Redaktion

No abstract supplied.Weiterlesen

BackgroundPsoriasis is a chronic inflammatory skin disorder that has been increasingly linked to metabolic imbalances, particularly obesity. Conventional anthropometric indicators such as BMI and waist circumference (WC) may not sufficiently capture body fat distribution or reflect metabolic risk. The body roundness index (BRI), which integrates both height and waist measurements, has emerged as a potentially superior metric, though its relevance to psoriasis risk remains underexplored.ObjectiveThis study aimed to investigate the use of BRI as a digital biomarker for assessing psoriasis risk and to compare its predictive strength against BMI and WC across various demographic and metabolic subgroups using data from a nationally representative sample.MethodsA cross-sectional analysis was conducted using data from 13,798 adults aged 20 to 59 years who participated in the National Health and Nutrition Examination Survey between 2003 and 2006 as well as between 2009 and 2014. Psoriasis status was self-reported. Anthropometric measures (BRI, BMI, and WC) were calculated from standardized physical assessments. Weighted multivariable logistic regression models and restricted cubic spline analyses were used to examine associations while adjusting for demographic, metabolic, and lifestyle variables. A nomogram was constructed to quantify the relative predictive contributions of each metric.ResultsBRI exhibited a strong linear association with psoriasis risk (odds ratio [OR] 1.11 per unit increase, 95% CI 1.05-1.17; P<.001), outperforming BMI (OR 1.03) and WC (OR 1.01). Tertile analysis revealed a 1.73-fold increased risk of psoriasis in the highest BRI group (P=.003). Subgroup analyses confirmed consistent associations across age, sex, race or ethnicity, and metabolic status (P for interaction >.05). The nomogram highlighted BRI as the most influential predictor, indicated by its broad scoring range.ConclusionsBRI shows stronger and more consistent associations with psoriasis risk than BMI or WC, supporting its potential role as a digital biomarker for early risk stratification. Incorporating BRI into clinical decision-making tools may enhance personalized approaches to psoriasis prevention and management.Weiterlesen

No abstract supplied.Weiterlesen

BackgroundPsoriasis is a systemic disease that brings enormous mental pressure and economic burden to patients and has a significant impact on patients' quality of life (QoL). This study aimed to explore factors affecting the dermatology life quality index (DLQI) in patients with psoriasis.MethodsThis retrospective cross-sectional study used data sourced from the Psoriasis Diagnosis and Treatment Real-world Database, and 8839 patients with psoriasis (recruited between June 24, 2020 and September 2, 2021) were included. Demographic and clinical characteristics and DLQI scores were retrospectively analyzed, and correlations between DLQI score and age, disease course, psoriasis area and severity index (PASI) score were calculated. Regression analysis was conducted to explore the factors affecting the DLQI scores of patients with psoriasis.ResultsThe average DLQI scores were significantly higher in young (8.58 ± 7.22) and middle-aged individuals (8.09 ± 6.61) than those in juveniles (6.00 ± 5.79) and older individuals (7.39 ± 6.29) (P = 1.70E-15). The average DLQI scores gradually decreased among individuals whose work status were unemployment (10.4 ± 7.83), part-time (9.02 ± 6.83), full-time (8.43 ± 6.90), retired (7.93 ± 6.07), and students (7.10 ± 6.31) (P = 9.82E-23). Except for those with disease course ≥20 years, DLQI scores increased gradually with prolongation of the disease course (P = 4.72E-22). The higher the severity of psoriasis, the higher the average DLQI score (P = 3.79E-113). The presence of psoriatic lesions at the exposed sites significantly affected DLQI scores (P <0.001). The average DLQI scores were significantly higher among individuals with nail holes, joint pain, and comorbidities than among those without these conditions (P <0.05). Correlation analysis indicated that the PASI scores were positively correlated with the DLQI scores (r = 0.26, P = 4.19E-134). Multinomial logistic regression analysis showed significant influencing factors (excluding comorbidity) with different degrees of impact based on the DLQI score (P <0.05).ConclusionPhysicians should focus on significant factors, such as sex, age, marital status, education, work status, sub-types, disease course, PASI score, without joint pain, and without nail holes, to improve the QoL of patients with psoriasis.Weiterlesen

BackgroundPsoriasis is associated with increased psychiatric comorbidity, yet patterns of mental health care use and spending remain unclear.ObjectiveTo characterize use and expenditures for outpatient mental health services and psychotropic medications among U.S. persons with psoriasis and identify sociodemographic disparities.MethodsCross-sectional analysis of 2,123 participants with psoriasis in the 2005-2022 Medical Expenditure Panel Survey. Negative binomial and two-part models examined associations between sociodemographic characteristics and mental health care utilization and spending.ResultsHigher education and income levels were associated with fewer psychiatrist visits, but lower-income groups had greater utilization overall. Men spent more on psychotropic medications than women. Racial minorities had lower medication spending than White patients. Medicare coverage was linked to greater total expenditure compared to private insurance.LimitationsPsoriasis severity was unavailable. International Classification of Diseases-based identification may undercount cases.ConclusionSubstantial sociodemographic and insurance disparities persist in mental health care use and spending among psoriasis patients.Weiterlesen

BackgroundPsoriasis is a frequent and complex dermatosis of uncertain origin. A few years ago, a family of gasdermin proteins was implicated in psoriasis pathogenesis. Although the number of therapeutic options for psoriasis is growing, considering the burden of the disease, treatment personalization, and the possibility of side effects or loss of the drug's efficacy, it is important to seek new therapeutic targets.ObjectiveThe aim of this study was to assess the efficacy of antibodies against gasdermin E (GSDME) in the treatment of psoriatic lesions.MethodsThe study involved 30 male BALB/c mice, 8 weeks old. 5% imiquimod cream was applied topically on the skin to induce psoriatic lesions. The next day after the psoriatic lesions appeared, the antibodies were administered. Mice from the study group received the rabbit polyclonal anti-GSDME antibody intravenously or intraperitoneally. The control group was administered sterile 0.9% saline solution.ResultsThe injection of anti-GSDME antibodies to mice with imiquimod-induced psoriasis resulted in the resolution of skin lesions, whereas the injection of saline to the control group did not result in significant changes.ConclusionAntibodies targeting GSDME seem to be promising therapeutic agents in psoriasis; however, their utility has to be confirmed in future studies.Weiterlesen

PurposeTo explore the mechanism of cuprotosis in psoriasis, screen cuprotosis related genes (PDCRGs) in psoriasis, and provide new targets for precise diagnosis and treatment of psoriasis.Material and methodsIntegrate bioinformatics analysis and experimental validation. Firstly, based on the GEO database (GSE161683, GSE166388, GSE277173), differentially expressed genes (DEGs) and weighted gene co-expression network analysis (WGCNA) in psoriasis were screened; Identification of differential cuprotosis related genes (PDCRGs) in psoriasis using a self built cuprotosis gene database (1098 CRGs); Screen key PDCRGs through PPI network, machine learning, and ROC analysis. Subsequently, a mouse model of psoriasis induced by imiquimod (IMQ) was constructed, and gene expression, copper ion levels, inflammatory factors, and oxidative stress factors were validated using qPCR, Western blot, immunohistochemistry, fluorescence, and ELISA.ResultsThirty-four PDCRGs were identified, among which STAT1, DLD, GBP1, CXCL10, PDHB, and LIAS are Hub genes. Machine learning and ROC analysis further identified APOL6, CD274, and LIAS as key diagnostic biomarkers. PDCRGs are significantly enriched in the TCA cycle, copper ion transport, and glucose metabolism pathways. The levels of FDX1 and serum copper ions were increased in the skin lesions of psoriasis mice, accompanied by upregulation of TCA cycle key proteins and PDCRGs expression; Copper overload triggers oxidative stress and inflammation cascade.ConclusionAPOL6, CD274, and LIAS were screened as cuprotosis markers in psoriasis. Overexpression of these PDCRGs in psoriasis model mice can promote copper ion accumulation and interfere with the TCA cycle, increase oxidative stress and inflammation levels, and ultimately lead to the occurrence of psoriasis. Therefore, targeted intervention of cuprotosis is of great significance for the clinical treatment of psoriasis.Weiterlesen

ObjectivesThe Disease Activity index for Psoriatic Arthritis (DAPSA) was developed to assess disease activity in patients with psoriatic arthritis (PsA). A modified version, DAPSA28, uses 28 joints instead of 66/68. This study evaluated key psychometric properties of DAPSA and DAPSA28.MethodsData from 1865 patients with PsA in the European Spondyloarthritis (EuroSpA) Research Collaboration Network, having DAPSA and DAPSA28 scores at baseline and follow-up, were analysed. Tests included assessment of internal construct validity by scree plots, confirmatory factor analysis (CFA) and structural equation modelling (SEM), supplemented by tests of differential item functioning (DIF) and evaluation of internal consistency reliability by Cronbach's α (CA). A subset of 625 patients was used for most analyses, except descriptive statistics, correlation matrix and CA.ResultsOne-dimensional CFA models for DAPSA and DAPSA28 showed acceptable model fit at baseline (root mean square error of approximation, RMSEA: 0.020, 0.034). However, model fit at 6 months follow-up was poor (RMSEA: 0.057, 0.063). SEM combining baseline and follow-up data could not identify an acceptable model fit. DIF was found for sex and country. CA indicated acceptable internal consistency (DAPSA: 0.65; DAPSA28: 0.63). Heterogeneity across countries was observed.ConclusionsOverall, the model fit was acceptable across model fit statistics, supporting internal construct validity, but some evidence of misfit at country level was disclosed. Our findings support acceptable internal consistency reliability, but DIF was found for sex and country. Based on mixed results of model fit and DIF, further investigation of these and other PsA disease activity measures is warranted.Weiterlesen

Cumulative life course impairment (CLCI) is the irreversible harm resulting from the chronic burden of disease, such as psoriasis. This cumulative impact encompasses physical, psychological, social, and emotional challenges that can significantly alter the life trajectory of a patient with psoriasis. The risk of CLCI and the impact of living with psoriasis are exacerbated when the disease is inadequately managed. Even with improvements in skin symptoms, psychological factors, such as anxiety about relapse, can persist, adding to the long-term burden. The development and validation of screening tools to better identify and assess CLCI may provide a valuable framework for clinical practice, supporting holistic care and serving as an effective measure for evaluating the long-term impact of new therapies.Weiterlesen

**DermatoVax – Eine App hilft beim Impfen** Eine neue App namens DermatoVax hilft Menschen mit Schuppenflechte (Psoriasis), sich impfen zu lassen.[1] Das ist wichtig, denn diese Menschen bekommen schneller Infektionen. Trotzdem impfen sich die meisten nicht ausreichend. Die App funktioniert einfach: Du gibst einige persönliche Daten ein, dann zeigt dir die App, welche Impfungen du brauchst.[1] Ärzte haben die App bewertet – das Ergebnis war sehr gut. Im Durchschnitt bekam sie 4,22 von 5 Punkten.[1] **Das beste Ergebnis:** 85 % der ärztlichen Tester denken, dass die App Menschen zum Impfen motiviert.[1] 89 % sind sicher, dass sie das Impfwissen verbessert.[1] Und 80 % glauben, dass sich Originaltitel: A Mobile App to Enhance Awareness of Vaccination in Adults With Psoriasis and Atopic Dermatitis: Development and Preliminary Evaluation Study. Link zur Quelle

Psoriasis-Arthritis tritt bei manchen Menschen erst nach dem 60. Lebensjahr auf[1]. Forscher wollten wissen, ob diese Spätzünder sich von Patienten mit früherem Krankheitsbeginn unterscheiden[1]. Sie untersuchten 281 Patienten. Bei 14 Prozent von ihnen war die Krankheit erst nach 60 ausgebrochen[1]. Was die Ärzte überraschte: Die älteren Patienten hatten weniger Beschwerden an den Sehnenansätzen[1]. Dafür zeigten sie aber deutlich mehr Herzprobleme[1]. Sie litten häufiger unter Fettstoffwechselstörungen[1]. Sie hatten auch mehr Herzinfarkte oder Schlaganfälle[1]. Das ist wichtig für Ärzte zu wissen. Ältere Menschen mit Psoriasis-Arthritis zeigen andere Symptome als jüngere[1]. Die Ärzte müssen deshalb besonders aufmerksam sein. Sie sollten auch das Herz dieser Patienten im Blick behalten[1]. Originaltitel: Late-onset psoriatic arthritis: data from a nationwide cross-sectional study Link zur Quelle

# Abnehmen hilft gegen Psoriasis Neue Studien zeigen es deutlich: Wenn du mit Psoriasis übergewichtig bist, kann abnehmen deine Haut deutlich verbessern.[1][2] Forschende haben mehrere Studien analysiert und sind zu einem klaren Ergebnis gekommen. Wer durch Diät oder Sport abnimmt, hat weniger Psoriasis-Beschwerden.[1] Die Verbesserung ist dabei nicht klein. Menschen, die ihr Gewicht reduzierten, erreichten häufiger eine starke Verbesserung ihrer Hauterscheinungen.[2] Das heißt: Ihre Psoriasis besserte sich um mindestens 50 bis 75 Prozent. Besonders interessant ist das für dich, wenn du übergewichtig oder adipös bist. Denn Übergewicht verstärkt Psoriasis-Entzündungen im Körper.[2] Wenn du abnimmst, bremst du diese Entzündungen. Die gute Nachricht lautet: Du brauchst keine Wunderdiät.[1] Normale Gewichtsverlust-Programme funktionieren. Das kann eine Ernährungsumstellung sein oder regelmäßig Sport treiben oder beides zusammen. Ärzte sollten daher Patienten mit Psoriasis und Übergewicht anbieten, beim Abnehmen zu helfen.[2] Das ist genauso wichtig wie Cremes oder Medikamente. Wenn du merkst, dass deine Psoriasis schwer ist, könnte ein Gespräch mit deinem Arzt über dein Gewicht sehr hilfreich sein. Originaltitel: Impact of weight-loss interventions on psoriasis severity: A systematic review and meta-analysis Link zur Quelle

# Wie Halsschmerzen zu Schuppenflechte führen können Forscher haben jetzt entdeckt, wie Psoriasis wirklich entsteht. Sie beobachteten, dass B-Zellen eine wichtige Rolle spielen. Diese B-Zellen wecken T-Zellen auf und lassen sie die Pigment-Zellen in der Haut angreifen. Das passiert besonders nach einer Mandelentzündung durch Streptokokken. Für Menschen, die das Erbe-Merkmal HLA-C*06:02 haben, ist das besonders problematisch. Bei ihnen verwechselt der Körper dann eigene Zellen mit Eindringlingen und greift sich selbst an. Die B-Zellen übernehmen dabei sozusagen die Rolle eines falschen Wachhundes. **Das erklärt auch, warum Psoriasis nach einer Halsentzündung oft ausbricht.** Manche Menschen bekommen Schuppenflechte-Schübe genau nach so einer Infektion. Jetzt weiß man endlich, warum das zusammenhängt. Die gute Nachricht: Diese Entdeckung könnte zu neuen Behandlungen führen. Ärzte könnten gezielter eingreifen, wenn sie verstehen, welche Zellen sich da gegenseitig hochfahren. Originaltitel: B Cells Can Trigger the T-Cell-Mediated Autoimmune Response Against Melanocytes in Psoriasis. Link zur Quelle

## Neuer Hoffnungsträger gegen Schuppenflechte: So wirkt Icotrokinra Icotrokinra ist ein neues Medikament zum Schlucken, das gegen mittelschwere bis schwere Schuppenflechte helfen soll.[1] Es funktioniert anders als viele bekannte Mittel: Der Wirkstoff blockiert gezielt den IL-23-Rezeptor in deinem Körper. Das ist wichtig, weil dieser Rezeptor die Entzündungen auslöst, die zu Schuppenflechte führen.[1] **Was die Studien zeigen** In den Studien FRONTIER-1 und FRONTIER-2 testeten Forscher das Mittel über 16 bis 52 Wochen. Die Ergebnisse sind beeindruckend: Schon nach vier Wochen begannen die entzündlichen Marker im Blut zu sinken. Noch besser: Diese Verbesserung hielt über das ganze Jahr an.[2] Das Besondere ist, dass höhere Dosen stärker wirken. Die höchste getestete Dosis (100 mg zweimal täglich) zeigte die besten Ergebnisse. Icotrokinra blockiert dabei sehr gezielt die IL-23-Entzündungen. Es beeinflusst andere Abwehrprozesse im Körper kaum – das könnte bedeuten, weniger Nebenwirkungen. **Was es für dich bedeutet** Nach 16 Wochen verschwanden die Symptome in der Haut deutlich. Die entzündlichen Proteine sanken sogar auf Werte normaler Haut. Das Fazit der Forscher: Das Mittel wirkt schnell und langfristig. Die gute Nachricht für dich: Es ist eine Tablette zum Einnehmen – kein Spritzen nötig.[1] Originaltitel: Icotrokinra induces early and sustained pharmacodynamic responses in phase IIb study of patients with moderate-to-severe psoriasis. Link zur Quelle

IntroductionPsoriasis is a chronic inflammatory skin disease with a global prevalence of 1-5%, however its clinical and demographic profile in Kenya remains underexplored. This article describes the establishment of the Kenyan Psoriasis Registry at Moi Teaching and Referral Hospital in Eldoret, Kenya.Methods214 subjects were enrolled between October 2024 and August 2025 at Moi Teaching and Referral Hospital. Both healthy controls and patients with psoriasis completed enrollment surveys and physical exams, and donated saliva samples.ResultsThe initial cohort of 214 subjects (108 patients with psoriasis, 106 healthy controls) provides valuable insights into the demographics, clinical profiles, quality of life, and mental health characteristics of patients with psoriasis in Kenya. The mean age of psoriasis onset was 30.4 years, and mean age of diagnosis by a medical provider was 38.9 years old. 13.9% of patients with psoriasis reported a positive family history of psoriasis, and 9.3% of patients with psoriasis reported a diagnosis of psoriatic arthritis. The mean psoriasis area and severity index was 9.9 and mean Investigator Global assessment score was 3.0. Examination of treatment patterns revealed that moisturizers, prescription topical medications, and methotrexate were commonly tried while only 9.3% of individuals had ever received a biologic therapy. Patients with psoriasis reported significantly worse sleep disturbance, quality of life, and mental health compared to healthy controls.ConclusionThis data highlights the unique characteristics of patients with psoriasis in Kenya. The Kenyan Psoriasis Registry continues to enroll patients and conduct yearly follow-ups, aiming to deepen the understanding of psoriasis in this population. These findings underscore the need for targeted research and advocacy to improve psoriasis care in Kenya.Weiterlesen

This study aimed to evaluate the utility of netrin 1, CRP (C-reactive protein), and ESR (erythrocyte sedimentation rate) biomarkers for distinguishing between psoriatic arthritis (PsA) and psoriasis. This study included 44 patients with PsA and 44 with psoriasis. CASPAR (-Classification criteria for psoriatic arthritis) was used to classify PsA patients, and the PASI (-Psoriasis Area and Severity Index) was used to determine the degree of psoriatic plaques. Serum netrin 1 levels were measured using a commercial, ready-to-use ELISA kit that employs a quantitative immunoassay. Serum netrin 1 and ESR levels were similar between the PsA and psoriasis groups, but the median netrin 1 values were significantly higher in the PsA subtype with axial involvement than in the non-PsA subtype (respectively, 69.9 [64.0-97.6], 58.7 [56.2-64.0], p: 0.002). CRP levels were significantly higher in the PsA group than in the psoriasis group (B: - 0.134, OR [95% CI]: 0.874 [0.783-0.977], p: 0.018). A cut-off value of 12.05 for CRP was found to have a specificity of 27.3% and a sensitivity of 97.7% in distinguishing patients with PsA from those with psoriasis (AUC [95% CI]: 0.699 [0.590-0.809], p: 0.01). Netrin 1 is not a significant biomarker for distinguishing PsA from psoriasis, but it may be a potential biomarker for identifying the PsA subtype with axial involvement. Although CRP is a sensitive biomarker for distinguishing PsA from psoriasis, its specificity is low.Weiterlesen

BackgroundThe relationship between cancer and the use of systemic immunosuppressants in psoriasis treatment has not well established. The aim of this study was to evaluate the association between the systemic immunosuppressants used in the treatment for psoriasis and the risk of certain cancers in Korean patients with moderate to severe psoriasis.MethodsA retrospective cohort study was conducted involving 93,152 patients with moderate to severe psoriasis and 205,850 matched controls in Korea, using merged data from the National Health Insurance System, Health Insurance Review & Assessment Service, and Korea National Cancer Incidence Database from 2008 to 2018.ResultsThe study observed a lower incidence of any cancer in moderate to severe psoriasis patients (2.4%) compared to the general population (2.99%). However, there was a higher risk of hematologic cancers, particularly Hodgkin's lymphoma, non-Hodgkin's lymphoma, leukemia, and cutaneous T cell lymphoma. Notably, methotrexate doses of ≥ 17.5 mg/week increased the risk of hematologic cancer risk by 7.546 times and cutaneous T cell lymphoma risk by 9.038 times, but cyclosporine and corticosteroids use did not show a significant association with increased incidence of hematologic cancers. Meanwhile, use of cyclosporine, methotrexate and corticosteroid did not significantly affect the risk of skin cancer among patients with psoriasis.ConclusionThis study reveals an increased risk of hematologic cancers, such as cutaneous T cell lymphomas, associated with high-dose immunosuppressant use in moderate to severe psoriasis, underscoring the need for careful treatment management.Weiterlesen

BackgroundLife's Crucial 9 (LC9) is a new tool used to evaluate cardiovascular health. At present, no studies have reported the association between LC9 and psoriasis.MethodsThis cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2014. The LC9 score was calculated based on the American Heart Association's recommendations and the Patient Health Questionnaire-9 assessment. Psoriasis status was identified using self-reported questionnaires. Weighted multivariable logistic regression and restricted cubic splines were applied to assess the association between LC9 and psoriasis. Subgroup analyses were conducted for each covariate, and the interaction between LC9 and potential confounders was examined. Additionally, sensitivity analyses were performed to assess the robustness of the results.ResultsA total of 11,762 participants aged 20 years and older were included in this study. After comprehensive adjustments, a negative linear association was observed between psoriasis and LC9: Each 10-point increment in LC9 corresponded to an odds ratio (OR) of 0.87 (95% CI: 0.78-0.96) for psoriasis. Relative to participants in the lowest LC9 quartile (Q1), the ORs for psoriasis were 0.73 (95% CI: 0.55-0.96) for Q3 and 0.55 (95% CI: 0.36-0.85) for Q4. Among participants aged 45 to 64 years, those in the highest LC9 quartile (Q4) had an adjusted OR of 0.42 (95% CI: 0.23-0.78). Heavy drinkers in Q4 exhibited an adjusted OR of 0.37 (95% CI: 0.15-0.92). Sensitivity analyses confirmed these results.ConclusionA linear negative relationship between psoriasis and LC9 was identified in this study. This observational result suggesting that enhancing LC9-related cardiovascular health factors may serve as an effective approach for psoriasis prevention and management.Weiterlesen

ObjectiveThe purpose of this study was to evaluate the relationship between nutritional status-assessed by the Controlling Nutritional Status (CONUT) score-and disease activity, fatigue, and sleep quality in patients with psoriatic arthritis (PsA), with attention to sex-specific differences.Methods113 adults with PsA were included in this cross-sectional study. Nutritional status was classified as normal (CONUT 0-1) or malnutrition (CONUT ≥ 2). Disease activity was assessed using the Disease Activity in Psoriatic Arthritis (DAPSA) score, fatigue using the Fatigue Severity Scale (FSS), and sleep quality using the Jenkins Sleep Scale (JSS). Correlation and ROC analyses were performed.ResultsMalnutrition was identified in 18.6% of patients. Compared to those with normal nutritional status, malnourished patients had higher CRP (12.8 vs. 6.4 mg/L, p = 0.012) and lower albumin and lymphocyte levels (p < 0.001). High disease activity (DAPSA > 28) was more common in the malnutrition group (38.1% vs. 15.2%, p = 0.029). The CONUT score correlated with DAPSA (Rho = 0.327, p < 0.001), CRP (Rho = 0.422, p < 0.001), and fatigue severity (Rho = 0.186, p = 0.048). No association was observed with sleep quality. ROC analysis showed that CONUT ≥ 2 predicted high disease activity (AUC 0.70). In sex-stratified analyses, correlations with DAPSA and fatigue were present only in females.ConclusionHigher CONUT scores were associated with greater disease activity and fatigue among patients with psoriatic arthritis. These results underscore the potential value of incorporating routine nutritional evaluation into the comprehensive management of PsA.Weiterlesen

Psoriasis is a chronic inflammatory skin disease with well-documented psychological comorbidities, yet the mechanisms linking early life experiences to its psychosocial impact remain underexplored. This cross-sectional study examined the associations between childhood trauma, early maladaptive schemas (EMSs), and psychological distress in adults with psoriasis (n = 85), other chronic illnesses (n = 85), and healthy controls (n = 85). Participants completed validated self-report measures assessing childhood maltreatment (Childhood Trauma Questionnaire-Short Form), EMSs (Young Schema Questionnaire-Short Form), and symptoms of depression, anxiety, and stress (Depression Anxiety Stress Scale). Statistical analysis revealed that, relative to healthy controls, the psoriasis group endorsed higher Emotional Deprivation, Insufficient Self-Control, and Emotional Inhibition schemas, consistent with enduring emotion regulation difficulties. Psoriasis patients also reported greater depression symptoms than healthy controls, and higher anxiety and stress than both healthy and chronically ill controls. Although no between-group differences emerged in retrospectively reported childhood trauma, the pattern of schema elevations suggests that difficulties in early emotional development, such as unmet emotional needs or subtle forms of neglect, may have contributed to later vulnerability, reflected at the schema rather than the trauma-report level. Overall, the findings highlight schema-level vulnerabilities in psoriasis that may underlie psychological distress and potentially contribute to symptom maintenance. Clinically, brief screening for EMSs and emotion-regulation problems in dermatological settings may support risk stratification and referral. Integrating schema-focused and stress-reduction interventions into routine psoriasis care could improve well-being and disease management.Weiterlesen

BackgroundPsoriasis affects at least 60 million people worldwide, and 80% also live with overweight or obesity. Excess weight increases susceptibility to psoriasis and is associated with more severe disease.ObjectiveTo evaluate the impact of weight-loss interventions on psoriasis severity (Psoriasis Area and Severity Index [PASI], PASI50, PASI75, PASI100 [50%/75%/100% reduction in baseline PASI, respectively]) and quality of life (Dermatology Life Quality Index [DLQI]).MethodsWe systematically searched five databases and two trial registries (inception to 03/09/2025). Outcomes were informed by patient focus-group discussions. Randomized controlled trials (RCTs) in adults with psoriasis, comparing any weight-loss intervention versus usual care or a lower-intensity weight-loss intervention, were included. Studies had to report a change in weight and ≥1 psoriasis severity or quality-of-life measure. Random effects meta-analyses were used.ResultsThirteen RCTs (1145 participants) with 14 comparisons were included. Eleven interventions advised dietary changes, of which four included physical activity. Three used weight-loss medications. Across 14 comparisons (n = 1145, mean difference (MD) in weight change: -6.7 kg), weight-loss interventions produced a greater reduction in PASI versus control: MD -2.5 (95%CI: -3.8 to -1.1, I2 = 85.2%). We found a significant effect of weight-loss interventions on the likelihood of achieving PASI75 (RR = 1.6, 95%CI: 1.1-2.2, I2 = 22.6% [based on six comparisons, n = 681, MD in weight change: -7.3 kg]). There was no statistically significant effect of the interventions on the likelihood of achieving PASI50 (RR = 1.5, 95%CI: 0.9-2.4, I2 = 72.8% [based on four comparisons, n = 509, MD in weight change: -4.0 kg]) or PASI100 (RR = 1.6, 95%CI: 0.3-9.7, I2 = 0.0% [based on two comparisons, n = 334, MD in weight change: -5.2 kg]), but both analyses were limited by few studies. Across seven comparisons (n = 364; MD in weight change -7.8 kg), weight-loss interventions were associated with a significant improvement in DLQI compared to control: MD -5.0 (95%CI: -9.7 to -0.3, I2 = 96.0%).ConclusionHigh-certainty evidence suggests weight-loss interventions can improve psoriasis severity and quality of life, and should be considered as part of routine treatment.Weiterlesen

Psoriasis is a chronic inflammatory disease with a well-established association with obesity. However, the role of diet remains unclear. This study examined dietary habits in patients with psoriasis and compared adherence to national dietary guidelines with matched healthy controls. We included 466 patients with psoriasis from the BIOSKIN cohort and 1,029 healthy controls from the Copenhagen General Population Study. According to a Food Frequency Questionnaire, 53% of the patients reported a "healthy and varied diet," and 39% "no specific diet". Approximately 10% practiced intermittent fasting, while smaller proportions followed a Mediterranean diet (4%), a ketogenic/low-carb, high-fat diet (3%), or an anti-inflammatory diet (2%). Overall, 90% showed high or intermediate adherence to dietary guidelines. Patients with mild psoriasis adhered more often to guidelines than those with moderate-to-severe disease (33% vs. 17%, p = 0.001). No significant difference in dietary adherence was observed between patients with psoriasis and matched healthy controls (p = 0.79). In conclusion, patients with moderate-to-severe psoriasis have less healthy dietary patterns compared to those with mild disease. When comparing all patients with psoriasis to healthy controls, no difference in adherence to dietary guidelines was found. Due to the cross-sectional nature of this study, the causal relationship between diet and psoriasis remains unclear.Weiterlesen

Immune dysregulation is critically involved in psoriasis (PSO) and psoriatic arthritis (PsA). This study aims to identify shared immunomodulatory targets, predict potential therapeutics, and validate drug mechanisms for these diseases. Transcriptomic datasets were retrieved from GEO. Differential expression analysis was conducted using Limma. Weighted gene co-expression network analysis (WGCNA) and protein-protein interaction (PPI) networks were employed to identify key modules. Machine learning algorithms (Random Forest and LASSO) were applied to pinpoint critical immune-related genes. Diagnostic utility was assessed via ROC curves. Immune infiltration analysis and single-cell RNA sequencing (scRNA-seq) were used to evaluate immune dysregulation and cell-type-specific gene expression. Reverse drug screening was performed using Coremine Medical. Molecular docking and dynamics simulations assessed binding stability between candidate drugs and target proteins. RT-qPCR was utilized to examine drug-induced changes in gene expression and pathway activity. CXCL10, ISG15, and IFI27 were identified as hub genes. scRNA-seq confirmed their specific enrichment in immune cells. Garlic (Allium sativum) was prioritized through reverse screening, with allicin selected as its primary immunomodulatory component. Molecular simulations demonstrated stable binding of allicin to each target. Experimentally, allicin significantly upregulated ISG15 and downregulated CXCL10 and IFI27, likely via suppression of NF-κB signaling. CXCL10, ISG15, and IFI27 represent key immunotherapeutic targets in PSO and PsA. Allicin modulates these targets through NF-κB inhibition, demonstrating its potential as a therapeutic agent for autoimmune conditions.Weiterlesen

Psoriasis has been successfully treated by directly blocking the interleukin (IL)-23/IL-17 pathway and several inhibitors that specifically target the IL-23/IL-17 signaling axis have been approved by the Food and Drug Administration for clinical use and show excellent efficacy. However, all the approved IL-23/IL-17 axis targeting agents cannot be non-invasively delivered as topical treatment due to their biological and physicochemical properties, e.g., susceptibility to degradation, large molecular size, hydrophobicity and charge. Herein, we used novel ionic liquid biomaterials, amino acid esters and octanoic acids, as a non-invasive transdermal drug delivery system for bicyclic peptide inhibitors targeted to IL-23R and IL-17A. Using phenotypical images, psoriasis area and severity index, hematoxylin-eosin, and immunohistochemistry, we demonstrate that a biocompatible ionic liquid-based topical delivery approach of peptide inhibitors alleviates psoriasis in an imiquimod-induced psoriasis mouse model. Flow cytometry of innate lymphoid cells (ILCs) within the spleen, peripheral blood, and lesional epidermis shows that treatment with ionic liquids-peptides selectively blocks and reconfigures the spectrum of skin-resident and circulating ILCs. These results provide a framework for a topical delivery approach for peptides. Our findings highlight the potential of topical administration of peptide inhibitors of the IL-23/IL-17 pathway by biocompatible ionic liquids to treat psoriasis. The main immunopathogenic mechanism of peptide inhibitors mitigating psoriasis is reconfiguration of a spectrum of skin-resident and circulating ILCs.Weiterlesen

Die STAMP-Studie vergleicht zwei Behandlungsarten bei neu erkrankter Psoriasis arthritis. 120 Menschen in den Niederlanden nahmen teil.[1] Die erste Gruppe startete sofort mit Secukinumab und Methotrexat. Die zweite Gruppe begann nur mit Methotrexat.[1] Nach sechs Monaten zeigten sich ähnliche Erfolge: 42 Prozent versus 35 Prozent erreichten das Ziel ACR50. Das war kein wichtiger Unterschied.[1] Nach einem Jahr hatten beide Gruppen vergleichbare Ergebnisse. Etwa die Hälfte schaffte das Ziel ACR50.[1] Die aggressive Anfangs Originaltitel: Intensive biological DMARD-first strategy versus standard step-up care in psoriatic arthritis (STAMP): 1-year results from a multicentre, open-label, randomised controlled trial comparing two treat-to-target strategies Link zur Quelle