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Eine große Studie hat Menschen mit axialer Spondyloarthritis und Psoriasis Arthritis drei Jahre lang begleitet. Sie bekamen alle vier Wochen Bimekizumab, ein modernes Entzündungsmedikament. Die meisten fühlten sich deutlich besser und konnten im Alltag mehr schaffen. Auch bei der Arbeit ließen sie sich weniger bremsen und waren mit ihrer Situation eher zufrieden. Viele fühlten sich fast so gut wie Menschen ohne diese Krankheiten. Firmen sparten dadurch viel Geld, weil Beschäftigte seltener bei der Arbeit ausfielen. Für Betroffene zeigt die Studie, dass Bimekizumab nicht nur Schmerzen und Steifigkeit senken kann sondern auch Job und Sozialleben stärken. Originaltitel: Bimekizumab Improves Health Status and Work Productivity, With Reduced Productivity Costs, to 3 Years in Axial Spondyloarthritis and Psoriatic Arthritis. Link zur Quelle

Chronische Entzündungen wie bei Psoriasis hören oft nicht von selbst auf. Ein Forscherteam schlägt dafür das CURE Modell vor. CURE heißt CONTROL UNLOAD and RESET EQUILIBRATE und läuft in drei Phasen. In CONTROL bremst eine starke Therapie zuerst die Entzündung deutlich. In UNLOAD and RESET fährt man die Medikamente Schritt für Schritt runter und stärkt die eigene Abwehr. In EQUILIBRATE folgt eine leichte Dauertherapie die das Gleichgewicht hält und Rückfälle vermeiden soll. Ziel ist nicht Heilung sondern ein stabiles Leben mit möglichst wenig Beschwerden. Originaltitel: CURE: a phase-based therapeutic framework for chronic inflammation. Link zur Quelle

Trial number: 2025-522567-15-00 Overall trial status: Ongoing, recruiting Trial title: A Phase 3, Randomized, Multicenter, Double-Blind, Placebo-Controlled Trial to Evaluate the Efficacy, Safety, Tolerability, and Pharmacokinetics of Zasocitinib in Pediatric Participants Aged 4 to Less Than 18 Years With Moderate-to-Severe Plaque Psoriasis Medical conditions: Plaque Psoriasis Status in each country: Spain:Authorised, recruiting, Poland:Ongoing, recruiting, Germany:Ongoing, recruiting, Italy:Authorised, recruitment pending Trial phase: Therapeutic confirmatory (Phase III) Therapeutic Areas: Diseases [C] - Skin and Connective Tissue Diseases [C17] Primary end point: Part A: Coprimary Endpoints (vs Placebo) at Week 16 • sPGA 0/1 response: Proportion of participants achieving an sPGA of clear (0) or almost clear (1) with a ≥2-point decrease from baseline. • PASI-75 response: Proportion of participants achieving ≥75% improvement from baseline in PASI score. Part A Cohort 1: Includes adolescent participants aged 12 to <18 years. Part A Cohort 2: Includes children participants aged 4 to <12 years., Part B: PK Primary Endpoints • PK parameters (that is Cmax, Tmax, AUC0-Last) of zasocitinib on Day 7. Part B: Includes only children participants aged 4 to <12 years. Part B participants will be separate from Part A Cohort 2 participants. Secondary end point: Part A: Key Secondary Efficacy Endpoints (vs Placebo) at Week 16 • PASI-90 response: Proportion of participants achieving PASI-90. • Enhanced sPGA response: Proportion of participants achieving an sPGA of clear (0). • PASI-100 response: Proportion of participants achieving PASI-100., Part A: Additional Secondary Efficacy Endpoints (vs Placebo) at Week 16 • ssPGA response: Proportion of participants achieving an ssPGA of clear (0) or almost clear (1) with a ≥2-point decrease from baseline for participants with a baseline ssPGA ≥3. • Change and percent change from baseline in BSA affected by psoriasis., • DLQI response: Proportion of participants with a DLQI score of 0/1 (for participants with a baseline DLQI score ≥2). • CDLQI response: Proportion of participants with a CDLQI score of 0/1 (for participants with a baseline CDLQI score ≥2). • Change from baseline in DLQI. • Change from baseline in CDLQI., Part A (Cohort 1 only): Additional Secondary Efficacy Endpoints (vs Placebo) at Week 16 • Itch NRS response: Proportions of participants achieving a ≥4-point improvement in Itch NRS for participants in Cohort 1 who had an itch NRS ≥4 at baseline. • Change and percent change from baseline in Itch NRS for participants in Cohort 1., Parts A and B: Additional Secondary Efficacy Endpoints at Each Scheduled Visit Over the Duration of the Open-Label Period • PASI-75 response: Proportion of participants achieving PASI-75. • PASI-90 response: Proportion of participants achieving PASI-90. • PASI-100 response: Proportion of participants achieving PASI-100., • sPGA 0/1 response: Proportion of participants achieving an sPGA of clear (0) or almost clear (1) with a ≥2-point decrease from baseline. • Enhanced sPGA response: Proportion of participants achieving an sPGA of clear (0)., • ssPGA response: Proportion of participants achieving an ssPGA of clear (0) or almost clear (1) with a ≥2-point decrease from baseline for participants with a baseline ssPGA ≥3. • Change and percent change from baseline in BSA affected by psoriasis., • DLQI response: Proportion of participants with a DLQI score of 0/1 (for participants with a baseline DLQI score ≥2). • CDLQI response: Proportion of participants with a CDLQI score of 0/1 (for participants with a baseline CDLQI score ≥2)., • Change from baseline in DLQI. • Change from baseline in CDLQI., Part A (Cohort 1 only): Additional Secondary Efficacy Endpoints at Each Scheduled Visit Over the Duration of the Open- Label Period • Itch NRS responses: Proportions of participants achieving a ≥4-point improvement in Itch NRS for participants in Cohort 1 who had an itch NRS ≥4 at baseline. • Change and percent change from baseline in Itch NRS for participants in Cohort 1., Part A: Additional Secondary PK Endpoint • Plasma concentrations of zasocitinib in participants receiving active treatment., Part B: Additional Secondary Endpoint • Acceptability/palatability assessment scores. Age of participants: 0-17 years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 54 Sponsor: Takeda Development Center Americas Inc. Sponsor type: Pharmaceutical company Trial product: ZASOCITINIB, Matching Placebo for TAK-279 Results posted: No Overall decision date: 01/04/2026 Countries decision date: DE: 07/04/2026, IT: 01/04/2026, ES: 06/04/2026, PL: 03/04/2026 Last updated date: 22/06/2026View the full article

Trial number: 2025-522567-15-00 Overall trial status: Ongoing, recruiting Trial title: A Phase 3, Randomized, Multicenter, Double-Blind, Placebo-Controlled Trial to Evaluate the Efficacy, Safety, Tolerability, and Pharmacokinetics of Zasocitinib in Pediatric Participants Aged 4 to Less Than 18 Years With Moderate-to-Severe Plaque Psoriasis Medical conditions: Plaque Psoriasis Status in each country: Spain:Authorised, recruiting, Poland:Ongoing, recruiting, Germany:Ongoing, recruiting, Italy:Authorised, recruitment pending Trial phase: Therapeutic confirmatory (Phase III) Therapeutic Areas: Diseases [C] - Skin and Connective Tissue Diseases [C17] Primary end point: Part A: Coprimary Endpoints (vs Placebo) at Week 16 • sPGA 0/1 response: Proportion of participants achieving an sPGA of clear (0) or almost clear (1) with a ≥2-point decrease from baseline. • PASI-75 response: Proportion of participants achieving ≥75% improvement from baseline in PASI score. Part A Cohort 1: Includes adolescent participants aged 12 to <18 years. Part A Cohort 2: Includes children participants aged 4 to <12 years., Part B: PK Primary Endpoints • PK parameters (that is Cmax, Tmax, AUC0-Last) of zasocitinib on Day 7. Part B: Includes only children participants aged 4 to <12 years. Part B participants will be separate from Part A Cohort 2 participants. Secondary end point: Part A: Key Secondary Efficacy Endpoints (vs Placebo) at Week 16 • PASI-90 response: Proportion of participants achieving PASI-90. • Enhanced sPGA response: Proportion of participants achieving an sPGA of clear (0). • PASI-100 response: Proportion of participants achieving PASI-100., Part A: Additional Secondary Efficacy Endpoints (vs Placebo) at Week 16 • ssPGA response: Proportion of participants achieving an ssPGA of clear (0) or almost clear (1) with a ≥2-point decrease from baseline for participants with a baseline ssPGA ≥3. • Change and percent change from baseline in BSA affected by psoriasis., • DLQI response: Proportion of participants with a DLQI score of 0/1 (for participants with a baseline DLQI score ≥2). • CDLQI response: Proportion of participants with a CDLQI score of 0/1 (for participants with a baseline CDLQI score ≥2). • Change from baseline in DLQI. • Change from baseline in CDLQI., Part A (Cohort 1 only): Additional Secondary Efficacy Endpoints (vs Placebo) at Week 16 • Itch NRS response: Proportions of participants achieving a ≥4-point improvement in Itch NRS for participants in Cohort 1 who had an itch NRS ≥4 at baseline. • Change and percent change from baseline in Itch NRS for participants in Cohort 1., Parts A and B: Additional Secondary Efficacy Endpoints at Each Scheduled Visit Over the Duration of the Open-Label Period • PASI-75 response: Proportion of participants achieving PASI-75. • PASI-90 response: Proportion of participants achieving PASI-90. • PASI-100 response: Proportion of participants achieving PASI-100., • sPGA 0/1 response: Proportion of participants achieving an sPGA of clear (0) or almost clear (1) with a ≥2-point decrease from baseline. • Enhanced sPGA response: Proportion of participants achieving an sPGA of clear (0)., • ssPGA response: Proportion of participants achieving an ssPGA of clear (0) or almost clear (1) with a ≥2-point decrease from baseline for participants with a baseline ssPGA ≥3. • Change and percent change from baseline in BSA affected by psoriasis., • DLQI response: Proportion of participants with a DLQI score of 0/1 (for participants with a baseline DLQI score ≥2). • CDLQI response: Proportion of participants with a CDLQI score of 0/1 (for participants with a baseline CDLQI score ≥2)., • Change from baseline in DLQI. • Change from baseline in CDLQI., Part A (Cohort 1 only): Additional Secondary Efficacy Endpoints at Each Scheduled Visit Over the Duration of the Open- Label Period • Itch NRS responses: Proportions of participants achieving a ≥4-point improvement in Itch NRS for participants in Cohort 1 who had an itch NRS ≥4 at baseline. • Change and percent change from baseline in Itch NRS for participants in Cohort 1., Part A: Additional Secondary PK Endpoint • Plasma concentrations of zasocitinib in participants receiving active treatment., Part B: Additional Secondary Endpoint • Acceptability/palatability assessment scores. Age of participants: 0-17 years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 54 Sponsor: Takeda Development Center Americas Inc. Sponsor type: Pharmaceutical company Trial product: ZASOCITINIB, Matching Placebo for TAK-279 Results posted: No Overall decision date: 01/04/2026 Countries decision date: DE: 07/04/2026, IT: 01/04/2026, ES: 06/04/2026, PL: 03/04/2026 Last updated date: 22/06/2026Den kompletten Artikel zeigen

### Suchtverhalten bei chronischen Hauterkrankungen Die Übersicht zeigt: Suchtverhalten kommt bei Menschen mit chronisch‑entzündlichen Hauterkrankungen wie Psoriasis häufiger vor als in der Allgemeinbevölkerung.[1][4][7] Dazu gehören Rauchen, Alkohol, Medikamente und Essverhalten, aber auch Internet und Glücksspiel.[1][7] Diese Suchtformen können Schwere der Hauterkrankung, Therapieerfolg und Lebensqualität deutlich beeinflussen.[1][4] Die Autorinnen empfehlen, Sucht systematisch in der Hautarztpraxis zu erfassen, auch nach Alter und Geschlecht differenziert.[1] Das bedeutet für Euch: Die Haut soll nicht mehr getrennt von Psyche und Sucht betrachtet werden. Ihr dürft erwarten, dass Ärztinnen aktiv nach Belastungen fragen und bei Bedarf an Psychotherapie oder Suchtberatung vermitteln.[1][4] Für den Alltag heißt das: Achtet gut auf Euer Rauchen, Euren Alkoholkonsum, Essen, Medikamente oder Gaming. Wenn Ihr das Gefühl habt, die Kontrolle zu verlieren, sprecht es in der Sprechstunde offen an. Früh Hilfe zu holen kann Eure Haut und Euren Alltag entlasten.[4][6] Originaltitel: Addiction in chronic inflammatory skin diseases: A systematic review of prevalence, impact and screening practices - PubMed Link zur Quelle

Die Übersichtsarbeit zeigt: Bei chronisch entzündlichen Hauterkrankungen wie Psoriasis treten **Nikotin**‑ und **Alkoholkonsum** sowie andere **Suchtformen** häufiger auf als in der Allgemeinbevölkerung.[2][3] ### Was heißt das für euch? Rauchen und viel Alkohol können Entzündungen verstärken und Therapien schwächen.[2] Das kann Plaques und Schmerzen verschlimmern.[8] Die Forschenden betonen: Haut und Psyche hängen eng zusammen.[1] Belastung durch Juckreiz und Aussehen und soziale Probleme kann dazu führen dass ihr zu Alkohol, Nikotin oder anderen Gewohnheiten greift.[1][5] Wichtig ist dass ihr mit euren Ärztinnen und Ärzten offen über euren Konsum sprecht.[2][3] So können sie euch passende Hilfe anbieten, zum Beispiel Psychotherapie oder Suchtberatung.[3][7] Im Alltag helfen kleine Schritte: Stress senken und Entspannung üben und Unterstützung annehmen.[1][6] Ihr müsst das nicht allein schaffen. Originaltitel: emJournal of the European Academy of Dermatology and Venereology/em | Wiley Online Library Link zur Quelle

Background Psoriatic arthritis (PsA) is an inflammatory condition involving joints, tendon-bone entheses and synovium that can develop in individuals with psoriasis. Early, accurate clinical diagnosis remains difficult. Extracellular vesicles (EVs) carry proteins and miRNAs that Methods PubMed and Embase were searched from inception through May 21st, 2026, and human studies examining EV-associated protein or miRNA biomarkers in PsA and related psoriatic or inflammatory diseases were included, with risk of bias assessed using a modified Newcastle-Ottawa Scale and diagnostic accuracy summarized using HSROC/BRMA models when data were sufficient. Results Seven studies met the inclusion criteria, including 119 individuals with PsA (weighted mean age: 49.8 years; 43.7% female), 205 individuals with non-PsA psoriasis (weighted mean age: 46.4 years; female %: NA), 55 controls (weighted mean age: 44.5 years; 38.2% female), and 50 individuals with other inflammatory joint disorders (weighted mean age: 58.0 years; 58.0% female). EV-associated protein markers demonstrated heterogeneous findings related to immune, vascular, inflammatory, and osteoimmunological signaling. Only 4.2% (4/95) of miRNAs were consistently identified across studies comparing PsA with non-PsA psoriasis, with lower overlap (1.5%, 1/67) in studies comparing PsA with controls. ROC meta-analysis suggested preliminary diagnostic potential, particularly for distinguishing PsA from non-PsA psoriasis, although evidence was constrained by small study numbers. Conclusions EV-associated proteins and miRNAs are potential biomarker candidates for PsA, reflecting inflammatory, vascular, and osteoimmunological processes underlying disease pathophysiology. However, current evidence remains preliminary and limited by small cohorts, methodological heterogeneity, and inconsistent reporting across studies.Weiterlesen

Psoriasis is a chronic, immune-mediated inflammatory disease with heterogeneous manifestations. Reliable biomarkers reflecting disease severity and treatment response remain limited. Glycans-carbohydrate structures attached to proteins and lipids-play key roles in biological processes, contributing to functional specificity. Abnormal glycosylation has been implicated in the pathogenesis of inflammatory and neoplastic diseases, highlighting their potential as therapeutic targets and biomarkers. This study aimed to evaluate serum N-glycan profiles as potential biomarkers for psoriasis, focusing on the ratio of sialylated biantennary N-glycan (S) to fucosylated asialo-biantennary N-glycan (FA), termed the S/FA ratio. Serum samples from 45 patients with psoriasis, 12 with atopic dermatitis (AD), and 19 healthy controls were analyzed using high-performance liquid chromatography. The performance of the S/FA ratio was compared with reported biomarkers (CRP and CCL20), and its associations with Psoriasis Area and Severity Index (PASI) and treatment response were examined. The S/FA ratio was significantly higher in psoriasis than in healthy controls (p < 0.001) and correlated with PASI (r = 0.485, p < 0.001) and its components. Receiver operating characteristic analysis showed comparable diagnostic accuracy among the S/FA ratio (AUC = 0.788, sensitivity: 73.7%, specificity: 73.3%), CRP (AUC = 0.780), and CCL20 (AUC = 0.741). Changes in the S/FA ratio were correlated with improvements in PASI after systemic treatment (r = 0.467, p = 0.002), including a patients subgroup receiving IL-23 inhibitors. The S/FA ratio was not significantly influenced by demographics, comorbidities, or arthralgia. No significant difference was observed between psoriasis and AD, and the S/FA ratio was not significantly elevated in AD compared with healthy controls. The serum S/FA ratio may serve as a glycan-based biomarker associated with disease severity and treatment response in psoriasis, although its ability to distinguish psoriasis from other inflammatory diseases requires further validation in larger and treatment-naïve cohorts.Weiterlesen

IntroductionPsoriasis (PsO) and psoriatic arthritis (PsA) are chronic inflammatory conditions treated with primarily immune-modulating medication. However, interest is growing in gut microbiome therapies. Studies have reported altered gut microbiota in PsO/PsA and explored probiotics and fecal microbiota transplantation (FMT) as potential therapies. This review synthesizes global studies on the microbiome's associations in PsO/PsA.MethodsWe conducted a scoping literature review to understand the association between gut microbiota in PsO and PsA patients. Pubmed was used to identify 4,126 published manuscripts between 2015-2025. Thirty studies were included, encompassing 749,275 participants, with balanced gender representation and ages ranging from 18 to 76 years. These studies included 21 case-control studies, 1 case-series, 2 genome-wide analyses, 5 clinical trials, and 1 retrospective review.ResultsEighteen studies reported significant gut microbiome differences in PsO/PsA vs healthy controls. Variation in the Firmicutes/Bacteroides (F/B) ratio was of interest, with one study suggesting a low F/B ratio and five studies suggesting an elevated F/B ratio in PsO. A higher F/B ratio was linked to increased acetate production. Acetate and propionate, key short-chain fatty acids (SCFAs), were associated with modulation of the IL-23/Th17 axis in psoriasis and activation of keratinocytes. The role of therapeutics targeting the gut microbiome was explored. Ustekinumab and tofacitinib altered gut microbiome composition. Probiotic and FMT interventions showed mixed outcomes. Six of eight probiotic studies reported increased SCFA producing species and/or reduced inflammatory markers. FMT improved immune markers in mice but had no significant benefit in human trials.ConclusionAlterations in the microbiome linked to inflammation and immune response, suggest the microbiome as a potential therapeutic target for PsO/PsA.Weiterlesen

Obesity impacts both the clinical management and therapeutic strategies for psoriasis. This study aims to describe the use of biological medicines in treating obese patients with moderate-to-severe psoriasis. We conducted a retrospective cohort study (2007-2022) of obese patients who initiated biological treatments for moderate-severe psoriasis. The primary outcome was the number of biological treatment lines required to achieve an optimal or adequate Psoriasis Area and Severity Index (PASI) score reduction. Secondary outcomes included the duration of biological use and reasons for discontinuation. We included 58 patients (mean age 50 years, body mass index [BMI] 35.9 kg/m2, psoriasis duration 16.5 years). Biological treatments enabled 77.6% (45) of patients to achieve an optimal response, and 87.9% (51) achieved an adequate response. The median time-to-response was 2-7 months, with the greatest improvements seen with adalimumab, etanercept, and ustekinumab. The primary reason for discontinuation was lack of effectiveness (50% of first-line treatments). This study suggests that systemic biologics are effective for obese psoriasis patients and emphasizes the need for close monitoring of reasons that lead to discontinuation. As biologics evolve, refining guidelines will be essential for optimizing psoriasis management in obese patients.Weiterlesen

BackgroundThe efficacy of interleukin-17 inhibitors may be impacted by baseline psoriasis features.ObjectiveThis post hoc analysis aimed to explore the efficacy of vunakizumab in patients with moderate-to-severe plaque psoriasis stratified by diverse disease features.MethodsThis post hoc analysis used data from a phase III trial (NCT04839016); 690 patients with moderate-to-severe plaque psoriasis receiving vunakizumab (n = 461) or placebo (n = 229) were included.ResultsThe proportions of patients achieving Psoriasis Area and Severity Index (PASI) 75, PASI 90, PASI 100, and static physician's global assessment (sPGA) 0/1 responses at week (W)12 were significantly higher in the vunakizumab group than in the placebo group, regardless of the duration of psoriasis, PASI score, body surface area (BSA) involvement, and sPGA score. Similarly, at W4 and W8, treatment response rates were higher in the vunakizumab group than in the placebo group, regardless of the above-mentioned features. The same trend was also found at W24. However, treatment responses at W52 were almost not different between patients continuously receiving vunakizumab and those switching from placebo to vunakizumab, regardless of disease duration and disease severity.ConclusionVunakizumab shows satisfactory efficacy in patients with moderate-to-severe plaque psoriasis, regardless of psoriasis duration and severity.Weiterlesen

We report a case of a 17-year-old girl diagnosed with several severe dermatological conditions: atopic dermatitis (AD), inverse and scalp psoriasis, pustular acne, and hidradenitis suppurativa (HS). We consider this case of particular interest because it is therapeutically challenging and because of its psychological impact on the patient's quality of life. We believe that this case may be useful in understanding the management of complex dermatoses as inescapable from the overall assessment of the inflammatory process, which impacts at different levels (skin, cardiovascular, central nervous system, and psyche).Weiterlesen

ObjectivesTo determine the frequency and baseline characteristic differences of complex-to-manage (C2M), difficult-to-manage (D2M) and treatment-refractory (TR) psoriatic arthritis (PsA) in a real-world longitudinal cohort, using the recently proposed 2025 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and the European Alliance of Associations for Rheumatology (EULAR) definitions.MethodsWe analysed data from newly diagnosed, disease-modifying antirheumatic drug-naïve patients with PsA enrolled in the Dutch Southwest Early Psoriatic Arthritis cohort between 2013 and 2023. Patients were classified using the 2025 GRAPPA (C2M, TR) and EULAR (D2M, TR) PsA definitions. Frequencies were calculated for each definition. Time-to-event analyses using Kaplan-Meier methods assessed the timing of definition fulfilment and individual components. Longitudinal differences in patient-reported outcomes (PROs) were assessed using linear mixed-effects models.ResultsAmong 885 newly diagnosed patients with PsA, 20% (179/885) fulfilled the GRAPPA-C2M definition, 4.2% (37/885) fulfilled the EULAR-D2M definition, 3.8% (34/885) met the EULAR-TR and 1.2% (11/885) fulfilled the GRAPPA-TR criteria definition during follow-up. Female sex, higher body mass index (BMI), longer symptom duration, presence of enthesitis and greater skin involvement differed with meeting definitions at baseline. Patients classified as GRAPPA-C2M, GRAPPA-TR, EULAR-D2M and EULAR-TR consistently reported worse long-term PROs (Health Assessment Questionnaire-Disability Index scores in C2M (β=0.17, 95% CI 0.10 to 0.24), GRAPPA-TR (β=0.37, 95% CI 0.22 to 0.51), EULAR-D2M (β=0.36, 95% CI 0.20 to 0.48) and EULAR-TR (β=0.40, 95% CI 0.25 to 0.55)).ConclusionsApproximately 20% of patients with early PsA fulfilled the GRAPPA-C2M criteria, representing the earliest and broadest subgroup, while 4% met EULAR-D2M/EULAR-TR and 1.2% GRAPPA-TR definitions. These latter subgroups were more likely to be female, had higher BMI, greater skin involvement and enthesitis and experienced persistently worse PROs, underscoring the need for tailored management strategies.Weiterlesen

Male genital psoriasis (mGP) is an inflammatory dermatosis affecting the penis and scrotum, a common but significantly under-reported manifestation of psoriasis. Owing to the unique anatomical and microenvironmental characteristics of the male genital region, mGP differs from chronic plaque psoriasis in its clinical presentation, exacerbating factors and therapeutic considerations. Similar to other forms of psoriasis, mGP carries a substantial psychosocial burden. This is amplified by the intimate nature of mGP and its detrimental effects on sexual and interpersonal functioning, which is often overlooked in routine consultations. This narrative review aims to summarise the presentation, consequences and management options of mGP. Assessment of disease severity is further challenged by limited body surface area involvement, leading to underestimation by conventional psoriasis severity measurement tools. Moreover, certain established treatments for psoriasis are unsuitable in mGP due to differing microanatomy and increased susceptibility to adverse effects. Despite its significant physical and psychosocial impact, mGP remains an under-recognised and under-studied subtype of psoriasis with no therapies specifically approved. Existing studies seldomly distinguish genital from inverse psoriasis, and even fewer distinguish male from female GP. The nuances of mGP merit dedicated clinical trials using validated and specific measurement tools to accurately characterise mGP and evaluate treatment efficacy.Weiterlesen

BackgroundPsoriasis is a chronic immune-mediated inflammatory disease associated with heightened cardiovascular risk. Platelets are increasingly implicated in this link through their capacity to amplify vascular inflammation and interact with leukocytes. Circulating leukocyte-platelet aggregates are elevated in psoriasis, although the biological significance of these aggregates remains incompletely understood. We investigated whether increased leukocyte-platelet aggregates is associated with alterations in the platelet transcriptomic profile in psoriasis.MethodsLeukocyte-platelet aggregate levels were compared between psoriasis patients (n = 42) and healthy controls (n = 29). Psoriasis patients were stratified by the cohort median lymphocyte-platelet aggregate (LyPA) or neutrophil-platelet aggregate (NPA) levels into high vs low aggregate groups. Platelet RNA sequencing was then performed to define transcriptomic differences in high-vs low-aggregate psoriasis.ResultsPsoriasis patients (mean age 46; 60% male; 81% Caucasian) had higher LyPA (P = 0.001) and NPA (P = 0.04) compared with healthy controls (mean age 42; 55% male; 69% Caucasian). Platelet RNA sequencing revealed that psoriasis patients with high LyPA or high NPA had downregulation of platelet inflammatory pathways, including interferon, tumor necrosis factor (TNF), IL-8, and IL-6 signaling.ConclusionThese findings identify inflammatory platelet transcriptomic alterations associated with elevated lymphocyte-platelet and neutrophil-platelet aggregates in psoriasis and motivate further work to define the functional consequences of leukocyte-platelet aggregates in psoriasis.Weiterlesen

Psoriasis is a chronic skin disease driven by skin inflammation and abnormal subcutaneous blood vessels. Yinxie Granules (YXKL) is a clinically effective traditional Chinese medicine (TCM) formula that has shown promise in psoriasis treatment, but its pharmacological mechanisms and material basis remain unclear, limiting its clinical application and co-administration with other drugs. In this study, we explored the mechanism and active components of YXKL in the treatment of psoriasis using patient samples, IMQ-induced psoriatic mice, zebrafish, and in vitro assays. We discovered that YXKL alleviated skin inflammation and restored the skin barrier by reducing M1 macrophage/Th17 infiltration, lowering pro-inflammatory cytokines (IL-6, IFN-β, IL-23, IL-17), and increasing loricrin expression. Mechanistically, we identified a dynamic transition in STING signaling during psoriasis progression. Both the STING/IRF3 and STING/NF-κB pathways were activated in moderate psoriasis, while only the STING/NF-κB pathway was hyperactivated in severe disease. YXKL specifically targeted the STING/NF-κB pathway to mitigate inflammation and vasculopathy but had no significant impact on the upstream regulators, including TRAF6, LKB1, AMPK, and ULK1. Quercetin and kaempferol were identified as the primary STING-modulating components in YXKL, binding to STING proteins and inhibiting downstream pathway activation. These flavonoid components mediate the anti-psoriatic effects of YXKL by simultaneously suppressing skin inflammation and angiogenesis while enhancing vascular integrity through STING inhibition in both keratinocytes and endothelial cells. Our results elucidated the molecular basis of YXKL for psoriasis treatment, highlighting STING/NF-κB as a pivotal therapeutic target in mitigating psoriasis development and providing natural candidate compounds as potential STING inhibitors.Weiterlesen

No abstract supplied.Weiterlesen

BackgroundThe Psoriasis Area and Severity Index (PASI) is the standard measure for psoriasis severity but reflects only a single time point and may underestimate long-term disease burden. To assess whether the highest-ever recorded PASI (PeakPASI) can serve as a marker of historical disease severity and correlate with treatment burden and comorbidities.Patients and methodsA cross-sectional analysis of 308 psoriasis patients from a German university hospital was conducted. Data on PASI, PeakPASI, therapies, and comorbidities were obtained from self-report and medical records. Group comparisons used non-parametric tests; Poisson regression assessed PeakPASI as a predictor of systemic therapy use and comorbidity burden.ResultsMedian PeakPASI (11.4 [IQR 5.9-17.0]) exceeded current PASI (2.0 [IQR 1.0-5.1]). PeakPASI ≥ 10 was associated with more systemic therapies (p < 0.001), phototherapy (p < 0.001), smoking (p = 0.021), and diabetes (p = 0.020). PeakPASI correlated with number of systemic (ρ = 0.296), topical therapies (ρ = 0.367), and hospital visits (ρ = 0.186). It significantly predicted systemic therapy use (β = 0.355, p < 0.001), but not comorbidity burden.ConclusionsPeakPASI may complement current measures by reflecting historical severity and informing treatment. While not a cumulative burden marker, it may prevent underestimation of long-term disease impact. Prospective validation is warranted.Weiterlesen

The S1 guideline "Therapy of generalized pustular psoriasis (GPP)" is a German guideline developed in accordance with the criteria of the AWMF. The full version addresses clinical presentation, pathogenesis, diagnosis and differential diagnosis, comorbidities, and therapy. In addition, therapy recommendations for adults with GPP are provided. Both approved and off-label therapies are considered. The present article is a shortened version of the guideline, whose therapy recommendations are presented in full and without omission.Weiterlesen

No abstract supplied.Weiterlesen

Background and objectivesTrust in therapy impacts adherence and satisfaction in chronic inflammatory skin diseases, including atopic dermatitis (AD) and psoriasis (PSO). This study assessed and compared trust in skincare and topical therapies and explored influencing factors among AD and PSO patients.Patients and methodsCross-sectional surveys of AD or PSO patients were conducted at two dermatological university centers in Germany. Group differences were analyzed using Mann-Whitney U and Kruskal-Wallis tests; associations between trust (6-point Likert scale: 1 = very high, 6 = none) and demographics, disease severity, pruritus, pain, and quality of life (QoL) using Spearman correlations. All analyses were exploratory.ResultsAmong 253 AD or PSO patients (median age 53.0 years, interquartile range 36.0-63.0; 43.9% female) median trust in skin care and topical therapies was moderate. AD patients reported significantly higher trust than PSO patients. In AD, trust in skin care correlated with pruritus intensity (p < 0.001), pain intensity (p < 0.05), and QoL (p < 0.001); trust in topical therapy correlated with QoL (p < 0.01). No significant correlations were observed in PSO.ConclusionsTrust levels were higher in AD than in PSO but tended to decline with increasing disease burden and poorer QoL. Enhancing patient education and shared decision-making may help improve trust and adherence.Weiterlesen

### Sucht und chronische Hautkrankheiten Die Übersichtsarbeit wertete 38 Studien zu Sucht bei chronisch entzündlichen Hauterkrankungen aus. Besonders oft wurden **Rauchen** und **Alkoholkonsum** untersucht. Viele Betroffene konsumieren mehr als Menschen ohne Hauterkrankung. Das kann mit stärkerer Entzündung, häufigeren Schüben und mehr seelischer Belastung zusammenhängen. Verhaltenssüchte wie Glücksspiel, Internet oder Solarium kamen seltener vor, können aber die Lebensqualität deutlich verschlechtern. In den meisten Hautarztpraxen wird bisher kaum gezielt nach Sucht gefragt. Standardisierte Fragebögen werden nur selten genutzt. Für Euch heißt das: Es ist sinnvoll, den eigenen Umgang mit Nikotin, Alkohol und anderen Mitteln ehrlich zu prüfen. Sprecht Eure Dermatologin oder Euren Hausarzt darauf an. Unterstützung bei Sucht ist kein Zeichen von Schwäche. Sie kann helfen, Haut und Allgemeingesundheit zu entlasten. Originaltitel: Addiction in chronic inflammatory skin diseases: A systematic review of prevalence, impact and screening practices Link zur Quelle

Menschen mit Schuppenflechte oder anderen chronisch entzündlichen Hautkrankheiten haben oft Probleme mit Sucht. Alkoholabhängigkeit tritt bei bis zu der Hälfte der Betroffenen auf. Viele rauchen stark und schaffen den Ausstieg nicht. Auch andere Süchte spielen eine Rolle, zum Beispiel Drogen oder Internet und Glücksspiel. Wer süchtig ist hat meist stärkere Hautbeschwerden und mehr andere Krankheiten. Die Therapien wirken dann oft schlechter. Fachleute sagen Hautärzte sollen nach Sucht fragen und Hilfe anbieten. Wichtig ist auch, auf psychische Belastung zu achten und Männer und Frauen passend anzusprechen. Wenn du dich hier wiedererkennst sprich dein Behandlungsteam offen an. Originaltitel: Addiction in chronic inflammatory skin diseases: A systematic review of prevalence, impact and screening practices. Link zur Quelle

Psoriasisarthritis betrifft nicht nur Gelenke.[4][7] Sie kann auch den Herzrhythmus durcheinanderbringen.[4][7] In einer neuen Analyse verglichen Ärzte die EKGs von Menschen mit PsA mit gesunden Personen.[4][7] Sie fanden mehr Vorhofflimmern und andere Rhythmusstörungen bei PsA, vor allem wenn die Entzündung stark war.[4][7] Wer eine niedrige Krankheitsaktivität oder sogar eine Remission hatte, zeigte deutlich weniger Auffälligkeiten im EKG.[4] Die Botschaft ist klar.[4] Lass deine PsA gut behandeln und sprich deinen Arzt auch auf Herz und EKG an. Originaltitel: Electrocardiographic markers of arrhythmic risk in psoriatic arthritis: a retrospective comparative cohort analysis Link zur Quelle

Biologika gegen TNF‑alpha helfen vielen mit Psoriasis, sie können aber auch neue Hautprobleme machen. Ärztinnen nennen das oft paradoxes Psoriasis, weil rote Flecken und Pusteln wie Schuppenflechte aussehen. In einem Bericht zu sechs Betroffenen zeigte sich etwas anderes. Die Haut war mit dem Keim Staphylococcus aureus voller Eiterherde, zum Beispiel an Händen, Füßen und Kopfhaut. Vermutlich wandern die Keime aus der Nase auf die Haut. Mit Salben gegen Keime und Antibiotika gingen die Stellen wieder weg, die TNF‑Therapie musste nicht immer enden. Wichtig ist, dass Ärztinnen neue Hautveränderungen genau prüfen und auch an eine Infektion denken. Originaltitel: Case Report: Paradoxical psoriasis under TNF-α blockade may represent generalized abscessing staphyloderma - GASD syndrome by TNF antagonists. Link zur Quelle