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Neue Studien
This study analyzed over 2000 images of psoriasis across major web-based platforms and found a significant underrepresentation of darker skin tones, highlighting a critical gap in dermatologic representation that may contribute to misdiagnoses and health disparities among patients with skin of color.Weiterlesen
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Psoriasis is a chronic inflammatory disease associated with high morbidity and few cases of sustained remission. Innovative immunomodulatory therapies, including fibroblast-based cell therapies, offer promising alternatives. This study investigates the therapeutic potential of human dermal fibroblasts (HDFs) organized into three-dimensional (3D) spheroids in a mouse model of imiquimod (IMQ)-induced psoriasis. Methods HDF spheroids were cultured using Elplasia microcavity plates, and their size, viability, and phenotype were compared with single cells in 2D monolayer cultures. Cellular responses in whole blood and acute inflammatory responses were evaluated at various time points following intravenous injection of HDFs. The therapeutic efficacy of HDF spheroids was assessed using an IMQ-induced psoriasis mouse model, with disease severity scored using the Psoriasis Area and Severity Index (PASI). Optimized HDF spheroids (~150 um, 1x106 cells/mouse) were administered intravenously in a single dose for mild psoriasis or multiple doses for moderate-to-severe psoriasis. The efficacy of HDF spheroids was compared to a pre-clinical monoclonal antibody targeting interleukin 23 (anti-IL-23). Results Spheroid cultures of HDFs showed reduced cell size, enhanced viability, and distinct phenotypic changes compared to monolayer cultures. Intravenous injection of HDF spheroids resulted in less thrombocytopenia and reduced acute inflammatory responses compared to single-cell injection. A single dose of HDF spheroids reduced the severity of mild psoriasis by 35%, while repeated doses resulted in a 36% reduction in moderate-to-severe psoriasis. Single-dose administration normalized blood cell counts, alleviated spleen enlargement, and improved cytokine dysregulation. Although HDF spheroids and anti-IL-23 reduced epidermal thickening and immune cell infiltration, HDF spheroids uniquely inhibited monocyte production and infiltration, a benefit not observed with anti-IL-23. No acute or chronic toxicity was observed. Conclusions HDF spheroids offer comparable therapeutic efficacy to anti-IL-23 in treating psoriasis, with a distinct mechanism involving inhibiting monocyte production and infiltration. Their safety profile and broader immunomodulatory potential support their development as a novel therapeutic strategy for psoriasis and other inflammatory diseases.Weiterlesen
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Psoriasis has been associated with an increased risk of various cancers, including thyroid cancer (TC), yet the molecular mechanisms linking these two diseases remain unclear.Objective
This study aimed to identify and analyze the differentially expressed genes (DEGs) between TC and psoriasis using bioinformatics approaches to explore potential molecular mechanisms and shared pathways. To the best of our knowledge, this is the first bioinformatics-based study to systematically identify and validate shared hub genes between thyroid cancer and psoriasis.Methods
A TC dataset from the TCGA database and five GEO datasets (GSE35570, GSE13355, GSE14905, GSE53431, and GSE29265) were analyzed, with GSE53431 and GSE29265 serving as validation sets. Differential expression was identified using Xiantao and GEO2R, followed by a series of bioinformatics analyses, including Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Ontology (GO) enrichment, protein-protein interaction (PPI) network construction, transcription factor (TF)-gene interaction, TF-miRNA coregulatory network analysis, and drug molecule prediction.Results
A total of 79 DEGs associated with TC were identified. Key Enrichr KEGG pathways included a response to the bacterium, NABA MATRISOME ASSOCIATED, negative regulation of cell population proliferation, response to wounding, and HALLMARK KRAS SIGNALING UP. Six hub genes (SERPINA1, S100A9, CCL20, SLPI, LCN2, and CXCL8) were identified from the PPI network, with three genes (SERPINA1, CCL20, and LCN2) showing high diagnostic value for both TC and psoriasis. TF gene and miRNA interactions involving these hub genes and potential drug molecules were also identified.Conclusion
This study provides insight into potential biomarkers and therapeutic targets relevant to TC and psoriasis, identifying shared molecular pathways and hub genes that may guide future diagnostic and therapeutic approaches for these diseases.Weiterlesen
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This study aims to investigate the relationship between Relative Fat Mass (RFM) and the risk of psoriasis based on data from the US National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014.Methods
This cross-sectional study included 19,565 adults aged 20 years and older. Psoriasis diagnosis was determined using self-reported questionnaires, and RFM was calculated based on established formulas. Multivariable logistic regression models were used to analyze the association between RFM and psoriasis risk, adjusting for covariates such as age, gender, race, socioeconomic factors, and health behaviors. Nonlinear relationships and potential threshold effects between RFM and psoriasis were assessed using restricted cubic splines.Results
The analysis revealed a significant positive association between RFM and psoriasis risk. Each 1-unit increase in RFM was associated with a 3% higher likelihood of psoriasis (OR=1.03, 95% CI: 1.02-1.05, P<0.05). The restricted cubic spline analysis showed a nonlinear relationship between RFM and psoriasis risk (P_non-linear=0.028). Subgroup analysis further demonstrated that income level (with lower associations observed among those with a poverty-to-income ratio ≤1.3) moderated the relationship. RFM exhibited moderate predictive performance for psoriasis risk, with an area under the receiver operating characteristic curve (AUC) of 0.549.Conclusion
RFM is significantly associated with increased psoriasis risk, with a dose-response relationship observed. These findings suggest that RFM may serve as a useful predictor for psoriasis risk and could be incorporated into screening strategies for early detection and prevention.Weiterlesen
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Psoriatic arthritis (PsA) is a heterogeneous inflammatory disease in which a significant proportion of patients remain refractory to existing therapies. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) initiated a project aimed at unravelling the reasons for treatment failures in PsA, culminating in the establishment of definitions for difficult-to-treat PsA (D2T-PsA) and complex-to-manage PsA (C2M-PsA). This study explores patient perspectives on treatment-resistant PsA, incorporating a broader patient perspective into the overarching GRAPPA project.Methods
A multilingual (10 languages), online survey to explore PsA patients' perspectives on treatment inefficacies was used. It was developed collaboratively by GRAPPA members and patient research partners. It included sections on demographic data, structured questions about treatment failures, and open-ended questions. Data analysis used descriptive statistics and inductive coding of qualitative responses via Dedoose.Results
Among 570 respondents, most were female (68.8%) and White (72.6%), with an average PsA diagnosis delay of 4.3 years. Key contributors to D2T- and C2M-PsA were persistent joint pain and psoriasis (65.7%), fatigue (52.8%) and medication side effects (41.7%). Ranked by impact, arthritis was the most debilitating symptom. Quality of life concerns were notable, with sleep impairment and reduced life enjoyment being reported by 66.4%. Language differences emerged; for instance, Dutch and Italian respondents prioritized fatigue and daily life impact, respectively.Conclusion
This is the first international study to highlight patient-driven insights in the management of resistant PsA, emphasizing a multidimensional approach that considers biological and psychosocial factors. These insights will inform the ongoing GRAPPA initiative to standardize definitions for treatment-resistant PsA, ultimately improving patient care.Weiterlesen
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Topical drugs containing corticosteroids are recommended first-line treatment for patients with mild-moderate psoriasis. However, the optimal recommended dosage of topical drugs has not been well established.Objectives
To investigate the effect of topical drug application quantity and treatment duration on psoriasis treatment outcome.Methods
We conducted a post-hoc analysis of two randomized controlled trials investigating 214 patients with psoriasis using topical drugs containing corticosteroids and/or calcipotriol for up to 48 weeks. We measured the amount of topical drugs used during the study period and calculated the mean amount of applied drugs per 1% affected body surface area (BSA) divided by number of days in the study period. Improvement in severity of psoriasis was measured by Lattice-System Physician's Global Assessment (LS-PGA) (where affected BSA was divided into seven categories) from baseline to last study visit. Descriptive results were reported as counts with proportions, and as means with normality-based confidence intervals (CI). Associations were analyzed using linear regressions.Results
Most study participants had a duration of psoriasis greater than 20 years, moderate psoriasis, and no history of using systemic psoriasis treatment. They had applied a mean of 1.0 g per 1% BSA per day (95% CI 0.9; 1.2). Daily use of topical drugs for four-weeks reduced severity of psoriasis. However, extended daily use for up to 48 weeks provided further reduction in disease severity (coefficient --0.30 (95% CI -0.51, -0.09)) and -0.73 (95% CI -1.09; -0.38) (P= 0.028). Greater amount of applied topical drugs reduced severity of psoriasis in a linear manner. Every increase of 1 g of topical drugs applied per 1% BSA per day reduced LS-PGA by 0.43 (95% CI 0.24; 0.61). Finally, patients who had never used systemic drugs experienced a greater reduction in psoriasis when applying the same mean amount of topical drugs (coefficient -0.7 (95% CI -1.1, -0.4) compared to those who had a history of taking systemic treatment (-0.3 (95% CI -0.5; -0.1), P=0.026).Conclusions
A mean application amount of at least 1.0 g of topical drugs per 1% BSA per day seems safe and effective and can be used daily until clearance.Weiterlesen
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The approach to pediatric psoriasis requires special considerations, given the potential for negative consequences on overall physical and psychosocial health.Objective
The aim of this study was to systematically review the literature to characterize the burden of pediatric psoriasis.Methods
Papers assessing associations between pediatric psoriasis (in children <18 years old) and quality of life, physical symptoms (e.g., skin pain, itch, sleep disruption), and adverse psychological, social, and financial effects were searched with no date restrictions through July 2023. Databases searched included Ovid MEDLINE®, CENTRAL, the Cochrane Database of Systematic Reviews, and PsycInfo. Articles were excluded if they focused on comorbidities (including psoriatic arthritis/enthesitis), were of low quality, or were not in English.Results
64 publications met eligibility criteria. Composite quality of life was the most frequently reported domain (40 publications) and was negatively impacted by psoriasis as a function of severity. Physical burdens, especially itch, occurred in 44.1-96.3% of children with psoriasis, while skin pain was less common. Psychosocial and family burdens were less frequently assessed and often with non-validated tools. Children with psoriasis participated less in social activities, but there were no clear associations between psoriasis and school performance or interpersonal relationships. Psoriasis was associated with a higher mental health burden on caregivers and greater family financial burden.Conclusions
Psoriasis leads to high burden for pediatric patients and caregivers. Evaluation and management decisions should include and incorporate a thorough assessment of burden. Additional studies using validated tools are necessary to fully assess psychosocial and family burdens of psoriasis.Weiterlesen
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Bimekizumab (BKZ), a monoclonal antibody targeting interleukin (IL)-17A and IL-17F, has shown high efficacy in clinical trials. However, real-world data on its use in psoriatic arthritis (PsA) are limited. This study aimed to evaluate the effectiveness and safety of BKZ over 24 weeks in a real-world setting.Methods
A retrospective, multicenter study was conducted at two Italian rheumatology centers, enrolling adult patients with PsA who initiated BKZ treatment between January 2023 and February 2025. Clinical data were collected at baseline, week 12, and week 24.Results
Forty patients with PsA were included. Of these, 75% had failed at least two biologic and/or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) prior to BKZ and 25/40 (62.5%) had failed at least one IL-17A inhibitor (IL-17Ai). Among these 25 patients, 32% experienced a primary failure and 68% a secondary failure. The median baseline Disease Activity in Psoriatic Arthritis (DAPSA) score was 22.9 (17.5-27.2), decreasing to 6.0 (3.1-12.8) at week 24 (p < 0.001). By week 24, 72.5% achieved DAPSA low disease activity (LDA), and 25% achieved DAPSA remission. The median swollen joint count (SJC) decreased from 3.0 (0.8-5.3) to 0.0 (IQR 0.0-1.0), and median tender joint count (TJC) decreased from 4.5 (3.0-7.3) to 1.0 (0.0-2.0) (both p < 0.001). Pain visual analog scale (VAS) and Patient Global Assessment (PGA) improved significantly, from 7.0 (6.0-8.0) and 7.5 (6.5-8.0) at baseline to 2.0 (1.0-5.0) and 2.0 (1.0-4.5) at week 24 (both p < 0.001). Skin involvement also improved, with 51.5% achieving Psoriasis Area and Severity Index (PASI) 100 by week 24. The safety profile was favorable; 15% of patients developed mild oral candidiasis, none of which required treatment discontinuation.Conclusion
BKZ demonstrated rapid and sustained improvements in PsA symptoms in a challenging real-world population, with a favorable safety profile.Weiterlesen
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Psoriasis is frequently associated with non-communicable disease (NCD) comorbidities, prompting interest in how these concurrent conditions may influence psoriasis treatment outcomes.Objectives
To assess NCD prevalence and their influence on psoriasis treatment outcomes.Methods
From 2022 to 2024, we recruited psoriasis patients in Shanghai Skin Disease Hospital. Data on demographic features, NCD comorbidities and treatment outcomes at week 4 and week 8 were systematically collected through questionnaire, physical examination, and clinical severity assessment (psoriasis area and severity index [PASI], body surface area [BSA], physician's global assessment [PGA]).Results
Among 1116 patients, 48.4% had at least one NCD comorbidity. NCD-free patients exhibited higher PASI50 response rates at both week 4 (46.5 vs. 39.1%) and week 8 (72.2 vs. 70.9%). Log binomial regression revealed that NCDs significantly reduced the likelihood of achieving PASI50 at week 4 (relative risk [RR] = 0.84, 95% confidence interval [CI]: 0.73-0.96), with a similar but non-significant trend at week 8 (RR = 0.98, 95% CI: 0.92-1.06).Conclusion
NCDs negatively impact early treatment outcomes in psoriasis patients. So we propose that dermatologists should integrate systematic NCD management into psoriasis treatment regimen.Weiterlesen
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Continuous biologic treatment is recommended for patients with psoriasis; however, treatment interruption in daily practice is inevitable. The impact of treatment interruption is difficult to study in a real-world setting. In Taiwan, biologics are reimbursed by the National Health Insurance for moderate-to-severe psoriasis for a 2-year course, followed by regulatory discontinuation. Thus, our study provides pragmatic data on the impact of the interruption of biologics treatment for non-medical reasons on therapy effectiveness.Patients and methods
This single-center retrospective cohort study recruited patients who underwent two consecutive 2-year courses of biologics between 2012 to 2021.Results
A total of 192 treatment courses from 61 patients were analyzed, with secukinumab and ustekinumab being the most frequently administered biologics. Among patients who continued with the same biologic across two consecutive courses, the time to achieve PASI 75 was shorter during the first course compared to the second, while overall maintenance effects remained similar. Switching to a different biologic usually produced superior results in the second course of treatment.Conclusions
Although the overall effectiveness after interruption and resumption of treatment with secukinumab or ustekinumab was comparable, the time to achieve PASI 75 was longer following an interruption. Continuous, uninterrupted treatment with a given biologic is therefore recommended whenever possible.Weiterlesen
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