Zu Inhalt springen
View in the app

A better way to browse. Learn more.
Psoriasis-News

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.

Neue Studien

Alle Kategorien zeigen

Biosimilars for the Treatment of Moderate to Severe Chronic Plaque Psoriasis.

Psoriasis is an immune-mediated chronic inflammatory skin disease affecting over 60 million adults and children worldwide and can occur at any age, from childhood to adulthood. If the patient has a diffuse form of psoriasis, affecting more than ten percent of the body surface, or involving sensitive areas such as the face, scalp, nails, and/or palmoplantar region, he or she is a candidate for systemic therapy. Currently, several drugs are approved for the treatment of moderate to severe chronic plaque psoriasis in Europe and US. These are classified into conventional systemics, biologics, and small molecules. These immunomodulatory agents are available in different forms of administration, such as oral, subcutaneous, and intravenous. Novel treatments, including biologics and small molecules, can provide reliable disease control with a good safety profile even in the long term and have greatly improved the quality of life for many patients. Nevertheless, biologics can be expensive, placing a significant burden on national healthcare systems and creating a barrier to access for patients in need of these life-changing therapies. A biosimilar drug is a biologic medical product that is highly similar to an already approved reference biologic drug (also known as the originator). Biosimilars have no clinically meaningful differences in terms of safety, purity, and efficacy compared to the reference product. Biosimilar drugs have been on the market-and therefore in clinical practice-for several years now, helping to overcome these challenges. Biosimilars have the potential to improve access to biologic therapies for psoriasis while reducing healthcare costs. The aim of this narrative review is to describe biosimilars and the potential cost-saving benefits their use can offer. In this review, we will discuss adalimumab, infliximab, etanercept, and ustekinumab, as well as their corresponding biosimilars.Weiterlesen
  • 299 Aufrufe
Redaktion

Development and Validation of an Artificial Intelligence-Driven Model for Accurate Classification of Erythrodermic Psoriasis Severity: Erythrodermic Psoriasis Integrated Classification System (EPICS).

Erythrodermic psoriasis is a rare subtype of psoriasis with widespread skin lesions, with some patients experiencing severe systemic symptoms. We aimed to develop and validate an artificial intelligence-driven model for accurate classification of erythrodermic psoriasis severity by integrating clinical and laboratory indicators. A retrospective cohort study was conducted at Peking Union Medical College Hospital (2005-22). Patients were divided into mild and moderate-to-severe groups using k-means clustering. After imputing missing values, we trained seven candidate algorithms-K-Nearest Neighbors, Artificial Neural Network, Random Forest, Extreme Gradient Boosting, Support Vector Machine, Bayesian classifier, and logistic regression-using repeated, stratified ten-fold cross-validation with three repeats (10 × 3 CV); performance was summarized by the mean area under the receiver operating characteristic curve across folds. Feature importance was assessed using SHAP (Shapley Additive exPlanations), a game-theoretic approach that quantifies each features contribution to individual model predictions, ten indicators were incorporated into a diagnostic scoring system. The optimal cut-off for mild/moderate-to-severe cases classification was selected with the Youden index on the cross-validated receiver operating characteristic curve. Of 260 screened records, 242 erythrodermic patients met the study criteria. Histology confirmed psoriasis in 108 cases, while the remaining patients were diagnosed based on clinical presentation and medical history. K-means clustering assigned 94 patients to the moderate-to-severe group and 148 to the mild group. Moderate-to-severe erythrodermic psoriasis was characterized by a higher inflammatory burden (median neutrophil-to-lymphocyte ratio 4.11 vs 2.70, p < 0.001), more frequent fever (88% vs 41%, p < 0.001), greater edema severity (16% vs 1.4%, p < 0.001), lower albumin and higher calcium levels (both p < 0.001), and longer hospitalization (median 26 vs 20 days, p = 0.005). After adjustment for age and sex, moderate-to-severe cases required systemic therapy roughly twice as often as mild cases (odds ratio 2.21, p < 0.05). Of seven machine-learning algorithms, the Artificial Neural Network yielded the highest mean validation area under the curve. The SHAP analysis highlighted the ten most influential predictors adopted from the Artificial Neural Network-edema, edematous erythema (defined as the combination of both redness and swelling of the skin), fever, albumin, neutrophil-to-lymphocyte ratio, serum calcium, white blood cell count, acute-phase reactants (C-reactive protein or erythrocyte sedimentation rate), pruritus, and superficial lymphadenopathy-and these were converted to integer points to form the bedside score. The receiver operating characteristic analysis identified 33.5 points as the optimal threshold for distinguishing between mild and moderate-to-severe cases. The model, named 'EPICS' (Erythrodermic Psoriasis Integrated Classification System), effectively stratified patients, as evidenced by internal validation. This model is currently available online ( https://pumch-dermatology.shinyapps.io/classification/ ). The EPICS model is a robust tool for assessing erythrodermic psoriasis severity, offering precise classification based on easily accessible clinical and laboratory indicators. However, its effectiveness in clinical practice requires further validation through additional research.Weiterlesen
  • 286 Aufrufe
Redaktion

The role of psychological stress in the pathogenesis of psoriasis.

Psoriasis is an immune-mediated dermatosis characterized by systemic inflammation and multifactorial pathogenesis. Among its many triggers, psychological stress has emerged as a pivotal yet underappreciated contributor to disease onset and exacerbation. Although the pathomechanisms by which psychological stress is involved in the pathogenesis of psoriasis are not clear, evidence suggests a regulatory role of psychologic stress in immune functions, including increasing expression levels of proinflammatory cytokines and intracellular adhesion molecule-1 (ICAM-1), and decreasing anti-inflammatory cytokines and the function of glucocorticoid receptors, possibly in part via activation of corticotropin-releasing hormone (CRH)-proopiomelanocortin (POMC)-adrenocorticotropic hormone (ACTH)-corticosteroids axis. In addition, the onset and/or worsening of psoriasis can also be attributed to psychological stress-induced defective epidermal permeability barrier function. Moreover, the bidirectional nature of this relationship often leads to a vicious cycle of flare-ups and psychological distress, further complicating patient management and quality of life. This review aims to synthesize current evidence on the relationship between stress and psoriasis, examining mechanistic pathways through which psychosocial stress contributes to immune dysregulation in psoriatic pathology. It also underscores the significance of psychological interventions in the management of psoriasis.Weiterlesen
  • 298 Aufrufe
Redaktion

Leveraging Pixel-wise Embeddings for Segmenting Psoriasis Lesion Areas

Abstract In the context of psoriasis lesion segmentation, traditional methods in image segmentation, including region-based approaches like Mask R-CNN, have shown notable success. However, the problem of segmenting irregular and intricate biological structures such as psoriasis lesions presents significant challenges that cannot be effectively captured by standard bounding box approximations. This paper explores the potential of transforming psoriasis lesion segmentation into pixel labeling tasks, which promise greater efficiency and integration with modern image-to-image networks widely used across various domains. We investigate the limitations of convolutional-based architectures in generating dense pixel embeddings capable of distinguishing individual lesions. Through both theoretical analysis and empirical evidence, we propose a novel approach that leverages semi-convolutional operations. These modifications, which introduce spatially guided pixel embeddings, offer substantial improvements over traditional methods and demonstrate their applicability to the segmentation of complex biological forms. By drawing connections to advanced techniques such as Hough voting and bilateral kernels steered by convolutional networks, we show that these methods significantly enhance the segmentation accuracy of psoriasis lesions, outperforming conventional region-based models like Mask R-CNN in terms of precision and adaptability to irregular shapes.
Weiterlesen
  • 278 Aufrufe
Redaktion

Association Between Alcohol Consumption and Psoriasis: Exploratory Analysis of Crowdsourced Web Search Data in Sweden.

The nature of the relationship between psoriasis and alcohol consumption has been the topic of discussion for many years. Some studies have found that a higher intake of alcohol may be associated with a more severe manifestation of the disease. At the same time, patients with psoriasis often demonstrate elevated levels of alcohol consumption. It has not yet been fully established whether alcohol abuse serves as a trigger for psoriasis or if patients with psoriasis are simultaneously more prone to alcohol abuse. The objective of this study was to employ Google Trends as a tool for crowdsourcing data on a national level to explore the relationship between psoriasis and the consumption of alcohol in Sweden. This study examines crowdsourced web search data related to psoriasis and other skin disease-related search terms (such as utslag [rash]) as well as search interest in different types of alcohol. The analysis covers a 5-year period from 2018 to 2023 in Sweden, focusing on search behavior and correlations across this period. The search behavior regarding psoriasis and alcohol-related search terms showed seasonal variations throughout the year. The relative search volume for psoriasis peaked in February, while alcohol-related searches, particularly Systembolaget and vodka, peaked in December and June. Our statistical analysis revealed relationships between the search interest regarding psoriasis and terms related to alcohol consumption, with disparities between different types of alcohol. The term "psoriasis" was negatively correlated with "Systembolaget" (r=-0.210), "vitt vin" (r=-0.224), and "vodka" (r=-0.220) (all P<.001), while the term "utslag" showed positive correlations with these same alcohol-related terms (r=0.278-0.347; P<.001). Crowdsourced data can offer valuable insights into population-level behavior. The observed negative correlations between psoriasis and alcohol-related searches suggest complex interactions, possibly reflecting reduced disease awareness or care during periods of higher alcohol consumption. The direction and strength of the correlations with psoriasis were not consistent across the different types of alcohol investigated in this study, which poses the question whether the relationship might be influenced by the type of beverage consumed. Further research is warranted to explore underlying mechanisms and validate these findings in clinical populations.Weiterlesen
  • 110 Aufrufe
Redaktion

Efficacy of risankizumab across GRAPPA domains in psoriatic arthritis: a pooled analysis of patients from the phase 3 KEEPsAKE 1 and 2 studies.

To assess the efficacy of long-term treatment with risankizumab across the updated Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) domains and key related conditions of psoriatic arthritis (PsA). This post hoc analysis primarily used data from the phase 3 KEEPsAKE 1 trial of adult patients with PsA, with data from KEEPsAKE 2 pooled for prespecified outcomes. Outcomes measuring risankizumab efficacy across key GRAPPA-recognised domains of PsA (peripheral arthritis, enthesitis, dactylitis, skin and nail psoriasis, axial disease) and PsA-related conditions such as inflammatory bowel disease (IBD) and uveitis were assessed over 100 weeks of treatment (~2 years). Statistical approaches included non-responder imputation (as-observed with imputation) for categorical variables and mixed-effect model for repeated measures for continuous variables including as-observed measurements at all visits. PsA-related conditions were evaluated via adverse events through 100 weeks. Overall, in KEEPsAKE 1 and KEEPsAKE 2, 412/483 (85.3%) and 181/224 (80.8%) of patients randomised to risankizumab completed treatment to week 100. Risankizumab demonstrated efficacy across all GRAPPA-defined domains through 100 weeks, including swollen and tender joint counts, enthesitis, dactylitis, skin and nail outcomes, and axial disease. In KEEPsAKE 1, 42.4% of patients had achieved a Disease Activity in Psoriatic Arthritis measurement of low disease activity and 62.9% had reached a minimal clinically important difference in pain at week 100. Rates of new onset or flare of IBD and uveitis were low. Treatment with risankizumab provides durable improvement in the signs and symptoms of PsA across all GRAPPA disease domains and related conditions.Weiterlesen
  • 284 Aufrufe
Redaktion

Trifolirhizin improves the hyperproliferation and excessive inflammatory response in human HaCaT keratinocytes and ameliorates skin lesions in psoriasis-like mouse models.

Keratinocyte hyperproliferation and excessive inflammatory responses are associated with psoriasis pathogenesis. Trifolirhizin has anti-inflammatory and anti-proliferation effects. The purpose of the study was to investigate the role of trifolirhizin in psoriasis-like skin lesions and its molecular mechanism. Imiquimod-induced psoriasis-like mouse models were treated with trifolirhizin. Skin lesions and inflammatory factors were assessed. In vitro, human HaCaT keratinocytes were stimulated by a mixture of interleukin (IL)-1α, IL-17, IL-22, tumor necrosis factor (TNF)-α, and oncostatin M (M5) to establish a psoriatic keratinocyte model. Cell viability and cycle were assessed via CCK-8 assay and flow cytometry. Inflammatory factors, autophagy levels, and AMPK-mTOR pathway activation were detected by western blot. Trifolirhizin dose-dependently inhibited epidermal layer erythema, scaling, and thickening and reduced epidermal thickness and IL-12 level in an imiquimod-induced psoriasis-like mouse model. Trifolirhizin also inhibited cell viability, PCNA expression, and excessive synthesis and secretion of IL-8 and IL-12 in HaCaT keratinocytes induced by M5. Furthermore, the inhibition of autophagy and AMPK-mTOR pathway could be reversed by trifolirhizin in M5-induced HaCaT keratinocytes and skin lesions from imiquimod-mediated psoriasis-like mouse model. The improvement effects of trifolirhizin could be inhibited by the autophagy inhibitor chloroquine. Trifolirhizin up-regulated autophagy through the AMPK-mTOR pathway, improved the hyperproliferation and excessive inflammatory responses of keratinocytes, thus alleviating psoriatic skin lesions. Trifolirhizin may have therapeutic potential in improving the progression of psoriasis.Weiterlesen
  • 263 Aufrufe
Redaktion

Long-term Safety and Efficacy of Ixekizumab in Patients With Moderate to Severe Psoriasis – a Systematic Review of Randomised Controlled Trials

Abstract Background This systematic review evaluates the efficacy, safety, and tolerability of ixekizumab (IXE), an anti-IL 17A monoclonal antibody, in treating moderate to severe psoriasis. Methods A comprehensive search of PubMed and Scopus using the terms ‘ixekizumab’ and ‘psoriasis’ was conducted. This study was registered in PROSPERO (CRD42024539975) and followed the PRISMA guidelines for reporting systematic reviews. Inclusion criteria encompassed randomised clinical trials assessing the efficacy and safety/tolerability of ixekizumab for moderate-to-severe psoriasis, published from inception until April 2024. Case reports, conference papers, and observational studies were excluded. A total of 5 studies (6 randomised controlled trials) with 4705 participants met the selection criteria out of 1172 search results. The risk of bias was assessed among the selected studies using the RoBViS tool. Results The standardised dosing regimen of ixekizumab demonstrated superior efficacy compared to placebo in improving Psoriasis Area and Severity Index (PASI) from baseline and Static Physician Global Assessment (sPGA) across most of the included studies. No significant difference in efficacy was observed when comparing ixekizumab with ustekinumab in a survey conducted by Reich et al. Most adverse events were mild, although some serious ones were reported. Conclusion Ixekizumab, a monoclonal antibody approved for treating moderate to severe psoriasis, exhibits a superior safety profile comparable to other biologics used in psoriasis. However, its widespread usage in psoriasis is still relatively less than conventional non-selective immunomodulatory agents.
Weiterlesen
  • 259 Aufrufe
Redaktion

Relative sensitivity and preference of indicators in pharmaceutical trials of psoriasis and psoriatic arthritis.

Numerous indicators have been proposed to evaluate the efficacy for randomized clinical trials (RCTs) of psoriasis (Pso) and psoriatic arthritis (PsA), but their comparability and correlation remain unknown. We aim to evaluate the preference and relative sensitivity of the most widely used indicators that report response rate, and to offer guidance for the primary endpoint selection for Pso and PsA trials. We conducted a systematic search, including five databases and four registries, to identify all pharmacological intervention-controlled RCTs. A Bayesian hierarchical linear mixed model was employed to assess relative discriminations and provide a ranking of these indicators. This model, considered the gold standard for sparse and heterogeneous data, was applied to estimate differences between control and intervention groups and assess the preference and relative sensitivity of outcome indicators in Pso and PsA. Altogether, 386 RCTs met our inclusion criteria. We included 9 and 8 commonly used response rate indicators for Pso and PsA trials, respectively, all of which were treated as primary endpoints. We found evidence of significant differences among indicators. PASI 50, PASI 75 and IGA 0,1 proved to be robust indicators for assessing pharmacological efficacy in the majority of RCTs of Pso. Conversely, PASI 125, DIQI 0,1 and NRS-4 were not preferred under different circumstances. Furthermore, PASI 50, PASI 75 and PASI 90 appeared to be highly effective in almost all categories of pharmacological RCTs of PsA. However, due to their extreme sensitivity, it was advisable to use ACR 20 to prevent an overestimation of the therapeutic benefits of interventions. ACR 50, ACR 70 and MDA were less sensitive, but they were supposed to be more cautious in evaluating disease changing. The choice of indicators was slightly influenced by disease severity, intervention type and administration method. The notable efficacy discrimination ability of indicators underscores the importance of flexibility and comprehensiveness in selecting primary outcome(s). Our findings provide practical implications for optimizing indicator selection in future trial design, ensuring better alignment with trial objectives and disease characteristics. PROSPERO number: CRD42022337725.Weiterlesen
  • 250 Aufrufe
Redaktion

Toward Harmonized Recommendations for Psoriatic Arthritis: A Comparative Viewpoint on Global Guidelines.

Objective
Psoriatic arthritis (PsA) guidelines aim to provide consistent, evidence-based recommendations. Multiple regional guidelines exist, often based on similar evidence but with different methodologies and contexts. Our aim was to compare recent PsA treatment guidelines from the American College of Rheumatology, Group for Research and Assessment of Psoriasis and Psoriatic Arthritis, European Alliance of Associations for Rheumatology, and Pan American League of Associations for Rheumatology, identifying similarities, differences, and opportunities for global harmonization with regional adaptation.Methods
Narrative comparative review of guideline documents published between 2018 and 2024 by major rheumatology societies was performed. Data on methodology, panel composition, treatment domains, pharmacologic recommendations, and update strategies were extracted and synthesized.Results
Guidelines share core principles, including domain-based approaches, treat-to-target strategies, and the use of conventional synthetic disease-modifying antirheumatic drugs and biologics. Differences arise from methodological frameworks (eg, GRADE [Grading of Recommendations Assessment, Development, and Evaluation], domain-based, adolopment), stakeholder composition, and explicit consideration of regional drug access.Conclusion
A hybrid framework combining global core recommendations with modular regional adaptations may optimize resource use, improve guideline sustainability, and maintain local relevance. Living systematic reviews and artificial intelligence could support more timely updates.Weiterlesen
  • 149 Aufrufe
Redaktion

The Skin-Brain Axis in Psoriasis and Depression: Roles of Inflammation, Hormones, Neuroendocrine Pathways, Neuropeptides, and the Microbiome.

Psoriasis, a common chronic inflammatory skin disease affecting approximately 2-3% of the global population, frequently co-occurs with depression. This highly prevalent comorbidity significantly impairs patients' quality of life. Despite the substantial physical and mental health burden imposed by psoriatic depression, the underlying pathophysiological mechanisms connecting psoriasis and depression remain poorly understood. In this review, we explored several pathological processes that may contribute to psoriasis-associated depression, including immune cells dysregulations, hormones imbalances, hypothalamic-pituitary-adrenal (HPA) axis dysfunctions, neuropeptides expression abnormalities, and gut dysbiosis. The primary purpose of this review was to present a comprehensive overview of the pathogenic mechanisms linking psoriasis and depression. These insights may guide trans-disciplinary interventions aimed at both skin and mood symptoms.Weiterlesen
  • 145 Aufrufe
Redaktion

Successful guselkumab treatment for a psoriasis patient experiencing an adrenal crisis: a case report.

Prolonged glucocorticoid therapy may lead to adrenal insufficiency (AI) or even adrenal crisis (AC) due to suppression of the hypothalamic-pituitary-adrenal (HPA) axis. This case report describes a male patient with psoriasis who had received long-term irregular glucocorticoid therapy for psoriasis management. Following an upper respiratory tract infection, the patient developed generalized skin lesions accompanied by systemic symptoms including abdominal pain, vomiting, fatigue, fever, and lethargy. After multiple misdiagnoses, the patient was ultimately diagnosed with psoriasis complicated by AC. The patient was subjected to guselkumab combined with glucocorticoid therapy for the treatment of psoriasis and AC. After 6 months, complete resolution of skin lesions was achieved, and adrenal function returned to normal. Dermatologists should be aware of the potential for AI when prescribing glucocorticoids (topical or systemic) to treat psoriasis. Guselkumab represents a viable therapeutic option for psoriasis patients with concurrent AI/AC.Weiterlesen
  • 123 Aufrufe
Redaktion

Clinical efficacy of 308 nm excimer laser irradiation combined with 0.1% tacrolimus ointment in the treatment of plaque-type psoriasis.

Plaque psoriasis is an immune-mediated chronic recurrent skin disease. In recent years, 308 nm excimer laser (308 nm EL) and topical tacrolimus have been widely used to treat psoriasis. The purpose of this study was to evaluate the efficacy of 308 nm EL irradiation combined with 0.1% tacrolimus ointment in the treatment of plaque psoriasis. This study was a retrospective observational study involving 100 patients with plaque psoriasis, divided into two groups: the control group (50 cases) was treated with 0.1% tacrolimus ointment; the observation group (50 cases) was treated with 308 nm EL and 0.1% tacrolimus ointment. After eight weeks of treatment, the psoriasis area and severity index (PASI) of the two groups were compared, and the occurrence of adverse reactions during treatment was recorded. Before treatment, there was no significant difference in PASI scores between the two groups (p > 0.05). However, the PASI scores of the two groups were significantly lower after treatment than before treatment, and the PASI scores of the observation group after treatment were lower than those of the control group (p < 0.05). No serious adverse reactions occurred in either group. 308 nm EL irradiation combined with 0.1% tacrolimus ointment could be considered a safe and effective method for the treatment of plaque psoriasis, which can significantly reduce the PASI score and is more effective than the use of 0.1% tacrolimus ointment alone, and it is expected to be popularized in the clinic.Weiterlesen
  • 400 Aufrufe
Redaktion

Characterising Alternative Diagnoses to Psoriatic Arthritis in a Rheumatology-Dermatology Combined Clinic.

Psoriatic arthritis (PsA) is a chronic inflammatory arthritis involving axial and peripheral joints and tendons that affects a subset of patients with psoriasis (PsO). PsA can be a debilitating disease and warrants prompt rheumatologic evaluation and management. The diagnosis of PsA can be challenging for the practising dermatologist as there is often an overlap in the symptoms of PsA and non-inflammatory musculoskeletal conditions such as osteoarthritis, tendonitis and myofascial pain. The primary aim of the study is to examine psoriasis patients seen at our tertiary institution's combined rheum-derm clinic for a concern for PsA, specifically examining the revised diagnosis and the joint symptom similarities to psoriatic arthritis. We performed a retrospective chart review of patients referred to the rheumatology-dermatology clinic (RDC) at our institution between November 2019 and March 2022. Our review included 242 patients, of which 34 (14%) were psoriasis patients specifically referred due to suspicion for PsA. Each patient underwent a comprehensive rheumatic evaluation, including history, physical examination, laboratory tests and imaging as needed. Fourteen (41.2%) of the 34 patients referred for suspected PsA were diagnosed with non-inflammatory musculoskeletal conditions, primarily mechanical joint pain. Stiffness and/or swelling were significantly more common among patients with confirmed PsA. These findings underscore the importance of thorough evaluation of musculoskeletal symptoms, particularly stiffness and swelling, in patients with psoriasis. Improving education on distinguishing non-inflammatory musculoskeletal conditions may enhance diagnostic accuracy and optimise referral practices.Weiterlesen
  • 184 Aufrufe
Redaktion

Causal Effect of Plasma Fatty Acid Profiles on Psoriasis Risk: Genetic Evidence from a Mendelian Randomization Study.

Emerging evidence indicates that omega-3 fatty acids from fish oil may serve as beneficial dietary supplements for psoriasis management. Clinical observations demonstrate a significant association between psoriasis improvement and increased docosahexaenoic acid (DHA) levels. However, the causal relationship between fatty acids and psoriasis risk requires further investigation. Using summary-level genome-wide association study (GWAS) data, we applied univariable (UVMR), reverse, and multivariable (MVMR) Mendelian randomization analyses to assess causal effects of multiple fatty acids-including polyunsaturated (PUFA), saturated (SFA), monounsaturated (MUFA), omega-3/6 fatty acids, DHA, eicosapentaenoate (EPA) and docosapentaenoate (DPA)-on psoriasis risk. The analysis revealed that higher circulating levels of omega-3 fatty acids were significantly associated with a reduced risk of psoriasis development (UVMR: OR = 0.900, p = 0.022; MVMR: OR = 0.862, p = 0.007). Sensitivity analyses supported the robustness of this causal relationship, with consistent effects across multiple MR methods. Notably, DHA (UVMR: OR = 0.788, p = 0.006; MVMR: OR = 0.856, p = 0.021) drove this inverse association, while EPA and DPA showed marginal contributions. This study provides valuable insights for targeted nutritional strategies to prevent and manage psoriasis, but further validation is needed.Weiterlesen
  • 156 Aufrufe
Redaktion

Composite Outcome Measures for Psoriatic Arthritis: Project Updates 2024.

J Rheumatol 2025; doi: 10.3899/jrheum.2025-0268 The affiliation for Tommy Kok Annfeldt should be Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark. This correction applies only to the August 5 First Release. The correct affiliation appears in the print and online issues. doi: 10.3899/jrheum.2025-0268.C1.Weiterlesen
  • 182 Aufrufe
Redaktion

Generalized Pustular Psoriasis

Pustular psoriasis is a rare and severe variant of psoriasis characterized by the eruption of sterile pustules, which may present in distinct clinical patterns. The pathologic features of psoriasis, including keratinocyte hyperproliferation, neutrophilic infiltration, and immune dysregulation, are markedly accentuated. Generalized pustular psoriasis (GPP) displays clinical heterogeneity in age of onset, severity, and disease course. Several overlapping phenotypes are recognized. A variable relationship exists between GPP and plaque psoriasis. Some individuals experience plaque psoriasis before or after GPP episodes, while others exhibit GPP as the sole phenotype without any history of plaque involvement (see Image. Pustular Psoriasis).Weiterlesen
  • 196 Aufrufe
Redaktion

Beyond Skin Clearance: Personalized Strategies for DLQI Improvement in Psoriasis -Insights From a Shanghai Prospective Cohort.

Introduction
Psoriasis is a chronic immune-mediated disease that significantly impacts patients clinically and psychologically. Physician-assessed severity measures, including Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), and Physician Global Assessment (PGA), often fail to capture patient-reported outcomes, particularly when clinical improvement and perceived quality-of-life gains are misaligned.Purpose
To clarify the association between clinical improvements and Dermatology Life Quality Index (DLQI) outcomes, identify predictors of substantial DLQI improvement (≥90% reduction), and explore reasons for suboptimal DLQI responses in patients achieving skin clearance.Methods
In this 12-week prospective study, 551 psoriasis patients were enrolled at Shanghai Skin Diseases Hospital. Data on demographics, clinical severity (PASI, BSA, and PGA), DLQI scores, and treatment modalities were collected. Logistic regression analyses were employed to assess the dose-response relationships between improvements in clinical parameters and DLQI reduction, and to identify factors of suboptimal DLQI improvement among patients achieving significant skin clearance.Results
Median DLQI improved significantly (8.0 to 3.0) at week 12, with 24.1% of patients achieving ≥90% DLQI reduction. Strong dose-response associations existed between clinical severity improvements (PASI, BSA, PGA) and DLQI gains. PASI75 responders were significantly more likely to achieve substantial DLQI improvement (OR = 2.48, 95% CI: 1.51-4.07). However, only 33.3% of PASI75 achievers reached ≥90% DLQI improvement. Early clinical response (as early as week 4) strongly predicted superior DLQI outcomes. Female sex, older age, lower baseline DLQI scores, and shorter disease duration were associated with achieving high skin clearance but suboptimal DLQI improvement.Conclusion
Early clinical response effectively predicts substantial DLQI improvement, whereas demographic and disease-related factors help identify patients at risk for suboptimal quality-of-life gains despite significant skin clearance. These insights support personalized therapeutic strategies aimed at improving patient satisfaction beyond skin clearance alone.Weiterlesen
  • 191 Aufrufe
Redaktion

Exosome mediated delivery of Epigallocatechin 3 gallate as a novel approach to alleviate psoriasis symptoms through cytokine and apoptotic pathway modulation.

Psoriasis is a chronic skin disorder with significant individual and societal impacts. Current therapies often lack efficacy, are costly, or cause side effects, necessitating new treatments. This study explores regenerative therapies-exosomes, mesenchymal stem cells (MSCs), epigallocatechin-3-gallate nanoparticles (EGN), and EGN-loaded exosomes (EGN-Exo)-in regulating psoriasis-related markers (IL-6, IL-4, Bcl-2, Bax, NF-κB, CDC25B). An imiquimod-induced psoriasis model in Wistar rats was used, with six groups: negative control, positive control, and treatments (MSCs, exosomes, EGN, EGN-Exo). After seven days, ELISA revealed EGN-Exo most effectively reduced pro-inflammatory IL-6 and pro-apoptotic Bax while increasing anti-inflammatory IL-4 and anti-apoptotic Bcl-2. EGN-Exo also significantly lowered NF-κB and CDC25B, demonstrating superior anti-inflammatory effects. Apoptosis profiling showed EGN-Exo reduced late apoptotic cells, highlighting cytoprotective abilities. EGN had a moderate effect, while MSCs and exosomes showed modest improvements. Histopathological and immunohistochemical analyses confirmed EGN-Exo's efficacy, notably reducing TGF-β expression. These findings suggest EGN-Exo combines EGCG's antioxidant and anti-inflammatory properties with exosomes' targeted delivery, offering a promising advanced therapy for psoriasis.Weiterlesen
  • 193 Aufrufe
Redaktion

Risk of Serious Infection With Adalimumab in Hidradenitis Suppurativa Compared With Psoriasis.

Previous research suggests that patients with hidradenitis suppurativa (HS) may face a higher risk of serious infections compared with those with psoriasis. However, these studies are subject to limitations that could constrain their reliability. To compare the risk of hospitalization from noncutaneous infections, infection profiles, and the length of stay (LOS) of adult patients with HS and psoriasis treated with adalimumab. This retrospective cohort study was conducted using deidentified claims data from the MarketScan database. All adult patients with HS or psoriasis who initiated adalimumab therapy between January 2017 and December 2020 were included. Data were analyzed from October 2023 to March 2024. New users of adalimumab diagnosed with psoriasis or HS, identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes and adalimumab prescriptions. The primary outcome was hospitalization from noncutaneous infections in a time-to-event analysis using inverse probability weighting to account for confounders in the Cox regression models. Secondary outcomes included the infection types compared using incidence rate ratios and LOS analyzed with multivariable Poisson regression. Of 10 349 included patients, 5641 (54.5%) were female, and the mean (SD) age was 44.8 (12.8) years. The cohort included 1650 patients with HS and 8699 with psoriasis. The HS cohort was younger (mean [SD] age, 36.2 [11.5] years vs 46.5 [12.4] years) and predominantly female (1271 [77.0%] vs 4370 [50.2%]), with higher rates of obesity, Crohn disease, anxiety, and depression. The weighted Cox analysis indicated an increased risk of serious infection in patients with HS (hazard ratio, 1.53; 95% CI, 1.34-1.86). This group also had a higher likelihood of sepsis and genitourinary infections (sepsis: incidence rate ratio, 2.07; 95% CI, 1.35-3.12; genitourinary infections: incidence rate ratio, 2.22; 95% CI, 1.22-3.86) and greater odds of prolonged LOS (odds ratio, 1.28; 95% CI, 1.13-1.45) compared with the psoriasis cohort. In this cohort study, among adults treated with adalimumab, those with moderate to severe HS had an elevated risk of infection and different infection profiles compared with those with psoriasis. Future research should focus on the impacts of disease severity and treatment regimens on infection risk and develop targeted prevention strategies.Weiterlesen
  • 184 Aufrufe
Redaktion

Impact of psoriasis on THA and TKA outcomes: A systematic review.

Psoriasis is an autoimmune inflammatory condition that often intersects with orthopaedic care due to its connection to psoriatic arthritis. However, not all psoriasis patients develop psoriatic arthritis. Psoriasis patients may undergo hip or knee arthroplasties for reasons unrelated to psoriasis. This condition, marked by inflamed, scaly skin caused by an overactive immune system, may pose challenges for orthopaedic surgeries. This systematic review evaluated outcomes for psoriasis patients after total hip arthroplasty (THA) or total knee arthroplasty (TKA), focusing on postsurgical impact to inform additional considerations for patients. Following PRISMA guidelines, a systematic search was conducted in Medline, Embase, Web of Science, and Cochrane (up to October 2024). Studies involving patients with psoriasis undergoing THA or TKA were analyzed for postoperative outcomes. 359 studies were screened, 7 met inclusion criteria. Two studies focused on THA, three on TKA, and two examined both procedures. Patients with psoriasis undergoing THA showed increased risk of infections compared to non-psoriasis patients. For TKA, results were mixed in whether psoriasis led to higher infection rates. Psoriasis did not lead to increased revisions in both THA and TKA. Additionally, two studies found no significant differences in wound complications in TKA patients. This systematic review underscores the importance of considering post-surgical complications in psoriasis patients undergoing either a THA or TKA. However, lack of research makes it difficult to generalize findings. Psoriasis is an important factor to consider for surgical outcomes, but further research is needed to clarify risks and optimize care for patients.Weiterlesen
  • 191 Aufrufe
Redaktion

Configure browser push notifications
Chrome (Android)
  1. Tap the lock icon next to the address bar.
  2. Tap Permissions → Notifications.
  3. Adjust your preference.
Chrome (Desktop)
  1. Click the padlock icon in the address bar.
  2. Select Site settings.
  3. Find Notifications and adjust your preference.