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Psoriasis is a chronic inflammatory skin disorder that has been increasingly linked to metabolic imbalances, particularly obesity. Conventional anthropometric indicators such as BMI and waist circumference (WC) may not sufficiently capture body fat distribution or reflect metabolic risk. The body roundness index (BRI), which integrates both height and waist measurements, has emerged as a potentially superior metric, though its relevance to psoriasis risk remains underexplored.Objective
This study aimed to investigate the use of BRI as a digital biomarker for assessing psoriasis risk and to compare its predictive strength against BMI and WC across various demographic and metabolic subgroups using data from a nationally representative sample.Methods
A cross-sectional analysis was conducted using data from 13,798 adults aged 20 to 59 years who participated in the National Health and Nutrition Examination Survey between 2003 and 2006 as well as between 2009 and 2014. Psoriasis status was self-reported. Anthropometric measures (BRI, BMI, and WC) were calculated from standardized physical assessments. Weighted multivariable logistic regression models and restricted cubic spline analyses were used to examine associations while adjusting for demographic, metabolic, and lifestyle variables. A nomogram was constructed to quantify the relative predictive contributions of each metric.Results
BRI exhibited a strong linear association with psoriasis risk (odds ratio [OR] 1.11 per unit increase, 95% CI 1.05-1.17; P<.001), outperforming BMI (OR 1.03) and WC (OR 1.01). Tertile analysis revealed a 1.73-fold increased risk of psoriasis in the highest BRI group (P=.003). Subgroup analyses confirmed consistent associations across age, sex, race or ethnicity, and metabolic status (P for interaction >.05). The nomogram highlighted BRI as the most influential predictor, indicated by its broad scoring range.Conclusions
BRI shows stronger and more consistent associations with psoriasis risk than BMI or WC, supporting its potential role as a digital biomarker for early risk stratification. Incorporating BRI into clinical decision-making tools may enhance personalized approaches to psoriasis prevention and management.Weiterlesen
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Psoriasis is associated with increased psychiatric comorbidity, yet patterns of mental health care use and spending remain unclear.Objective
To characterize use and expenditures for outpatient mental health services and psychotropic medications among U.S. persons with psoriasis and identify sociodemographic disparities.Methods
Cross-sectional analysis of 2,123 participants with psoriasis in the 2005-2022 Medical Expenditure Panel Survey. Negative binomial and two-part models examined associations between sociodemographic characteristics and mental health care utilization and spending.Results
Higher education and income levels were associated with fewer psychiatrist visits, but lower-income groups had greater utilization overall. Men spent more on psychotropic medications than women. Racial minorities had lower medication spending than White patients. Medicare coverage was linked to greater total expenditure compared to private insurance.Limitations
Psoriasis severity was unavailable. International Classification of Diseases-based identification may undercount cases.Conclusion
Substantial sociodemographic and insurance disparities persist in mental health care use and spending among psoriasis patients.Weiterlesen
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Psoriasis is a systemic disease that brings enormous mental pressure and economic burden to patients and has a significant impact on patients' quality of life (QoL). This study aimed to explore factors affecting the dermatology life quality index (DLQI) in patients with psoriasis.Methods
This retrospective cross-sectional study used data sourced from the Psoriasis Diagnosis and Treatment Real-world Database, and 8839 patients with psoriasis (recruited between June 24, 2020 and September 2, 2021) were included. Demographic and clinical characteristics and DLQI scores were retrospectively analyzed, and correlations between DLQI score and age, disease course, psoriasis area and severity index (PASI) score were calculated. Regression analysis was conducted to explore the factors affecting the DLQI scores of patients with psoriasis.Results
The average DLQI scores were significantly higher in young (8.58 ± 7.22) and middle-aged individuals (8.09 ± 6.61) than those in juveniles (6.00 ± 5.79) and older individuals (7.39 ± 6.29) (P = 1.70E-15). The average DLQI scores gradually decreased among individuals whose work status were unemployment (10.4 ± 7.83), part-time (9.02 ± 6.83), full-time (8.43 ± 6.90), retired (7.93 ± 6.07), and students (7.10 ± 6.31) (P = 9.82E-23). Except for those with disease course ≥20 years, DLQI scores increased gradually with prolongation of the disease course (P = 4.72E-22). The higher the severity of psoriasis, the higher the average DLQI score (P = 3.79E-113). The presence of psoriatic lesions at the exposed sites significantly affected DLQI scores (P <0.001). The average DLQI scores were significantly higher among individuals with nail holes, joint pain, and comorbidities than among those without these conditions (P <0.05). Correlation analysis indicated that the PASI scores were positively correlated with the DLQI scores (r = 0.26, P = 4.19E-134). Multinomial logistic regression analysis showed significant influencing factors (excluding comorbidity) with different degrees of impact based on the DLQI score (P <0.05).Conclusion
Physicians should focus on significant factors, such as sex, age, marital status, education, work status, sub-types, disease course, PASI score, without joint pain, and without nail holes, to improve the QoL of patients with psoriasis.Weiterlesen
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Psoriasis is a frequent and complex dermatosis of uncertain origin. A few years ago, a family of gasdermin proteins was implicated in psoriasis pathogenesis. Although the number of therapeutic options for psoriasis is growing, considering the burden of the disease, treatment personalization, and the possibility of side effects or loss of the drug's efficacy, it is important to seek new therapeutic targets.Objective
The aim of this study was to assess the efficacy of antibodies against gasdermin E (GSDME) in the treatment of psoriatic lesions.Methods
The study involved 30 male BALB/c mice, 8 weeks old. 5% imiquimod cream was applied topically on the skin to induce psoriatic lesions. The next day after the psoriatic lesions appeared, the antibodies were administered. Mice from the study group received the rabbit polyclonal anti-GSDME antibody intravenously or intraperitoneally. The control group was administered sterile 0.9% saline solution.Results
The injection of anti-GSDME antibodies to mice with imiquimod-induced psoriasis resulted in the resolution of skin lesions, whereas the injection of saline to the control group did not result in significant changes.Conclusion
Antibodies targeting GSDME seem to be promising therapeutic agents in psoriasis; however, their utility has to be confirmed in future studies.Weiterlesen
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To explore the mechanism of cuprotosis in psoriasis, screen cuprotosis related genes (PDCRGs) in psoriasis, and provide new targets for precise diagnosis and treatment of psoriasis.Material and methods
Integrate bioinformatics analysis and experimental validation. Firstly, based on the GEO database (GSE161683, GSE166388, GSE277173), differentially expressed genes (DEGs) and weighted gene co-expression network analysis (WGCNA) in psoriasis were screened; Identification of differential cuprotosis related genes (PDCRGs) in psoriasis using a self built cuprotosis gene database (1098 CRGs); Screen key PDCRGs through PPI network, machine learning, and ROC analysis. Subsequently, a mouse model of psoriasis induced by imiquimod (IMQ) was constructed, and gene expression, copper ion levels, inflammatory factors, and oxidative stress factors were validated using qPCR, Western blot, immunohistochemistry, fluorescence, and ELISA.Results
Thirty-four PDCRGs were identified, among which STAT1, DLD, GBP1, CXCL10, PDHB, and LIAS are Hub genes. Machine learning and ROC analysis further identified APOL6, CD274, and LIAS as key diagnostic biomarkers. PDCRGs are significantly enriched in the TCA cycle, copper ion transport, and glucose metabolism pathways. The levels of FDX1 and serum copper ions were increased in the skin lesions of psoriasis mice, accompanied by upregulation of TCA cycle key proteins and PDCRGs expression; Copper overload triggers oxidative stress and inflammation cascade.Conclusion
APOL6, CD274, and LIAS were screened as cuprotosis markers in psoriasis. Overexpression of these PDCRGs in psoriasis model mice can promote copper ion accumulation and interfere with the TCA cycle, increase oxidative stress and inflammation levels, and ultimately lead to the occurrence of psoriasis. Therefore, targeted intervention of cuprotosis is of great significance for the clinical treatment of psoriasis.Weiterlesen
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The Disease Activity index for Psoriatic Arthritis (DAPSA) was developed to assess disease activity in patients with psoriatic arthritis (PsA). A modified version, DAPSA28, uses 28 joints instead of 66/68. This study evaluated key psychometric properties of DAPSA and DAPSA28.Methods
Data from 1865 patients with PsA in the European Spondyloarthritis (EuroSpA) Research Collaboration Network, having DAPSA and DAPSA28 scores at baseline and follow-up, were analysed. Tests included assessment of internal construct validity by scree plots, confirmatory factor analysis (CFA) and structural equation modelling (SEM), supplemented by tests of differential item functioning (DIF) and evaluation of internal consistency reliability by Cronbach's α (CA). A subset of 625 patients was used for most analyses, except descriptive statistics, correlation matrix and CA.Results
One-dimensional CFA models for DAPSA and DAPSA28 showed acceptable model fit at baseline (root mean square error of approximation, RMSEA: 0.020, 0.034). However, model fit at 6 months follow-up was poor (RMSEA: 0.057, 0.063). SEM combining baseline and follow-up data could not identify an acceptable model fit. DIF was found for sex and country. CA indicated acceptable internal consistency (DAPSA: 0.65; DAPSA28: 0.63). Heterogeneity across countries was observed.Conclusions
Overall, the model fit was acceptable across model fit statistics, supporting internal construct validity, but some evidence of misfit at country level was disclosed. Our findings support acceptable internal consistency reliability, but DIF was found for sex and country. Based on mixed results of model fit and DIF, further investigation of these and other PsA disease activity measures is warranted.Weiterlesen
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Psoriasis is a chronic inflammatory skin disease with a global prevalence of 1-5%, however its clinical and demographic profile in Kenya remains underexplored. This article describes the establishment of the Kenyan Psoriasis Registry at Moi Teaching and Referral Hospital in Eldoret, Kenya.Methods
214 subjects were enrolled between October 2024 and August 2025 at Moi Teaching and Referral Hospital. Both healthy controls and patients with psoriasis completed enrollment surveys and physical exams, and donated saliva samples.Results
The initial cohort of 214 subjects (108 patients with psoriasis, 106 healthy controls) provides valuable insights into the demographics, clinical profiles, quality of life, and mental health characteristics of patients with psoriasis in Kenya. The mean age of psoriasis onset was 30.4 years, and mean age of diagnosis by a medical provider was 38.9 years old. 13.9% of patients with psoriasis reported a positive family history of psoriasis, and 9.3% of patients with psoriasis reported a diagnosis of psoriatic arthritis. The mean psoriasis area and severity index was 9.9 and mean Investigator Global assessment score was 3.0. Examination of treatment patterns revealed that moisturizers, prescription topical medications, and methotrexate were commonly tried while only 9.3% of individuals had ever received a biologic therapy. Patients with psoriasis reported significantly worse sleep disturbance, quality of life, and mental health compared to healthy controls.Conclusion
This data highlights the unique characteristics of patients with psoriasis in Kenya. The Kenyan Psoriasis Registry continues to enroll patients and conduct yearly follow-ups, aiming to deepen the understanding of psoriasis in this population. These findings underscore the need for targeted research and advocacy to improve psoriasis care in Kenya.Weiterlesen
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The relationship between cancer and the use of systemic immunosuppressants in psoriasis treatment has not well established. The aim of this study was to evaluate the association between the systemic immunosuppressants used in the treatment for psoriasis and the risk of certain cancers in Korean patients with moderate to severe psoriasis.Methods
A retrospective cohort study was conducted involving 93,152 patients with moderate to severe psoriasis and 205,850 matched controls in Korea, using merged data from the National Health Insurance System, Health Insurance Review & Assessment Service, and Korea National Cancer Incidence Database from 2008 to 2018.Results
The study observed a lower incidence of any cancer in moderate to severe psoriasis patients (2.4%) compared to the general population (2.99%). However, there was a higher risk of hematologic cancers, particularly Hodgkin's lymphoma, non-Hodgkin's lymphoma, leukemia, and cutaneous T cell lymphoma. Notably, methotrexate doses of ≥ 17.5 mg/week increased the risk of hematologic cancer risk by 7.546 times and cutaneous T cell lymphoma risk by 9.038 times, but cyclosporine and corticosteroids use did not show a significant association with increased incidence of hematologic cancers. Meanwhile, use of cyclosporine, methotrexate and corticosteroid did not significantly affect the risk of skin cancer among patients with psoriasis.Conclusion
This study reveals an increased risk of hematologic cancers, such as cutaneous T cell lymphomas, associated with high-dose immunosuppressant use in moderate to severe psoriasis, underscoring the need for careful treatment management.Weiterlesen
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Life's Crucial 9 (LC9) is a new tool used to evaluate cardiovascular health. At present, no studies have reported the association between LC9 and psoriasis.Methods
This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2014. The LC9 score was calculated based on the American Heart Association's recommendations and the Patient Health Questionnaire-9 assessment. Psoriasis status was identified using self-reported questionnaires. Weighted multivariable logistic regression and restricted cubic splines were applied to assess the association between LC9 and psoriasis. Subgroup analyses were conducted for each covariate, and the interaction between LC9 and potential confounders was examined. Additionally, sensitivity analyses were performed to assess the robustness of the results.Results
A total of 11,762 participants aged 20 years and older were included in this study. After comprehensive adjustments, a negative linear association was observed between psoriasis and LC9: Each 10-point increment in LC9 corresponded to an odds ratio (OR) of 0.87 (95% CI: 0.78-0.96) for psoriasis. Relative to participants in the lowest LC9 quartile (Q1), the ORs for psoriasis were 0.73 (95% CI: 0.55-0.96) for Q3 and 0.55 (95% CI: 0.36-0.85) for Q4. Among participants aged 45 to 64 years, those in the highest LC9 quartile (Q4) had an adjusted OR of 0.42 (95% CI: 0.23-0.78). Heavy drinkers in Q4 exhibited an adjusted OR of 0.37 (95% CI: 0.15-0.92). Sensitivity analyses confirmed these results.Conclusion
A linear negative relationship between psoriasis and LC9 was identified in this study. This observational result suggesting that enhancing LC9-related cardiovascular health factors may serve as an effective approach for psoriasis prevention and management.Weiterlesen
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The purpose of this study was to evaluate the relationship between nutritional status-assessed by the Controlling Nutritional Status (CONUT) score-and disease activity, fatigue, and sleep quality in patients with psoriatic arthritis (PsA), with attention to sex-specific differences.Methods
113 adults with PsA were included in this cross-sectional study. Nutritional status was classified as normal (CONUT 0-1) or malnutrition (CONUT ≥ 2). Disease activity was assessed using the Disease Activity in Psoriatic Arthritis (DAPSA) score, fatigue using the Fatigue Severity Scale (FSS), and sleep quality using the Jenkins Sleep Scale (JSS). Correlation and ROC analyses were performed.Results
Malnutrition was identified in 18.6% of patients. Compared to those with normal nutritional status, malnourished patients had higher CRP (12.8 vs. 6.4 mg/L, p = 0.012) and lower albumin and lymphocyte levels (p < 0.001). High disease activity (DAPSA > 28) was more common in the malnutrition group (38.1% vs. 15.2%, p = 0.029). The CONUT score correlated with DAPSA (Rho = 0.327, p < 0.001), CRP (Rho = 0.422, p < 0.001), and fatigue severity (Rho = 0.186, p = 0.048). No association was observed with sleep quality. ROC analysis showed that CONUT ≥ 2 predicted high disease activity (AUC 0.70). In sex-stratified analyses, correlations with DAPSA and fatigue were present only in females.Conclusion
Higher CONUT scores were associated with greater disease activity and fatigue among patients with psoriatic arthritis. These results underscore the potential value of incorporating routine nutritional evaluation into the comprehensive management of PsA.Weiterlesen
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Psoriasis affects at least 60 million people worldwide, and 80% also live with overweight or obesity. Excess weight increases susceptibility to psoriasis and is associated with more severe disease.Objective
To evaluate the impact of weight-loss interventions on psoriasis severity (Psoriasis Area and Severity Index [PASI], PASI50, PASI75, PASI100 [50%/75%/100% reduction in baseline PASI, respectively]) and quality of life (Dermatology Life Quality Index [DLQI]).Methods
We systematically searched five databases and two trial registries (inception to 03/09/2025). Outcomes were informed by patient focus-group discussions. Randomized controlled trials (RCTs) in adults with psoriasis, comparing any weight-loss intervention versus usual care or a lower-intensity weight-loss intervention, were included. Studies had to report a change in weight and ≥1 psoriasis severity or quality-of-life measure. Random effects meta-analyses were used.Results
Thirteen RCTs (1145 participants) with 14 comparisons were included. Eleven interventions advised dietary changes, of which four included physical activity. Three used weight-loss medications. Across 14 comparisons (n = 1145, mean difference (MD) in weight change: -6.7 kg), weight-loss interventions produced a greater reduction in PASI versus control: MD -2.5 (95%CI: -3.8 to -1.1, I2 = 85.2%). We found a significant effect of weight-loss interventions on the likelihood of achieving PASI75 (RR = 1.6, 95%CI: 1.1-2.2, I2 = 22.6% [based on six comparisons, n = 681, MD in weight change: -7.3 kg]). There was no statistically significant effect of the interventions on the likelihood of achieving PASI50 (RR = 1.5, 95%CI: 0.9-2.4, I2 = 72.8% [based on four comparisons, n = 509, MD in weight change: -4.0 kg]) or PASI100 (RR = 1.6, 95%CI: 0.3-9.7, I2 = 0.0% [based on two comparisons, n = 334, MD in weight change: -5.2 kg]), but both analyses were limited by few studies. Across seven comparisons (n = 364; MD in weight change -7.8 kg), weight-loss interventions were associated with a significant improvement in DLQI compared to control: MD -5.0 (95%CI: -9.7 to -0.3, I2 = 96.0%).Conclusion
High-certainty evidence suggests weight-loss interventions can improve psoriasis severity and quality of life, and should be considered as part of routine treatment.Weiterlesen
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Biologic therapies for psoriasis have shown promise in reducing the risk of Psoriatic Arthritis (PsA) by targeting inflammatory pathways. Emerging evidence suggests that phototherapy may also exert systemic anti-inflammatory effects. This study examines the impact of phototherapy on the progression to PsA.Patients and methods
This exploratory, hypothesis generating retrospective cohort study comprised 667 psoriatic patients, subclassified based on therapeutic interventions administered during longitudinal follow-up: phototherapy alone; phototherapy combined with systemic therapy [either conventional agents (e.g., methotrexate, acitretin, cyclosporine) or biologics (e.g., TNF inhibitors, anti-IL-12/23, anti-IL-17A, anti-IL-23A); topical therapy alone; and systemic monotherapy. PsA diagnoses were established in accordance with the Classification Criteria for Psoriatic Arthritis.Results
Patients receiving standalone phototherapy exhibited a reduced PsA incidence compared to those on topical agents (4.09 vs 5.30 events per 100 person-years; HR = 0.73; 95 % CI: 0.53-0.99; p = 0.047). Combining phototherapy with systemic therapy further reduced PsA risk compared to systemic monotherapy (2.26 vs 3.74 events per 100 person-years; HR = 0.56; 95 % CI: 0.38-0.82; p = 0.003). The lowest incidence was observed in patients treated with both phototherapy and biologics, outperforming biologics alone (HR = 0.43; 95 % CI: 0.19-0.93; p = 0.03).Conclusions
Phototherapy, especially in combination with systemic treatments, demonstrates synergistic potential in mitigating PsA risk.Weiterlesen
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Mental illness stigma is widely examined in healthcare, yet less is known about its intersections with the stigma of chronic physical conditions in shaping distinct forms of disadvantage. Here, we investigate whether patients with concurrent mental and physical health conditions are perceived and treated differently by prospective medical doctors.Methods
Using a mixed-methods design, preclinical medical students (N = 463) evaluated clinical vignettes describing patients with single (i.e., mental or physical chronic disease) and multiple health conditions (i.e., concurrent mental and physical conditions). We assessed emotional reactions, attributions of disease aetiology, caregiving attitudes and meta-beliefs about patients' disclosure behaviour. Participants were also asked to report as accurately as possible on symptoms presented by each patient in the vignette.Results
Findings revealed that stigmatized conditions were associated with higher levels of caregiving discomfort, greater disease disclosure reticence and lower levels of symptom recall accuracy. Compared with patients with single conditions, those with concurrent mental and physical illnesses were less likely to receive care, were attributed a lesser tendency to conceal their conditions and had their symptoms recalled less accurately.Conclusions
Results indicate that when mental and physical illnesses intersect, patients with multiple stigmatized conditions may be differentially perceived in the eyes of medical students and may become (in)visible targets of discrimination in a healthcare setting. We discuss implications for enhancing awareness of social determinants of health and disease for a more representative, responsive and inclusive healthcare curriculum and practice.Weiterlesen
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