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  2. Cureus. 2024 May 9;16(5):e59969. doi: 10.7759/cureus.59969. eCollection 2024 May. ABSTRACT Background Psoriasis is a chronic inflammatory skin disease with multiple organ manifestations such as arthritis and cardiovascular diseases. While recent therapeutic advancements in systemic biologics have demonstrated efficacy against psoriasis, a complete cure has not been achieved and patients require lifelong treatment to control symptoms. Objective This study aimed to clarify the clinical characteristics of psoriasis patients treated with biologics at an extended interval. Methods This study included patients with psoriasis who were administered biologic therapy for longer than the standard interval (at least a week) and who objectively maintained favorable conditions (static Physician's Global Assessment ≤ 0 to 1). Clinical characteristics, such as body weight (BW), body mass index (BMI), and body fat percentage, were compared to those of patients who were administered biologic therapy at standard intervals. Results Among 162 Japanese patients with psoriasis, 35 were treated with biologics at extended intervals. In the group with extended treatment intervals, patients treated with interleukin (IL)-17 inhibitors (n = 15) presented statistically lower BMI than those treated with IL-23 inhibitors (n = 17) (P < 0.016). The group treated with IL-17 inhibitors at extended intervals showed significantly lower BMI and body fat percentage than the group at standard intervals (P < 0.05). Conclusion Trends in our hospital suggest that psoriasis patients with low BMI and body fat percentage can maintain good status with extended interleukin (IL)-17 inhibitor dosing intervals (static Physician's Global Assessment ≤ 0 to 1). PMID:38854182 | PMC:PMC11162148 | DOI:10.7759/cureus.59969 Den ganzen Artikel lesen
  3. Cureus. 2024 May 8;16(5):e59878. doi: 10.7759/cureus.59878. eCollection 2024 May. ABSTRACT Background Psoriasis is a papulosquamous disease with variable morphology, distribution, severity, and course. Chronic plaque psoriasis, or psoriasis vulgaris, is the most common form of psoriasis. Present available preparations for mild to moderate chronic plaque psoriasis for topical use are local corticosteroids, coal tar, dithranol, tazarotene, calcipotriol, tapinarof, and calcineurin inhibitors. However, every preparation has its disadvantages. Calcipotriol, an active form of vitamin D, is available in topical form for dermatological use. Chronic plaque psoriasis is the chief medical use of calcipotriol for mild to moderate form. Methotrexate has dramatic results in psoriasis when used systemically. Now, topical formulation is being advocated in localized psoriasis, which is not associated with the side effects of the systemic form. Therefore, this study aimed to compare the effectiveness of topical calcipotriol and topical methotrexate on the basis of the psoriasis area severity index (PASI) in patients of chronic plaque psoriasis and compare their safety in terms of adverse effects. Methodology The total number of patients included in the study was 60. They were divided into two groups, with 30 patients each. One group was prescribed ointment calcipotriol 0.005% twice daily local application (Group C). The other group was prescribed methotrexate gel 1% twice daily local application (Group M). The patients were followed up on the fourth and eighth weeks, and at each time, thorough clinical examinations were conducted for all patients. The PASI score was calculated in each patient every time. Safety was assessed by biochemical parameters, and tolerability was assessed by the incidence of adverse effects. All the patients included in the study were investigated at baseline, fourth week, and eighth week. The data collected were transferred to a master chart and analyzed. Results For the patients in group C, the mean PASI score at 0 week was 5.93 ± 2.62, while at four weeks, the mean PASI score declined to 1.67 ± 1.13, and at eight weeks, the mean PASI score further declined to 0.67 ± 0.68. For the patients in group M, the mean PASI score at 0 week was 5.91 ± 2.22, while at four weeks, the mean PASI score declined to 1.91 ± 1.11, and at eight weeks, the mean PASI score further declined to 0.89 ± 0.72. Furthermore, there was no significant difference in the mean PASI score at various time points when compared between the two groups (p-value = 0.761, 0.296, 0.079, respectively). Thus, both drugs seem to be effective in treating mild- to moderate-grade chronic plaque psoriasis. Most of the patients in both groups showed marked clearance of the lesions. However, there were six patients in the calcipotriol group showing complete clearance of the lesions having mild-degree plaque psoriasis, as compared to three patients in the methotrexate group. In the present study, based on the comparison of safety and tolerability, four out of 30 patients (13.3%) in the calcipotriol group suffered skin irritation, whereas six out of 30 patients (20%) in the methotrexate group complained of a burning sensation. The adverse effects seen in the patients were transient and mild. Conclusion Topical calcipotriol and methotrexate were effective in reducing lesions in patients with chronic mild to moderate plaque psoriasis. Both drugs were well tolerated with mild and transient adverse effects and did not alter hematological and biochemical parameters. PMID:38854231 | PMC:PMC11157480 | DOI:10.7759/cureus.59878 Den ganzen Artikel lesen
  4. Cureus. 2024 May 9;16(5):e60008. doi: 10.7759/cureus.60008. eCollection 2024 May. ABSTRACT Methotrexate is an anti-inflammatory and immunomodulatory drug, widely used for moderate to severe psoriasis and other rheumatological conditions such as rheumatoid arthritis, besides some types of malignancies. Side effects are more prevalent in high acute doses but can also be seen in low-dose chronic use, especially in cases of drug-dosing errors. Possible symptoms of toxicity include gastrointestinal, hepatic, hematologic and renal dysfunctions, but may also include mucositis and worsening of the psoriatic lesions. Here, we describe a case involving methotrexate toxicity in an elderly patient with psoriasis, detailing the management. PMID:38854245 | PMC:PMC11162511 | DOI:10.7759/cureus.60008 Den ganzen Artikel lesen
  5. Cureus. 2024 May 10;16(5):e60051. doi: 10.7759/cureus.60051. eCollection 2024 May. ABSTRACT Psoriasis is a chronic dermatologic condition that oftentimes requires extensive trial and error with various topical and systemic therapies until improvement is achieved. Interleukin-17 inhibitors (IL-17i), such as secukinumab, have been utilized in the treatment of psoriasis due to their mechanism of action. As with all medications, IL-17 inhibitors possess adverse effects, the most common being infection, nasopharyngitis, and injection site reaction. However, one rare adverse event, the paradoxical eczematous reaction, has been known to occur among patients on biologics including IL-17 inhibitors. Although it is a rare occurrence, our paper stresses the importance of educating patients about this potential side effect, the benefits and risks of starting a biologic, and obtaining informed consent from the patient. We present a case of a 14-year-old male with recalcitrant psoriasis vulgaris who developed a paradoxical eczematous reaction while undergoing treatment with secukinumab. PMID:38854303 | PMC:PMC11162754 | DOI:10.7759/cureus.60051 Den ganzen Artikel lesen
  6. Int J Womens Dermatol. 2024 Jun 7;10(2):e152. doi: 10.1097/JW9.0000000000000152. eCollection 2024 Jun. ABSTRACT BACKGROUND: In some hidradenitis suppurativa (HS) clinical trial study arms, there is an unexpected decline in efficacy between the penultimate visit and the prespecified primary endpoint week, which we have termed a "wobble." OBJECTIVE: We aimed to establish how often study arms in HS programs wobble. METHODS: In a retrospective review, we identified HS clinical trials listed on ClinicalTrials.gov testing systemic, nonantibiotic medications that utilized Hidradenitis Suppurativa Clinical Response (HiSCR) as an outcome measure. We identified study arms demonstrating greater improvement in a visit prior to the primary endpoint week. Baseline subject characteristics were compared between studies with HiSCR wobble and no HiSCR wobble. RESULTS: A total of 21 studies (randomized control trial [RCT], n = 14; open-label, n = 7) with 35 study drug arms (RCT, n = 27; open-label, n = 8) and 14 placebo arms were identified. HiSCR wobble occurred significantly more often in RCT compared to open-label study drug arms (11/27 [40.7%] vs 0/8 [0%]). In RCT study arms with HiSCR wobble, baseline draining fistula counts were significantly lower (2.3 vs 3.2), and numerically fewer Hurley stage 3 patients (33.2% vs 42.5%), lower weighted total abscess and nodule counts (12.1 vs 12.6), lower weighted dermatology life quality index scores (12.5 vs 14.5), and a higher proportion of female patients (63.9% vs 58.3%) were observed. LIMITATIONS: Include low number of HS clinical trials and insufficient data reported in many studies to assess for wobble, degree of wobble, and to compare all baseline characteristics. CONCLUSION: Nonlinear improvement in study arm response occurs in some HS RCTs. Potential contributing factors include a higher proportion of less severe patients at baseline and more female patients. PMID:38854891 | PMC:PMC11161284 | DOI:10.1097/JW9.0000000000000152 Den ganzen Artikel lesen
  7. Clin Epidemiol. 2024 Jun 4;16:395-407. doi: 10.2147/CLEP.S445120. eCollection 2024. ABSTRACT PURPOSE: This research aimed to develop and validate a META-algorithm combining individual immune-mediated inflammatory disease (IMID)-specific algorithms to identify the exact IMID indications for incident biological drug users from claims data within the context of the Italian VALORE project. METHODS AND PATIENTS: All subjects with at least one dispensing of TNF-alpha inhibitors, anti-interleukin agents, and selective immunosuppressants approved for IMIDs were identified from claims databases of Latium region in Italy (observation period: 2010-2020). Validated coding algorithms for identifying individual IMIDs from claims databases were found from published literature and combined into a META-algorithm. Positive predictive value (PPV), sensitivity (Se), negative predictive value (NPV), specificity (Sp), and accuracy (Acc) were estimated for each indication against the electronic therapeutic plans (ETPs) of the Latium region as the reference standard. Lastly, the frequency of the indication of use across individual biologic drugs was compared with that reported in three other Italian regions (Lombardy, Apulia, and the Veneto region). RESULTS: In total, 9755 incident biological drug users with a single IMID indication were identified. Using the newly developed META-algorithm, an indication of use was detected in 95% (n=9255) of the total cohort. The estimated Acc, Se, Sp, PPV, and NPV, against the reference standard were as follows: 0.96, 0.86, 0.97, 0.82, and 0.98 for Crohn's disease, 0.96, 0.80, 0.98, 0.85, and 0.97 for ulcerative colitis, 0.93, 0.76, 0.99, 0.95, and 0.92 for rheumatoid arthritis, 0.97, 0.75, 0.99, 0.85, and 0.98 for spondylarthritis, and 0.91, 0.92, 0.91, 0.88, and 0.94 for psoriatic arthritis/psoriasis, respectively. Additionally, no substantial difference was observed in the frequency of indication of use by active ingredient among Latium and the other three Italian regions included in the study. CONCLUSION: The newly developed META-algorithm demonstrated high validity estimates in the Italian claims data and was capable of discriminating with good performance among the most frequent IMID indications. PMID:38854895 | PMC:PMC11162210 | DOI:10.2147/CLEP.S445120 Den ganzen Artikel lesen
  8. Theranostics. 2024 May 27;14(8):3339-3357. doi: 10.7150/thno.93764. eCollection 2024. ABSTRACT Rationale: Skin cells actively metabolize nutrients to ensure cell proliferation and differentiation. Psoriasis is an immune-disorder-related skin disease with hyperproliferation in epidermal keratinocytes and is increasingly recognized to be associated with metabolic disturbance. However, the metabolic adaptations and underlying mechanisms of epidermal hyperproliferation in psoriatic skin remain largely unknown. Here, we explored the role of metabolic competition in epidermal cell proliferation and differentiation in psoriatic skin. Methods: Bulk- and single-cell RNA-sequencing, spatial transcriptomics, and glucose uptake experiments were used to analyze the metabolic differences in epidermal cells in psoriasis. Functional validation in vivo and in vitro was done using imiquimod-like mouse models and inflammatory organoid models. Results: We observed the highly proliferative basal cells in psoriasis act as the winners of the metabolic competition to uptake glucose from suprabasal cells. Using single-cell metabolic analysis, we found that the "winner cells" promote OXPHOS pathway upregulation by COX7B and lead to increased ROS through glucose metabolism, thereby promoting the hyperproliferation of basal cells in psoriasis. Also, to prevent toxic damage from ROS, basal cells activate the glutathione metabolic pathway to increase their antioxidant capacity to assist in psoriasis progression. We further found that COX7B promotes psoriasis development by modulating the activity of the PPAR signaling pathway by bulk RNA-seq analysis. We also observed glucose starvation and high expression of SLC7A11 that causes suprabasal cell disulfide stress and affects the actin cytoskeleton, leading to immature differentiation of suprabasal cells in psoriatic skin. Conclusion: Our study demonstrates the essential role of cellular metabolic competition for skin tissue homeostasis. PMID:38855186 | PMC:PMC11155411 | DOI:10.7150/thno.93764 Den ganzen Artikel lesen
  9. Transl Androl Urol. 2024 May 31;13(5):748-758. doi: 10.21037/tau-24-10. Epub 2024 May 28. ABSTRACT BACKGROUND: The association between psoriasis and erectile dysfunction (ED) is currently inconsistent in epidemiological and observational studies and the causal relationship between them has not been established. The aim of our study is to explore the potential genetic association between ED and psoriasis. METHODS: We explored the putative causality between psoriasis and ED by bidirectional Mendelian randomization (MR). The single nucleotide polymorphisms (SNPs) associated with psoriasis were retrieved from a large-scale public genome-wide association study (GWAS). The summary statistics of ED were obtained from individuals of European ancestry with 6,175 cases vs. 217,630 controls. Inverse-variant weighted (IVW), weighted median (WM), MR-Egger, MR-Steiger, and MR pleiotropy residual sum and outlier (MR-PRESSO) test were employed in MR analyses to investigate the bidirectional causal relationship between psoriasis and ED. Several sensitivity analyses were employed to confirm the findings of the MR analysis. RESULTS: Our MR analysis indicated that genetically predicted psoriasis showed no association with a higher risk of ED [odds ratio (OR) 2.878, 95% confidence interval (CI): 0.175-47.289, P=0.46]. As for the other direction, no causal association was disclosed between ED and psoriasis (OR 0.999, 95% CI: 0.997-1.002, P=0.62). These findings remained consistent in sensitivity analyses. CONCLUSIONS: The study revealed a negative genetic association between psoriasis and ED. Certain acquired factors may contribute to a strong clinical connection between the two, highlighting the need for comprehensive management of these risk factors. PMID:38855583 | PMC:PMC11157395 | DOI:10.21037/tau-24-10 Den ganzen Artikel lesen
  10. Appl Opt. 2024 May 20;63(15):4131-4143. doi: 10.1364/AO.520397. ABSTRACT Planar X e B r ∗ and X e C l ∗ excilamps emitting noncoherent narrowband UVB light (280-315 nm) are now widely used to cure psoriasis and vitiligo as well as to improve vitamin D synthesis. The two-dimensional integral formula has been deducted in this study, which is a good method and has great practical significance to calculate the total radiant power and assess the energy efficiency of a planar UV lamp. The measured radiant power of planar white LED lamps through a two-dimensional Keitz formula has been compared to that of gonio-photometer, verifying the applicability of the formula. The optimum measurement distance is dependent on the lamp length (1.5L≤D≤3.5L) for which the derivation from the two methods can be controlled within 10%. The planar X e B r ∗ excilamps have been measured and compared to coaxial excilamps, which show similar patterns of change for the radiant characteristics. Since the planar radiant power formula only needs to measure normal illuminance at a certain distance from the symmetric center of the lamp, it is more convenient to use and is a low-cost method to promote the development of large-sized planar ultraviolet lamps. PMID:38856507 | DOI:10.1364/AO.520397 Den ganzen Artikel lesen
  11. J Immunol. 2024 Jun 10:ji2300752. doi: 10.4049/jimmunol.2300752. Online ahead of print. ABSTRACT Psoriasis is a common inflammatory skin disorder with no cure. Mesenchymal stem cells (MSCs) have immunomodulatory properties for psoriasis, but the therapeutic efficacies varied, and the molecular mechanisms were unknown. In this study, we improved the efficacy by enhancing the immunomodulatory effects of umbilical cord-derived MSCs (UC-MSCs). UC-MSCs stimulated by TNF-α and IFN-γ exhibited a better therapeutic effect in a mouse model of psoriasis. Single-cell RNA sequencing revealed that the stimulated UC-MSCs overrepresented a subpopulation expressing high tryptophanyl-tRNA synthetase 1 (WARS1). WARS1-overexpressed UC-MSCs treat psoriasis-like skin inflammation more efficiently than control UC-MSCs by restraining the proinflammatory macrophages. Mechanistically, WARS1 maintained a RhoA-Akt axis and governed the immunomodulatory properties of UC-MSCs. Together, we identify WARS1 as a master regulator of UC-MSCs with enhanced immunomodulatory capacities, which paves the way for the directed modification of UC-MSCs for escalated therapeutic efficacy. PMID:38856632 | DOI:10.4049/jimmunol.2300752 Den ganzen Artikel lesen
  12. Arch Dermatol Res. 2024 Jun 8;316(7):363. doi: 10.1007/s00403-024-03051-8. ABSTRACT Streptococcal infections may contribute to psoriasis development, and antistreptococcal treatments are considered potential therapies, but their effectiveness remains uncertain due to limited systematic evidence. Our objective was to analyze antistreptococcal therapies' effectiveness in improving psoriasis. We conducted a systematic review following PRISMA guidelines, evaluating antistreptococcal treatment efficacy in psoriasis patients from PubMed, Scopus, and Embase databases until August 14, 2022. Eligible studies included psoriasis patients undergoing antistreptococcal therapy, regardless of demographics or psoriasis type. 50 studies (1778 patients) were analyzed, with penicillins/aminopenicillins as the most studied antibiotics (21 studies), showing mixed outcomes, some reporting significant improvement in guttate psoriasis, while others showed no significant difference. Rifampin demonstrated positive results in most of ten studies, and macrolides showed varying effectiveness in two studies. Tonsillectomy in 14 studies (409 patients) mainly focusing on guttate and chronic plaque psoriasis showed positive outcomes, indicating improved symptoms and quality of life. Limitations include heterogeneous studies, sampling bias, and quality of evidence. This systematic review reveals limited and varied evidence for systemic antibiotic therapy efficacy in psoriasis treatment, while tonsillectomy emerges as a potentially beneficial antistreptococcal option, urging further well-designed, controlled studies with larger sample sizes and standardized protocols for better comparisons. PMID:38850287 | DOI:10.1007/s00403-024-03051-8 Den ganzen Artikel lesen
  13. Arch Dermatol Res. 2024 Jun 8;316(7):369. doi: 10.1007/s00403-024-03074-1. NO ABSTRACT PMID:38850288 | DOI:10.1007/s00403-024-03074-1 Den ganzen Artikel lesen
  14. Arch Dermatol Res. 2024 Jun 8;316(7):365. doi: 10.1007/s00403-024-03036-7. ABSTRACT Nail psoriasis is a chronic, inflammatory condition which is difficult to treat, linked with greater psoriasis severity, and may be associated with anxiety and significant functional impairment of the quality of life. The 1064 nm Nd: YAG laser was reported to yield satisfactory results in the treatment of nail psoriasis.The aim of the study was to assess the clinical and ultrasonographic efficacy of long-pulsed 1064 nm Nd: YAG laser in the treatment of fingernail psoriasis and compare its effect to control fingernails.This intra-patient randomized controlled trial analyzed 86 fingernails collected from 13 patients suffering from cutaneous and nail psoriasis. The nails were randomized into two groups. Group A was treated with Nd: YAG laser once monthly for three sessions while group B served as control. Assessment took place at baseline, 1 and 3 months after the last treatment session. For scoring, the 32-points target NAPSI scoring systems was used. Additionally, two blinded dermatologists' score of improvement, patients' pain assessment by visual analogue score and ultrasonographic assessment were all performed.At the end of follow up, the medians of tNAPSI score, plate definition, matrix thickness, bed thickness and bed vascularity decreased significantly in the Nd: YAG laser treated group in comparison to baseline (p = 0.001, 0.006, 0.039, < 0.001 and 0.010, respectively). While, there was a non-significant reduction in median tNAPSI score in the control group at last follow up, however, ultrasonography recorded a significant reduction in the medians of plate definition, bed thickness and vascularity (p = 0.002, 0.011 and 0.033, respectively) from the baseline. Comparison of the Nd: YAG laser and the control groups showed no significant difference from baseline regarding the medians of tNAPSI, tNAPSI percentile improvement, pits count, blinded evaluation of photographs and ultrasonographic assessments.In conclusion, Nd: YAG laser showed clinical and ultrasonographic improvement in fingernail psoriasis. Ultrasonography is a useful noninvasive tool in diagnosing and monitoring the clinical and even the subclinical changes in nail psoriasis. Nail psoriasis although difficult to treat, may show spontaneous improvement. PMID:38850336 | DOI:10.1007/s00403-024-03036-7 Den ganzen Artikel lesen
  15. Arch Dermatol Res. 2024 Jun 8;316(7):362. doi: 10.1007/s00403-024-03122-w. ABSTRACT Secukinumab is a fully human IgG1 antibody that selectively binds to and neutralizes the proinflammatory cytokine interleukin-17A. Secukinumab is an effective and well-tolerated treatment for plaque psoriasis. There is a limited real-word evidence for dose optimisation of secukinumab based on clinical response. PURE is a multi-national, prospective, observational study in patients with moderate to severe chronic plaque psoriasis in Canada and Latin America, assessing the real-world safety and effectiveness of secukinumab and other indicated therapies. The aim of the current snapshot analysis was to evaluate the effectiveness and safety of on-label dose and updosed secukinumab in patients with plaque psoriasis enrolled in the PURE study. At the time of analysis, 676 patients received secukinumab, of which 84.6% (n = 572) remained on the on-label dose, while 15.4% (n = 104) were updosed. With on-label secukinumab, the absolute Psoriasis Area and Severity Index (PASI) score was reduced from 13.6 at baseline to 1.2 over 36 months, with treatment persistence of 73% at 40 months. At Month 36, 73.2% of the patients receiving on-label secukinumab achieved Investigator's Global Assessment (IGA) 0/1. With updosed secukinumab (300 mg every 2 weeks, 300 mg every 3 weeks, 450 mg every 4 weeks, or 450 mg every 3 weeks), 57.9% of the patients showed improvement in the absolute PASI score at the first visit after updosing, with treatment persistence of 50% at 12 months after updosing. At Month 15, 40% of patients receiving updosed secukinumab achieved IGA 0/1. Patients with previous biologic exposure (odds ratio [OR]: 3.25; 95% confidence interval [CI]: 2.03, 5.18, p < 0.0001) were more likely to be updosed while those with a body weight < 90 kg (OR: 0.49; 95% CI [0.31, 0.77], p = 0.0019) were less likely to be updosed. Previous biologic exposure (HR [hazard ratio]: 1.47; 95% CI [1.24, 1.75], p < 0.0001) and current biologic exposure (secukinumab vs. other indicated therapies: HR 0.57; 95% CI [0.43, 0.75], p = 0.0001) were significantly associated with time to secukinumab updosing. No new or unexpected safety signals were observed with updosed secukinumab. Secukinumab updosing was efficacious and well-tolerated in patients with psoriasis who failed to respond to the approved on-label regimen, suggesting that updosing may be a useful therapeutic option for approved dose non-responders. PMID:38850346 | DOI:10.1007/s00403-024-03122-w Den ganzen Artikel lesen
  16. Arch Dermatol Res. 2024 Jun 8;316(7):374. doi: 10.1007/s00403-024-03024-x. ABSTRACT The microbiome is intricately linked to the development of psoriasis, serving as both a potential cause and consequence of the psoriatic process. In recent years, there has been growing interest among psoriasis researchers in exploring how psoriasis treatments affect the skin and gut microbiome. However, a comprehensive evaluation of the impact of modern treatment approaches on the microbiome has yet to be conducted. In this systematic review, we analyze studies investigating alterations in the skin and gut microbiome resulting from psoriasis treatment, aiming to understand how current therapies influence the role of the microbiome in psoriasis development. The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed and Scopus databases were searched for eligible studies from the inception dates until July 5, 2023. Study selection, data extraction, and risk of bias assessment were carried out by three overlapping pairs of reviewers, resolving any disagreements through consensus. Our analysis of various treatments, including biologics, conventional medications, phototherapy, and probiotics, reveals significant shifts in microbial diversity and abundance. Importantly, favorable treatment outcomes are associated with microbiota alterations that approach those observed in healthy individuals. While the studies reviewed exhibit varying degrees of bias, underscoring the need for further research, this review supports the potential of microbiome modulation as both a preventive and therapeutic strategy for psoriasis patients. The findings underscore the importance of personalized therapeutic approaches, recognizing the profound impact of treatment on the microbiome. They also highlight the promise of probiotics, prebiotics, and dietary interventions in psoriasis management. PMID:38850443 | DOI:10.1007/s00403-024-03024-x Den ganzen Artikel lesen
  17. Display options Display options Background: Little is known about the exact impact of psoriasis on the disease burden of close relatives and partners …Den ganzen Artikel lesen
  18. Front Immunol. 2024 May 23;15:1410540. doi: 10.3389/fimmu.2024.1410540. eCollection 2024. ABSTRACT Psoriasis is a common, life-long skin disease with a significant negative health and societal impact. Data on rates of disease control and treatment strategies are lacking in Central and Eastern European countries. We aimed to describe the real-world disease severity, control, and treatment strategies for psoriasis in patients from Central and Eastern European countries. CRYSTAL (EUPAS36459) was a cross-sectional, retrospective study in adults (18-75 years) from Bulgaria, Estonia, Hungary, Latvia, Lithuania, Romania, and Russia. We enrolled patients with moderate-to-severe psoriasis receiving continuous systemic treatment for ≥24 weeks. We used the Psoriasis Area and Severity Index (PASI) to describe disease severity and the Dermatology Life Quality Index (DLQI) to assess quality of life (QoL) and collected other outcomes [psoriasis work productivity and activity impairment (WPAI-PSO), patient satisfaction] at enrollment. Analyses were descriptive. A total of 690 patients were included in the analyses. Median disease duration was 11.8 years. Current treatment was monotherapy for most patients (95.8%) with either biological (BIO group; 88.4%) or conventional (NON-BIO group; 7.4%) agents. Mean (± standard deviation) absolute PASI scores were 3.5 ± 5.7, 3.1 ± 5.3, and 6.6 ± 7.4 in the overall population, the BIO group, and the NON-BIO group, respectively. Among patients treated with monotherapy, absolute PASI scores ≤1, ≤3, and ≤5 were observed for 44.1%, 72.0%, and 82.6% of BIO patients and 21.6%, 33.3%, and 49.0% of NON-BIO patients. Mean DLQI total score was 3.3 ± 5.1; higher scores were noted for higher absolute PASI. The most impacted WPAI-PSO domain was presenteeism; for all domains, impact increased with increased absolute PASI. A total of 91.8% of BIO patients and 74.5% of NON-BIO patients were satisfied with the current treatment. We observed a better disease control in BIO than NON-BIO patients. However, around half of BIO patients did not reach clear skin status and reported an impact on QoL. An improvement in treatment strategies is still needed in Central and Eastern European countries to optimize outcomes of moderate-to-severe psoriasis. PMID:38846952 | PMC:PMC11153796 | DOI:10.3389/fimmu.2024.1410540 Den ganzen Artikel lesen
  19. J Dermatol. 2024 Jun 7. doi: 10.1111/1346-8138.17317. Online ahead of print. NO ABSTRACT PMID:38847289 | DOI:10.1111/1346-8138.17317 Den ganzen Artikel lesen
  20. J Dermatol. 2024 Jun 7. doi: 10.1111/1346-8138.17313. Online ahead of print. ABSTRACT Nail psoriasis is a chronic condition characterized by nail dystrophy affecting the nail matrix and bed. The severity of nail psoriasis is commonly assessed using the Nail Psoriasis Severity Index (NAPSI), which evaluates the characteristics and extent of nail involvement. Although the NAPSI is numeric, reproducible, and simple, the assessment process is time-consuming and often challenging to use in real-world clinical settings. To overcome the time-consuming nature of NAPSI assessment, we aimed to develop a deep learning algorithm that can rapidly and reliably evaluate NAPSI, thereby providing numerous clinical and research advantages. We developed a dataset consisting of 7054 single fingernail images cropped from images of the dorsum of the hands of 634 patients with psoriasis. We annotated the eight features of the NAPSI in a single nail using bounding boxes and trained the YOLOv7-based deep learning algorithm using this annotation. The performance of the deep learning algorithm (DLA) was evaluated by comparing the NAPSI estimated using the DLA with the ground truth of the test dataset. The NAPSI evaluated using the DLA differed by 2 points from the ground truth in 98.6% of the images. The accuracy and mean absolute error of the model were 67.6% and 0.449, respectively. The intraclass correlation coefficient was 0.876, indicating good agreement. Our results showed that the DLA can rapidly and accurately evaluate the NAPSI. The rapid and accurate NAPSI assessment by the DLA is not only applicable in clinical settings, but also provides research advantages by enabling rapid NAPSI evaluations of previously collected nail images. PMID:38847292 | DOI:10.1111/1346-8138.17313 Den ganzen Artikel lesen
  21. J Cutan Med Surg. 2024 Jun 7:12034754241260023. doi: 10.1177/12034754241260023. Online ahead of print. ABSTRACT There has been a call to action to enhance representation of non-white individuals in dermatology clinical trials. Investigations in differential response to treatment across populations are limited, particularly in conditions of commonality, impact, distinct presentation, and diagnosis in non-white participants, such as atopic dermatitis and psoriasis. This systematic review summarized and identified if biologic treatment outcomes in moderate-to-severe atopic dermatitis and psoriasis varied in skin of colour (SOC) participants in phase 3 trials. MEDLINE, COCHRANE, and EMBASE databases were used to conduct the search following PROSPERO registration. Following screening of 3209 articles, 11 studies were collected with 1781 SOC participants with a mean age of 40.99 ± 6.3 years (range: 30.6-51.6 years). Male participants accounted for 76.9% (n = 1370/1781) of the sample, and Chinese, Japanese, Taiwanese, and Korean participants accounted for 64.3%, 24.2%, 4.5%, and 3.4% of participants, respectively. Participants with atopic dermatitis were treated with dupilumab (n = 216/388) and participants with psoriasis were treated with adalimumab (n = 313/1393), bimekizumab (n = 62/1393), ixekizumab (n = 13/1393), secukinumab (n = 117/1393), and ustekinumab (n = 289/1393). No significant SOC population-based outcomes were found across treatment groups. However, differences in baseline characteristics or comorbidities were found, suggesting race or ethnic background should be considered when treatment is prescribed in psoriasis or atopic dermatitis. Although no significant SOC participant differential response to treatment were found, large-scale randomized controlled trials investigating comparable treatment outcomes and stratifying results by SOC population in atopic dermatitis and psoriasis are warranted to confirm these findings. PMID:38847375 | DOI:10.1177/12034754241260023 Den ganzen Artikel lesen
  22. Int J Dermatol. 2024 Jun 7. doi: 10.1111/ijd.17303. Online ahead of print. NO ABSTRACT PMID:38847446 | DOI:10.1111/ijd.17303 Den ganzen Artikel lesen
  23. Arch Dermatol Res. 2024 Jun 7;316(7):340. doi: 10.1007/s00403-024-03075-0. ABSTRACT Psoriasis (PsO) is a chronic inflammatory skin condition, often accompanied by psoriatic arthritis (PsA) and linked to various comorbidities and increased mortality rates. This study aimed to explore the relationship between PsO and accelerated biological aging, specifically focusing on epigenetic DNA methylation clocks. Using a matched case-control design, 20 PsO cases were selected along with age, race, and sex-matched 20 controls without PsO from the Skin Disease Biorepository at Brown Dermatology, Inc, Providence, Rhode Island. Blood samples retrieved from both groups were analyzed for DNA methylation, and epigenetic ages were calculated using DNA methylation clocks, including Horvath, Hannum, Pheno, SkinBlood, and Grim ages. Generalized estimation equations were employed to test the differences in epigenetic and chronological ages between PsO cases and controls, as well as within various subgroups in comparison to their respective controls. There were no statistically significant differences in epigenetic ages between PsO cases and controls. However, notably, PsO cases with PsA demonstrated an accelerated PhenoAge, compared to their matched controls. This study represents a pioneering investigation into the potential link between PsO and epigenetic aging, shedding light on the possibility of accelerated epigenetic aging in PsA, possibly associated with heightened inflammatory burden. These findings emphasize the systemic impact of PsA on the aging process, prompting the need for deeper exploration into autoimmune pathways, inflammation, and epigenetic modifications underlying PsO pathogenesis and aging mechanisms. Larger-scale studies with diverse populations are imperative to discern PsO subgroups experiencing accelerated biological aging and decipher the intricate interplay between PsO, inflammation, and aging pathways. PMID:38847964 | DOI:10.1007/s00403-024-03075-0 Den ganzen Artikel lesen
  24. Rheumatol Ther. 2024 Jun 7. doi: 10.1007/s40744-024-00680-3. Online ahead of print. ABSTRACT INTRODUCTION: Biologic therapies are licensed for both psoriasis (PsO) and psoriatic arthritis (PsA) with some electronic medical record data suggest that IL (Interleukin)-23 blockers might be more protective in PsA prevention than TNF blockers; however, the findings have been inconsistent. Higher Psoriasis Area and Severity Index (PASI) scores have also been linked to an increased PsA risk. To clarify these unresolved issues we investigated biologic agents, methotrexate, phototherapy, and topical therapy for PsA prevention in patients with psoriasis. METHODS: This retrospective cohort study analyzed data from 58,671 patients with psoriasis from the Israeli Meuhedet Health Services Organization database was evaluated for incident PsA. Patients were categorized on the basis of treatment: group 1, topical therapy; group 2, phototherapy; group 3, conventional disease-modifying antirheumatic drugs (cDMARDs; methotrexate); group 4, biologic DMARDs which was also stratified according to biologic class. RESULTS: The PsA incidence rate was lower in the biologic agents' group versus the methotrexate group (HR 0.46 [95% CI 0.35-0.62]). The incidence rates per 100 person-years varied across biologic treatment groups, with the anti‑IL‑12/23 or anti‑IL‑23p19 group at 4.57, the anti-IL-17 group at 4.35, and the TNF inhibitor group at 2.55. No differences were found between various biological agents in terms of preventing PsA. The phototherapy group exhibited a higher PsA development rate than the topical therapy group (HR 1.85 [95% CI 1.65-2.07]). CONCLUSION: Biological agents are more effective than methotrexate in reducing incident PsA in patients with psoriasis. This lower rate of PsA on topical therapy compared to phototherapy supports the importance of psoriasis severity as a risk factor. PMID:38847993 | DOI:10.1007/s40744-024-00680-3 Den ganzen Artikel lesen
  25. Aging (Albany NY). 2024 Jun 6;16. doi: 10.18632/aging.205902. Online ahead of print. ABSTRACT BACKGROUND: Psoriasis is a complex and recurrent chronic inflammatory skin disease, and the abnormal proliferation of keratinocytes plays a crucial role in the pathogenesis of psoriasis. Long non-coding RNAs (lncRNAs) play an indispensable role in regulating cellular functions. This research aims to explore the potential impact of lncRNA MIR181A2HG on the regulation of keratinocyte proliferation. METHODS: The expression level of MIR181A2HG and the mRNA level of KRT6, KRT16, and SOX6 were assessed using qRT-PCR. The viability and proliferation of keratinocytes were evaluated using CCK-8 and EdU assays. Cell cycle analysis was performed using flow cytometry. Dual-luciferase reporter assays were applied to test the interaction among MIR181A2HG/miR-223-3p/SOX6. Protein level was detected by Western blotting analysis. RESULTS: The findings indicated that psoriasis lesions tissue exhibited lower levels of MIR181A2HG expression compared to normal tissue. The overexpression of MIR181A2HG resulted in the inhibition of HaCaT keratinocytes proliferation. The knockdown of MIR181A2HG promoted cell proliferation. The dual-luciferase reporter assay and rescue experiments provided evidence of the interaction among MIR181A2HG, SOX6, and miR-223-3p. CONCLUSIONS: The lncRNA MIR181A2HG functions as a miR-223-3p sponge targeting SOX6 to regulate the proliferation of keratinocytes, which suggested that MIR181A2HG/miR-223-3p/SOX6 might be potential diagnostic and therapeutic targets for psoriasis. PMID:38848163 | DOI:10.18632/aging.205902 Den ganzen Artikel lesen
  26. J Rheumatol. 2024 Jun 7:jrheum.2024-0330. doi: 10.3899/jrheum.2024-0330. Online ahead of print. ABSTRACT The 78th Annual Meeting of the Canadian Rheumatology Association was held at the RBC Convention Centre in Winnipeg, Manitoba, Canada, and virtually on February 28-March 2, 2024. The program consisted of presentations covering original research, symposia, awards, and lectures. Highlights of the meeting include the following 2024 Award Winners: Distinguished Rheumatologist, John M. Esdaile; Distinguished Investigator, Ann Clarke; Distinguished Teacher-Educator, Nicole Johnson; Emerging Investigator, Tom Appleton; Emerging Teacher-Educator, Pari Basharat; Ian Watson Award for the Best Abstract on SLE Research by a Trainee, Eugene Krustev; Phil Rosen Award for the Best Abstract on Clinical or Epidemiology Research by a Trainee, Derin Karacabeyli; Best Abstract on Research by a Rheumatology Resident, Shane Cameron; Best Abstract on Basic Science Research by a Trainee, Kaien Gu; Best Abstract by a Post-Graduate Research Trainee, Zoha Faheem; Best Abstract on Quality Care Initiatives in Rheumatology, Jean-Charles Mourot; Best Abstract by a Medical Student, Angel Gao; Best Abstract by an Undergraduate Student, Nicholas Chan; Best Abstract by a Rheumatology Post-Graduate Research Trainee, Carolina Munoz-Grajales; Best Abstract on Research by Young Faculty, Lauren King; Best Abstract on Pediatric Research by Young Faculty, Ruud Verstegen; Best Abstract on Spondyloarthritis Research, Fadi Kharouf. Lectures and other events included: Keynote Lecture by Jillian Horton: From Burnout to...What? Critical Frameworks for Tackling Our Burnout Crisis; State of the Art Lecture by Lihi Eder: From Psoriasis to Psoriatic Arthritis: Towards Prevention?; Dunlop-Dottridge Lecture by Hani El-Gabalawy: What is the Impact of RA on First Nations People, and How We Can Work with Communities to Detect and Prevent It?; and the Great Debate: Be it Resolved That EMRs Save Time for Healthcare Providers and Improve Quality of Care. Arguing for: Steven Katz and Jill Hall, and against: Tom Appleton and Dax Rumsey. Topics including rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjögren syndrome, psoriatic arthritis, spondyloarthritis, vasculitis, osteoarthritis, fibromyalgia, and their respective diagnoses, treatments, and outcomes are reflected in the abstracts, which we are pleased to publish in this issue of The Journal of Rheumatology. PMID:38849145 | DOI:10.3899/jrheum.2024-0330 Den ganzen Artikel lesen
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