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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-α, and 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 patient oriented clinical and translational research, as well as basic research studies.

A second area of investigation relates to clinical and translational research related to autoimmune skin disease. We are longitudinally evaluating patients with outcome measures validated in our translational research program. Ongoing studies include systematic studies of cutaneous lupus, dermatomyositis, and pemphigus.



Dr. Werth's Lab Personnel:
Rachele Klein, Pre Doctoral Research Fellow
Muhammad M. Bashir, Ph.D., Research Associate
Meena Sharma, Ph.D., Lab Manager


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

A Randomized, Double-Blind, Placebo-Controlled Phase II Trial of Infliximab for the Treatment of Pemphigus Vulgaris

Evaluation of Lenalidomide (Revlimid®) in Cutaneous LE: A Prospective, Non-Controlled, Open Label Pilot Study to Evaluate the Off-Label Use of the FDA-approved Drug Lenalidomide (Revlimid®) in Subjects with Cutaneous Lupus Erythematosus (CLE)

Selected Publications

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

  2. Werth VP. Cutaneous manifestations of infectious arthritides. In Cutaneous Manifestations of Rheumatic Diseases. (Eds: Sontheimer and Provost), 2004.

  3. 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.

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

  5. 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.

  6. 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.

  7. 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.

  8. Werth VP, Voorhees J, Freedberg IM, Sontheimer RD. Preserving Medical Dermatology: A Colleague Lost, a Call to Arms, and a Plan for Battle. Dermatology Clinics 19:583-592,2001

  9. Patel P, Werth V. Cutaneous lupus erythematosus: a review. Dermatol Clin 20:373-385,2002

  10. Miwa T, Maldonado MA, Sun, XJ, Luo HY, Cai, DW, Werth VP, Madaio MP, Eisenberg RA, and Song WC. Deletion of decay-accelerating factor (CD55) exacerbates autoimmune disease development in MRL/lpr mice.. Am J Pathol 161:1077-1086, 2002.

  11. Werth VP, Berlin J, Callen JP, Mick R, Sullivan KE. Mannose-binding lectin (MBL) polymorphisms associated with low MBL Production in patients with dermatomyositis. J Invest Dermatol 119: 1394-1399, 2002.

  12. Werth VP, Bashir M, Zhang W. IL-12 completely blocks the secretion of TNF? from cultured skin fibroblasts and keratinocytes. J Invest Dermatol 120:116-122,2003.

  13. Albrecht JA, Braverman IM, Callen JP, Connolly MK, Costner M, Fivenson D, Franks A, Jorizzo J, Lee LA, McCauliffe D, Sontheimer RD, Werth VP. Dermatology position paper on the revision of the 1982 ACR criteria for SLE. Lupus 13: 839-849, 2004.

  14. Sabir SM, Werth VP. Cutaneous manifestations of infectious arthritides. In Cutaneous Manifestations of Rheumatic Diseases. (Eds: Sontheimer and Provost). 2004.

  15. Werth VP. Clinical Manifestations of Cutaneous Lupus Erythematosus. Autoimmunity Reviews 4:296-302, 2005.

  16. Joerg Albrecht, Lynne Taylor, Jesse Berlin, Samuel Dulay, Gina Ang, Steven Fakharzadeh, Jonathan Kantor, Ellen Kim,Giuseppe Militello , Karen McGinnis, Stephen Richardson, James Treat, Camela Vittorio, Abby Van Voorhees, Victoria P. Werth. The CLASI (Cutaneous LE Disease Area and Severity Index): an outcome instrument for cutaneous lupus erythematosus. J Invest Dematol 125:889-894, 2005.

  17. Dick SE, Werth VP. Pemphigus: A treatment update. Autoimmunity 39:591-599, 2006.

  18. Clarke JT and Werth VP. Therapy for Cutaneous Lupus Erythematosus. Expert Review of Dermatology 1:105-120, 2006.

  19. Levin J, Werth VP. Skin Disorders with Arthritis. In – Baillere’s Best Practice & Research in Clinical Rheumatology. (Ed: Kay J and So AKL). Harcourt Health Sciences, London, UK, 20:809-826, 2006.

  20. Dick SE, Werth VP. Bullous Diseases. In - Conn’s Current Therapy (Eds: Robert & Rakel), 2006.

  21. Werth VP. Photoaggravated dermatoses. In – Principles and Practice of Photodermatology (Eds: Lim, Hönigsmann, and Hawk), Taylor & Francis Groups, New York, submitted for publication, 2006.

  22. Sperber B, Martin LK, Murrell DF, Werth VP. Pemphigus. In – Evidence-Based Dermatology (Eds: Williams H, Bigby M, Diepgen T, Herxheimer A, Naldi L, Rzany B). British Medical Journal books London, UK, 2006.

  23. Quain R, Werth VP. The management of cutaneous dermatomyositis: current therapeutic options. Am J Clin Dermatol 7:341-351, 2006.

  24. Albrecht J, Werth VP. The development process of the CLASI as an outcome instrument for cutaneous lupus erythematosus. Dermatologic Therapeutics 20:93-101, 2007.

  25. Rosenbach M, Werth VP. Dermatologic Therapeutics: Thalidomide, a practical guide. Dermatologic Therapeutics, 20:175-186, 2007.

  26. Quain RD, Teal V, Taylor L, Werth VP. Number, characteristics, & classification of dermatomyositis patients seen by dermatology & rheumatology at a tertiary medical center. J Am Acad Dermatol 57: 937-943, 2007.

  27. Lin JH, Dutz J, Sontheimer R.D., Werth VP. Pathophysiology of Cutaneous Lupus Erythematosus. Clinical Reviews in Allergy and Immunology 33:85-106, 2007.

  28. Werth VP, Fivenson D, Pandya A, Chen D, Rico J, Albrecht J, Jacobus D. Multicenter randomized placebo-controlled clinical trial of dapsone as a Glucocorticoid-sparing agent in maintenance phase Pemphigus Vulgaris, Arch Dermatol 144:25-32, 2008.

  29. Bonilla-Martinez Z, Albrecht J, Taylor L, Okawa J, Werth VP. The CLASI is a useful clinical instrument to separately follow activity and damage during therapy of cutaneous lupus erythematosus. Arch Dermatol 144: 173-180, 2008.

  30. Krathen MS, Dunham J, Gaines E, Grove G, Junkins-Hopkins J, Kim E, Kolasinski SL, Kovarik C, Kwan-Morley J, Okawa J, Propert K, Rogers N, Rose M, Thomas P, Troxel AB, Van Voorhees A, Von Feldt J, Weber AL, Werth VP. The Cutaneous Lupus Erythematosus Disease Activity and Severity Index (CLASI) expansion for rheumatology and dermatology, Arthritis Care & Research, 59:338-344, 2008.

  31. Gaines EG, Albrecht J, Werth, VP. Development of outcome measures for autoimmune dermatoses. Archives of Dermatological Research 300:3-9, 2008.

  32. Gaines E, Bonilla-Martinez Z, Albrecht J, Taylor L, Okawa J, Troxel AB, Werth VP. QoL and disease severity in a CLE pilot study. Arch Dermatol (letter), 144:1061-1062, 2008.

  33. Klein RQ, Bangert CC, Costner M, Connolly MK, Dugan, Tanikawa EA, Okawa J, Rose M, Fakharzadeh SS, Fiorentino D, Lee LA, Sontheimer RD, Taylor L, Troxel AB, Werth VP. The CDASI, DSSI, & CAT: Comparison of reliability and validity in the development of an outcome instrument for cutaneous dermatomyositis. Br J Dermatol 159:887-894, 2008.

  34. D.F. Murrell, S. Dick, R. Ahmed, M. Amagai, M.A. Barnadas, L. Borradori , J-C. Bystryn, G. Cianchini, L. Diaz, D. Fivenson, L.A. Goldsmith, R. Hall, K. Harman, T. Hashimoto, M. Hertl, N. Hunzelmann, P. Iranzo, P. Joly, M. F. Jonkman, Y. Kitajima, N. J. Korman, L. K. Martin, D. Mimouni, A.G. Pandya, A. S. Payne, D. Rubenstein, H. Shimizu, A. A. Sinha, D. Sirois, D. Zillikens, V.P. Werth. Consensus Statement on Definitions of Disease Endpoints and Therapeutic. J Am Acad Dermatol 58:1043-1046, 2008.

  35. Werth VP. Systemic Corticosteroids. In - Dermatology in General Medicine (Eds: Fitzpatrick TB, Eisen AZ, Wolff K, Freedberg IM, Austen KF). McGraw-Hill, Inc, 7th Edition, 2008.
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