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Victoria P. Werth, M.D.
Associate Professor

2 Rhoads Pavilion
3600 Spruce Street
Philadelphia, Pennsylvania 19104

Tel: 215-662-2737
Fax: 215-823-5171

 
 

Education
1976        B.A.,M.S.   Catholic University
1980        M.D.         Johns Hopkins

Clinical Specialties
 Autoimmune blistering and connective diseases;
Prevention of side effects of systemic glucocorticoids;

Research Area of Interests
The immunopathogenesis and treatment of autoimmune diseases and photoaging; Clinical trials in autoimmune blistering disease;

Basic Science Research Summary
We are studying the differential effects of ultraviolet (UV) light on skin, including studies of the effects UVA vs. UVB on important matrix components in skin, such as tropoelastin and hyaluronan. This has led to investigations of UVB-specific effects in activation of TNF , and most recently the discovery of a TNF promoter polymorphism associated with photosensitive forms of lupus erythematosus. Ongoing studies are dissecting the molecular control of the wildtype and polymorphism TNF promoter. These fundamental studies benefit from the clinical link the PI has with a large number of patients with different forms of cutaneous LE, forming the basis for translational research as well as basic research studies.

A second area of investigation relates to the effects of glucocorticoids (GCs) on skin. Specifically we have dissected the mechanism of GC suppression of hyaluronan synthases, a key explanation for the depression of hyaluronic acid (HA) in skin. Since HA plays a major role in cell migration and proliferation, its decrease is undoubtedly important in the severe skin atrophy seen with GCs. Studies of this mechanism of suppression are onging, with the goal to develop and evaluate potential agents that could reverse these changes in skin.

Dr. Werth's Lab Personnel:
Michele L. Rosenbaum, Post Doctoral Research Fellow
Muhammad M. Bashir, Ph.D., Research Associate
Wei Zhang, Ph.D., Research Specialist


Clinical Research Summary
There are a number of onging clinical studies related to patients with autoimmune skin diseases:

Dapsone as a steroid-sparing agent in pemphigus vulgaris. This is a multicenter, international trial evaluating the role of dapsone for patients who are controlled with their disease, but steroid dependent.

Monoclonal antibody against C5 for bullous pemphigoid. Patients with resistant bullous pemphigoid or patients who are unable to tolerate prednisone are eligible for this trial.

Etanercept in the treatment of psoriasis.

Selected Publications

  1. Werth VP. Cutaneous manifestations of infectious arthritides. In Cutaneous Manifestations of Rheumatic Diseases. (Eds: Sontheimer and Provost): 285-322, 1995.

  2. Guzzo CL, Lazarus GS, Werth VP. Dermatologic Pharmacology. In - Goodman and Gilman's The Pharmacological Basis of Therapeutics. (Ed: Hardman JG, Limbird LE), 1995.

  3. Sontheimer RD, Werth VP., Provost TT. The Medical Dermatology Society. Editorial, Arch Dermatol 132:1373-1374,1996.

  4. Werth VP. Treatment of pemphigus vulgaris with pulse glucocorticoids. Arch Dermatol 132:1435-1439,1996.

  5. Werth VP., Williams KJ, Fisher E, Bashir M, Rosenbloom JR, Shi X. UVB Irradiation Alters Cellular Responses to Cytokines: Role in Extracellular Matrix Gene Expression J Invest Dermatol 108:290-294,1997.

  6. Werth VP. Glucocorticoid-Induced Osteoporosis: Evaluation, Prevention, and Treatment. Revue du Rhumatisme 64: S84-S88, 1997.

  7. Werth VP., Dutz JP, Sontheimer RS. Cutaneous lupus: an update on pathogenetic mechanisms and treatment. Current Opinion in Rheumatology 9:400-409,1997.

  8. Werth VP. Miscellaneous syndromes involving skin and joints. In - Primer on the Rheumatic Diseases, 11th edition (Eds: Schumacher HR), 365-369,1997.

  9. Sontheimer RD, Werth VP. Whither the patient-oriented researcher? J Am Acad Dermatol, 109-113,1998.

  10. Werth VP., Kligman AM, Shi X, Pagnoni A. Lack of correlation of skin thickness with bone density in patients receiving chronic glucocorticoid. Arch Derm Res 290:388-392,1998.

  11. Werth VP., Zhang W: Wavelength-specific synergy between ultraviolet radiation and interleukin-1 alpha in the regulation of matrix-related genes: mechanistic role for tumor necrosis factor-alpha. J Invest Dermatol 113:196-201, 1999

  12. Werth VP., Lazarus GS. Systemic Corticosteroids. In - Dermatology in General Medicine (Eds: Fitzpatrick TB, Eisen AZ, Wolff K, Freedberg IM, Austen KF). McGraw-Hill, Inc, pp. 2783-2789, 1999.

  13. Werth VP., VonFeldt JM. Connective Tissue Disease. In - Conn's Current Therapy (Eds: Robert & Rakel). W.B. Saunders Company, 809-813, 1999.

  14. Galaria NA, Werth VP., Schumacher HR. Embrel-induced leukocytoclastic vasculitis. J. Rheum 27: 2041-2044,2000.

  15. Werth VP., Zhang W, Dortzbach K, et al: Association of a promoter polymorphism of TNFalpha with subacute cutaneous lupus erythematosus and distinct photoregulation of transcription. J Invest Dermatol 115:726-730, 2000

  16. Zhang W, Watson CE, Liu C, et al: Glucocorticoids induce a near-total suppression of hyaluronan synthase mRNA in dermal fibroblasts and in osteoblasts: A molecular mechanism contributing to organ atrophy. Biochem J 349:91-97, 2000

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