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Psoriasis is a chronic immune-mediated inflammatory disorder with systemic implications. While transcobalamin 2 (TCN2) has been linked to several autoimmune diseases, its role in psoriasis remains unclear. Here, we investigated the contribution of TCN2 to psoriatic pathogenesis. TCN2 expression was significantly elevated in both lesional skin and peripheral blood mononuclear cells (PBMCs) from psoriasis patients, and its levels declined following biologic therapy. Similarly, increased TCN2 expression was observed in imiquimod (IMQ)-induced psoriatic lesions in mice. To further evaluate its function, we generated Tcn2-deficient (Tcn2-/-) mice and established an IMQ-induced psoriasis model. Compared with wild-type controls, Tcn2-/- mice developed attenuated skin lesions with reduced epidermal hyperplasia and inflammation. Transcriptomic analysis of lesional skin revealed downregulation of inflammatory mediators (S100A7, S100A8, S100A9, IL-1β, IL-6) and suppression of STAT3 signaling in Tcn2-/- mice. In parallel, TCN2-knockdown HaCaT cells exhibited impaired proliferation due to G1-phase arrest, along with reduced expression of proinflammatory factors. Together, these findings demonstrate that TCN2 promotes keratinocyte hyperproliferation and amplifies inflammatory responses in psoriasis. In conclusion, this study identifies TCN2 as a previously unrecognized regulator of psoriatic inflammation and keratinocyte biology, highlighting its potential as a novel therapeutic target.Weiterlesen

BackgroundThe IL-23/Th17 axis is the cornerstone of psoriasis pathogenesis, but molecular heterogeneity across different ethnicities remains poorly defined.ObjectiveTo comprehensively define the immunological and pathogenic transcriptomic profiles of a Taiwanese psoriasis cohort.MethodsLesional skin (LS) and non-lesional skin (NL) biopsies from 11 patients with chronic plaque psoriasis and normal skin (N) from 9 healthy controls were analyzed via bulk RNA-sequencing. Differential gene expression (DEG), pathway enrichment (GSEA), and clinical correlations (PASI score) were performed. Serum levels of cytokines were validated via ELISA from all 50 psoriasis patients and 9 healthy controls.ResultsAnalysis identified 4,694 DEGs in LS vs. N. We confirmed robust Th17 upregulation (IL-17A/C, IL-23A). Unanticipatedly, a profound dual immune dysregulation was identified, involving significant upregulation of Type 2 (Th2) signatures (IL-4R, CCL17, TSLP). The IL-36 family was the most highly activated cytokine axis (IL-36G log2FCH=5.5). Barrier function genes (KRT77, GJB4) were significantly downregulated. Correlation analysis identified IL-36RN and the combination of AREG/CDSN (r ≈ -0.9, p=0.002) as potential severity biomarkers.LimitationsThe small sample size and focus on a single ethnic group. Transcriptomic findings represent associations rather than mechanistic evidence of pathogenesis.ConclusionTaiwanese psoriasis is characterized by a dual Th17/Type 2 endotype and extreme IL-36 activation. This molecular landscape underscores the need for stratified therapeutic strategies in Taiwanese populations.Weiterlesen

Methotrexate (MTX) is a widely used, cost-effective systemic treatment for moderate-to-severe psoriasis, but concerns about hepatotoxicity often limit its long-term use. Hepatic adverse effects range from transient enzyme elevations to fibrosis and cirrhosis. Despite established guidelines, monitoring practices remain inconsistent, and the mechanisms underlying MTX-induced hepatotoxicity in psoriasis patients are not fully elucidated. This systematic literature review evaluates the association between MTX and hepatotoxicity, identifies key risk factors, assesses monitoring strategies and addresses misconceptions about its hepatic safety. A comprehensive search of MEDLINE/PubMed, EMBASE, Cochrane Library and grey literature (2003-2024) included English and French studies on human subjects, encompassing guidelines, reviews and observational/interventional studies. MTX-related hepatotoxicity is multifactorial, with risk factors including obesity, diabetes, hyperlipidaemia, excessive alcohol consumption and pre-existing liver disease. Psoriasis itself may also contribute to liver dysfunction. There is no consensus on optimal monitoring frequency for liver function tests or the role of noninvasive tools like transient elastography. While folic acid supplementation may mitigate risk, dosing remains inconsistent.Though MTX carries a potential hepatotoxic risk, this is patient-specific rather than inherent to the drug. Standardized monitoring protocols and risk stratification are essential to optimize safety, prevent unnecessary treatment discontinuation and improve long-term psoriasis management.Weiterlesen

Biologic therapies targeting IL‑17 and IL‑23 have revolutionized psoriasis management, enabling rapid and durable disease control. Yet treatment selection still follows a trial‑and‑error approach, and clinically validated biomarkers for personalization remain absent. To outline current challenges in biomarker development for psoriasis and describe the design and aims of the PICASSO prospective cohort as a platform for future personalized medicine. Despite evidence that IL‑17/IL‑23 inhibitors may induce disease modification through effects on effector, memory, and regulatory immune cells, reliable predictive or prognostic biomarkers have not emerged. Barriers include complex pathogenesis, universally high biologic efficacy reducing need for stratification, inconsistent findings from genetic or transcriptomic studies, and the multifactorial nature of comorbidities. PICASSO is a 10‑year prospective biobank/registry enrolling patients within three years of disease onset. Biological samples are longitudinally linked to clinical and epidemiological data, with follow‑ups every 2.5 years. The ultimate aim is to identify biomarkers predicting disease trajectory. Personalized psoriasis care requires biomarkers predicting progression and comorbidity risk. PICASSO represents a step toward disease‑modifying, preventive precision medicine.Weiterlesen

Psoriasis is a chronic immune-mediated inflammatory disease associated not only with cutaneous manifestations but also with substantial psychosocial burden, including impaired quality of life, depression, anxiety, stigmatization, fatigue, and sexual dysfunction. While cyclosporine A (CsA) is an established systemic therapy for moderate-to-severe psoriasis, its broader psychosocial effects remain insufficiently characterized. This prospective study enrolled 37 patients (20 men, 17 women; mean age 47.8 ± 4.9 years) with moderate-to-severe plaque psoriasis treated with oral CsA for 12 weeks. Therapy was initiated at 5 mg/kg/day for the first 42 days and subsequently reduced to 2.5 mg/kg/day until Day 84. Clinical severity was assessed using the Psoriasis Area and Severity Index (PASI) and Body Surface Area (BSA). Patient-reported outcomes included assessments of quality of life, illness acceptance, life satisfaction, depression, anxiety, fatigue, sexual satisfaction, stigmatization, disability, stress, and pruritus using validated psychometric instruments. Sociodemographic and metabolic determinants were additionally analyzed. CsA therapy resulted in rapid and marked clinical improvement, with PASI scores decreasing from 20.3 ± 4.2 at baseline to 0.9 ± 0.9 at week 12 (p < 0.001) and BSA involvement declining from 41.9% to 1.9% (p < 0.001). Significant improvements were additionally observed across multiple psychosocial domains, including dermatology-related quality of life, depressive and anxiety symptoms, fatigue, sexual satisfaction, illness acceptance, stigmatization, disability, stress, and pruritus (all p < 0.05). Younger age, single marital status, urban residence, longer disease duration, and metabolic comorbidity burden were associated with greater baseline psychosocial impairment. CsA therapy provides multidimensional benefits in patients with moderate-to-severe plaque psoriasis, improving not only clinical disease severity but also psychological well-being, social functioning, fatigue, illness acceptance, and overall quality of life. These findings support the integration of psychosocial assessment into routine therapeutic evaluation and reinforce the continued role of CsA as a multidimensional therapeutic approach in contemporary psoriasis management.Weiterlesen

BackgroundPediatric psoriasis may result in significant cumulative life course impairment, and there is comparatively less evidence available than for adult psoriasis.ObjectiveThe aim of this study is to provide an update on the management of pediatric psoriasis, integrating recent immunogenetic and therapeutic advances. It highlights challenges, including clinical heterogeneity, complex differential diagnosis, and limited treatment options, especially in Brazil.MethodsA narrative review was conducted, including studies published in English, Portuguese, and Spanish between 2009 and 2025, retrieved from the United States National Library of Medicine (PubMed), Cochrane Library, and Scientific Electronic Library Online (SciELO). The following descriptors were used: "psoriasis", "child health", "pediatrics", "therapeutics", "comorbidity", and "T-lymphocyte antigen differentiation".ResultsPediatric psoriasis most commonly presents as chronic plaque. Differential diagnoses are broad and include atopic dermatitis and autoimmune diseases. Data about comorbidities, particularly cardiovascular risk, are controversial. Although severe cases are less frequent, they are associated with a substantial impact on quality of life. Conventional therapies include topical corticosteroids, phototherapy, and non-targeted systemic agents such as acitretin, methotrexate, and cyclosporine. Biologic therapies have been approved for pediatric use and demonstrate safety profiles and superior efficacy compared to conventional treatments.Study limitationsScarcity of pediatric psoriasis guidelines.ConclusionsDespite advances in understanding adult psoriasis, evidence in pediatric populations remains limited, especially in Brazil. Expanding knowledge in pediatric psoriasis is essential to improve diagnosis, optimize treatment strategies, and increase access to innovative therapies, thereby reducing inflammatory burden and cumulative life course impairment.Weiterlesen

BackgroundPsoriasis represents a prevalent long-term inflammatory skin condition marked by the dysregulation of immune responses. T cells are integral to the pathogenesis of psoriasis. This study conducted a comprehensive analysis to recognize biomarkers associated with T cell infiltration in psoriasis and to elucidate their underlying molecular mechanisms.ResultsThree biomarkers (AKR1B10, C10orf99, and CKS2) demonstrated high sensitivity and specificity in receiver operating characteristic (ROC) curve, and the reliability of the developed nomogram diagnostic model was observed. In addition, gene set enrichment analysis (GSEA) revealed notable enrichment of the biomarkers in the NOD-like receptor signaling pathway and focal adhesion. Immune infiltration analysis indicated elevated levels of activated B cells and CD8 T cells in psoriasis samples, with the biomarkers showing meaningful correlations with the majority of immune cell infiltration statuses. Importantly, preliminary reverse transcription quantitative PCR (RT-qPCR) validation showed increased expression of AKR1B10, C10orf99, and CKS2 in psoriasis tissues, confirmed higher expression of AKR1B10, C10orf99, and CKS2 in psoriasis patients.ConclusionAKR1B10, C10orf99, and CKS2 may serve as candidate molecules for future mechanistic studies and provide potential diagnostic biomarkers for further investigation of psoriasis-related immune regulation.Weiterlesen

Eine große Studie zeigt, dass sich Psoriasis Arthritis und axiale Spondyloarthritis im Immunsystem deutlich unterscheiden. Die Forschenden haben Blut von fast 180 Betroffenen geprüft und es mit gesunden Menschen verglichen. Bei axialer SpA fanden sie mehr Zellen der angeborenen Abwehr und viele stark aktivierte Abwehrzellen. Bei Psoriasis Arthritis sahen sie eher Zellen, die zur Gedächtnisabwehr gehören. Beide Krankheiten haben ähnliche T Helferzellen, doch bei axialer SpA gibt es mehr stark entzündliche Varianten. Durch solche Muster stellen Ärztinnen und Ärzte in Zukunft die Diagnose genauer und wählen die Therapie gezielter. Vielleicht entstehen daraus später Bluttests die die Wahl eines passenden Medikaments erleichtern. Originaltitel: Deep Immunophenotyping Reveals Distinct Immune Signatures in Axial Spondyloarthritis and Psoriatic Arthritis. Link zur Quelle

Die Studie zeigt: Seit Beginn der Corona‑Pandemie werden manche entzündliche Gelenkerkrankungen seltener erkannt als vorher[1][4]. Das betrifft auch Psoriasis‑Arthritis und rheumatoide Arthritis[1][4]. Fünf Jahre nach Pandemiebeginn liegen die Diagnosen für Psoriasis‑Arthritis etwa ein Viertel niedriger als erwartet, für rheumatoide Arthritis etwa ein Zehntel[1][4]. Gleichzeitig nehmen Diagnosen der axialen Spondyloarthritis zu, besonders bei Frauen[1][4]. ## Was bedeutet das für Euch? Die Ergebnisse sprechen dafür, dass weiterhin Menschen mit Gelenkbeschwerden ohne klare Diagnose leben[1][4]. Wenn Ihr anhaltende Gelenk‑ oder Rückenschmerzen oder Morgensteifigkeit oder Schwellungen bemerkt, sucht früh ärztlichen Rat beim Rheumatologen[1]. Notiert Symptome und macht Fotos von Hautveränderungen, das kann die Diagnose erleichtern[1]. Die Forschenden schlagen vor, Gesundheitsdaten besser zu nutzen und so Lücken zu erkennen und Angebote zu verbessern[1][4]. Das kann helfen, dass Psoriasis und mögliche Gelenkbeteiligung künftig schneller erkannt und behandelt werden. Originaltitel: Trends in autoimmune rheumatic disease diagnoses before and after the COVID-19 pandemic in England: a population-based cohort study using OpenSAFELY Link zur Quelle

Icotrokinra ist eine neue Tablette gegen mittelschwere bis schwere Schuppenflechte. In zwei großen Studien nahmen über 1500 Erwachsene einmal täglich 200 mg Icotrokinra oder Vergleichsmedikamente. Nach einem Jahr hatten rund 70 bis 75 Prozent fast klare Haut und etwa die Hälfte komplett klare Haut. Wer nach 16 Wochen gut ansprach, blieb meist stabil bis Woche 52. Auch Juckreiz und Lebensqualität besserten sich deutlich. Nebenwirkungen waren ähnlich wie unter Placebo und geringer als bei Deucravacitinib, schwerwiegende Probleme traten nicht auf. Die Daten sprechen dafür dass Icotrokinra die Schuppenflechte langfristig gut in Schach hält. Die Ergebnisse klingen vielversprechend. Originaltitel: Durability of Response to Icotrokinra in Adults With Moderate-to-Severe Plaque Psoriasis: One-Year Results From the Phase 3, Placebo- and Active Comparator-Controlled ICONIC-ADVANCE 1 & ICONIC-ADVANCE 2 Trials. Link zur Quelle

IntroductionTopical therapy plays an essential role in psoriasis management. However, lack of rapid improvement may negatively impact adherence. The calcipotriol and betamethasone dipropionate (CAL/BDP) cream based on polyaphron dispersion (PAD) technology has demonstrated high efficacy, favorable safety, and convenience compared with CAL/BDP gel in phase III trials. This post-hoc analysis aims to assess early treatment response to CAL/BDP PAD-cream at Week (W) 4.MethodsThis was a post-hoc pooled analysis of adults with mild-to-moderate psoriasis from two multicenter, investigator-blind, phase III trials (MC2-01-C2 and MC2-01-C7). Patients were randomized 3:1:3 to CAL/BDP PAD-cream (N = 551), PAD-cream vehicle (N = 178), or CAL/BDP gel (N = 542) once daily for 8 weeks. Physician's Global Assessment (PGA) and Subject's Global Assessment (SGA) were assessed at W1 and W4. At W4, early responders were defined as patients achieving PGA controlled disease (i.e., any improvement from baseline to a PGA score of 0-1), while PGA success was defined as a PGA score of 0-1 combined with a minimum 2-point improvement from baseline. SGA controlled disease and SGA success were also assessed. Comparisons between groups were performed by logistic regression models using multiple imputation. Rates of PGA/SGA concordance were assessed by simple percent agreement.ResultsAt W4, CAL/BDP PAD-cream was associated with a significantly higher proportion of patients achieving early response compared with CAL/BDP gel (32.1% vs 21.4%, P < 0.0001). Differences were already significant at W1 (7.8% vs 4.8%, P = 0.0410). PGA success at W4 was also higher with CAL/BDP PAD-cream than with CAL/BDP gel (23.6% vs 14.8%, P < 0.0001). Rates of SGA controlled disease and success were also statistically significantly higher for CAL/BDP PAD-cream at W4. Concordance between PGA/SGA assessments at W4 was observed in 65.5% (controlled disease) and 69.5% (success) of patients treated with CAL/BDP PAD-cream.ConclusionCAL/BDP PAD-cream was associated with significantly higher early response rates at W4 than CAL/BDP gel, suggesting earlier clinical improvements.Weiterlesen

IntroductionPsoriasis imposes a substantial clinical and quality-of-life burden across the Asia-Pacific (APAC) region. Despite advances in systemic therapies, variability in disease severity classification, assessment tools, and treatment escalation criteria continues to contribute to undertreatment and delayed access to effective care.MethodsA modified Delphi panel was conducted to develop APAC-contextualised consensus recommendations for psoriasis management. Statements were generated from a literature review and refined through Steering Committee interviews and review. The steering committee (n = 6) and Delphi panellists (n = 12) was comprised of dermatology experts from six APAC markets (Australia, China, Japan, South Korea, Malaysia, Taiwan). Consensus was generated through two structured online voting rounds involving all panellists, followed by a moderated consensus meeting, involving only the steering committee, to deliberate on any remaining non-consensus items. Consensus was defined a priori as ≥ 75% agreement among panellists.ResultsIn rounds 1 and 2, 92/130 (71%) and 17/24 (71%) statements achieved consensus, respectively. Eight statements were discussed during the steering committee meeting, during which consensus was reached on all eight. In total, 121 statements achieved formal consensus, which includes an additional 4 non-consensus statements from round 1 that were retained in the final recommendations based on steering committee determination of clinical relevance. Recommendations focused on severity classification and assessment thresholds, treatment goals and response criteria, and systemic therapy eligibility and escalation.ConclusionThese Delphi-derived recommendations provide a practical, patient-centred framework to standardise psoriasis assessment and guide timely treatment escalation in APAC. Adoption may reduce variability in care, support equitable access to appropriate systemic therapies, and improve outcomes across diverse APAC health systems.Weiterlesen

Psoriasis is a chronic autoinflammatory skin disease lacking curative options. Ronomilast is a novel PDE4i inhibitor with potent anti-inflammatory properties. To evaluate the therapeutic efficacy of topical ronomilast, alone and combined with clobetasol, in an imiquimod (IMQ)-induced psoriasis mouse model. Fifty BALB/c male albino mice were randomly assigned to five groups (n = 10): healthy control, imiquimod-induced, clobetasol-treated (0.05%), ronomilast-treated (0.3%), and combination-treated (ronomilast 0.15% + clobetasol 0.025%). Psoriasis-like lesions were induced by daily topical application of 5% imiquimod for five consecutive days. Treatments were applied topically 3 h after imiquimod. Skin samples were analyzed for IL-17A and IL-23 levels via ELISA, TNF-α expression via immunohistochemistry, and histopathological changes. In silico molecular docking with PDE4B and PDE4D targets was also conducted. Ronomilast significantly reduced IL-17A and IL-23 levels compared to the induction group. The combination therapy produced the greatest reduction in IL-17A and IL-23. TNF-α expression scores were also significantly decreased by ronomilast and the combination relative to the induction group, consistent with histopathological improvements. Molecular docking demonstrated that ronomilast has higher binding affinity than roflumilast for PDE4B and comparable affinity for PDE4D. Topical ronomilast alone or combined with clobetasol, substantially ameliorates psoriasiform dermatitis by inhibiting key inflammatory cytokines. These results strengthen its prospects as an antipsoriatic candidate; nonetheless, more clinical investigations are necessary to validate its effectiveness and safety in humans.Weiterlesen

Abstract Psoriasis is a chronic immune-mediated disease driven by interacting pro-inflammatory, angiogenic, and regulatory cytokine pathways. While individual cytokines of the IL-23/Th17 and Th1 axes have been widely studied, less is known about how multiple mediators behave collectively in relation to clinical severity. This study evaluated the integrated serum profile of IL-17A, IL-22, TNF-α, VEGF-A, IL-12(p40), and IL-10 in 34 patients with chronic plaque psoriasis and 19 matched healthy controls, and examined their associations with the Psoriasis Area and Severity Index (PASI). Psoriasis patients showed significantly elevated IL-17A, IL-22, TNF-α, VEGF-A, and IL-12(p40), whereas IL-10 displayed inverse pattern. Hierarchical clustering revealed a tightly interconnected pro-inflammatory cytokine network in untreated patients, with IL-17A, IL-22, and TNF-α forming a core synergistic cluster strongly associated with PASI. Systemic therapy reduced PASI and significantly decreased IL-17A, IL-22, IL-12(p40), and VEGF-A, accompanied by partial normalization of cytokine correlations. ROC analysis identified IL-22 and IL-12(p40) as potential biomarkers of treatment response. These findings demonstrate that psoriasis severity reflects coordinated activity across multiple immune pathways. Integrated cytokine profiling offers a more comprehensive understanding of disease biology and may support development of multi-marker tools for monitoring disease activity and guiding personalized therapy. Weiterlesen

Assessing disease activity in psoriatic arthritis (PsA) remains challenging, and additional biomarkers that can complement conventional inflammatory markers are still needed. The CRP-albumin-lymphocyte (CALLY) index integrates inflammatory, immune, and nutritional components into a single measure. This study examined the relationship between the CALLY index and disease activity in patients with PsA. This retrospective longitudinal cohort study included 150 patients with PsA and 50 age- and sex-matched healthy controls. Blood-derived inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), pan-immune inflammation value (PIV), and the CALLY index, were calculated using routine laboratory data. Disease activity was evaluated with the clinical Disease Activity Index for Psoriatic Arthritis (cDAPSA). Correlation analyses, receiver operating characteristic (ROC) analyses, subgroup analyses, and multivariable logistic regression models were performed. Patients with moderate-to-high disease activity had markedly lower CALLY index values than those with remission or low disease activity. The CALLY index showed a moderate inverse correlation with cDAPSA scores (r = - 0.529, p < 0.001). During follow-up, CALLY values increased significantly in both csDMARD-treated and biologic-treated patients (both p < 0.001), whereas no significant differences were observed between treatment groups. In multivariable analysis, lower log-transformed CALLY index values remained independently associated with moderate-to-high disease activity (OR 0.39, 95% CI 0.23-0.66). The discriminative performance of the CALLY index was similar to that of CRP (AUC 0.724 vs. 0.738; p = 0.42). Lower CALLY index values were linked to greater disease activity in PsA and improved alongside reductions in inflammatory burden during follow-up. Although its performance was comparable to CRP rather than superior, the CALLY index may represent a useful complementary biomarker for disease activity assessment in PsA. Prospective studies are needed to further clarify its clinical utility.Weiterlesen

BackgroundPsoriasis is a chronic immune-mediated skin disorder characterized by excessive keratinocyte proliferation and abnormal T-cell activation. Cluster of Differentiation 28 (CD28), a costimulatory protein, plays a crucial role in psoriasis pathophysiology by enhancing T-cell activation and promoting cytokine release.MethodsA case-control study was involving 168 newly diagnosed psoriasis patients and 159 healthy control individuals (HC), Genotyping of rs1879877 in promoter of CD28 gene was performed using the tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR), and serum levels of soluble CD28 (sCD28) and selected cytokines (Interleukin (IL), IL-38, IL-39 and Granulocyte Macrophage Colony Stimulating Factor (GM-CSF)) were measured using sandwich enzyme-linked immunosorbent assay (ELISA).ResultsThe heterozygous GT genotype was predominant among psoriasis patients and was significantly associated with elevated serum sCD28 levels compared to controls, who predominantly carried the wild type GG genotype. Elevated sCD28 levels were linked to increased T-cell activation, contributing to immune dysregulation and disease severity. This was evidenced by increased production of pro-inflammatory cytokines, including IL-39 and GM-CSF, with a concurrent decrease in the anti-inflammatory cytokine IL-38.ConclusionSerum sCD28 levels were significantly elevated in psoriasis patients. The CD28 gene variant rs1879877 (-1198 G/T) appears to be associated with psoriasis pathogenesis, potentially due to increased transcriptional activity that elevates sCD28 expression, thereby influencing T-cell activation and immune modulation.Weiterlesen

Pediatric psoriasis accounts for approximately 2% of dermatological conditions in children under 16 years of age. The objective of this study is to describe the clinical characteristics, treatment regimens, and observed efficacy and safety profiles in a real-world cohort. This retrospective study analyzed 15 pediatric patients treated with biologics in Argentina between 2010 and 2024. The median age at treatment initiation was 8 years, with a predominance of female patients. The biologics used were primarily adalimumab, followed by secukinumab, etanercept, and ixekizumab. Five patients experienced treatment failure secondary to adalimumab. The therapy was well tolerated, with no adverse events reported.The data suggest that early intervention can alter the course of the disease and prevent long-term complications.Weiterlesen

BackgroundGeneralized pustular psoriasis (GPP) is a rare and severe inflammatory disease characterized by widespread pustular eruptions and systemic inflammation.ObjectiveTo evaluate the clinical characteristics and disease burden of patients with GPP in Taiwan using a national claims database.MethodsPatients with GPP and no prior diagnosis of psoriasis vulgaris (PV) who experienced an incident flare between January 1, 2017, and September 30, 2020, were identified from Taiwan's National Health Insurance Database. Clinical characteristics, comorbidities, and treatment patterns were described. Recurrent flare frequency, healthcare resource utilization (HCRU) and costs were compared with those of a propensity score-matched PV cohort at a ratio of up to 1:4. Outpatient-managed flares were classified as moderate, whereas hospitalized flares were classified as severe.ResultsA total of 245 patients with GPP were included (mean age 51.3 years; 49.8% male). During follow-up, 1,156 moderate-to-severe flares were identified. Compared with matched patients with PV, patients with GPP had a higher recurrent flare rate (rate ratio 1.14; 95% CI 1.06-1.23). Patients with GPP also had greater HCRU, including more outpatient visits (incidence rate ratio [IRR] 1.03 [95% CI 1.01-1.05]), emergency room visits (IRR 1.33, 95% CI 1.19-1.49), and hospital admissions (IRR 1.69 [1.50-1.91]). Median monthly healthcare costs were approximately twice as high among patients with GPP as among matched patients with PV.ConclusionPatients with GPP experienced recurrent flares, greater healthcare utilization, and higher healthcare costs than matched patients with PV, underscoring the substantial real-world clinical and economic burden of GPP.Weiterlesen

There are no real-world studies on the long-term effectiveness of anti-interleukin-23 antibody tildrakizumab in Japanese patients with psoriasis stratified by pretreatment status. To evaluate the 52-week real-world effectiveness of tildrakizumab for psoriasis patients, stratified by prior systemic therapy, prior biologic therapy, or prior deucravacitinib treatment, and to assess the maintenance of week 16 responses and achievement of delayed responses in patients without week 16 responses. This study included 57 patients with psoriasis treated with tildrakizumab. Psoriasis area and severity index (PASI) and static physician's global assessment (sPGA) were analyzed through week 52 in subgroups stratified by the presence or absence of prior systemic therapy, prior biologic therapy, or prior deucravacitinib treatment. Patients who achieved PASI 75, PASI 90, PASI 100, absolute PASI ≤ 3, absolute PASI ≤ 2, or sPGA 0/1 at week 16 were assessed for the maintenance of respective responses, and patients without week 16 responses were assessed for the achievement of delayed responses through week 52. Analyses were descriptive and used an as-observed approach. Tildrakizumab reduced PASI throughout 52 weeks regardless of the presence or absence of prior systemic therapy, prior biologic therapy, or prior deucravacitinib treatment. Responses achieved at week 16 were mostly maintained through week 52. Some patients without week 16 responses achieved delayed responses by week 52. Tildrakizumab reduced PASI throughout 52 weeks in patients with psoriasis regardless of prior systemic therapy, prior biologic therapy, or prior deucravacitinib treatment. Responses achieved at week 16 were mostly sustained through week 52. Some patients without week 16 responses could achieve delayed responses by week 52.Weiterlesen

Psoriasis is a chronic inflammatory disease characterized by thickened erythematous skin lesions covered with white and silvery scales and accompanied by macrophage infiltration into the dermis. Although 2-3% of the world's population suffers from psoriasis, there is still a requirement for novel, safe, and effective treatment options. Previously, our group demonstrated the theranostic effects of two-dimensional germanium telluride nanosheets (GeTe-NSs) in the treatment of inflammatory bowel disease. However, the precise mechanisms underlying their therapeutic action remained unclear. In this study, the specific anti-inflammatory mechanisms of GeTe-NSs in lipopolysaccharide-stimulated RAW 264.7 macrophages were evaluated, along with their therapeutic potential for psoriasis treatment in an imiquimod (IMQ)-induced murine model. GeTe-NS treatment significantly decreased cell proliferation and reduced the production of reactive nitrogen and oxygen species in activated RAW 264.7 macrophages. The GeTe-NSs lowered the mRNA levels of key pro-inflammatory mediators (Nos2, Tnf, Ccl2, and Cxcl15), while enhancing the mRNA levels of an anti-inflammatory factor (Arg1) and an antioxidant enzyme (Nqo1). Flow cytometric analysis revealed that the GeTe-NSs promoted a shift from the M1 (pro-inflammatory) macrophage phenotype toward the M2 (anti-inflammatory) phenotype. Western blot analysis demonstrated that anti-inflammatory effects were achieved by inhibiting the activation of the TLR4/CD14 and ERK/NF-kB/STAT1/STAT3 pathways. In vivo, the oral administration of GeTe-NSs in an IMQ-induced psoriasis mouse model resulted in significant improvements in clinical scores, epidermal thickening, and the proportions of M1/M2 macrophages in spleen and skin lesions. Taken together, these findings suggest that GeTe-NSs could be a promising nanomaterial for treating inflammatory diseases, including psoriasis.Weiterlesen

Trial number: 2023-507039-39-00 Overall trial status: Authorised, recruiting Trial title: 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 Medical conditions: Moderate to Severe Plaque Psoriasis Status in each country: Italy:Not authorised, Germany:Ongoing, recruitment ended, Romania:Ongoing, recruitment ended, Spain:Ongoing, recruitment ended, Poland:Ongoing, recruitment ended, Hungary:Ongoing, recruitment ended Trial phase: Therapeutic confirmatory (Phase III) Therapeutic Areas: Diseases [C] - Immune System Diseases [C20] Primary end point: IGA score of 0 or 1 and a ≥2-grade improvement from baseline at Week 16., PASI 90 at Week 16. Secondary end point: N/A Age of participants: 65+ years, 18-64 years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 342 Sponsor: Janssen - Cilag International Sponsor type: Pharmaceutical company Trial product: JNJ-77242113, DEUCRAVACITINIB, Film-Coated Tablet without Deucravacitinib, Film-Coated Tablet without JNJ-77242113 Results posted: No Overall decision date: 19/03/2024 Countries decision date: IT: 21/03/2024, RO: 21/03/2024, HU: 04/04/2024, DE: 20/03/2024, PL: 25/03/2024, ES: 21/03/2024 Last updated date: 02/07/2026Den kompletten Artikel zeigen

Normalerweise raten Ärztinnen und Ärzte zu einem klaren Plan für Impfungen unter Guselkumab[4][5]. Lebendimpfstoffe wie die **Masern Mumps Röteln Impfung** gelten dabei als Tabu[4][5]. Ein aktueller Bericht beschreibt nun eine Person mit Psoriasis, die trotz laufender Guselkumab Therapie eine MMR Impfung bekam. Sie bildete schützende Antikörper und hatte keine schweren Nebenwirkungen. Das klingt beruhigend, ist aber nur ein einzelner Fall. Für dich heißt das, du solltest Impfungen immer früh mit deiner Ärztin planen[5][6]. Oft ist ein Abstand von mindestens zwölf Wochen zur letzten Guselkumab Spritze sinnvoll[5][8]. Originaltitel: Safe seroconversion after receiving measles, mumps, and rubella live vaccine during guselkumab treatment for psoriasis. Link zur Quelle

Orales CBD-Öl hat die Schwere der Psoriasis in dieser Studie nicht deutlich verringert.[1] Es zeigte nur vorübergehend etwas weniger Juckreiz und schnelleres Einschlafen.[1] ## Was bedeutet das für Euch? Die Teilnehmenden bekamen täglich 60 mg CBD-Öl oder ein Scheinpräparat.[1] Die Plaques wurden dadurch im Durchschnitt nicht besser, die PASI-Werte blieben ähnlich.[1] Kurzzeitig nahm der Juckreiz ab und einige schliefen schneller ein, dieser Effekt hielt aber nicht an.[1] Nebenwirkungen waren meist mild und traten in beiden Gruppen ähnlich oft auf.[1] Für Eure Hoffnung heißt das: CBD-Öl in dieser Dosis ist derzeit keine eigenständige Behandlung, die Psoriasis klar abschwächt.[1] Es könnte als Ergänzung einmal Juckreiz oder Einschlafprobleme etwas lindern, ersetzt aber keine bewährten Therapien.[1] Für den Alltag: Setzt Eure verordnete Behandlung und Hautpflege weiter konsequent fort. Wenn Ihr CBD ausprobieren möchtet, besprecht das vorher mit Eurem Hautarzt, besonders wegen möglicher Wechselwirkungen mit anderen Medikamenten.[3][5] Weitere Studien mit höheren Dosen und längerer Einnahme sind geplant, bis dahin ist ein vorsichtiger, gut begleiteter Einsatz sinnvoll.[1][5] Originaltitel: Efficacy and safety of cannabidiol oil in psoriasis: a randomized, double-blind, placebo-controlled trial - PubMed Link zur Quelle

Wer cremt, will schnell etwas sehen. Genau das zeigt eine neue Studie zu einer Kombi Creme mit Calcipotriol und Betamethason. Die PAD Creme wirkt bei leichter und mittlerer Plaque Psoriasis oft schneller als das bekannte Gel. Nach vier Wochen hatten etwa ein Drittel der Menschen mit PAD Creme fast klare Haut, mit Gel war es nur gut ein Fünftel. Erste Effekte gab es schon nach einer Woche. Auch die Patienten selbst fanden Haut und Befinden eher besser. Für den Alltag heißt das, dranbleiben lohnt sich. Mit dieser Creme sieht man oft früh einen Unterschied. Originaltitel: Early Response to Calcipotriol and Betamethasone Dipropionate PAD-Cream at Week 4 in Patients with Mild-to-Moderate Plaque Psoriasis: A Post-Hoc Pooled Analysis of Two Phase III Trials. Link zur Quelle

Psoriasis Arthritis greift oft erst wenige Gelenke an, später können mehr Gelenke dazukommen. Die Studie FOREMOST schaute auf Menschen mit früher PsA, sie hatten höchstens vier betroffene Gelenke. Nach 16 Wochen hatte etwa ein Viertel mehr als vier entzündete Gelenke. Wer Apremilast nahm, hatte deutlich seltener neue Gelenkprobleme. Frauen und Menschen ohne früh eingesetzte Basismittel sowie mit Wurstfingern hatten ein höheres Risiko. Wer bis zu 48 Wochen Apremilast nahm, berichtete weniger Schmerzen und blieb meist stabil. Das spricht dafür Originaltitel: Progression from oligoarticular to polyarticular psoriatic arthritis and apremilast as a disease modifier: novel insights from FOREMOST. Link zur Quelle