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'I Didn't Know, I Definitely Guessed.' Exploring Pre-Registration Podiatry Students' Approach to Identifying Dermatological Conditions in Different Skin Tones, a Mixed Methods Study.
BackgroundResearch suggests that healthcare professionals find it more difficult to correctly diagnose dermatological conditions in the nonwhite patient demographic. People of colour experience higher rates of delayed and misdiagnosis, contributing to an increased mortality risk and increased health inequalities that remain widespread throughout the health care setting. This study aimed to investigate podiatry student's ability, confidence, approaches and perceptions in diagnosing dermatology pathologies in different skin tones.MethodsA mixed methods explanatory sequential design was undertaken with pre-registration podiatry students from universities across South-central England. Participants completed a validated pictorial multiple-choice questionnaire comprising six images of either eczema or psoriasis in three different skin tone categories: light, medium or dark. Results were used to inform focus groups and a process of thematic analysis explored participants perceptions surrounding their diagnostic approaches and underpinning confidence.ResultsThe medium skin tone (Fitzpatrick groups III/IV) was associated with the most correct responses for psoriasis (69%) followed by light skin tone (Fitzpatrick groups I/II) with 48%. Psoriasis in darker skin tones (Fitzpatrick groups V/VI) received the least correct responses (3%). In eczema, results were more evenly spread with darker skin tones (Fitzpatrick groups V/VI), receiving a slightly higher percentage of correct diagnoses (39%). Qualitative analysis revealed two emergent themes: (i) reports on confidence and apprehension and (ii) limitations in education provision: each with a series of sub-themes. Participants reported barriers to their diagnostic ability included an underrepresentation of dark skin tones in medical images and inadequate exposure to pathology on patients with dark skin tones.ConclusionsThere was a notable lack of confidence in participants' ability to correctly diagnose dermatological pathology, particularly in dark skin tones. This study addresses the research gap in podiatric health inequalities and pinpoints the associated educational shortcomings from the podiatry education perspective.Weiterlesen
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A Diagnostic Pitfall: Secondary Syphilis Mimicking Psoriasis in a Patient With Alcoholic Liver Disease
No abstract supplied.Weiterlesen
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Human Immunodeficiency Virus-Associated Vasculitis: A Case Report of Sensorineural Hearing Loss, Bell's Palsy, and Psoriasis Guttata
No abstract supplied.Weiterlesen
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Psoriatic arthritis-evolution of our understanding of the phenotype.
The psoriatic arthritis phenotype has evolved over the past several decades. The original description of 5 clinical patterns has been expanded into 6 domains including peripheral arthritis (which includes 3 of the patterns described by Moll and Wright namely distal, oligoarticular and polyarticular), axial disease, dactylitis, enthesitis, skin and nails. In this article we review the evolution of the PsA phenotype, from the Moll and Wright subtypes described in 1973 and how they might have changed, evolution of our understanding of axial PsA, consider race and geographic differences in disease expression, role of obesity and sex on the PsA phenotype, effect of co-expression of PsA and FM as well as OA on the phenotype, and consider difficult to treat PsA.Weiterlesen
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Subclinical psoriatic arthritis: concepts, dilemmas, and research needs.
Psoriatic arthritis (PsA) develops in up to one-third of patients with psoriasis (PsC), yet increasing attention is now focused on a putative subclinical phase preceding overt arthritis. Several conceptual frameworks describe the PsC-PsA transition, including the pragmatic definition proposed by the European Alliance of Associations for Rheumatology, which defines subclinical PsA as arthralgia and/or imaging abnormalities in the absence of clinical synovitis. However, the absence of validated serological biomarkers, the marked clinical heterogeneity of PsA, the frequent occurrence of nonspecific musculoskeletal symptoms, and the limited specificity of imaging findings complicate risk stratification and may lead to misclassification and overtreatment. Lessons from rheumatoid arthritis highlight both the potential and the pitfalls of applying prevention paradigms to subclinical disease. This viewpoint critically appraises current definitions of subclinical PsA, discusses therapeutic and trial-design implications, and outlines key research priorities, including longitudinal PsC cohorts, advanced and molecular imaging, and multiomic biomarker discovery. Future progress depends on developing robust risk-stratification models that capture the full spectrum of psoriatic disease and enable targeted prevention strategies while minimising unnecessary intervention. At the same time, caution is warranted against broad expansion of the 'subclinical' disease state concept, as it may dilute disease definitions, increase overdiagnosis, and divert attention from improving early and accurate identification of clinically meaningful PsA.Weiterlesen
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Definition of the terms used to describe psoriatic disease datasets: a HIPPOCRATES initiative.
Psoriatic arthritis (PsA) is a complex, multisystem disease with no diagnostic criteria and discordant approaches to assessing disease activity and response to treatment. PsA is part of the Psoriatic Disease spectrum, encompassing cutaneous psoriasis and nail changes, PsA and in some cases, uveitis and inflammatory bowel disease. The HIPPOCRATES consortium is addressing unmet needs in PsA and has now established a harmonised data platform, the Secure HIPPOCRATES Data Management Platform (SHDMP), which will be transformative in providing researchers with the ability to interrogate at scale psoriatic disease datasets. The SHDMP datasets are diverse and include people with psoriasis being followed for the development of PsA, as well as cross-sectional, observational and randomised control trial data on people with PsA. To better understand and describe the nature of the SHDMP datasets, the HIPPOCRATES consortium has now defined and agreed on the terms that will be applied to each dataset. In this short report, the process adopted to obtain consensus on the dataset definition and the final set of terms agreed upon is described and discussed. The agreement on the terms to be used will greatly enhance a researcher's ability to select the appropriate SHDMP datasets to study.Weiterlesen
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Assessing the reliability and quality of content on social media regarding biologic therapies for psoriasis: A cross-sectional content analysis.
BackgroundBiologic agents are an important novel therapeutic option for moderate-to-severe psoriasis. In recent years, TikTok and Bilibili have gradually become important channels for Chinese patients to obtain health information. This study aims to evaluate the content, quality, reliability, and transparency of videos related to biologic therapy for psoriasis on these platforms.MethodsWe searched both platforms using the dual keywords "psoriasis" and "biological agents," confirmed compliance with relevant criteria, and collected the top 150 videos based on their composite rankings. Fundamental characteristics, uploader categories, and content types were documented. Two independent reviewers evaluated video quality using the mDISCERN, GQS, and the JAMA criteria. Nonparametric tests were performed for group comparisons, and Spearman correlation analysis was applied.ResultsBilibili videos more frequently addressed medical expenses, types of biologic agents, and recurrence, whereas TikTok videos focused on etiology and clinical manifestations. The video quality was barely acceptable. On TikTok, the median GQS, mDISCERN, and JAMA scores were 3.00 (2.25, 4.00), 3.00 (3.00, 4.00), and 2.00 (2.00, 3.00). On Bilibili, the median scores were 3.00 (2.00, 4.00), 3.00 (2.00, 4.00), and 1.00 (1.00, 3.00). Videos uploaded by professional organizations achieved the highest GQS (median 4.00, IQR: 4.00-4.00) but had the lowest engagement. Engagement metrics showed a moderate correlation with quality scores (P < 0.05).ConclusionsThis study found that videos related to biologic therapy for psoriasis lack content completeness, with overall quality, reliability, and transparency remaining at a suboptimal level. Greater participation by professional organizations and increased visibility of their videos should be encouraged to promote the dissemination of high-quality content. This study provides preliminary insights for health communication strategies and highlights the necessity of strengthening content regulation.Weiterlesen
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Die durch Entzündungen hervorgerufene Reduktion von p75NTR in Schwann-Zellen vermittelt Hautschmerzen bei Psoriasis.
Originaltitel: Depletion of p75NTR in Schwann Cells Driven by Inflammation Mediates Cutaneous Pain in Psoriasis. Link zur Quelle
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Zehnjährige Längsschnittstudie zur Enthesen-Sonographie bei Psoriasis: Eingeschränkte Aussagekraft zur Diagnose von Psoriasis-Arthritis | Rheumatology Advances in Practice | Oxford Academic
# Was Ultraschall über Sehnenansatzpunkte wirklich aussagt **Die Studie im Überblick** Forscher verfolgten Psoriasis-Patienten über zehn Jahre. Sie wollten wissen: Können Ultraschallaufnahmen von Sehnenansatzpunkten vorhersagen, wer später Psoriasis-Arthritis bekommt? Das Ergebnis fiel überraschend aus. **Das Wichtigste für euch** Die Ultraschallbefunde von Anfang konnten nicht vorhersagen, welche Patienten später Gelenkprobleme entwickelten. Das gilt auch für strukturelle Veränderungen und Entzündungszeichen im Ultraschall. Nur drei der 13 Patienten ohne PSA am Anfang bekamen später die Diagnose. Ein weiteres Ergebnis beruhigt: Bei gut behandelten Patienten blieben Strukturveränderungen sichtbar, obwohl die Entzündung minimal war. Das zeigt: Der Ultraschall sieht nicht immer aktive Entzündung, wenn Therapien wirken. **Was das für euren Alltag bedeutet** Ultraschallbefunde allein sind kein zuverlässiger Warnhinweis für PSA. Das ist einerseits beruhigend, andererseits zeigt es: Wir brauchen bessere Methoden zur Früherkennung. Eure rheumatologische Betreuung bleibt wichtiger als einzelne Bildgebungsbefunde.[1] Originaltitel: Ten-year longitudinal assessment of entheseal ultrasound in psoriasis: limited discriminatory capacity for psoriatic arthritis | Rheumatology Advances in Practice | Oxford Academic Link zur Quelle
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Auswirkungen der Parodontitisbehandlung auf Psoriasis: Eine systematische Übersicht begrenzter klinischer und präklinischer Evidenz | MDPI
# Zahnfleischbehandlung und Psoriasis: Was die Forschung zeigt **Die Verbindung zwischen Zahnfleisch und Haut** Euer Zahnfleisch und Eure Psoriasis hängen stärker zusammen als bislang gedacht.[1][2][3] Menschen mit Psoriasis haben ein etwa zwei- bis dreifach höheres Risiko für Zahnfleischerkrankungen.[2][3] Umgekehrt erhöht Zahnfleischerkrankung das Psoriasis-Risiko um etwa 60 Prozent.[5] Der Grund: Beide Erkrankungen aktivieren ähnliche Entzündungsprozesse in Eurem Körper. **Was bringt eine Zahnfleischbehandlung?** Eine Behandlung des Zahnfleisches könnte Euch also auch der Psoriasis helfen.[7] Erste Studien zeigen, dass eine professionelle Zahnfleischreinigung die Psoriasis zusätzlich zu einer dermatologischen Therapie verbessert.[7] Besonders Menschen, die mit modernen Biologika-Medikamenten behandelt werden, haben zugleich bessere Zahngesundheit.[3] **Was könnt Ihr tun?** Achtet auf regelmäßige Zahnarztbesuche und gute Mundhygiene. Das ist für Euch nicht nur wichtig für die Zähne – es könnte auch Eure Psoriasis beeinflussen. Sprecht mit Euerem Zahnarzt und Euerem Dermatologen offen über beide Erkrankungen, damit sie zusammen besser behandelt werden können.[3][4] Originaltitel: The Effects of Periodontal Treatment on Psoriasis: A Systematic Review of Limited Clinical and Preclinical Evidence | MDPI Link zur Quelle
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Retention, Wirksamkeit und Sicherheit von Secukinumab bei Plaque-Psoriasis: 5-Jahres-Ergebnisse der SERENA-Studie – Dermatologie und Therapie
# Was bringt Secukinumab auf lange Sicht? Secukinumab hilft den meisten von Euch langfristig gegen Schuppenflechte.[1][2] In einer großen europäischen Studie mit 1.740 Patienten über fünf Jahre zeigt sich: Die Haut wird schnell deutlich besser und bleibt es.[1] Die Werte, die den Schweregrad messen, sinken von 21 auf unter 2 – fast klare Haut für viele von Euch.[1] **Das bedeutet für Euren Alltag:** Etwa 6 von 10 Patienten nehmen die Spritze auch nach fünf Jahren noch regelmäßig.[1] Besonders wichtig: Das Mittel scheint auch Schuppenflechte-Arthritis zu verhindern – vor allem bei Euch mit Nagelbeteiligung.[2] **Sicherheit ist kein großes Risiko:** Schwere Nebenwirkungen treten selten auf.[1] Es gibt keine Überraschungen nach Jahren der Behandlung. Wichtig zu wissen: Wer noch kein anderes Biolog bekommen hat, profitiert oft besser als Patienten mit Vorbehandlung.[1] Originaltitel: Retention, Effectiveness, and Safety of Secukinumab in Plaque Psoriasis: 5-Year Results from SERENA - Dermatology and Therapy Link zur Quelle
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Definition der Begriffe zur Beschreibung von Datensätzen zu Psoriasis-Erkrankungen: eine HIPPOCRATES-Initiative.
# HIPPOCRATES: Ein Forschungsprojekt für bessere Diagnosen bei Psoriasis-Arthritis Das EU-Projekt HIPPOCRATES bringt Experten aus Forschung, Klinik und Industrie zusammen[1]. Es soll helfen, Psoriasis-Arthritis besser zu verstehen und früher zu erkennen. Das Projekt hat eine neue Datenplattform gegründet[7]. Sie heißt SHDMP und sammelt Informationen von vielen Patienten mit Psoriasis und Psoriasis-Arthritis[2]. Die Daten stammen aus verschiedenen europäischen Studien. Das Besondere: Das Projekt hat klare Begriffe und Definitionen festgelegt[7]. Diese beschreiben genau, welche Daten in welchem Datensatz enthalten sind. Damit können Forscher viel leichter die richtigen Informationen für ihre Arbeit finden. Warum ist das wichtig für dich? Mit besseren und einheitlichen Daten entstehen bessere Erkenntnisse[1]. Das führt zu früheren Diagnosen und besseren Behandlungsmöglichkeiten. Letztendlich profitierst du als Patient oder Patientin davon[2]. Originaltitel: Definition of the terms used to describe psoriatic disease datasets: a HIPPOCRATES initiative. Link zur Quelle
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'I Didn't Know, I Definitely Guessed.' Exploring Pre-Registration Podiatry Students' Approach to Identifying Dermatological Conditions in Different Skin Tones, a Mixed Methods Study.
Research suggests that healthcare professionals find it more difficult to correctly diagnose dermatological conditions in the nonwhite patient demographic. People of colour experience higher rates of delayed and misdiagnosis, contributing to an increased mortality risk and increased health inequalities that remain widespread throughout the health care setting. This study aimed to investigate podiatry student's ability, confidence, approaches and perceptions in diagnosing dermatology pathologies in different skin tones. A mixed methods explanatory sequential design was undertaken with pre-registration podiatry students from universities across South-central England. Participants completed a validated pictorial multiple-choice questionnaire comprising six images of either eczema or psoriasis in three different skin tone categories: light, medium or dark. Results were used to inform focus groups and a process of thematic analysis explored participants perceptions surrounding their diagnostic approaches and underpinning confidence. The medium skin tone (Fitzpatrick groups III/IV) was associated with the most correct responses for psoriasis (69%) followed by light skin tone (Fitzpatrick groups I/II) with 48%. Psoriasis in darker skin tones (Fitzpatrick groups V/VI) received the least correct responses (3%). In eczema, results were more evenly spread with darker skin tones (Fitzpatrick groups V/VI), receiving a slightly higher percentage of correct diagnoses (39%). Qualitative analysis revealed two emergent themes: (i) reports on confidence and apprehension and (ii) limitations in education provision: each with a series of sub-themes. Participants reported barriers to their diagnostic ability included an underrepresentation of dark skin tones in medical images and inadequate exposure to pathology on patients with dark skin tones. There was a notable lack of confidence in participants' ability to correctly diagnose dermatological pathology, particularly in dark skin tones. This study addresses the research gap in podiatric health inequalities and pinpoints the associated educational shortcomings from the podiatry education perspective.Weiterlesen
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Effectiveness, Quality of Life and Durability of Risankizumab in Patients with Moderate-to-Severe Psoriasis: Real-World Evidence from the PRIMMA Study.
IntroductionPatients with moderate-to-severe psoriasis often experience significant physical symptoms and notable psychosocial distress. Pruritus is the most bothersome symptom and a key contributor to sleep disturbances and reduced quality of life (QoL). Though biologics such as risankizumab have advanced clinical management, real-world evidence of patient-reported outcomes (PROMs) and objective pruritus assessment remains limited. This study assessed risankizumab's effectiveness in improving QoL, symptom burden, and sleep and evaluated the feasibility of nocturnal scratch monitoring using a wearable sensor.MethodsPRIMMA was a multicenter, prospective, non-interventional study conducted in Israel among adults with moderate-to-severe psoriasis initiating label-approved risankizumab therapy. Outcomes were assessed at baseline and week 52, and included Dermatology Life Quality Index (DLQI), static Psoriasis Global Assessment (sPGA), Pruritus Numeric Rating Scale (PNRS), Psoriasis Symptoms Scale (PSS), Medical Outcomes Study Sleep Scale (MOS-SS), Work Productivity and Activity Impairment (WPAI), and adverse events. Objective nocturnal scratch activity was measured using ADAM digital patch sensors in a subgroup of patients.ResultsIn 136 participants, the median age was 51 years, 57% were male, 43% were female, and 35% were bio-naïve. At week 52, 58% achieved DLQI 0/1 (versus 5.1% at baseline; p < 0.001) and 81% had PNRS 0-3 (versus 21% at baseline; p < 0.001). sPGA 0/1 was reached by 77% at week 52, and components of PSS and WPAI improved significantly. In patients who achieved any favorable outcome (DLQI 0/1, PNRS 0-3, sPGA 0/1) at week 24, ≥ 68% maintained it at week 52, demonstrating treatment durability. In the digital subcohort (n = 14), sensor data confirmed significant reduction in nocturnal scratch duration at week 4 and week 16 compared to baseline (both p ≤ 0.032). Adverse events were mostly mild to moderate.ConclusionsIn real-world practice, risankizumab showed substantial improvements in QoL, pruritus, sleep, and work/activity impairment in moderate-to-severe psoriasis. Digital scratch monitoring showed reduction in nocturnal scratch duration. Integrating objective digital measures with PROMs may enable more data-driven, individualized management in psoriasis care.Clinical trial registrationClinicalTrials.gov Identifier NCT04780516.Weiterlesen
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Enzymatically-modified isoquercitrin alleviates skin inflammation, mast cell degranulation, and vascular hyperpermeability in a mouse model of plaque psoriasis.
Psoriasis is a prevalent, autoimmune skin disease that easily relapses and is difficult to cure. Given its increased global prevalence and the limitations of synthetic therapies, developing of natural product-originated agents with fewer side effects and high therapeutic efficacy is of serious concern. Therefore, this work aimed to evaluate the potential effect of enzymatically-modified isoquercitrin (EMIQ, 50 and 100 mg/kg body weight "b.wt", administered orally for 8 days), in comparison with methotrexate (MTX, a synthetic drug), against imiquimod (IMQ)-induced psoriatic lesions in female BALB/c mice. Furthermore, the protective effect of EMIQ against the skin associated-vascular permeability response was investigated by using IMQ-induced Evans blue extravasation mouse model. The results showed that EMIQ (particularly at the higher dose) attenuated significantly (P < 0.05-0.001) all complications shown in psoriatic mice like MTX. These effects included reduction in the psoriasis area and severity index, prevention of b.wt loss, and alleviation of histopathological alterations and oxidative stress. Importantly, EMIQ reduced the elevated expression of interleukin (IL)-23 and IL-17A (the key cytokines involved in psoriasis pathogenesis), inhibited phosphorylation of nuclear factor-κBp65, and down-regulated tumor necrosis factor-α, IL-1β, and cyclooxygenase-2 levels in mice skin tissues. Moreover, oral administration of EMIQ prevented significantly (P < 0.001) the vascular permeability associated with augmented Evans blue leakage and dermal accumulation of degranulated mast cells, suggesting a reduction in inflammation and edema. Taken together, our study demonstrated that EMIQ can alleviate psoriasis and may be considered as a promising strategy for psoriasis treatment via targeting IL-23/IL-17A axis and mast cell degranulation.Weiterlesen
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Diagnostic Algorithm for Axial Involvement in Psoriatic Arthritis.
To develop a unified diagnostic algorithm for axial psoriatic arthritis (axPsA). MATERIALS AND METHODS. : A total of 122 patients with psoriatic arthritis (PsA), duration less than 10 years, were included in the study according to CASPAR criteria, provided that they also had axial involvement. Axial involvement was detected in case of radiographic sacroiliitis [(rSI); bilateral grade ≥2 or unilateral grade ≥ 3] or active MRI SI (MRI-SI), or ≥ 1 syndesmophyte(s) of the cervical and/or lumbar spine (CS/LS), or facet joints ankyloses of the CS. Patients were evaluated for the presence of inflammatory back pain (IBP) by ASAS criteria. Back pain lasting over 3 months, that did not meet ASAS criteria was considered chronic back pain (chrBP). HLA-B27 antigen status was observed. Results and discussion. IBP was identified in 87 (71.3%), chrBP-in 35 (28.7%) patients, 49 (40.2%) patients had older age (>40 years) at back pain onset; 120 (98.4%) patients had peripheral arthritis, 75 (61.5%)-dactylitis, 69 (56.6%)-enthesitis, 122 (100%)-psoriasis, 90 (73.8%)-nail psoriasis. Isolated axial disease without peripheral arthritis was found in 2 (1.6%) patients. rSI was detected in 85 (69.7%) patients, in 28 of 85 (32.9%) patients rSI developed without IBP. Spinal lesions of the LS and CS were found in 100 (82.0%) patients, chunky "non-marginal" syndesmophytes-in 60 (49.2%), asymmetrical syndesmophytes of the LS-in 22 of 72 (30.6%), paravertebral ossification-in 5 (4.1%) patients. Isolated spinal lesions without rSI were found in 37 (30.3%), isolated spinal lesions without rSI or MRI-SI-in 21 (17.2%) patients. HLA-B27 was observed in 27 of 86 (31.4%) examined patients. Diagnostic algorithm for axPsA was developed. All PsA patients, regardless whether they experienced IBP/chrBP or not, must undergo diagnostic imaging: pelvis, LS and CS X-ray. In patients without rSI, MRI of the sacroiliac joints should be performed. AxPsA diagnosis must be confirmed by imaging. Axial involvement is detected in case of rSI or MRI-SI, or ≥1 syndesmophyte(s) of the CS/LS, or facet joints ankyloses of the CS.Weiterlesen
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The Effects of Periodontal Treatment on Psoriasis: A Systematic Review of Limited Clinical and Preclinical Evidence.
Background/Objectives: Psoriasis and periodontitis share inflammatory pathways. Current evidence suggests a bidirectional non-causal relation. However, the evidence on the effects of periodontal treatment on psoriasis outcomes (severity, inflammatory markers, quality of life) is limited. This study aims to synthetize the available clinical and preclinical evidence of periodontal treatment effects on psoriasis outcomes, in patients with comorbid psoriasis and periodontitis (CRD420261298145). Methods: Several databases (PubMed, WebOfScience, ScienceDirect, ProQuest and GoogleScholar) were searched for relevant articles, without language or time restrictions. We included randomised and non-randomised clinical studies on humans, and controlled animal experiments. Interventions included periodontal treatment (surgical and non-surgical). Outcomes were the Psoriasis Area and Severity Index and dermatology-specific quality of life scores; secondary outcomes included inflammatory biomarkers and periodontal parameters. Studies were screened in duplicate, data extracted independently and risk of bias was assessed using Cochrane RoB 2, ROBINS I, NOS and SYRCLE. Results: A total of five studies were included in this systematic review (four clinical studies and one preclinical studies). Three studies directly assessed post-treatment psoriasis outcomes, with two studies investigating inflammation mediators as secondary outcomes. Two studies directly assessed PASI (Psoriasis Area and Severity Index) modifications, both studies confirming PASI scores decreasing post-periodontal treatment; one study also reported DLQI (Dermatology Life Quality Index). Typical follow-up durations ranged from 8 to 10 weeks for interventional studies, to 5 years for one cohort study. Conclusions: Although momentarily limited by the small number of available studies, the results of this review suggest that periodontal treatment may be associated with improvements in psoriasis outcomes. Further studies on larger samples, with longer follow-up periods would be necessary to confirm and possibly strengthen the existing results.Weiterlesen
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Genetic pharmacoepidemiology of JAK inhibitors in chronic immune-mediated skin diseases: implications for precision therapy and medication safety
No abstract supplied.Weiterlesen
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The protocol for a patient-driven online prospective European observational cohort aiming to determine risk factors for the development of psoriatic arthritis among people living with psoriasis: the HIPPOCRATES Prospective Observational Study.
BackgroundUp to one-third of people living with psoriasis develop psoriatic arthritis (PsA), and the majority have active psoriasis prior to the development of arthritis. Clinical risk factors, such as nail involvement, in conjunction with novel blood biomarkers, could improve PsA risk monitoring and early diagnosis.ObjectivesThe aim of the HIPPOCRATES Prospective Observational Study (HPOS-www.hpos.study) is to follow a cohort living with psoriasis and identify risk factors for the development of PsA.DesignHPOS is a patient-driven online prospective European observational cohort.MethodsAdult participants with psoriasis but with no prior diagnosis of PsA are eligible. Participants are invited to provide consent and join the study online. They complete a semi-structured questionnaire to collect data on demographics, psoriasis, comorbidities, risk factors for PsA, and the Psoriasis Epidemiology Screening Tool screening questionnaire. Follow-up is conducted through a questionnaire every 6 months. The primary outcome is the new onset of PsA confirmed by a diagnosis from their doctor. The study will also collect peripheral blood samples from a subset of participants for biomarker identification.EthicsThis study follows the principles of the Declaration of Helsinki. To date, ethical approval has been granted by independent ethical committees in 10 countries.DiscussionStudying a cohort of individuals with psoriasis will allow us to identify risk factors for arthritis development and to develop a risk calculator. This can support focused efforts on screening, patient education, and even studies looking to delay or prevent the onset of arthritis. This study, run via remote online data collection, provides an efficient way to recruit a large cohort (25,000) across multiple countries. However, challenges have had to be addressed with some key changes in study design, ethical review, and recruitment strategies required for each individual country.Trial registrationHPOS, Clinicaltrials.gov ID: NCT05858528, IRAS number 325080; https://clinicaltrials.gov/study/NCT05858528?locStr=United%20Kingdom&country=United%20Kingdom&cond=Psoriasis&term=HPOS&aggFilters=status%3Anot%20rec&rank=1.Weiterlesen
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Systemic Type I Interferon Blockade Mitigates Insulin Resistance in a Preclinical Model of Psoriasis.
Psoriasis is a cutaneous autoimmune disease with worldwide prevalence. In situ activation of skin-infiltrating plasmacytoid dendritic cells (pDCs) leading to local induction of type I interferons (IFNs) is a crucial innate initiation event in psoriasis. Psoriatic patients also have notable susceptibility to the development of metabolic syndrome, especially systemic insulin resistance. Interestingly, a crucial role of systemic and metabolic tissue-restricted induction of type I IFNs is now established in metabolic syndrome. We aimed at exploring whether systemic type I IFN abundance contributes to metabolic derangements in psoriatic patients as well. We developed a preclinical murine model of chronic psoriasis that develops systemic insulin resistance, accompanied by a chronic low-grade systemic inflammation. Then we showed that systemic ablation of type I IFN signaling, using a monoclonal antibody against type I IFN receptor IFNAR1, can mitigate the metabolic dysregulation in this preclinical model of psoriasis-associated insulin resistance. Thus, we report a hitherto unknown role of systemic type I IFN abundance in driving systemic insulin resistance and metabolic dysregulations in psoriasis.Weiterlesen
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A phosphorous-based dendrimer targets mitochondria and normalizes the keratinocyte proliferation/differentiation balance to improve psoriasis.
Psoriasis vulgaris is a common chronic inflammatory skin disease associated with hyperproliferation and defective differentiation of keratinocytes. Despite new effective treatments using biologicals targeting key cytokines or their receptors, innovative therapeutic approaches remain to be discovered. Here, psoriasis-like imiquimod-induced skin lesions in mice were improved when topically treated with a nano-sized, phosphorus-based dendrimer capped with azabisphosphonate groups, so-called IMD-006, and previously known as ABP dendrimer. This effect was confirmed using ex vivo and in vitro human psoriasis models generated by adding T helper (Th)1-type and Th17-type inflammatory cytokines to skin explants and reconstructed epidermises, in which topically-applied IMD-006 normalized keratinocyte proliferation and differentiation. In 2D keratinocyte cultures, IMD-006 also decreased proliferation whilst promoting differentiation. It was internalized by keratinocytes and distributed to mitochondria. After treatment with IMD-006, changes to the morphology of the mitochondrial network, increases in mitochondrial ROS levels, and co-localization of mitochondria with lysosomes suggest it promotes mitochondrial degradation, a key step in keratinocyte differentiation. Therefore, our results show that IMD-006 could be a promising candidate for the topical treatment of psoriasis.Weiterlesen
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Psoriasis Flare Following Interleukin-17 (IL-17) Inhibition and Recent Streptococcal Infection: A Case Report Highlighting Management Complexity
No abstract supplied.Weiterlesen
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Peroxisome Proliferator-Activated Receptors (PPARs) in Psoriasis: Metabolic Intersections, Molecular Mechanisms, and Potential Treatments
No abstract supplied.Weiterlesen
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Association between Epicardial Adipose Tissue Thickness and Clinical and Metabolic Parameters in Patients with Psoriasis and Psoriatic Arthritis: A Cross-Sectional Study from Türkiye.
BackgroundPsoriasis and psoriatic arthritis (PsA) are chronic inflammatory diseases that affect not only the skin and joints but also the cardiovascular system.AimTo investigate the relationship between epicardial adipose tissue (EAT) thickness and anthropometric measurements, laboratory parameters, and clinical variables in patients with psoriasis and PsA.MethodsThis cross-sectional study included 65 patients with psoriasis vulgaris (with or without PsA) and 54 healthy controls. Demographic, clinical, and laboratory data of the participants were recorded. EAT, left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), interventricular septum thickness (IVS), and ejection fraction (EF) were measured by echocardiography. Associations between EAT thickness and patient parameters were evaluated using Spearman correlation and multivariate linear regression analyses.ResultsThe mean ages of the patient and control groups were 43.88 ± 13.1 years and 44.81 ± 12.88 years, respectively. Low-density lipoprotein cholesterol, LVESD, and IVS were significantly higher in the control group compared with psoriasis patients (P = 0.021, P < 0.001, P < 0.001, respectively). C-reactive protein (CRP) levels (P < 0.001), systolic blood pressure (P < 0.001), diastolic blood pressure (P = 0.023), and EAT thickness (P < 0.001) were significantly higher in the patient group. Disease duration (P = 0.028) and PASI (P = 0.012) were significantly greater in psoriasis patients with PsA. EAT positively correlated with body mass index (BMI) (r = 0.307, P = 0.024), CRP (r = 0.344, P < 0.001), and systolic blood pressure (r = 0.185, P = 0.044).ConclusionsEAT thickness was higher in patients with psoriasis than in control participants. EAT positively correlated with BMI, CRP, and systolic blood pressure.Weiterlesen
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Environmental and Neighborhood Determinants of Psoriasis: A Systematic Review of Pollution, Built Environment, and Socioeconomic Vulnerability on Psoriasis.
Psoriasis is a chronic, immune-mediated skin disease with well-studied genetic and immunologic drivers. Substantial unexplained variability remains, however, in disease onset, severity, and treatment response. There is evidence that implicates the role of environmental and social determinants in these observed differences in psoriasis. We conducted a systematic review to synthesize the current evidence examining the relationship between external exposures, including air and chemical pollution, the built environment, and neighborhood characteristics, and their impact on psoriasis incidence, severity, and exacerbation. Our search in PubMed and Embase (on August 8, 2025 and October 15, 2025, respectively) identified 26 eligible studies. These included nine cohort studies, four ecological studies, and 12 case-control studies. Papers that assessed exposures of ambient air pollutants, chemical pollutants, neighborhood, built environment, income, education, and insurance status were included. The risk of bias for each study was evaluated using the Critical Appraisal Skills Programme (CASP) criteria. Across diverse patient populations and study designs, higher exposure to air pollutants, such as particulate matter and nitrogen oxides, and chemical pollutants, including per- and polyfluoroalkyl substances (PFAS), was associated with increased disease incidence and severity. These were found to contribute to an independently increased risk of psoriasis, even among individuals with a genetic susceptibility to the disease. Climate change associated events, such as wildfires, were linked to increased healthcare utilization for psoriasis. Deleterious neighborhood-level exposures and poor social determinants were also associated with greater psoriasis incidence and exacerbation. Our analysis of existing limitations highlights the need for longitudinal and mechanistic studies to elucidate these relationships, and for the development of standardized definitions for environmental exposures. These findings support a framework for psoriasis that considers environmental and social determinants alongside genetic contributors. Addressing these risk factors requires broader public health initiatives that mitigate exposure and expand healthcare access to at-risk communities.Weiterlesen