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**Hoffnung für seltene Psoriasis-Form** Eine seltene und schwere Psoriasis-Form lässt sich besser behandeln als bisher gedacht. Forscher aus Bayern untersuchten 29 Patienten. Die meisten erhielten biologische Medikamente. Bei allen Patienten verbesserte sich die Erkrankung deutlich. Die Messwerte der Schwere sanken stark. Besonders wirksam sind Medikamente gegen die Botenstoffe IL-17 und IL-23. Einige Patienten wurden sogar ganz gesund. Ältere Medikamente verursachten mehr Nebenwirkungen. Ärzte fordern nun klare Behandlungsrichtlinien. Originaltitel: Systemic Treatment and Outcome in Erythrodermic Psoriasis: A Retrospective Multicenter Study. Link zur Quelle

Biosimilars demonstrate **comparable efficacy and safety to originator biologics** for moderate-to-severe psoriasis while offering substantially lower costs, creating significant potential to expand treatment access in low- and middle-income countries where price barriers currently restrict patients' access to effective treatments.[1][2][5] **Clinical Equivalence Confirmed** A systematic review of 14 randomized clinical trials and 3 cohort studies found no clinically or statistically significant differences in efficacy and safety between biosimilars and their originator products for psoriasis treatment.[5] Specific comparisons—including biosimilar MSB11022 (adalimumab) and CT-P13 (infliximab)—showed similar reductions in Psoriasis Area and Severity Index scores and comparable adverse event rates.[1] Twenty-four biosimilars derived from 4 reference products are now approved for psoriasis treatment in the United States.[6] **Addressing Access Barriers** Although biologic therapies have significantly improved psoriasis outcomes, their high costs have limited access and created healthcare inequalities, particularly in resource-limited regions.[2] Biosimilars promise to improve patient access to these proven effective treatments while maintaining improved health outcomes and reducing overall treatment costs.[2] **Important Considerations and Limitations** Evidence quality varies across settings. Most clinical evidence derives from randomized controlled trials; high-quality real-world effectiveness data across diverse healthcare systems remains limited.[5] Biosimilars can receive regulatory approval for psoriasis based on extrapolated evidence from other diseases rather than direct psoriasis trials.[5] Long-term safety and immunogenicity data are limited compared to originators due to their shorter market presence.[1] Additionally, patent protections continue to restrict biosimilar availability in some regions.[3] While switching from originator to biosimilar appears safe based on available evidence, careful patient monitoring during transitions remains important.[2] Originaltitel: The role of biosimilars in enhancing global access to psoriasis treatment Link zur Quelle

I notice that while your query references a specific cross-sectional survey on patient attitudes toward digital health interventions in dermatology, the full study details aren't included in the search results provided. However, I can share what the search results reveal about **dermatological patients' attitudes toward digital health interventions**: ## Patient Acceptance and Interest Patients generally show **positive attitudes and interest in digital health tools**, though their actual adoption remains limited[1]. Only a small minority of patients (6%) had prior experience with digital health interventions before participating in studies[1]. Importantly, patients reported being **dependent on their dermatologists' acceptance** of these tools—meaning they're more likely to use digital solutions if their physicians recommend them[1]. ## Key Barriers and Facilitators The main obstacle is **lack of digital competence**: inadequate digital health literacy affects a significant portion of patients, ranging from 22% in Norway to 58% in Germany[1]. Additionally, patients exhibit **hesitancy toward AI-based diagnoses without dermatologist involvement**—84% of patients prefer a dermatologist's diagnosis over AI alone[4]. Trust remains crucial: patients strongly prefer receiving dermatology information directly from their dermatologists (99%), with 78% reporting high satisfaction with physician-provided information[5]. ## Practical Implications For these findings to translate into better care, digital health tools must be **user-friendly and adapted to varying skill levels**[1]. Data privacy transparency is essential, and successful implementation requires dermatologists' active endorsement and integration into existing workflows[1]. To provide more detailed analysis of the specific study you're referencing, please share the complete study text or clarify which results you'd like me to focus on. Originaltitel: Attitudes of dermatological patients towards digital health interventions: a cross‐sectional survey and cluster analysis Link zur Quelle

**Spurenelemente und deine Gelenkschmerzen** Forscher haben etwas Neues herausgefunden. Menschen mit Psoriasis-Arthritis haben oft zu wenig von bestimmten Stoffen im Blut. Diese Stoffe heißen Spurenelemente. Die wichtigsten sind Selen, Kupfer und Zink. Dein Körper braucht sie wirklich. Eine neue Studie hat 160 Patienten untersucht.[1] Die Forscher verglichen Menschen mit Psoriasis-Arthritis mit gesunden Menschen. Das Ergebnis war eindeutig. Allen Patienten fehlten diese wichtigen Spurenelemente. Das Interessante: Wenn die Entzündungswerte steigen, sinken die Selen-Werte besonders.[1] Das ist kein Zufall. Vielleicht könnte Selen-Behandlung dir helfen. Sie könnte deine Entzündung besser kontrollieren. Die gute Nachricht: Ärzte wissen das jetzt. Bald könnten personalisierte Behandlungen mit diesen Stoffen dir Erleichterung bringen.[1] Sprich mit deinem Arzt darüber. Originaltitel: Trace Element Deficiency in Axial Spondyloarthritis and Psoriatic Arthritis in Relation to Markers of Inflammation and Remission. Link zur Quelle

Psoriasis is a relapsing autoimmune disease exacerbated by aberrant interleukin (IL)-17 A activity. Majoon Ushba, a unani polyherbal formulation implicated in clinical cases of psoriasis lacks immunopharmacological validation. The study aims to investigate the pre-clinical efficacy of Majoon Ushba and its therapeutic role in mitigating IL-17A-induced keratinocytes ferroptosis via ablation of JAK-2/STAT-3 pathway. HaCaT cells were stimulated with IL-17A to assess the activation of the JAK-2-STAT-3 pathway. The STAT-3 inhibitor, S3I-201, was used to confirm the role of the STAT-3 axis in keratinocyte ferroptosis. Majoon Ushba pretreatment was assessed to determine its efficacy in alleviating keratinocyte ferroptosis. An imiquimod (IMQ)-induced psoriasis mouse model was used to evaluate the pre-clinical efficacy of Majoon Ushba. Furthermore, prior high-performance liquid chromatography (HPLC) profiling was leveraged for in-silico docking analysis to identify the binding affinities of key phytoconstituents with IL-17RA and STAT-3. Majoon Ushba alleviated the IL-17A/JAK-2-STAT-3 axis, improved GPX4 expression, and regulated lipid peroxidation. Subsequently, Majoon Ushba also reversed the expression of pathogenic mediators and led to a reduction in serum cytokine levels of IL-17A, IL-23, and IFN-γ. An in-silico docking analysis suggested favorable binding affinities for key phytoconstituents of Majoon Ushba against IL-17RA and STAT-3. Aligned with pre-clinical and in vitro results, the computational findings offer initial evidence that the polyherbal formulation may influence the IL-17A/JAK-2-STAT-3 signaling pathway. In conclusion, our preliminary findings reveal a plausible mechanistic basis for the anti-psoriatic efficacy of Majoon Ushba, warranting larger clinical trials in psoriasis patient cohorts.Weiterlesen

ObjectivesThere is very limited data regarding atlantoaxial instability (AAI) in patients with psoriatic arthritis (axPsA). In this study, we aimed to contribute to the existing literature on this topic.MethodsAdult patients were included in this single-center study who were classified as PsA by the 'CASPAR' criteria and evaluated as having axial involvement according to the 'Calin' criteria. Those with inflammatory or non-inflammatory diseases that could affect the spine were excluded. Electronic patient files were reviewed retrospectively. Lateral neutral/full extension/full flexion and open-mouth anteroposterior cervical radiographs were evaluated by three rheumatologists blinded to the patients. Patients were compared in two groups as AAI-positive and AAI-negative.ResultsA total of 100 patients with a mean age of 48.8 years and a mean PsA duration of 7.4 years, 57% of whom were female, were included in the study. A total of 20 AAI lesions were detected in 18% patients; subaxial subluxation was detected in eight, anterior atlantoaxial subluxation (AAS) in seven, posterior AAS in three, lateral AAS in one, and vertical subluxation in one case. In the group with AAI, the presence of psoriasis (Ps) (p = 0.037), scalp psoriasis (p < 0.001), and the use of targeted therapy for Ps and PsA (p < 0.001, p < 0.001) were significantly higher than in the AAI-negative group.ConclusionGiven that Ps and PsA patients on targeted therapy may reflect cases with higher disease activity and inadequate response to conventional treatments, it may be appropriate to consider closer monitoring for AAI in these patients. Key Points • Atlantoaxial instability is present in approximately one-fifth of patients with axial psoriatic arthritis. • The most common instability lesion is subaxial subluxation, accounting for 40% of all lesions. • The presence of psoriasis, scalp psoriasis, and the use of targeted therapies for psoriatic arthritis or psoriasis are significantly more frequent in the group with atlantoaxial instability. These factors may be useful for cervical spine monitoring in patients with axial psoriatic arthritis. • The use of targeted therapies for psoriatic arthritis or psoriasis may indirectly indicate an association between high disease activity and atlantoaxial instability.Weiterlesen

This study collected and analyzed clinical data of psoriasis patients to develop and validate a psoriasis relapse risk prediction model. It aims to support early relapse risk assessment in clinical practice and inform the design of preventive interventions. To develop and validate a risk prediction model for psoriasis relapse. A convenience sampling method was used to select 504 psoriasis patients admitted to a tertiary hospital in China between January 2022 and December 2024, including 353 cases in the training set and 151 cases in the testing set. Independent risk factors for psoriasis relapse were identified through univariate analysis and logistic regression analysis to develop a prediction model. A nomogram and SHAP summary plot were generated for model visualization, and the model's goodness of fit and discriminative ability were evaluated. The 1-year relapse rate of psoriasis patients after treatment was 66.67%. Logistic regression identified six independent risk factors for psoriasis relapse: BMI, diabetes, biologic use, smoking, upper respiratory tract infection (URTI), and non-standard medication, all of which were incorporated into the model. The area under the ROC curve (AUC) values for the training and testing sets were 0.767 [95% CI 0.715-0.818] and 0.704 [95% CI 0.620-0.789], respectively. The model showed moderate discrimination and good calibration. Decision curve analysis (DCA) confirmed clinically meaningful net benefit in both training and test sets. The predictive model for psoriasis relapse risk established in this study demonstrated only moderate predictive performance. This model can serve as a preliminary exploratory tool, providing a certain degree of quantitative reference for assessing the risk of psoriasis relapse; however, rigorous external validation in independent multicenter cohorts is still required before clinical application.Weiterlesen

BackgroundLifestyle factors have the potential to enhance well-being and quality of life (QoL). This study aimed to identify lifestyle patterns among UK-based adults with psoriasis and examine associations with QoL.MethodsThis was a cross-sectional analysis of the 'Asking People with Psoriasis about Lifestyle and Eating' (APPLE) study (n=353). QoL, Body Mass Index (BMI), and physical activity were assessed using the Dermatology Life Quality Index (DLQI), self-reported weight and height, and the International Physical Activity Questionnaire.ResultsParticipant demography was: 82% female; mean (SD) age of 41 (13) years; and BMI of 27 (7) kg/m2. When fully adjusted for age, sex, smoking, and alcohol use, compared to individuals in the highest BMI tertile (35 (5) kg/m2), those in the lowest tertile (21 (2) kg/m2) reported a 71% reduced likelihood of QoL impairments (Odds Ratio (OR) = 0.29; 95% CI 0.14-0.59, adjusted P<0.01). Dairy-free, gluten-free, and pescatarian diets were more frequently adopted in individuals reporting healthy BMIs (≈24 kg/m2, adjusted P<0.05). Higher levels of physical activity (2932 (1509) Metabolic Equivalent of Task Minutes per week), and adequate sleep duration (7 (0) hours/day) were associated with lower odds of QoL impairments, although attenuated by multiple testing. Participants affected by embarrassment or self-consciousness related to their psoriasis engaged in less vigorous-intensity and walking activities compared to those who were less affected (adjusted P<0.05).ConclusionsAssessing weight status and physical activity in individuals reporting high DLQI scores may help identify modifiable behaviours contributing to poorer QoL and thereby shape interventions.Weiterlesen

BackgroundPsoriasis is a chronic, immune-mediated skin disorder that causes physical, psychological, and social burdens. There is a growing need to better characterize the distinct clinical features and specific treatment needs of elderly patients with psoriasis, which remains an important area for further research to optimize care in this population.ObjectiveTo investigate the clinical characteristics, comorbidities, and treatment preferences of elderly patients with psoriasis vulgaris.MethodsPatients with psoriasis vulgaris were included in this retrospective study. Data on demographics, disease characteristics, including age at diagnosis, body surface area (BSA), Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), comorbidities, and treatment needs were collected. Patients at the visit over 60 years of age were defined as elderly patients. Patients who were diagnosed before 40 years of age were defined as early-onset psoriasis (EOP), and patients who were diagnosed over 40 years of age were defined as late-onset psoriasis (LOP). Continuous variables were compared using t-tests or Mann-Whitney U-tests, categorical variables using Chi-square or Fisher's exact tests. Spearman correlation was used for association analysis. Statistical significance was set at P<0.05.ResultsA total of 375 patients were included, comprising 70 (18.67%) elderly and 305 (81.33%) non-elderly patients. The elderly group had a significantly higher proportion of LOP (87.14% vs 48.76%, P<0.05). A higher percentage of elderly patients had moderate-to-severe (27.14% vs 20.98%, P<0.05) and severe (1.43% vs 0.66%, P<0.05) disease. Comorbidities were more prevalent in the elderly, including cardiovascular disease (12.86% vs 3.93%, P<0.05) and diabetes (12.86% vs. 1.31%, P<0.05). Despite this, elderly patients reported lower DLQI scores (median 2.00 vs. 3.00, P<0.05). Regarding treatment needs, elderly patients were less likely to prioritize reducing treatment costs (10.00% vs 20.98%, P<0.05) and preventing disease recurrence (30.00% vs 44.26%, P<0.05) compared to non-elderly patients. Within the elderly cohort, EOP patients exhibited more severe disease (median BSA: 3.00 vs 2.00; median PASI: 3.30 vs 0.80, P<0.05), a higher rate of familial psoriasis (33.33% vs 4.92%, P<0.05), and a greater demand for reducing treatment costs (33.3% vs 6.56%, P<0.05) compared to LOP patients.ConclusionElderly patients with psoriasis present a distinct clinical profile characterized by a high prevalence of late-onset disease, a significant comorbidity burden, and differing treatment priorities focused less on cost and recurrence. Despite the increased clinical severity, their perceived quality-of-life impact is lower. Besides, they report higher dissatisfaction linked to unmet needs in itch relief, drug safety, and long-term control. Within the elderly cohort, early-onset patients had more severe disease, stronger familial predisposition, and greater cost-related concerns. The findings highlight the necessity for age-specific, multidimensional management strategies for this population.Weiterlesen

IntroductionThis study analyzed the mechanisms of action of Andrographis paniculata (AP), a medicinal plant with diverse pharmacological properties, on psoriasis.Materials and methodsThe active components of AP and their corresponding targets were identified. These targets were subsequently intersected with differentially expressed genes (DEGs) and immune-related genes associated with psoriasis. The resulting gene set was subjected to functional enrichment analysis and immune infiltration analysis. The scRNA-seq data were analyzed to delineate the single-cell landscape in psoriasis and cell type-specific expression of genes of interest. Further, the molecular docking and experimental verification were performed for validation.ResultsActive components of AP and their targets were predicted. Cross-referencing these targets with psoriasis DEGs revealed 2 feature genes (AR and ITGAL), both exhibiting strong diagnostic potential. The two genes were associated with differentially enriched pathways and immune cell infiltration. Further, scRNA-seq analysis identified 10 cell subclusters. Notably, AR was expressed in reticular fibroblasts of healthy controls, while ITGAL was expressed in T cells of psoriasis samples. Molecular docking confirmed a stable binding interaction between Dehydroandrographolide and AR. In vitro validation using an M5 cytokine-induced keratinocyte model demonstrated that Dehydroandrographolide exerted potent anti-inflammatory and antiproliferative effects. Furthermore, it significantly modulated the protein expression levels of both genes.DiscussionCombining in-silico and in-vitro analyses, this study identified AR and ITGAL as potential key mediators and validated the efficacy of the active component of AP, Dehydroandrographolide, against psoriasis.ConclusionCollectively, the study demonstrated that AP had the potential anti-psoriasis effects.Weiterlesen

To compare the efficacy and safety of different ustekinumab biosimilars for treating moderate-to-severe plaque psoriasis (PP), providing an evidence-based basis for clinical medication. We systematically searched randomized controlled trials on ustekinumab biosimilars for treating moderate-to-severe PP in adults from Embase, PubMed, Cochrane Library, and Web of Science. Stata 18.0 was utilized for data analysis. Nine studies were included, involving 4293 moderate-to-severe PP patients. 1) Ustekinumab biosimilars and the reference listed drug (RLD) ustekinumab-RP had no significant difference in the psoriasis area and severity index (PASI) improvement (P > 0.05), and the biosimilar CT-P43 was most effective in improving PASI at different time points. 2) For the dermatology life quality index, Bmab1200, AVT04 and CT-P43, had statistically significant differences from the RLD (P < 0.05). 3) The biosimilar CT-P43 was most effective in improving the Physician Global Assessment score, with the highest SUCRA value (99.8%). 4) The reduction of the body surface area and the treatment-emergent adverse event rate had no statistically significant difference from the RLD (P > 0.05). 5) The biosimilar CT-P43 and Bmab1200 demonstrated a lower probability of generating anti-drug antibodies, showing statistically significant differences from other biosimilars (P < 0.05). Ustekinumab biosimilars demonstrate comparable efficacy and safety to ustekinumab-RP for treating moderate-to-severe PP in adults. The biosimilar CT-P43 is more effective in improving short-term PASI. Due to limitations in the number and quality of included studies, more high-quality studies are required to validate these findings.Weiterlesen

Originaltitel: Difficult to treat disease in psoriatic arthritis- is it different from axial spondyloarthritis? Link zur Quelle

Originaltitel: Using causal machine learning and real world data to improve dose response decision making for secukinumab in psoriatic arthritis. Link zur Quelle

# Psoriasis arthritis verbindet Haut- und Gelenkerkrankung Wissenschaftler haben eine spannende Entdeckung gemacht. Sie zeigt, dass Psoriasis arthritis wie eine Brücke zwischen zwei Krankheiten funktioniert. Auf der einen Seite steht die Gelenkerkrankung Rheumatoide Arthritis. Auf der anderen Seite steht die Hauterkrankung Psoriasis. Die Forscher untersuchten spezielle Blutzellen namens Monozyten. Sie schauten sich an, wie diese Zellen bei Psoriasis arthritis arbeiten. Dabei fanden sie etwas Besonderes. Psoriasis arthritis hat nämlich Merkmale von beiden Krankheiten gleichzeitig. Die Wissenschaftler entdeckten auch gemeinsame Entzündungsmuster. Diese treten bei allen drei Erkrankungen auf. Besonders interessant ist: Bei Psoriasis arthritis wirken zwei verschiedene Entzündungsprogramme gleichzeitig. Das eine wirkt wie bei der Gelenkerkrankung. Das andere wirkt wie bei der Hauterkrankung. Was bedeutet das für dich? Diese neuen Erkenntnisse helfen Ärzten besser zu verstehen, was in deinem Körper passiert. Sie könnten künftig auch bessere Vorhersagen machen. Das bedeutet: Deine Behandlung könnte später noch gezielter auf dich abgestimmt werden. Originaltitel: Psoriatic arthritis monocyte DNA methylomes bridge joint and skin inflammatory pathways across rheumatoid arthritis and psoriasis. Link zur Quelle

# Neue Daten zeigen: So häufig ist Psoriasis wirklich Forscher haben untersucht, wie oft Psoriasis und andere Erkrankungen bei Menschen ab 50 Jahren in Deutschland auftreten. Dafür nutzen sie Daten von Millionen versicherten Personen. Das Ergebnis ist interessant für Menschen mit Psoriasis. Bei Männern ab 50 treten pro 100.000 Menschen zwischen 268 und 430 Fälle von Psoriasis auf. Bei Frauen sind es 230 bis 412 Fälle. Das bedeutet: Männer erkranken etwas häufiger an Psoriasis als Frauen. Die genaue Häufigkeit hängt vom Alter ab. Die Forscher wollten vor allem herausfinden, welche Nebenwirkungen nach einer Impfung normal sind. Deshalb brauchten sie diese genauen Zahlen. Sie zeigen, wie oft Psoriasis und ähnliche Erkrankungen ohne Impfung auftreten würden. Die Studie nutzte echte Krankenkassendaten. Das macht die Ergebnisse sehr zuverlässig. Ärzte können diese Werte jetzt besser einschätzen, ob eine Erkrankung durch eine Impfung verursacht wurde. Für Patienten bedeutet das: Es wird sicherer nachvollziehbar, ob eine Impfung wirklich schuld an einer neuen Diagnose war. Originaltitel: Sex- and age-specific background incidence rates for various medical events in the German population aged ≥ 50 years using a nationwide monitoring system of claims data. Link zur Quelle

No abstract supplied.Weiterlesen

Lipoxygenases peroxidise polyunsaturated fatty acids, resulting in oxylipins, which may act pro- or anti-inflammatory. Arachidonate 15-lipoxygenase type B was shown to play a role in the resolution of keratinocyte inflammation and is upregulated in psoriasis. Its murine ortholog, arachidonate 8-lipoxygenase (Alox8), differs in regiospecificity in that it adds molecular oxygen to the 8th and not 15th carbon of arachidonic acid. This study aimed to determine if Alox8 plays a role in the resolution of murine imiquimod-induced psoriasis. Alox8 knockout (KO) mice, which are not commercially available, were generated with a functional KO targeting the enzyme's active site. Untargeted Lipidomics revealed changes in the skin lipidome from both imiquimod-induced psoriasis as well as between wild-type and KO mice. Furthermore, LC-MS/MS revealed a functional KO with reductions in Alox8-specific oxylipins. Lipid peroxidation marker 4-hydroxynonenal was elevated in the epidermis of wild-type mice from imiquimod treatment, however, it was significantly reduced in Alox8 KO mice. Alox8 KO mice exhibited a thickened epidermis, resulting from reduced DNA damage and increased proliferation. Moreover, immune cell infiltration was enhanced in Alox8 KO mice, including a higher abundance of γδ T cells. Elevated cytokine levels of interleukin-17 and -22, accompanied by keratinocyte-produced C-X-C motif chemokine ligand 1, were detected in the skin of Alox8 KO mice. Additionally, cyclooxygenase 2 expression and prostaglandin E2 levels were enhanced in Alox8 KO mice. These data demonstrate an exacerbated and prolonged inflammatory psoriasis phenotype in Alox8 KO mice, implying that Alox8 aids in the resolution of murine psoriasis.Weiterlesen

# Alter kein Hindernis für Secukinumab-Therapie Die gute Nachricht: Das Alter spielt bei der Wirksamkeit von Secukinumab keine wesentliche Rolle.[1] In dieser großen Analyse von über 1400 Patienten zeigte das Medikament bei jüngeren und älteren Patienten ähnlich gute Ergebnisse bei der Verbesserung der Symptome.[1] ## Das bedeutet für Euer tägliches Leben Die Hauptziele der Therapie – weniger Schmerzen, bessere Beweglichkeit, geringere Entzündung – werden in beiden Altersgruppen gleich gut erreicht.[1] Daher sollte Euer Alter kein Grund sein, auf diese moderne Therapie zu verzichten. Kleine Unterschiede zeigten sich nur bei Nebenpunkten: Ältere Patienten verzeichneten etwas weniger Verbesserung bei der Lebensqualität und in Entzündungsmarkern.[1] Diese Unterschiede sind aber gering und ändern nichts an der grundsätzlich guten Wirksamkeit. **Fazit:** Wenn Euer Arzt Secukinumab empfiehlt, ist Euer Alter kein Grund, die Therapie abzulehnen. Die Studie zeigt: Auch mit 40+ profitiert Ihr von dieser Behandlung.[1] Originaltitel: No major effect of age ( 40 vs. ≥ 40 years) on response to secukinumab in patients with axSpA: a post hoc analysis of six phase 3 trials - Arthritis Research & Therapy Link zur Quelle

No abstract supplied.Weiterlesen

IntroductionPsoriasis is a chronic inflammatory skin disease that significantly impacts patients' quality of life. Patients with skin of colour (SoC) often face unique barriers related to gaining access to care, diagnosis and treatment, which can contribute to health disparities. The aim of this study was to assess patient-reported experiences across the psoriasis care continuum in Canada, comparing white and non-white populations.MethodsA 15-min online survey was administered between 9 December and 19 December 2022 to patients ≥ 18 years with a confirmed psoriasis diagnosis. The survey included 33 questions covering demographics, medical history, psoriasis experience and access to information. Responses were analysed using t-tests at a 90% confidence level to identify significant differences based on ethnicity, treatment users, gender, psoriasis severity and region.ResultsOf approximately 2500 invited participants, 103 met the eligibility criteria: 62 self-identified as white and 41 as non-white. A higher proportion of non-white patients reported severe psoriasis, delays in diagnosis and greater emotional and social burden during the pre-diagnosis stage. Non-white patients were more frequently diagnosed and treated by dermatologists and more commonly used non-topical therapies. Misdiagnosis, often as eczema or dermatitis, was more prevalent among non-white patients. Treatment initiation was more commonly delayed in non-white patients, with 71% reporting difficulty accessing effective therapy, compared to 31% of white patients. A greater proportion of non-white respondents sought additional support and education, especially for mental wellness and advocacy resources.ConclusionDisparities in psoriasis care are evident across the experience of patients with psoriasis. Among those who participated in the survey, a greater proportion of the non-white patients faced delayed diagnosis, misdiagnosis, and greater barriers to treatment access, often reflecting more severe disease and unmet informational needs. These findings highlight the importance of culturally competent care and inclusive research to ensure equitable outcomes for all patients with psoriasis. Enhanced representation in clinical trials and targeted health interventions are essential to address these disparities.Weiterlesen

IntroductionCutaneous lupus erythematosus (CLE), particularly discoid lupus erythematosus (DLE), is a chronic autoimmune condition driven in part by type I interferon signaling. No systemic therapies are specifically approved for CLE, and management is often extrapolated from systemic lupus erythematosus. Deucravacitinib, a selective oral tyrosine kinase 2 (TYK2) inhibitor targeting the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway, has shown efficacy in psoriasis and emerging promise in lupus.Case reportWe describe a 29-year-old woman with biopsy-proven DLE refractory to prednisone and hydroxychloroquine who subsequently developed moderate-to-severe plaque psoriasis (Psoriasis Area and Severity Index [PASI] 16). Initial treatment with ixekizumab improved psoriasis but failed to control DLE, and psoriatic lesions later relapsed. Therapy was switched to deucravacitinib 6 mg daily. After 9 weeks, marked improvement of both conditions was observed (PASI 0.2) with progressive regression of DLE lesions. By week 27, complete clinical remission of psoriasis (PASI 0) and full resolution of DLE lesions were achieved, confirmed by reflectance confocal microscopy.ConclusionThis case highlights the potential of deucravacitinib as an effective therapeutic option for refractory DLE, particularly in patients with concomitant psoriasis, supporting TYK2 inhibition as a promising targeted strategy in cutaneous autoimmunity.Weiterlesen

BackgroundPediatric psoriasis is a chronic inflammatory skin disease that affects both physical and psychosocial well-being. The impact of the disease extends beyond the patient, significantly affecting caregivers' emotional and functional quality of life.ObjectivesThis systematic review and meta-analysis aimed to evaluate the health-related quality of life (HrQOL) burden of pediatric psoriasis on children and their caregivers. The study also sought to identify clinical and child-related factors associated with increased impairment in HrQOL.MethodsA systematic search of MEDLINE and Embase databases was conducted according to PRISMA guidelines. Studies included children under 18 years of age with a diagnosis of psoriasis and/or their caregivers, reporting outcomes using validated HrQOL measures. Two reviewers independently screened studies, extracted data, and assessed quality using the Mixed Methods Appraisal Tool. Where appropriate, correlation coefficients were pooled using random-effects meta-analysis after Fisher's Z-transformation.ResultsTwenty-one studies were included, encompassing 1038 children and 1161 caregivers. The most commonly used instruments were the Children's Dermatology Life Quality Index (CDLQI) and Family Dermatology Life Quality Index (FDLQI). Across studies, 84.8% of children and 96.1% of caregivers experienced some degree of HrQOL impairment. Meta-analysis revealed a moderate positive correlation between child disease severity (PASI scores) and caregiver HrQOL burden (r = 0.463), while no significant correlation was found with child age or disease duration. Amongst children, HrQOL was most affected in the domains of symptoms, leisure, and treatment-related concerns.ConclusionsPediatric psoriasis exerts a substantial impact on both child and caregiver quality of life, with greater burden associated with more severe disease. These findings highlight the need for early intervention and psychosocial support targeting families. Clinicians should consider the broader family context when managing pediatric psoriasis and prioritize counseling during disease flares to mitigate emotional and functional strain.Weiterlesen

Lipoxygenases peroxidise polyunsaturated fatty acids, resulting in oxylipins, which may act pro- or anti-inflammatory. Arachidonate 15-lipoxygenase type B was shown to play a role in the resolution of keratinocyte inflammation and is upregulated in psoriasis. Its murine ortholog, arachidonate 8-lipoxygenase (Alox8), differs in regiospecificity in that it adds molecular oxygen to the 8th and not 15th carbon of arachidonic acid. This study aimed to determine if Alox8 plays a role in the resolution of murine imiquimod-induced psoriasis. Alox8 knockout (KO) mice, which are not commercially available, were generated with a functional KO targeting the enzyme's active site. Untargeted Lipidomics revealed changes in the skin lipidome from both imiquimod-induced psoriasis as well as between wild-type and KO mice. Furthermore, LC-MS/MS revealed a functional KO with reductions in Alox8-specific oxylipins. Lipid peroxidation marker 4-hydroxynonenal was elevated in the epidermis of wild-type mice from imiquimod treatment, however, it was significantly reduced in Alox8 KO mice. Alox8 KO mice exhibited a thickened epidermis, resulting from reduced DNA damage and increased proliferation. Moreover, immune cell infiltration was enhanced in Alox8 KO mice, including a higher abundance of γδ T cells. Elevated cytokine levels of interleukin-17 and -22, accompanied by keratinocyte-produced C-X-C motif chemokine ligand 1, were detected in the skin of Alox8 KO mice. Additionally, cyclooxygenase 2 expression and prostaglandin E2 levels were enhanced in Alox8 KO mice. These data demonstrate an exacerbated and prolonged inflammatory psoriasis phenotype in Alox8 KO mice, implying that Alox8 aids in the resolution of murine psoriasis.Weiterlesen

Psoriasis is a chronic immune-mediated inflammatory disease with systemic manifestations beyond the skin, yet the role of subcutaneous adipose tissue (SAT) in disease biology and therapeutic response remains poorly understood. Here, we investigated inflammatory features of SAT in psoriasis and the effects of dimethyl fumarate (DMF) on this compartment. Six adults with moderate-to-severe plaque psoriasis received oral DMF for 24 weeks and were clinically evaluated measuring the Psoriasis Area and Severity Index (PASI), showing a consistent reduction in disease severity during treatment. Publicly available spatial transcriptomic data were analysed to profile inflammatory signatures in SAT clusters of psoriatic versus healthy skin. Bulk RNA sequencing was performed on SAT biopsies obtained from psoriatic plaques before and after DMF treatment in four patients. Complementary in vitro models using murine 3T3-L1 adipocytes and human adipocytes differentiated from mesenchymal stem cells were exposed to pro-inflammatory cytokines or macrophage-conditioned media (CM) with or without DMF to assess effects on inflammatory gene expression and NF-κB signalling. Spatial transcriptomics identified enrichment of inflammation-related pathways in SAT beneath psoriatic lesions. DMF treatment was associated with reduced expression of inflammatory mediators and with a shift in SAT transcriptional profile toward patterns observed in healthy tissue. In vitro, DMF significantly attenuated cytokine- and CM-induced adipocyte activation and reduced NF-κB phosphorylation in both murine and human adipocyte models. These data provide integrated clinical and experimental evidence that DMF treatment is associated with reduced disease activity and attenuation of inflammatory signalling within psoriatic SAT, supporting adipose tissue as a potentially modifiable inflammatory compartment in psoriasis.Weiterlesen

ImportanceAvailable evidence reveals markedly divergent metabolic signatures across biologics and small-molecule inhibitors, highlighting the need for further investigations.ObjectiveTo address this knowledge gap, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies in patients with psoriasis or psoriatic arthritis (PsA) to quantify the short- and long-term effects of targeted therapies on lipid profiles.Evidence reviewPubMed, Embase, and Cochrane databases were searched for RCTs and observational studies published through July 25, 2025. Eligible randomized RCTs were evaluated using the Cochrane Risk of Bias tool, while nonrandomized studies were assessed using the Methodological Index for Non-Randomized Studies. All lipid effect estimates were derived from within-group pre-to-post changes in patients with psoriasis or PsA.FindingsThirty-six articles involving 21,477 patients with psoriasis and 3098 patients with PsA (total 24,575) across seven targets were analyzed. The long-term use of Janus kinase inhibitors (JAKi) significantly increases total cholesterol (TC; weighted mean difference [WMD] = 7.03; 95% confidence interval [CI] = 1.22, 12.84), triglyceride (TG; WMD = 19.98; 95% CI = 13.82, 26.14), high-density lipoprotein cholesterol (HDL-c; WMD = 6.87; 95% CI = 4.38, 9.36), and low-density lipoprotein cholesterol (LDL-c; WMD = 12.37; 95% CI = 7.24, 17.50) levels. Long-term tumor necrosis factor alpha inhibitors (TNFi) significantly lowers TC (WMD = -8.40; 95% CI = -15.21, -1.60), TG (WMD = -15.22; 95% CI = -21.92, -8.51), and LDL-c (WMD = -10.61; 95% CI = -16.77, -4.45) levels while raising HDL-c (WMD = 4.13; 95% CI = 1.23; 7.03) levels. Long-term interleukin-17 A inhibitors significantly increases TG (WMD = 7.31; 95% CI = 3.17, 11.46) levels, whereas IL-23p19 inhibitors yield the opposite effect (WMD = -32.08; 95% CI = -51.87, -12.30).Conclusions and relevanceOur data underscore the need for routine lipid monitoring during TNF-α- and JAK-targeted therapy in patients with psoriasis or PsA. Due to the limitations of our analysis, well-designed prospective trials with extended follow-up periods are warranted to validate and refine these observations.Weiterlesen