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Neue Studien
Data on the prevalence of sensitive skin in patients with chronic inflammatory skin diseases are lacking. The aim of this study was to address this gap.Methods
This observational study included patients with psoriasis, atopic dermatitis or chronic hand eczema who attended the Unit of Dermatology of Ferrara and Messina, Italy, between June and December 2023. All participants completed a 10-item questionnaire for the diagnosis of sensitive skin (score range: 0-10). Participants were classified as having sensitive skin if they scored ≥4.Results
A total of 188 subjects were included, of whom 82 had psoriasis (mean Psoriasis Area and Severity Index [PASI] 4.2±5.1), 59 had atopic dermatitis (Eczema Area and Severity Index [EASI] 3.5±6.7) and 47 had hand eczema (Hand Eczema Severity Index [HECSI] 39.3±3.26). The mean questionnaire scores were 2.6±2.4 for psoriasis, 4.7±2.9 for atopic dermatitis, and 3.0±2.1 for hand eczema, with significant differences observed between atopic dermatitis and both psoriasis (P<0.001) and hand eczema (P<0.001). The prevalence of sensitive skin was higher among atopic dermatitis patients compared to those with psoriasis (P<0.001) and hand eczema (P<0.01).Conclusions
In the present study, which should be regarded as a pilot due to the relatively small number of cases included, sensitive skin was both more prevalent and more severe in patients with atopic dermatitis compared to those with psoriasis and hand eczema. Atopic dermatitis appears to promote skin sensitivity, independently of its clinical severity.Weiterlesen
- 87 Aufrufe
Psoriasis is a chronic immune-mediated skin disease influenced by genetic, environmental, and lifestyle factors, with increasing burden among working-age adults.Objective
To examine global trends in psoriasis prevalence among working-age adults, evaluate associations with lifestyle factors using a simplified Life's Essential 4 (LE4) index, and explore potential dietary causal relationships through Mendelian randomization (MR).Methods
Global prevalence trends from 1990 to 2021 were analyzed using GBD 2021 data, calculating age-standardized rates (ASR) and estimated annual percentage changes (EAPC), with projections to 2031. Regional variations across SDI levels were also assessed. The LE4 index, derived from core lifestyle components of the Life's Essential 8 framework using NHANES data, was evaluated via survey-weighted logistic regression and restricted cubic spline analysis. Two-sample MR analyses were conducted using the inverse-variance weighted (IVW) method to assess dietary traits.Results
The global prevalence of psoriasis among working-age adults increased from 555.7 to 600.6 per 100,000 (EAPC: 0.22%), with projections reaching 631.6 by 2031; Notably, upward trends were consistently observed across all SDI regions. Higher LE4 scores (≥81.2) were associated with lower odds of psoriasis (OR: 0.518, P=0.040). MR analyses suggested that genetically predicted fizzy drink consumption increased risk (OR: 1.57, P=0.0215), whereas salad vegetable intake showed a protective association (OR: 0.85, P=0.0224).Conclusion
The burden of psoriasis among working-age adults shows a modest global increase with regional heterogeneity. Healthier lifestyle patterns and favorable dietary factors were associated with reduced risk, highlighting the importance of modifiable behaviors in prevention strategies.Weiterlesen
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To disentangle tobacco constituents in psoriasis, we contrasted nicotine exposure-proxied by the nicotine metabolite ratio (NMR)-with smoking intensity (cigarettes per day, CPD) and evaluated cross-ancestry effects.Methods
This study applied multivariable Mendelian randomization (MR) jointly modeling genetically proxied NMR (instrumented using variants from a European-ancestry GWAS) and CPD to estimate their independent effects on liability to psoriasis and psoriatic arthritis (PsA). Chronic obstructive pulmonary disease (COPD) served as a positive control. Cross-ancestry generalizability was tested using a trans-ethnic MR (TEMR) framework under conditional likelihood with Nelder-Mead optimization. Sensitivity analyses assessed pleiotropy, heterogeneity, directionality (Steiger), MRLap, RadialMR, and multiple testing (Benjamini-Hochberg).Results
NMR showed an independent association with higher PsA risk irrespective of CPD (OR = 1.104, 95% CI: 1.039-1.174). CPD retained an independent effect on overall psoriasis after conditioning on NMR (OR = 1.305, 95% CI: 1.082-1.573), while the NMR effect on psoriasis attenuated (P > 0.05). In univariable MR, genetically predicted NMR increased psoriasis risk in Europeans (EUR; OR = 1.032, 95% CI: 1.013-1.051). CPD associated with psoriasis in EUR (OR = 1.130, 95% CI: 1.031-1.239) and strongly in Hispanics (HIS; OR = 1.448, 95% CI: 1.434-1.463), with suggestive evidence in East Asians. Reverse-direction MR indicated psoriasis liability correlated with lower CPD across EUR, EAS, AFR, and HIS (β < 0, Padj < 0.05).Conclusion
This study supports ancestry-specific differences and suggests distinct roles of nicotine-related versus non-nicotine tobacco smoke constituents in psoriasis and its subtypes, while the underlying biological mechanisms remain to be clarified.Weiterlesen
- 79 Aufrufe
B-cell depleting therapies (BCDT), including ocrelizumab, ofatumumab, and ublituximab, are highly effective disease-modifying therapies for multiple sclerosis (MS). Several case reports have raised concerns about new-onset or exacerbation of psoriasis under BCDT.Objectives
This article aims to analyze clinical characteristics, treatment courses, and outcomes of MS patients who developed or experienced worsening of psoriasis during BCDT.Design
This retrospective, multicenter analysis included patients from four German university hospitals (Düsseldorf, Hannover, Bochum, Giessen).Methods
We retrospectively screened 3228 MS patients under BCDT between 2020 and 2024 for development of psoriasis or an exacerbation of a known psoriasis. Clinical data, including Expanded Disability Status Scale, Psoriasis Area and Severity Index scores, treatment regimens, and comorbidities, were analyzed.Results
Among 3228 patients treated with BCDT, 7 developed new-onset psoriasis and 10 showed exacerbation of preexisting psoriasis. The median time to psoriasis onset or worsening was 13 months (3-83 months) under continuous treatment with BCDT. Topical therapies were effective in most cases, but a change of MS treatment or initiation of psoriasis-specific immunotherapies, including the interleukin-17A-antibody secukinumab, was required in four patients.Conclusion
Psoriasis onset or worsening during BCDT is rare. While most cases are manageable with standard psoriasis treatments, severe cases may necessitate therapy adjustments. The potential immunological interplay between MS and psoriasis treatment warrants further investigation.Weiterlesen
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The rising incidence of inflammatory skin diseases, including psoriasis, has necessitated new treatment approaches. This paper focuses on the development of a hibiscetin-impregnated nanogel that reduces the severity of skin inflammation.Methods
Imiquimod (IMQ) was used to induce psoriasis-like inflammation in animal models, and the nanogel's worthiness was compared. Nanogel was prepared in different concentrations of hibiscetin, namely F1 (1) and F2 (2), and characterized in terms of appearance, size, charge, spreadability, pH, release kinetics of the drug, skin penetration and stability.Results
Lab analyses showed that the nanogel possessed desirable characteristics, with an average particle size of 205 nm, a polydispersity index (PDI) of 0.385, and a surface charge of -69.5 mV. Its morphology was confirmed to be spherical by scanning electron microscopy (SEM). The nanogel demonstrated powerful anti-inflammatory properties, including the disappearance of redness and skin thickening, reduced pro-inflammatory cytokine concentrations, reduced oxidative stress markers, and apoptosis-mediated cell death in vivo. Hibiscetin, as an effect of IMQ, also had a reparative effect on damaged skin as evidenced by histopathological studies.Conclusion
The results imply that hibiscetin-conjugated nanogels offer an option for improving the delivery and therapeutic efficacy of inherent compounds in the management of skin inflammation.Weiterlesen
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Psoriasis is a chronic, inflammatory and systemic skin disease. Currently, none of the treatment can effectively prevent the recurrent of psoriasis. α-Hederin is the main active ingredient of the traditional Chineses medicine Ivy, which has been proven to have anti-inflammatory effects. However, its effects on psoriasis and mechanisms of action remain unclear.Objective
This study aimed to investigate the effects of α-Hederin on murine psoriasis and its underlying mechanisms.Methods
This study firstly evaluated the therapeutic effects of α-Hederin on psoriasis using imiquimod-induced psoriatic mice. H&E and Ki67 immunohistochemical stainings were used to observe the pathological changes and proliferation of the skin lesions. The expression of inflammatory cytokines in skin lesions was analyzed by ELISA. Subsequently, the network pharmacology was employed to predict the molecular targets of α-Hederin in psoriasis. CXCL2 expression and neutrophil infiltration in skin lesions were evaluated via immunohistochemical staining, immunofluorescent staining and flow cytometry. Finally, the effects of α-Hederin on NF-κB p65 pathway were evaluated. The binding of α-Hederin to NF-κB p65 protein was verified through molecular docking, molecular dynamics simulation, CETSA and DARTS.Results
α-Hederin significantly improved IMQ-induced psoriasiform skin lesions and inflammation in mice. It also reduced the expression of CXCL2 and infiltration of CD11b+Ly6G+ neutrophils in the skin of psoriatic mice. Importantly, administration of recombinant CXCL2 protein aggravated the skin lesions and increased CD11b+Ly6G+ neutrophil infiltration in psoriatic mice previously treated with α-Hederin. Furthermore, α-Hederin inhibited the production of CXCL2 in HaCaT cells and migration of neutrophils to HaCaT cells. But these effects were completely reversed by the CU-T12-9, an NF-κB p65 agonist. Similarly, α-Hederin failed to further alleviate psoriasiform skin lesions and inflammation in mice treated with SC75741 (NF-κB p65 inhibitor). Finally, based on molecular docking, molecular dynamics simulation, CETSA and DARTS, NF-κB p65 was revealed as the direct target of α-Hederin in treating psoriasis.Conclusion
This study has provided the first evidence that α-Hederin may be a promising anti-psoriatic drug by inhibiting NF-κB p65/CXCL2 axis.Weiterlesen
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Durability of response to IL-17A blockade (secukinumab) varies, representing a major clinical challenge. Psoriasis is inherently linked to immunometabolic dysfunction. We hypothesized that simple, routine metabolic indices could predict long-term treatment stability, offering crucial pre-treatment stratification tools.Methods
This was a 52-week prospective, single-center cohort study of 118 patients with moderate-to-severe plaque psoriasis initiating secukinumab. We defined Durable Response (DR) as PASI90 at Week 12 maintained as absolute PASI ≤ 2 until Week 52. Multivariable logistic regression and Cox models were used to identify independent predictors of DR and drug survival.Results
Independent predictors of durable response were biologic-naïve status (adjusted OR = 3.52, 95% CI: 1.58-7.85) and a lower baseline TG/HDL-C ratio (adjusted OR = 0.61, 95% CI: 0.47-0.79). Conversely, obesity (BMI≥30) (OR = 0.42) and higher baseline PASI (OR = 0.91) were associated with reduced odds of DR. Conventional systemic inflammatory markers (CRP, NLR) showed no significant difference. Drug survival was significantly higher in DRs (92.6% vs 78.3% at Week 52) and was independently reduced by psoriatic arthritis.Conclusion
The routine baseline TG/HDL-C ratio is a strong, independent predictor of sustained secukinumab efficacy. These easily accessible clinical and metabolic features capture the immunometabolic milieu influencing IL-17A inhibition durability. Integrating the TG/HDL-C ratio into pre-treatment assessment can support patient stratification and optimize long-term management strategies for plaque psoriasis.Weiterlesen
- 91 Aufrufe
The traditional Chinese herbal medicine called Xiao-bi decoction (XBD) has been used for decades to treat psoriasis, but its mechanism of action is poorly understood.Aim of the study
To investigate the underlying mechanism of XBD against psoriasis using systematic pharmacological techniques.Materials and methods
A psoriasis model was established in mice using imiquimod (IMQ). The efficacy of XBD was evaluated based on psoriasis severity scores and immune cell infiltration. Core components and targets were screened using UPLC-QE-MS/MS and network pharmacology. The mechanism was further explored via transcriptome sequencing, ELISA, western blotting, immunolocalization, and molecular docking.Results
XBD treatment significantly alleviated IMQ-induced psoriatic symptoms like erythema, scaling, and thickening. It reduced CD4+ T cell infiltration in skin and decreased serum levels of IL-17, IL-1β, IL-23, and IL-36. XBD specifically decreased CD4+-IL-17+ cells while increasing CD4+-FoxP3+ cells in both blood and skin. A total of 1223 chemical components were identified in XBD, including 78 blood-entering components. Network pharmacology and transcriptome analysis collectively demonstrate that XBD inhibits the activation of the JAK2/STAT3 signaling pathway, indicating its potential role in modulating this pathway. Our results also showed that XBD modulated Th17/Treg balance in serum and ameliorating skin inflammation in IMQ-induced psoriatic model.Conclusion
The herbal medicine Xiao-bi decoction may regulate the JAK2/STAT3 pathway, thereby influencing the Th17 response and Treg differentiation, and thereby alleviating the skin inflammation of psoriasis.Weiterlesen
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Individuals with psoriasis (PsO) or psoriatic arthritis (PsA) have an elevated risk of major adverse cardiac events (MACE), which include congestive heart failure (CHF), myocardial infarction (MI), and cerebrovascular accident (CVA). Biologic disease-modifying antirheumatic drugs (bDMARDs) may reduce cardiovascular risk; however, whether MACE risk differs by bDMARD class for this population is unknown.Methods
Using data from TriNetX database, we identified patients with PsO/PsA who were new bDMARD users, including tumor necrosis factor inhibitors (TNFi), interleukin (IL)-17A inhibitors (-i), IL-23i, or IL-12/23i. Time-dependent risk for MACE was calculated using weighted multinomial Cox proportional hazards regression with TNFi exposure as the referent. Additional analyses evaluated components of the primary outcome and baseline cardiovascular disease. A negative control outcome was used to assess bias.Results
We identified 32,758 patients with PsO/PsA who were new bDMARD users. Patients had PsO/PsA for a mean of 3.5 (SD 4.5) years prior to starting a biologic, the most common being TNFi (62.9%), followed by IL-17i (15.4%), IL-23i (11%), and IL-12/23i (10.7%). In weighted multinomial Cox proportional hazards regression, the adjusted risk of MACE was similar for IL-17Ai (adjusted hazard ratio [aHR] 0.98, 95% CI 0.73-1.32), IL-23i (aHR 0.84, 95% CI 0.54-1.31), and IL-12/23i (aHR 1.08, 95% CI 0.80-1.47) as compared to TNFi. Subset analyses supported the primary analysis. Negative control outcomes suggested adequate control of bias confounding.Conclusion
MACE risk does not significantly differ across bDMARD classes in patients with PsO/PsA. Therefore, cardiovascular risk should not guide biologic selection in this population.Weiterlesen
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General Practitioners (GPs) act as primary gatekeepers for patients with psoriasis and their screening practice for cardiovascular disease (CVD) and psoriastic arhtiris (PsA) y. This study aimed to assess the awareness and screening routines of Danish GPs regarding CVD and PsA in patients with psoriasis.Methods
A nationwide cross-sectional survey on screening practice was conducted involving 490 randomly selected Danish GPs. Data were analyzed descriptively based on 101 responses (21% response rate).Results
The survey revealed a high level of awareness regarding CVD risk (84%), with 60% of GPs reporting routine screening for cardiovascular issues. Commonly assessed parameters included blood pressure (93%) and cholesterol (67%). Conversely, screening for PsA was notably less frequent, with only 32% of GPs actively screening for PsA.Conclusion
While screening and awareness of CVD risk among primary care professionals, PsA screening remains suboptimal. The findings suggest an urgent need for updated guidelines endorsing simple, validated PsA screening tools and targeted education to prevent missed opportunities for early diagnosis.Weiterlesen
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