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Plaque psoriasis is an immune-mediated chronic recurrent skin disease. In recent years, 308 nm excimer laser (308 nm EL) and topical tacrolimus have been widely used to treat psoriasis. The purpose of this study was to evaluate the efficacy of 308 nm EL irradiation combined with 0.1% tacrolimus ointment in the treatment of plaque psoriasis. This study was a retrospective observational study involving 100 patients with plaque psoriasis, divided into two groups: the control group (50 cases) was treated with 0.1% tacrolimus ointment; the observation group (50 cases) was treated with 308 nm EL and 0.1% tacrolimus ointment. After eight weeks of treatment, the psoriasis area and severity index (PASI) of the two groups were compared, and the occurrence of adverse reactions during treatment was recorded. Before treatment, there was no significant difference in PASI scores between the two groups (p > 0.05). However, the PASI scores of the two groups were significantly lower after treatment than before treatment, and the PASI scores of the observation group after treatment were lower than those of the control group (p < 0.05). No serious adverse reactions occurred in either group. 308 nm EL irradiation combined with 0.1% tacrolimus ointment could be considered a safe and effective method for the treatment of plaque psoriasis, which can significantly reduce the PASI score and is more effective than the use of 0.1% tacrolimus ointment alone, and it is expected to be popularized in the clinic.Weiterlesen

Psoriatic arthritis (PsA) is a chronic inflammatory arthritis involving axial and peripheral joints and tendons that affects a subset of patients with psoriasis (PsO). PsA can be a debilitating disease and warrants prompt rheumatologic evaluation and management. The diagnosis of PsA can be challenging for the practising dermatologist as there is often an overlap in the symptoms of PsA and non-inflammatory musculoskeletal conditions such as osteoarthritis, tendonitis and myofascial pain. The primary aim of the study is to examine psoriasis patients seen at our tertiary institution's combined rheum-derm clinic for a concern for PsA, specifically examining the revised diagnosis and the joint symptom similarities to psoriatic arthritis. We performed a retrospective chart review of patients referred to the rheumatology-dermatology clinic (RDC) at our institution between November 2019 and March 2022. Our review included 242 patients, of which 34 (14%) were psoriasis patients specifically referred due to suspicion for PsA. Each patient underwent a comprehensive rheumatic evaluation, including history, physical examination, laboratory tests and imaging as needed. Fourteen (41.2%) of the 34 patients referred for suspected PsA were diagnosed with non-inflammatory musculoskeletal conditions, primarily mechanical joint pain. Stiffness and/or swelling were significantly more common among patients with confirmed PsA. These findings underscore the importance of thorough evaluation of musculoskeletal symptoms, particularly stiffness and swelling, in patients with psoriasis. Improving education on distinguishing non-inflammatory musculoskeletal conditions may enhance diagnostic accuracy and optimise referral practices.Weiterlesen

Emerging evidence indicates that omega-3 fatty acids from fish oil may serve as beneficial dietary supplements for psoriasis management. Clinical observations demonstrate a significant association between psoriasis improvement and increased docosahexaenoic acid (DHA) levels. However, the causal relationship between fatty acids and psoriasis risk requires further investigation. Using summary-level genome-wide association study (GWAS) data, we applied univariable (UVMR), reverse, and multivariable (MVMR) Mendelian randomization analyses to assess causal effects of multiple fatty acids-including polyunsaturated (PUFA), saturated (SFA), monounsaturated (MUFA), omega-3/6 fatty acids, DHA, eicosapentaenoate (EPA) and docosapentaenoate (DPA)-on psoriasis risk. The analysis revealed that higher circulating levels of omega-3 fatty acids were significantly associated with a reduced risk of psoriasis development (UVMR: OR = 0.900, p = 0.022; MVMR: OR = 0.862, p = 0.007). Sensitivity analyses supported the robustness of this causal relationship, with consistent effects across multiple MR methods. Notably, DHA (UVMR: OR = 0.788, p = 0.006; MVMR: OR = 0.856, p = 0.021) drove this inverse association, while EPA and DPA showed marginal contributions. This study provides valuable insights for targeted nutritional strategies to prevent and manage psoriasis, but further validation is needed.Weiterlesen

J Rheumatol 2025; doi: 10.3899/jrheum.2025-0268 The affiliation for Tommy Kok Annfeldt should be Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark. This correction applies only to the August 5 First Release. The correct affiliation appears in the print and online issues. doi: 10.3899/jrheum.2025-0268.C1.Weiterlesen

Pustular psoriasis is a rare and severe variant of psoriasis characterized by the eruption of sterile pustules, which may present in distinct clinical patterns. The pathologic features of psoriasis, including keratinocyte hyperproliferation, neutrophilic infiltration, and immune dysregulation, are markedly accentuated. Generalized pustular psoriasis (GPP) displays clinical heterogeneity in age of onset, severity, and disease course. Several overlapping phenotypes are recognized. A variable relationship exists between GPP and plaque psoriasis. Some individuals experience plaque psoriasis before or after GPP episodes, while others exhibit GPP as the sole phenotype without any history of plaque involvement (see Image. Pustular Psoriasis).Weiterlesen

Eine aktuelle Fallstudie zeigt: Die Behandlung von palmoplantarer Pustulose mit einer Creme, die den Wirkstoff **Ruxolitinib** enthält, kann sehr gut wirken[1]. Die Patientin litt an schmerzhaften, eitergefüllten Bläschen an Händen und Füßen. Nach der Anwendung der Salbe gingen die Beschwerden deutlich zurück, und die Haut heilte ab. Ruxolitinib gehört zu den sogenannten **JAK-Inhibitoren**. Diese Medikamente bremsen Entzündungen im Körper. Bei anderen Behandlungen hatte die Betroffene keine Besserung gespürt. Der Erfolg mit der Creme zeigt: Für schwere Fälle gibt es Hoffnung auf neue Therapien. Trotzdem ist Ruxolitinib-Salbe in Deutschland noch nicht für diese Diagnose zugelassen[1]. Sprich also immer mit deinem Hautarzt, bevor du neue Therapien ausprobierst. Originaltitel: Successful treatment of palmoplantar pustulosis with topical ruxolitinib Link zur Quelle

Menschen mit Psoriasis, die länger TNF-Alpha-Hemmer nehmen, haben laut einer großen Studie kein generell erhöhtes Krebsrisiko. Ihr Risiko, bestimmte Hautkrebsarten wie Melanom, Basalzellkarzinom und Plattenepithelkarzinom zu entwickeln, steigt aber deutlich. Überraschenderweise sinkt dafür das Risiko für Leukämie, Prostatakrebs und Non-Hodgkin-Lymphom. Speziell Menschen mit Psoriasis hatten ein erhöhtes Gesamtrisiko für Krebs, im Vergleich zu anderen mit chronischen Entzündungen, die diese Medikamente bekamen. Die Studie schlägt vor, für Patientinnen und Patienten mit TNF-Alpha-Hemmern gezieltere Vorsorge beim Hautkrebs zu machen. TNF-Alpha-Hemmer senken Entzündungen im Körper, was gut für die Gelenke und Haut ist. Aber sie schwächen etwas die Immunabwehr, das kann Krebs begünstigen. Forscherinnen und Forscher empfehlen: Mit dem Arzt gut klären, welche Krebsscreenings sinnvoll sind. Originaltitel: Long-term risk of de novo malignancy with tumor necrosis factor alpha (TNF) inhibitor immunosuppression: a multicenter, retrospective cohort study - Journal of Inflammation Link zur Quelle

**GLP-1-Rezeptor-Agonisten** wie Liraglutid oder Semaglutid, ursprünglich als Medikamente gegen Diabetes und Übergewicht entwickelt, könnten auch bei **Psoriasis** helfen[2][3][4]. Studien zeigen, dass sie nicht nur beim Abnehmen und beim Senken des Blutzuckers helfen, sondern auch Entzündungen im Körper und in der Haut bremsen können[2][3][5]. Vor allem Menschen mit Psoriasis und Übergewicht oder Diabetes scheinen davon zu profitieren. Die Medikamente beeinflussen bestimmte Immunzellen und senken wichtige Entzündungsstoffe in der Haut[3][4]. Die bisherigen Studien sind noch klein und kurz, deshalb wissen wir noch nicht, wie gut GLP-1-Agonisten wirklich als Psoriasis-Therapie allein wirken und ob sie für alle geeignet sind[1][3]. Man braucht noch größere und längere Studien, um das sicher beurteilen zu können[3][4]. Originaltitel: GLP-1 receptor agonists: emerging therapeutic potential in psoriasis management — current evidence and future outlook - European Journal of Clinical Pharmacology Link zur Quelle

Menschen mit Psoriasis haben nach einer Hüft- oder Kniegelenks-Operation ein etwas höheres Risiko für Komplikationen als andere Patienten[1]. Dazu gehören vor allem Infektionen nach dem Eingriff[2]. Besonders Frauen mit Psoriasis müssen häufiger am Knie operiert werden, weil die Entzündung die Gelenke angreift[3]. Für Operationen am Hüftgelenk ist dieser Zusammenhang weniger klar[3]. Die Lebensqualität nach einer Knie- oder Hüftprothese ist mit Psoriasis nicht unbedingt schlechter, aber Ärztinnen und Ärzte sollten bei Menschen mit Psoriasis-Arthritis besonders genau hinschauen[4]. Eine Operation kann manchmal zu einem erneuten Psoriasisausbruch führen, deshalb ist eine gute Hautpflege vor und nach der OP wichtig[5]. Wer eine Operation plant, sollte das Thema Infektionen und Psoriasis unbedingt mit dem Facharzt besprechen. Originaltitel: Impact of psoriasis on THA and TKA outcomes: A systematic review. - Abstract - Europe PMC Link zur Quelle

IntroductionPsoriasis is a chronic immune-mediated disease that significantly impacts patients clinically and psychologically. Physician-assessed severity measures, including Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), and Physician Global Assessment (PGA), often fail to capture patient-reported outcomes, particularly when clinical improvement and perceived quality-of-life gains are misaligned.PurposeTo clarify the association between clinical improvements and Dermatology Life Quality Index (DLQI) outcomes, identify predictors of substantial DLQI improvement (≥90% reduction), and explore reasons for suboptimal DLQI responses in patients achieving skin clearance.MethodsIn this 12-week prospective study, 551 psoriasis patients were enrolled at Shanghai Skin Diseases Hospital. Data on demographics, clinical severity (PASI, BSA, and PGA), DLQI scores, and treatment modalities were collected. Logistic regression analyses were employed to assess the dose-response relationships between improvements in clinical parameters and DLQI reduction, and to identify factors of suboptimal DLQI improvement among patients achieving significant skin clearance.ResultsMedian DLQI improved significantly (8.0 to 3.0) at week 12, with 24.1% of patients achieving ≥90% DLQI reduction. Strong dose-response associations existed between clinical severity improvements (PASI, BSA, PGA) and DLQI gains. PASI75 responders were significantly more likely to achieve substantial DLQI improvement (OR = 2.48, 95% CI: 1.51-4.07). However, only 33.3% of PASI75 achievers reached ≥90% DLQI improvement. Early clinical response (as early as week 4) strongly predicted superior DLQI outcomes. Female sex, older age, lower baseline DLQI scores, and shorter disease duration were associated with achieving high skin clearance but suboptimal DLQI improvement.ConclusionEarly clinical response effectively predicts substantial DLQI improvement, whereas demographic and disease-related factors help identify patients at risk for suboptimal quality-of-life gains despite significant skin clearance. These insights support personalized therapeutic strategies aimed at improving patient satisfaction beyond skin clearance alone.Weiterlesen

Previous research suggests that patients with hidradenitis suppurativa (HS) may face a higher risk of serious infections compared with those with psoriasis. However, these studies are subject to limitations that could constrain their reliability. To compare the risk of hospitalization from noncutaneous infections, infection profiles, and the length of stay (LOS) of adult patients with HS and psoriasis treated with adalimumab. This retrospective cohort study was conducted using deidentified claims data from the MarketScan database. All adult patients with HS or psoriasis who initiated adalimumab therapy between January 2017 and December 2020 were included. Data were analyzed from October 2023 to March 2024. New users of adalimumab diagnosed with psoriasis or HS, identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes and adalimumab prescriptions. The primary outcome was hospitalization from noncutaneous infections in a time-to-event analysis using inverse probability weighting to account for confounders in the Cox regression models. Secondary outcomes included the infection types compared using incidence rate ratios and LOS analyzed with multivariable Poisson regression. Of 10 349 included patients, 5641 (54.5%) were female, and the mean (SD) age was 44.8 (12.8) years. The cohort included 1650 patients with HS and 8699 with psoriasis. The HS cohort was younger (mean [SD] age, 36.2 [11.5] years vs 46.5 [12.4] years) and predominantly female (1271 [77.0%] vs 4370 [50.2%]), with higher rates of obesity, Crohn disease, anxiety, and depression. The weighted Cox analysis indicated an increased risk of serious infection in patients with HS (hazard ratio, 1.53; 95% CI, 1.34-1.86). This group also had a higher likelihood of sepsis and genitourinary infections (sepsis: incidence rate ratio, 2.07; 95% CI, 1.35-3.12; genitourinary infections: incidence rate ratio, 2.22; 95% CI, 1.22-3.86) and greater odds of prolonged LOS (odds ratio, 1.28; 95% CI, 1.13-1.45) compared with the psoriasis cohort. In this cohort study, among adults treated with adalimumab, those with moderate to severe HS had an elevated risk of infection and different infection profiles compared with those with psoriasis. Future research should focus on the impacts of disease severity and treatment regimens on infection risk and develop targeted prevention strategies.Weiterlesen

No abstract supplied.Weiterlesen

Abstract Background: Psoriasis vulgaris, particularly when manifesting in highly visible regions such as the face and hands, can profoundly impair self-perception and social functioning. Despite a growing interest in psychodermatology, the specific impact of visible psoriatic lesions on social appearance anxiety remains insufficiently explored. Objective: To assess the severity of social appearance anxiety in patients with visible psoriasis vulgaris lesions compared to healthy controls, and to examine its associations with general anxiety, depression, perceived disease severity, and dermatology-related quality of life. Methods: A cross-sectional case-control study was conducted involving 178 patients diagnosed with psoriasis vulgaris exhibiting visible skin lesions and 196 age- and sex-matched healthy controls. All participants completed the Social Appearance Anxiety Scale (SAAS) and the Hospital Anxiety and Depression Scale (HADS). Patients additionally completed the Dermatology Life Quality Index (DLQI) and a Visual Analog Scale (VAS) to evaluate subjective disease severity. Statistical analyses included group comparisons and Pearson correlations between psychological and clinical parameters. Results: SAAS scores were significantly elevated in the patient group (mean = 60.32 ± 8.10) compared to controls (mean = 22.15 ± 9.05; p < 0.001), indicating a large effect size. In psoriasis patients, social appearance anxiety showed a moderate positive correlation with perceived disease severity (r = 0.293, p < 0.01), while correlations with DLQI and depression scores were not statistically significant. General anxiety levels (HADS-A) demonstrated a moderate correlation with SAAS (r = 0.484, p < 0.01). Conclusion: Visible lesions in psoriasis vulgaris contribute substantially to social appearance anxiety, independent of general psychopathology. These findings underscore the psychological vulnerability of patients with visible psoriatic involvement and highlight the need for integrated psychosocial interventions as part of comprehensive dermatological care.Weiterlesen

Psoriasis is a chronic skin disorder with significant individual and societal impacts. Current therapies often lack efficacy, are costly, or cause side effects, necessitating new treatments. This study explores regenerative therapies-exosomes, mesenchymal stem cells (MSCs), epigallocatechin-3-gallate nanoparticles (EGN), and EGN-loaded exosomes (EGN-Exo)-in regulating psoriasis-related markers (IL-6, IL-4, Bcl-2, Bax, NF-κB, CDC25B). An imiquimod-induced psoriasis model in Wistar rats was used, with six groups: negative control, positive control, and treatments (MSCs, exosomes, EGN, EGN-Exo). After seven days, ELISA revealed EGN-Exo most effectively reduced pro-inflammatory IL-6 and pro-apoptotic Bax while increasing anti-inflammatory IL-4 and anti-apoptotic Bcl-2. EGN-Exo also significantly lowered NF-κB and CDC25B, demonstrating superior anti-inflammatory effects. Apoptosis profiling showed EGN-Exo reduced late apoptotic cells, highlighting cytoprotective abilities. EGN had a moderate effect, while MSCs and exosomes showed modest improvements. Histopathological and immunohistochemical analyses confirmed EGN-Exo's efficacy, notably reducing TGF-β expression. These findings suggest EGN-Exo combines EGCG's antioxidant and anti-inflammatory properties with exosomes' targeted delivery, offering a promising advanced therapy for psoriasis.Weiterlesen

Psoriasis is an autoimmune inflammatory condition that often intersects with orthopaedic care due to its connection to psoriatic arthritis. However, not all psoriasis patients develop psoriatic arthritis. Psoriasis patients may undergo hip or knee arthroplasties for reasons unrelated to psoriasis. This condition, marked by inflamed, scaly skin caused by an overactive immune system, may pose challenges for orthopaedic surgeries. This systematic review evaluated outcomes for psoriasis patients after total hip arthroplasty (THA) or total knee arthroplasty (TKA), focusing on postsurgical impact to inform additional considerations for patients. Following PRISMA guidelines, a systematic search was conducted in Medline, Embase, Web of Science, and Cochrane (up to October 2024). Studies involving patients with psoriasis undergoing THA or TKA were analyzed for postoperative outcomes. 359 studies were screened, 7 met inclusion criteria. Two studies focused on THA, three on TKA, and two examined both procedures. Patients with psoriasis undergoing THA showed increased risk of infections compared to non-psoriasis patients. For TKA, results were mixed in whether psoriasis led to higher infection rates. Psoriasis did not lead to increased revisions in both THA and TKA. Additionally, two studies found no significant differences in wound complications in TKA patients. This systematic review underscores the importance of considering post-surgical complications in psoriasis patients undergoing either a THA or TKA. However, lack of research makes it difficult to generalize findings. Psoriasis is an important factor to consider for surgical outcomes, but further research is needed to clarify risks and optimize care for patients.Weiterlesen

Psoriasis is a chronic immune-mediated skin disorder characterized by excessive keratinocyte proliferation, inflammation, and oxidative stress. This study investigates the role of the JNK/c-Jun cascade in psoriasis pathogenesis, focusing on its impact on keratinocyte proliferation and inflammatory responses. An in vitro psoriasis model was established using M5-stimulated HaCaT keratinocytes, while an in vivo model was created with imiquimod-treated Wistar rats. The results indicated that M5 stimulation significantly enhanced keratinocyte viability and proliferation, as demonstrated by increased optical density, EdU incorporation, and Ki-67 expression. M5 treatment also elevated pro-inflammatory cytokines TNF-α, IL-1β, and IL-6, while inducing oxidative stress through increased ROS production, lipid peroxidation, and mitochondrial membrane potential (MMP) disruption. Blocking the JNK/c-Jun cascade with the SP600125 inhibitor effectively reduced keratinocyte hyperproliferation, cytokine secretion, and oxidative stress, while restoring mitochondrial integrity. In addition, knockdown of Nrf2 suppressed M5-induced ROS generation, inflammatory signaling, and antioxidant enzyme activity. In psoriasis rats, JNK/c-Jun inhibition significantly alleviated skin tissue damage, reducing inflammatory cell infiltration, epidermal hyperkeratosis, and phosphorylation of key inflammatory markers. Correspondingly, serum pro-inflammatory cytokines were decreased, and oxidative stress indices improved. These findings suggest that the JNK/c-Jun cascade plays a central role in psoriasis pathogenesis by regulating keratinocyte proliferation, inflammation, and oxidative stress. Targeting this pathway presents a promising therapeutic strategy for psoriasis treatment. Further studies are warranted to explore upstream regulators and downstream effectors of the JNK/c-Jun signaling pathway.Weiterlesen

BackgroundPsoriasis is a chronic inflammatory disease associated with multiple comorbidities, including metabolic syndrome and cardiovascular disease. Although specific dietary interventions, such as intermittent fasting and caloric restriction, have been shown to ameliorate inflammation and promote weight loss, the effect of these interventions independent of weight loss remains unclear. Time-restricted eating (TRE), a type of intermittent fasting, limits the daily eating window to a fixed number of hours. Recent studies suggest TRE may improve immune function in individuals with metabolic syndrome and cardiovascular risk factors. A crucial advantage of TRE over other investigated dietary restriction strategies is its reported high adherence rate, making it a more feasible intervention for long-term use. Therefore, exploring the effects of TRE on metabolic and immunological parameters in psoriasis is warranted.ObjectiveThis study was designed to evaluate the effects of short-term, isocaloric TRE, independent of weight loss, on immune cell function and serum metabolite profiles of volunteers with mild-to-moderate psoriasis compared to healthy individuals.MethodsThis case-control, prospective study was performed on 10 healthy male participants and 10 age-, BMI-, and sex-matched individuals with mild-to-moderate psoriasis. All individuals with psoriasis had stable disease and were being treated with topical therapies without any exposure to immunomodulatory biologics. This study was conducted at the National Institutes of Health Clinical Center. Immune profiles, glucose handling, energy expenditure, and participants' weights were assessed at baseline and after 3 days of TRE following a daily 6-hour eating window and 18-hour fast.ResultsThe trial commenced in June 2021 and was completed in February 2023. A total of 20 participants were enrolled-10 with mild-to-moderate psoriasis and 10 age-, BMI-, and sex-matched healthy individuals. As of the time of manuscript submission, data processing is ongoing. Multiomic datasets, including gene expression, surface and intracellular protein levels, and metabolite profiles, are being generated from peripheral blood mononuclear cells, CD4+-enriched T-cells, and serum samples. The integrated bioinformatics analyses will be reported once the data analysis is completed.ConclusionsThis clinical protocol was designed to characterize the effects of short term (3-day) TRE on psoriasis, independent of weight loss, by comparing immune cell regulatory responses between healthy individuals and those with psoriasis. More specifically, we aim to map the molecular pathways activated by TRE and assess how they affect immune cell composition, activation, and metabolism. Additionally, components of the metabolic response to isocaloric TRE are being explored. Insights into how dietary interventions impact metabolism and the immune system will enhance our understanding of the pathogenesis of psoriasis and may reveal new therapeutic avenues for managing this inflammatory condition.Trial registrationClinicalTrials.gov NCT04728165; https://clinicaltrials.gov/study/NCT04728165.Weiterlesen

BackgroundPsoriasis is a persistent inflammatory skin condition. Several studies have revealed that obesity significantly contributes to both the initiation and advancement of psoriasis. The metabolic score for visceral fat (METS-VF) represents an innovative measure designed to forecast visceral obesity, integrating factors such as insulin resistance metabolic score, waist-to-hip ratio (WHR), age, and gender. The present study aimed to investigate the association between METS-VF and psoriasis prevalence, using information gathered from the National Health and Nutrition Examination Survey (NHANES).MethodsThis study utilized the data from a nationally representative cohort of 8023 adults from NHANES from 2003-2006 to 2009-2014, of which 234 declared a psoriasis history. Multivariate logistic regression analysis and restricted cubic spline (RCS) analyses were used to investigate the association between METS-VF and psoriasis, followed by subgroup analysis to identify populations that may exhibit higher sensitivity.ResultsAfter adjusting for confounding variables, the results of the multivariate logistic regression analysis showed a significant positive association between METS-VF and the risk of psoriasis. One-unit increasement in METS-VF corresponded to a 47% rise in psoriasis risk (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.10-1.96). Finally, the results were uniform across all subgroups (P for interaction > 0.05). The results from the RCS analysis indicated a notable linear association.ConclusionThis research indicated that elevated levels of METS-VF are linked to a higher occurrence of psoriasis, suggesting the potential of METS-VF as a predictive anthropometric index for assessing the risk of developing psoriasis.Weiterlesen

Ixekizumab is a monoclonal antibody used in the treatment of moderate-to-severe psoriasis and psoriatic arthritis by targeting interleukin-17 A (IL-17 A). It has demonstrated efficacy in controlling inflammation in autoimmune diseases, though adverse reactions can arise. This case study reports a case of 25-year-old female with psoriatic arthritis undergoing treatment with ixekizumab, who developed acute enlargement and inflammation of a pre-existing sebaceous cyst located posterior to the left auricle, occurring two days after the administration of a routine ixekizumab dose. The present study investigates the potential association between the inflammatory process observed within the cyst and the immunomodulatory mechanisms of ixekizumab. Literature review revealed no prior reports directly linking ixekizumab with sebaceous cyst inflammation. However, related adverse effects, including paradoxical inflammation, infectious complications, and immune dysregulation have been described in patients treated with IL-17 A inhibitors. These include IBD exacerbation, eczematous eruptions, paradoxical psoriasis, and rare systemic complications, suggesting broader immunological effects of IL-17 blockade.Weiterlesen

Psoriasis is a chronic inflammatory skin disease driven by immune dysregulation and often exacerbated by metabolic comorbidities. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), initially developed for type 2 diabetes mellitus (T2DM) and weight management, have emerged as a promising treatment due to their anti-inflammatory and immunomodulatory properties. This review evaluates the clinical efficacy, mechanisms of action, and limitations of GLP-1RAs, such as liraglutide, exenatide, and semaglutide, in the management of psoriasis. A comprehensive literature review was conducted, including evidence from case reports, randomized controlled trials, prospective cohorts, and experimental studies, to assess the role of GLP-1RAs in psoriasis treatment. Evidence suggests that GLP-1RAs mitigate psoriasis severity through systemic effects, including weight loss and improved glycemic control, and local immunomodulation, such as the regulation of invariant natural killer T (iNKT) cells and AMPK activation in psoriatic plaques. These benefits are particularly notable in patients with coexisting metabolic conditions. However, the existing evidence is limited by small cohort sizes, heterogeneous patient populations, and confounding effects of concurrent therapies, limiting its generalizability. GLP-1RAs offer a novel integrative approach to managing psoriasis by targeting both inflammatory and metabolic pathways. Larger, long-term randomized controlled trials are needed to validate their efficacy, optimize dosing, and determine their role as standalone or adjunctive therapies, particularly in patients without metabolic comorbidities.Weiterlesen

BackgroundThere are only limited histomorphological data on the response of psoriatic skin lesions to topical dithranol. In vivo reflectance confocal microscopy (RCM) in psoriatic skin is highly correlated with histopathological findings and allows non-invasive monitoring of treatment effects on a cellular level.Patients and methodsProspective, single-center pilot study at a university-based clinic of dermatology between January 1st and August 30th, 2016. Psoriatic lesions of 20 patients receiving dithranol treatment were assessed by RCM at baseline, day 4 and 8 of treatment.ResultsRCM measurements of psoriatic lesions receiving dithranol treatment revealed epidermal histomorphological changes with a strong median reduction of baseline hyperkeratosis by 45.0% (p < 0.001), acanthosis by 38.2% (p < 0.001), and epidermal thickness by 66.5% (p < 0.001) from baseline until day 8. Moreover, semiquantitative measurements of parakeratosis also showed a significant reduction until day 8 (p < 0.001). Correspondingly, RCM revealed dermal histomorphological changes with a decrease in diameter of dermal papillae by 32.1% (p < 0.001), decrease in diameter of papillary vessels by 16.9% (p = 0.002) and a strong semiquantitative reduction of the inflammatory infiltrate (p < 0.001).ConclusionsResults from our pilot study indicate that topical dithranol treatment of psoriatic lesions may induce a rapid and marked reduction of pathologic epidermal and dermal RCM features.Weiterlesen

No abstract supplied.Weiterlesen

No abstract supplied.Weiterlesen

BackgroundThe pathogenesis of nummular eczema (NE) remains unclear, and no targeted therapy has been approved. Apremilast is a small molecule inhibitor targeting phosphodiesterase-4.Patients and methodsA phase IIb randomized, double-blind, placebo-controlled study evaluating the effects of apremilast or placebo in patients with NE. Patients received apremilast (30 mg BID) or placebo until week 16 followed by an open label phase in which all patients were treated with apremilast until week 32. The primary endpoint was the number of patients achieving an improvement in Physician's Global Assessment (PGA) by two or more points or an absolute PGA of 0 or 1 at week 16. Secondary endpoints included changes in skin physiology, life quality, or dermato-pathology.Results33 patients were enrolled, of whom 31 were randomized to apremilast (n = 15) or placebo (n = 16). 1/15 (6.7%) patients in the apremilast group and 4/16 (25.0%) in the placebo group reached the primary endpoint (p = 0.369). There was no difference between placebo and apremilast with regard to all secondary endpoints at week 16 and week 32. The safety profile was in accordance with the known safety profile of apremilast.ConclusionPhosphodiesterase-4 inhibition by apremilast showed no beneficial effects for the treatment of NE.Weiterlesen

No abstract supplied.Weiterlesen