EA, Koehler EM, Dowlatshahi EA, Hofman A, Stricker BH, Janssen HL, et al. Psoriasis is independently associated with nonalcoholic fatty liver disease in patients 55 years old or older: Results from a population-based study. J Am Acad Dermatol. 2014;70(3):517-24. https://doi.org/10.1016/j.jaad.2013.10.044
  59. Koppe SW. Obesity and the liver: nonalcoholic fatty liver disease. Transl Res. 2014;164(4):312-22. https://doi.org/10.1016/j.trsl.2014.06.008
  60. Carrascosa JM, Vilavella M, Garcia-Doval I, Carretero G, Vanaclocha F, Dauden E, et al. Body mass index in patients with moderate-to-severe psoriasis in Spain and its impact as an independent risk factor for therapy withdrawal: results of the Biobadaderm Registry. J Eur Acad Dermatol Venereol. 2014;28(7):907-14. https://doi.org/10.1111/jdv.12208
  61. Boehncke WH, Boehncke S, Tobin AM, Kirby B. The 'psoriatic march': a concept of how severe psoriasis may drive cardiovascular comorbidity. Exp Dermatol. 2011;20(4):303-7. https://doi.org/10.1111/j.1600-0625.2011.01261.x
  62. Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, et al. Psoriasis and comorbid diseases: Implications for management. J Am Acad Dermatol. 2017;76(3):393-403. https://doi.org/10.1016/j.jaad.2016.07.065
  63. Gelfand JM, Yeung H. Metabolic syndrome in patients with psoriatic disease. J Rheumatol Suppl. 2012;89:24-8. https://doi.org/10.3899/jrheum.120237
  64. Ganzetti G, Campanati A, Offidani A. Non-alcoholic fatty liver disease and psoriasis: So far, so near. World J Hepatol. 2015;7(3):315-26. https://doi.org/10.4254/wjh.v7.i3.315
  65. Grozdev I, Korman N, Tsankov N. Psoriasis as a systemic disease. Clin Dermatol. 2014;32(3):343-50. https://doi.org/10.1016/j.clindermatol.2013.11.001
  66. Frieder J, Ryan C. Psoriasis and cardiovascular disorders. G Ital Dermatol Venereol. 2016;151(6):678-93.
  67. Arican O, Aral M, Sasmaz S, Ciragil P. Serum levels of$TNF-{\alpha}$, IFN-${\gamma}$, IL-6, IL-8, IL-12, IL-17, and IL-18 in patients with active psoriasis and correlation with disease severity. Mediators Inflamm. 2005;2005(5):273-9. https://doi.org/10.1155/MI.2005.273
  68. Hong SI. The Effects of Saengkankunbi-tang and Its Composition on Free Fatty Acid-Induced Lipotoxicity in HepG2 Cell. J Int Korean Med. 2013;34(1):14-30.
  69. Choi ES, Kim HY, Cho YH, Jang EG, Woo HJ, Kim YC. A Case Report of Adolescent Nonalcoholic Fatty Liver Disease (NAFLD) with Severe Obesity. J Int Korean Med. 2015:89-95.
  70. Sin SM, Cha JH, Kim GT, Byun SH, Ko HK. Saenggangeonbi-tang's effest on metabolic syndrome. J Int Korean Med. 2008:65-70.
  71. Kang KR, Baek SH, Lee MS, Jung YJ, Choi AR, Shin JS. A Male Nonalcoholic Steatohepatitis (NASH) Patient Diagnosed with Moderate Fibrosis using Fibroscan-a Case Report. J Int Korean Med. 2015:120-6.
  72. Swindell WR, Johnston A, Carbajal S, Han G, Wohn C, Lu J, et al. Genome-wide expression profiling of five mouse models identifies similarities and differences with human psoriasis. PLoS One. 2011;6(4):e18266. https://doi.org/10.1371/journal.pone.0018266
  73. Nakajima K, Terao M, Takaishi M, Kataoka S, Goto-Inoue N, Setou M, et al. Barrier abnormality due to ceramide deficiency leads to psoriasiform inflammation in a mouse model. J Invest Dermatol. 2013;133(11):2555-65. https://doi.org/10.1038/jid.2013.199
  74. Ye L, Lv C, Man G, Song S, Elias PM, Man M. Abnormal epidermal barrier recovery in uninvolved skin supports the notion of an epidermal pathogenesis of psoriasis. J Invest Dermatol. 2014;134(11):2843. https://doi.org/10.1038/jid.2014.205
  75. Hong KK, Cho HR, Ju WC, Cho YH, Kim NI. A study on altered expression of serine palmitoyltransferase and ceramidase in psoriatic skin lesion. J Korean Med Sci. 2007;22(5):862-7. https://doi.org/10.3346/jkms.2007.22.5.862
  76. Motta S, Monti M, Sesana S, Mellesi L, Ghidoni R, Caputo R. Abnormality of water barrier function in psoriasis. Role of ceramide fractions. Arch Dermatol. 1994;130(4):452-6. https://doi.org/10.1001/archderm.1994.01690040056007
  77. Ansidei V, Binazzi M, Cantelmi A, Gaiti A, Porcellati G. Phospholipid involvement in psoriatic epidermis. Ital J Biochem. 1981;30(1):40-5.
  78. Khyshiktuev BS, Falko EV. Alterations in the parameters of lipid metabolism in different biological objects in psoriatic patients during exacerbation and remission. Vestn Dermatol Venerol. 2005;6:40-3.
  79. Khyshiktuev BS, Karavaeva TM, Fal'ko EV. Variability of quantitative changes in short-chain fatty acids in serum and epidermis in psoriasis. Klin Lab Diagn. 2008(8):22-4.
  80. Maxfield FR, Tabas I. Role of cholesterol and lipid organization in disease. Nature. 2005;438(7068):612-21. https://doi.org/10.1038/nature04399
  81. Melton JL, Wertz PW, Swartzendruber DC, Downing DT. Effects of essential fatty acid deficiency on epidermal O-acylsphingolipids and transepidermal water loss in young pigs. BBA-Mol Cell Biol L. 1987;921(2):191-7.
  82. Hansen HS, Jensen B. Essential function of linoleic acid esterified in acylglucosylceramide and acylceramide in maintaining the epidermal water permeability barrier. Evidence from feeding studies with oleate, linoleate, arachidonate, columbinate and ${\alpha}$-linolenate. BBA-Mol Cell Biol L. 1985;834(3):357-63.
  83. Elias PM, Brown BE, Ziboh VA. The permeability barrier in essential fatty acid deficiency: evidence for a direct role for linoleic acid in barrier function. J Invest Dermatol. 1980;74(4):230-3. https://doi.org/10.1111/1523-1747.ep12541775
  84. Tsuji K, Mitsutake S, Ishikawa J, Takagi Y, Akiyama M, Shimizu H, et al. Dietary glucosylceramide improves skin barrier function in hairless mice. J Dermatol Sci. 2006;44(2):101-7. https://doi.org/10.1016/j.jdermsci.2006.08.005
  85. Holleran WM, Man M, Gao WN, Menon GK, Elias P, Feingold K. Sphingolipids are required for mammalian epidermal barrier function. Inhibition of sphingolipid synthesis delays barrier recovery after acute perturbation. J Clin Invest. 1991;88(4):1338-45. https://doi.org/10.1172/JCI115439
  86. Mao-Qiang M, Elias PM, Feingold KR. Fatty acids are required for epidermal permeability barrier function. J Clin Invest. 1993;92(2):791-8. https://doi.org/10.1172/JCI116652
  87. Feingold KR, Man MQ, Menon GK, Cho SS, Brown BE, Elias PM. Cholesterol synthesis is required for cutaneous barrier function in mice. J Clin Invest. 1990;86(5):1738-45. https://doi.org/10.1172/JCI114899
  88. Nikkari T, Schreibman PH, Ahrens Jr E. Isotope kinetics of human skin cholesterol secretion. J Exp Med. 1975;141(3):620-34. https://doi.org/10.1084/jem.141.3.620
  89. Bhattacharyya AK, Connor WE, Spector AA. Excretion of sterols from the skin of normal and hypercholesterolemic humans: Implications for sterol balance studies. J Clin Invest. 1972;51(8):2060-70. https://doi.org/10.1172/JCI107012
  90. Grubauer G, Feingold KR, Elias PM. Relationship of epidermal lipogenesis to cutaneous barrier function. J Lipid Res. 1987;28(6):746-52. https://doi.org/10.1016/S0022-2275(20)38670-3
  91. Menon GK, Feingold KR, Moser AH, Brown BE, Elias PM. De novo sterologenesis in the skin. II. Regulation by cutaneous barrier requirements. J Lipid Res. 1985;26(4):418-27. https://doi.org/10.1016/S0022-2275(20)34355-8
  92. Song HJ, Park CJ, Kim TY, Choe YB, Lee SJ, Kim NI, et al. The Clinical Profile of Patients with Psoriasis in Korea: A Nationwide Cross-Sectional Study (EPIPSODE). Ann Dermatol. 2017;29(4):462-70. https://doi.org/10.5021/ad.2017.29.4.462
  93. Kalantzis A, Marshman Z, Falconer DT, Morgan PR, Odell EW. Oral effects of low-dose methotrexate treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(1):52-62. https://doi.org/10.1016/j.tripleo.2004.08.020
  94. Tichy M, Hercogova J. Manifestation of Crohn's disease in a young woman during the course of treatment for severe form of chronic plaque psoriasis with etanercept. Dermatol Ther. 2014;27(4):211-4. https://doi.org/10.1111/dth.12119
  95. Guerra I, Algaba A, Perez-Calle JL, Chaparro M, Marin-Jimenez I, Garcia-Castellanos R, et al. Induction of psoriasis with anti-TNF agents in patients with inflammatory bowel disease: a report of 21 cases. J Crohns Colitis. 2012;6(5):518-23. https://doi.org/10.1016/j.crohns.2011.10.007
  96. Cullen G, Kroshinsky D, Cheifetz AS, Korzenik JR. Psoriasis associated with anti-tumour necrosis factor therapy in inflammatory bowel disease: a new series and a review of 120 cases from the literature. Aliment Pharmacol Ther. 2011;34(11-12):1318-27. https://doi.org/10.1111/j.1365-2036.2011.04866.x
  97. Lee IW, Choi HY, Lee JH, Park SD, Kim SM, Ku SK, et al. Saeng-Kankunbi-Tang (生肝健脾湯) protects liver against oxidative damage through activation of ERK/Nrf2 pathway. Chin J Integr Med. 2016;22(8):619-28. https://doi.org/10.1007/s11655-016-2466-5
  98. Kim JY, Kim YC, Lee JH, Woo HJ. The Effects of Saengkankunbi-tang on Proliferation, Apoptosis and Cell Signaling Pathways of HepG2 Cells. J Int Korean Med. 2006;27(1):149-65.
  99. Hong ND, Kim JW, Kim BW, Shon JG. Studies on the Efficacy of the Combined Preparation of Crude Drugs (VII): Effects of Saengkankunbi-Tang on the Liver Tissue Recovery. Korean J Pharmacog. 1982;13(2):70-8.
  100. Hong ND, Kim JW, Kim BW, Shon JG. Studies on the Efficacy of the Combined Preparation of Crude Drugs (VI): Effect of Saengkankunbi-Tang on Activities of the Liver Enzyme, Protein Contents and the Excretory Action of Bile Juice in the Serum of CCl4-intoxicated Rabbits. Korean J Pharmacog. 1982;13(1):33-8.

Cited by

  1. 건선의 동서의학적 연구 특징의 비교 vol.42, pp.2, 2020, https://doi.org/10.13048/jkm.21016
  2. 건선에 효과적인 한약 처방 탐색 - 지질 대사를 중심으로 vol.34, pp.3, 2020, https://doi.org/10.6114/jkood.2021.34.3.070