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Für Psoriasis-Arthritis gibt es viele internationale Behandlungsleitlinien, zum Beispiel von ACR, GRAPPA, EULAR oder PANLAR. Sie haben oft ähnliche Ziele: Lebensqualität verbessern, Schäden verhindern und die Therapie auf jede Patientin oder jeden Patienten anpassen[1]. Trotzdem gibt es Unterschiede bei Methoden und Empfehlungen, was dazu führen kann, dass Ärzte den Überblick verlieren. Fachleute schlagen daher vor, weltweit einheitliche Kernempfehlungen zu erarbeiten, die dann regional angepasst werden können. So bleiben die Leitlinien aktuell, verständlich und für alle relevant – egal wo man lebt[1]. Neue Tools wie künstliche Intelligenz könnten helfen, die Empfehlungen schneller zu aktualisieren. Originaltitel: Towards Harmonized Recommendations for Psoriatic Arthritis: A Comparative Viewpoint on Global Guidelines. Link zur Quelle

No abstract supplied.Weiterlesen

Psoriasis is a chronic immune-mediated disease mainly affecting the skin with different clinical manifestations. As patients with psoriasis may also suffer from psoriatic arthritis and the skin lesions of psoriasis are disfiguring, their quality of life is often impaired. Many environmental and genetic factors have been implicated in psoriasis development. Currently, there is no cure for the disease and long-term drug treatment is usually necessary, especially in moderate to severe cases. Mesenchymal stem cells (MSCs) are popular candidates for cell-based treatment in many immune-mediated diseases due to their ability to secrete a wide array of cytokines and growth factors and their immunomodulatory properties. MSCs from various sources administered via different routes have been shown to ameliorate psoriasis. This review gives an overview of psoriasis and MSCs and examine preclinical and clinical studies concerning the application of MSCs in the treatment of psoriasis, as well as consolidate major findings in this area of research.Weiterlesen

Psoriasis is an immune-mediated skin disease manifested in more than 3% of Americans and over 125 million people worldwide. The inflammatory skin condition with an increased rate of keratinocyte turnover involves every level of the skin and exhibits various forms of the disease, including plaque, guttate, inverse, pustular, and erythrodermic psoriasis, as well as disease-associated conditions, such as psoriatic arthritis and nail psoriasis. Innovative treatment has highlighted the importance of Apremilast, an oral drug that belongs to the phosphodiesterase- 4 (PDE4) class, which was approved by the FDA in 2014. Apremilast works by increasing the presence of cyclic adenosine monophosphate (cAMP) within cells, thereby affecting inflammatory processes and reducing the production of pathological cytokines. Randomized controlled trials have shown that it effectively treats moderately to severely affected plaque psoriasis and psoriatic arthritis, and it is safer than traditional systemic agents. The new perspective on the usage of ethosomes, niosomes, liposomes, and nanostructured lipid carriers in psoriasis treatment is based on emerging nanotechnology in drug delivery systems. These new formulations are designed to enhance the solubility and targeted release of Apremilast, thus providing an enhanced therapeutic effect. This review will discuss the basic mechanisms of the disease known as psoriasis, as well as the mode of operation, pharmacological properties, clinical trials, and pharmacokinetics of apremilast, particularly in relation to nanocarrier modification of this promising drug.Weiterlesen

BackgroundTopical drugs containing corticosteroids are recommended first-line treatment for patients with mild-moderate psoriasis. However, the optimal recommended dosage of topical drugs has not been well established.ObjectivesTo investigate the effect of topical drug application quantity and treatment duration on psoriasis treatment outcome.MethodsWe conducted a post-hoc analysis of two randomized controlled trials investigating 214 patients with psoriasis using topical drugs containing corticosteroids and/or calcipotriol for up to 48 weeks. We measured the amount of topical drugs used during the study period and calculated the mean amount of applied drugs per 1% affected body surface area (BSA) divided by number of days in the study period. Improvement in severity of psoriasis was measured by Lattice-System Physician's Global Assessment (LS-PGA) (where affected BSA was divided into seven categories) from baseline to last study visit. Descriptive results were reported as counts with proportions, and as means with normality-based confidence intervals (CI). Associations were analyzed using linear regressions.ResultsMost study participants had a duration of psoriasis greater than 20 years, moderate psoriasis, and no history of using systemic psoriasis treatment. They had applied a mean of 1.0 g per 1% BSA per day (95% CI 0.9; 1.2). Daily use of topical drugs for four-weeks reduced severity of psoriasis. However, extended daily use for up to 48 weeks provided further reduction in disease severity (coefficient --0.30 (95% CI -0.51, -0.09)) and -0.73 (95% CI -1.09; -0.38) (P= 0.028). Greater amount of applied topical drugs reduced severity of psoriasis in a linear manner. Every increase of 1 g of topical drugs applied per 1% BSA per day reduced LS-PGA by 0.43 (95% CI 0.24; 0.61). Finally, patients who had never used systemic drugs experienced a greater reduction in psoriasis when applying the same mean amount of topical drugs (coefficient -0.7 (95% CI -1.1, -0.4) compared to those who had a history of taking systemic treatment (-0.3 (95% CI -0.5; -0.1), P=0.026).ConclusionsA mean application amount of at least 1.0 g of topical drugs per 1% BSA per day seems safe and effective and can be used daily until clearance.Weiterlesen

Aim: Having psoriasis and being treated with medication could raise concerns regarding family planning and pregnancy (FPP), and no guidelines are available on healthcare practice and information provision regarding FPP for these patients. This study aims to gain insight in the perspectives of patients with psoriasis on this important subject.Methods: A cross-sectional questionnaire study including adult female and male patients with psoriasis, independent of their treatment type.Results: A total of 102 patients responded to the questionnaire (70% females, 30% males), of whom 47.1% have ever used biologic therapy. Respondents preferred dermatologists or general practitioners (GPs) as information provider. Patients would like to receive FPP information on fertility, heredity of psoriasis, use of psoriasis medication, and - specifically for females- the course of psoriasis during and after pregnancy and breastfeeding. Timing of FPP information provision was preferable at moment of diagnosis and medication changes or upon explicit request.Conclusion: Dermatologists and GPs have a crucial role in providing FPP information. The findings of this study have provided hands-on guidance for healthcare professionals to improve healthcare for both female and male patients with psoriasis in the reproductive age.Weiterlesen

Psoriasis is a chronic immune-mediated skin disease that is increasingly understood as a systemic inflammatory condition with implications that extend far beyond the skin. Among its most serious associations is an elevated risk of cardiovascular disease, which has emerged as a leading cause of morbidity and mortality in affected patients. The persistent immune activation characteristic of psoriasis, driven by cytokines such as tumor necrosis factor α (TNFα), interleukin (IL)-17, and IL-23, contributes to endothelial dysfunction, oxidative stress, and atherogenesis. This shared pathophysiology helps explain the increased prevalence of coronary artery calcification, impaired microvascular function, and early-onset myocardial infarction observed in this population. Traditional risk assessment tools often fail to capture the actual cardiovascular burden in patients with moderate to severe disease. Evidence suggests that biologic therapies targeting key inflammatory pathways not only improve dermatologic outcomes but may also mitigate vascular risk, offering systemic benefits that extend beyond skin clearance. Recognizing psoriasis as a multisystem disorder reinforces the need for a more integrated approach to risk assessment and long-term management.Weiterlesen

Psoriasis is a chronic inflammatory autoimmune disease that causes significant deterioration of the quality of life, and due to its multifactorial causes, it is often difficult to manage. Apart from genetic and environmental components, an important part of its pathophysiology comprises an oxidative stress induction that the standard antioxidative mechanisms of the human body cannot compensate for. Moreover, in many psoriatic patients, there is a documented imbalance between antioxidant and pro-oxidative factors. Usually, psoriasis is evaluated using the Psoriasis Area and Severity Index (PASI) score. It has been demonstrated that dietary choices can lead to significant modification of PASI scores. Hypocaloric diets that are rich in antioxidants are highly effective in this regard, especially when focusing on vegetables and restricting consumption of animal-derived protein. Specific dietary regimens, namely the Mediterranean diet and potentially the ketogenic diet, are very beneficial, in the former case owing in large part to the omega-three fatty acids it provides and its ability to alter gut microbiome, a factor which seems to play a notable role in the pathogenesis of the disease. Another option is the topical application of vitamin D and its analogues, combined with corticosteroids, which can ameliorate the manifestations of psoriasis at the level of the skin. Finally, oral vitamin D supplementation has a positive impact on psoriatic arthritis and can mitigate the risk of associated comorbidities.Weiterlesen

BackgroundThe approach to pediatric psoriasis requires special considerations, given the potential for negative consequences on overall physical and psychosocial health.ObjectiveThe aim of this study was to systematically review the literature to characterize the burden of pediatric psoriasis.MethodsPapers assessing associations between pediatric psoriasis (in children <18 years old) and quality of life, physical symptoms (e.g., skin pain, itch, sleep disruption), and adverse psychological, social, and financial effects were searched with no date restrictions through July 2023. Databases searched included Ovid MEDLINE®, CENTRAL, the Cochrane Database of Systematic Reviews, and PsycInfo. Articles were excluded if they focused on comorbidities (including psoriatic arthritis/enthesitis), were of low quality, or were not in English.Results64 publications met eligibility criteria. Composite quality of life was the most frequently reported domain (40 publications) and was negatively impacted by psoriasis as a function of severity. Physical burdens, especially itch, occurred in 44.1-96.3% of children with psoriasis, while skin pain was less common. Psychosocial and family burdens were less frequently assessed and often with non-validated tools. Children with psoriasis participated less in social activities, but there were no clear associations between psoriasis and school performance or interpersonal relationships. Psoriasis was associated with a higher mental health burden on caregivers and greater family financial burden.ConclusionsPsoriasis leads to high burden for pediatric patients and caregivers. Evaluation and management decisions should include and incorporate a thorough assessment of burden. Additional studies using validated tools are necessary to fully assess psychosocial and family burdens of psoriasis.Weiterlesen

IntroductionBimekizumab (BKZ), a monoclonal antibody targeting interleukin (IL)-17A and IL-17F, has shown high efficacy in clinical trials. However, real-world data on its use in psoriatic arthritis (PsA) are limited. This study aimed to evaluate the effectiveness and safety of BKZ over 24 weeks in a real-world setting.MethodsA retrospective, multicenter study was conducted at two Italian rheumatology centers, enrolling adult patients with PsA who initiated BKZ treatment between January 2023 and February 2025. Clinical data were collected at baseline, week 12, and week 24.ResultsForty patients with PsA were included. Of these, 75% had failed at least two biologic and/or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) prior to BKZ and 25/40 (62.5%) had failed at least one IL-17A inhibitor (IL-17Ai). Among these 25 patients, 32% experienced a primary failure and 68% a secondary failure. The median baseline Disease Activity in Psoriatic Arthritis (DAPSA) score was 22.9 (17.5-27.2), decreasing to 6.0 (3.1-12.8) at week 24 (p < 0.001). By week 24, 72.5% achieved DAPSA low disease activity (LDA), and 25% achieved DAPSA remission. The median swollen joint count (SJC) decreased from 3.0 (0.8-5.3) to 0.0 (IQR 0.0-1.0), and median tender joint count (TJC) decreased from 4.5 (3.0-7.3) to 1.0 (0.0-2.0) (both p < 0.001). Pain visual analog scale (VAS) and Patient Global Assessment (PGA) improved significantly, from 7.0 (6.0-8.0) and 7.5 (6.5-8.0) at baseline to 2.0 (1.0-5.0) and 2.0 (1.0-4.5) at week 24 (both p < 0.001). Skin involvement also improved, with 51.5% achieving Psoriasis Area and Severity Index (PASI) 100 by week 24. The safety profile was favorable; 15% of patients developed mild oral candidiasis, none of which required treatment discontinuation.ConclusionBKZ demonstrated rapid and sustained improvements in PsA symptoms in a challenging real-world population, with a favorable safety profile.Weiterlesen

BackgroundPsoriasis is frequently associated with non-communicable disease (NCD) comorbidities, prompting interest in how these concurrent conditions may influence psoriasis treatment outcomes.ObjectivesTo assess NCD prevalence and their influence on psoriasis treatment outcomes.MethodsFrom 2022 to 2024, we recruited psoriasis patients in Shanghai Skin Disease Hospital. Data on demographic features, NCD comorbidities and treatment outcomes at week 4 and week 8 were systematically collected through questionnaire, physical examination, and clinical severity assessment (psoriasis area and severity index [PASI], body surface area [BSA], physician's global assessment [PGA]).ResultsAmong 1116 patients, 48.4% had at least one NCD comorbidity. NCD-free patients exhibited higher PASI50 response rates at both week 4 (46.5 vs. 39.1%) and week 8 (72.2 vs. 70.9%). Log binomial regression revealed that NCDs significantly reduced the likelihood of achieving PASI50 at week 4 (relative risk [RR] = 0.84, 95% confidence interval [CI]: 0.73-0.96), with a similar but non-significant trend at week 8 (RR = 0.98, 95% CI: 0.92-1.06).ConclusionNCDs negatively impact early treatment outcomes in psoriasis patients. So we propose that dermatologists should integrate systematic NCD management into psoriasis treatment regimen.Weiterlesen

Frauen mit Psoriasis-Arthritis und Rheumatoider Arthritis haben häufiger Probleme mit der Handfunktion als Männer. Dazu gehören weniger Kraft beim Greifen und Schwierigkeiten bei Feinmotorik. Bei allen Patientinnen und Patienten waren die Einschränkungen ähnlich stark, aber Frauen waren besonders betroffen. Selbst ohne sichtbare Entzündungen in den Händen zeigten viele Frauen Funktionsstörungen. Bei Männern war vor allem die Feinmotorik bei Psoriasis-Arthritis eingeschränkt, die Griffkraft blieb meist besser erhalten. Steigt der Krankheitsaktivitätswert, nimmt bei allen Betroffenen die Griffkraft weiter ab. Vor allem bei Frauen mit Psoriasis-Arthritis leidet dann auch die Feinmotorik noch stärker. Originaltitel: Hand Function Impairments Are More Pronounced in Female RA... : Medicine & Science in Sports & Exercise Link zur Quelle

ME3183 ist ein neuer Wirkstoff, der gegen Schuppenflechte getestet wird. Er gehört zur Gruppe der PDE4-Hemmer und wird als Tablette eingenommen. In einer Studie mit 132 Teilnehmenden bekamen die Betroffenen verschiedene Dosen von ME3183 oder ein Scheinmedikament. Nach 16 Wochen hatten deutlich mehr Menschen mit ME3183 eine starke Besserung ihrer Haut erreicht als in der Vergleichsgruppe mit dem Scheinmedikament[2][3]. Schon früh zeigten sich Verbesserungen unter der Behandlung. Häufigste Nebenwirkungen waren Durchfall und Kopfschmerzen, wie man es auch von anderen PDE4-Hemmern kennt[1]. Insgesamt wurde ME3183 gut vertragen. In Labortests zeigte der Wirkstoff eine stärkere entzündungshemmende Wirkung als bereits zugelassene ähnliche Tabletten[3]. Originaltitel: emJournal of the European Academy of Dermatology and Venereology/em | Wiley Online Library Link zur Quelle

Neue Forschung zeigt, dass Psoriasis mehr ist als eine einfache Entzündung durch fehlgeleitete Immunzellen. Bisher dachte man, T-Zellen und bestimmte Botenstoffe wie IL-17A und IL-23 lösen die Schuppenflechte aus, indem sie Hautzellen zur Überproduktion anregen[1]. Das stimmt zwar, aber die Sache ist komplexer. Mit modernen Techniken wie Spatial Proteomics haben Forschende jetzt herausgefunden: Schuppenflechte verteilt sich auf verschiedene Hautschichten, die jeweils eigene Aufgaben und Zelltypen haben[1]. Vor allem die innere Epidermis spielt wohl eine zentrale Rolle. Dort verändern sich besonders viele Eiweiße – einige davon gehören zur Immunabwehr, andere sind wichtig für den Stoffwechsel wie die Cholesterinproduktion[1]. Auch das Zusammenspiel von Hautzellen, Bindegewebszellen und Immunzellen geschieht in Schichten und ist vielschichtiger als gedacht[4]. Dieses neue Verständnis könnte helfen, gezieltere Therapien zu entwickeln. Originaltitel: Spatial Proteomics Redefines Psoriasis as a Vertically Stratified, Immunometabolic Tissue State Link zur Quelle

Forscher haben bei Mäusen gezeigt: Fehlt das Enzym **Myeloperoxidase (MPO)**, werden Entzündungen bei **Psoriasis Arthritis** deutlich schlimmer[1]. Es kommt zu mehr Hautentzündungen, stärkeren Schwellungen an den Gelenken und sogar zu stärkerem Knochenabbau. In den betroffenen Bereichen fanden sie mehr Entzündungszellen und mehr entzündliche Botenstoffe. Normalerweise hilft MPO wohl mit, solche Entzündungen durch bestimmte Vorgänge in Abwehrzellen zu bremsen. Ohne MPO läuft das Immunsystem also besonders heiß[1]. Originaltitel: Loss of myeloperoxidase aggravates skin and joint inflammation in the mannan-induced psoriatic arthritis mouse model. Link zur Quelle

In dieser Studie wird untersucht, wie wirksam und sicher der Wirkstoff **JNJ-77242113** bei Erwachsenen mit mittelschwerer bis schwerer Plaque-Psoriasis ist. Die Studie ist eine große, internationale Phase-3-Studie, bei der die Teilnehmer nach dem Zufallsprinzip entweder das Prüfmedikament oder ein Placebo erhalten, ohne dass sie oder die Ärzte wissen, wer was bekommt. Nach einer ersten Behandlungsphase werden einige Patienten zufällig auf ein Absetzen oder eine erneute Behandlung umgestellt, um zu prüfen, wie stabil die Wirkung ist und wie gut das Medikament bei erneutem Bedarf wirkt. **JNJ-77242113** ist eine neuartige Substanz in Tablettenform, die gezielt den sogenannten IL-23-Rezeptor blockiert. IL-23 ist ein Botenstoff im Immunsystem, der eine zentrale Rolle bei der Entstehung und Aufrechterhaltung der Entzündungsreaktionen bei Psoriasis spielt. Durch die Blockade dieses Rezeptors wird die Aktivierung bestimmter Immunzellen gehemmt, was zu einer deutlichen Verbesserung der Hautsymptome führen kann. Im Unterschied zu vielen bisherigen Therapien, die gespritzt werden müssen, handelt es sich bei JNJ-77242113 um eine Tablette, die oral eingenommen wird. Frühere Studien zeigen, dass viele Patienten unter dieser Behandlung eine nahezu vollständige oder vollständige Abheilung der Haut erreichen und die Wirkung auch über längere Zeit anhält. Die bisherigen Daten deuten außerdem auf ein günstiges Sicherheitsprofil hin. Originaltitel: A Phase 3 Multicenter, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of JNJ-77242113 for the Treatment of Participants with Moderate to Severe Plaque Psoriasis with Randomized Withdrawal and Retreatment Erkrankung: mittelschwere bis schwere Plaque-Psoriasis Phase: III Firma: Janssen - Cilag International Art der Verabreichung: Tablette https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2023-505120-59-00

In dieser Studie wird untersucht, wie wirksam und sicher der Wirkstoff **JNJ-77242113** bei Erwachsenen mit mittelschwerer bis schwerer Plaque-Psoriasis ist. Die Teilnehmer erhalten entweder JNJ-77242113, ein Placebo (eine Tablette ohne Wirkstoff) oder Deucravacitinib, einen bereits zugelassenen Wirkstoff gegen Psoriasis. Ziel ist es herauszufinden, ob JNJ-77242113 die Hautsymptome besser lindert als die Vergleichssubstanzen und wie gut das Medikament vertragen wird. **JNJ-77242113** ist eine neuartige Tablette, die gezielt den sogenannten IL-23-Rezeptor blockiert. IL-23 ist ein Botenstoff im Immunsystem, der bei Entzündungen und damit auch bei der Entstehung von Psoriasis eine wichtige Rolle spielt. Durch das Blockieren dieses Rezeptors soll verhindert werden, dass Entzündungsprozesse in der Haut ausgelöst werden – dadurch können Rötungen und Schuppenbildung zurückgehen. Die Studie richtet sich an Erwachsene ab 18 Jahren mit einer ausgeprägten Form von Plaque-Psoriasis (mindestens 10% Körperoberfläche betroffen). Sie verläuft doppelblind und randomisiert: Das bedeutet, weder Teilnehmende noch Ärztinnen wissen zunächst, wer welches Präparat bekommt – so lassen sich Unterschiede objektiv messen. Originaltitel: A Phase 3 Multicenter, Randomized, Double-blind, Placebo-controlled and Deucravacitinib Active Comparator-controlled Study to Evaluate the Efficacy and Safety of JNJ-77242113 for the Treatment of Participants With Moderate to Severe Plaque Psoriasis Erkrankung: mittelschwere bis schwere Plaque-Psoriasis Phase: III Firma: Janssen - Cilag International Art der Verabreichung: Tablette (oral) https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2023-505121-14-00

In dieser Studie wird die Wirksamkeit und Sicherheit von **JNJ-77242113** bei Menschen mit Plaque-Psoriasis untersucht, insbesondere an Körperstellen, die als „spezielle Bereiche“ gelten (zum Beispiel Kopfhaut, Gesicht oder Nägel). Die Studie ist eine Phase-3-Studie – das bedeutet, dass sie bereits in einem fortgeschrittenen Stadium der klinischen Entwicklung ist und viele Patientinnen und Patienten einbezieht. Ziel ist es herauszufinden, wie gut das Medikament im Vergleich zu einem Placebo wirkt und wie sicher es ist. **JNJ-77242113**, auch bekannt unter dem Namen Icotrokinra (oder JNJ-2113), ist eine neuartige Substanz zur Behandlung von Plaque-Psoriasis. Es handelt sich um einen sogenannten „oralen Peptid-Wirkstoff“, also ein Medikament in Tablettenform. Das Besondere daran: Es blockiert gezielt den IL-23-Rezeptor – ein Schlüsselmolekül bei der Entstehung von Psoriasis. Durch diese Blockade wird die Entzündungsreaktion im Körper reduziert, was zu einer Verbesserung der Hautsymptome führen kann. In bisherigen Studien zeigte Icotrokinra vielversprechende Ergebnisse: Ein großer Anteil der behandelten Patientinnen und Patienten erreichte nach 16 bis 24 Wochen deutlich klarere Haut oder sogar vollständige Erscheinungsfreiheit – bei gleichzeitig guter Verträglichkeit. Originaltitel: A Phase 3 Multicenter, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of JNJ-77242113 for the Treatment of Participants with Plaque Psoriasis involving Special Areas Erkrankung: Plaque-Psoriasis Phase: III Firma: Janssen - Cilag International Art der Verabreichung: Tablette (oral) https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2023-505122-34-00

Neutrophile sind die häufigsten weißen Blutkörperchen im Blut und kommen als Erste zu Entzündungen oder Infektionen[1][4]. Sie können sogenannte Neutrophil Extracellular Traps (NETs) bilden[1][4]. NETs sind netzartige Strukturen aus DNA und Proteinen[1][3]. Sie fangen Keime ein und helfen, Infektionen zu bekämpfen[1][3]. Doch NETs können auch Probleme machen. Sie fördern Entzündungen und spielen eine Rolle bei Autoimmunerkrankungen wie Psoriasis sowie bei Thrombosen und Krebs[3][4]. So sind NETs wichtig, können aber auch Schaden anrichten. Originaltitel: Neutrophil Extracellular Traps (NETs) in Immunity and Diseases: Second Edition. Link zur Quelle

Background and objectivesContinuous biologic treatment is recommended for patients with psoriasis; however, treatment interruption in daily practice is inevitable. The impact of treatment interruption is difficult to study in a real-world setting. In Taiwan, biologics are reimbursed by the National Health Insurance for moderate-to-severe psoriasis for a 2-year course, followed by regulatory discontinuation. Thus, our study provides pragmatic data on the impact of the interruption of biologics treatment for non-medical reasons on therapy effectiveness.Patients and methodsThis single-center retrospective cohort study recruited patients who underwent two consecutive 2-year courses of biologics between 2012 to 2021.ResultsA total of 192 treatment courses from 61 patients were analyzed, with secukinumab and ustekinumab being the most frequently administered biologics. Among patients who continued with the same biologic across two consecutive courses, the time to achieve PASI 75 was shorter during the first course compared to the second, while overall maintenance effects remained similar. Switching to a different biologic usually produced superior results in the second course of treatment.ConclusionsAlthough the overall effectiveness after interruption and resumption of treatment with secukinumab or ustekinumab was comparable, the time to achieve PASI 75 was longer following an interruption. Continuous, uninterrupted treatment with a given biologic is therefore recommended whenever possible.Weiterlesen

No abstract supplied.Weiterlesen

Gluten-related disorders (GRDs) encompass a spectrum of clinical manifestations triggered by gluten ingestion in genetically susceptible individuals. These disorders include celiac disease (CD) and non-celiac gluten sensitivity (NCGS) and present with both intestinal and extraintestinal symptoms, including skin manifestations. Besides the well-known association between CD and dermatitis herpetiformis, considered as the cutaneous manifestation of CD, other dermatoses have been associated to GRDs. In this paper, we provide a concise overview of the clinical appearance, diagnosis and therapeutic management of GRDs, a tool which we hope will facilitate clinicians when faced with this challenging group of diseases.Weiterlesen

No abstract supplied.Weiterlesen

Tuberculosis (TB) continues to be a leading cause of death in many countries, and also remains a significant concern in Germany, particularly due to migration. The diagnosis of rare cutaneous tuberculosis is challenging as it manifests in various clinical forms that resemble more common dermatological conditions. Especially in paucibacillary forms, gold-standard diagnostic tests may yield negative results, complicating the identification of the disease. Therefore, a strong clinical suspicion based on the clinical presentation is essential for guiding further or repeated diagnostic evaluations. In this article, we present various forms of cutaneous tuberculosis, using excerpts from the image collection of the Department of Dermatology and Allergy at Biederstein, Technical University of Munich, to improve clinical recognition of cutaneous TB and raise awareness of this condition also as a potential differential diagnosis.Weiterlesen

No abstract supplied.Weiterlesen