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Background and objectivesPsoriasis is a chronic inflammatory skin disease, and noninvasive diagnostic tools are essential for accurate diagnosis and treatment monitoring. Multiphoton microscopy (MPM) enables real-time, noninvasive skin imaging with submicron resolution. This study evaluated the diagnostic accuracy of MPM in psoriasis and its potential application in therapeutic monitoring.Patients and methodsThis prospective observational study enrolled 34 patients with psoriasis. It comprised three parts: (1) analysis of imaging features of lesional and nonlesional skin using multiphoton microscopy (MPM; Transcend Vivoscope); (2) evaluation of the diagnostic performance of MPM parameters compared with reflectance confocal microscopy (RCM); and (3) prospective monitoring of 24 patients treated with Benvitimod (Tapinarof) cream for 8 weeks (T0/T1/T2).ResultsMPM detected psoriasis characteristics (including hyperkeratosis, parakeratosis, an absent stratum granulosum, enlarged nucleus diameter, and absent bright rimming) with comparable diagnostic efficiency to RCM (AUC = 0.838, p < 0.001 vs. 0.824, p < 0.001). Psoriatic lesions showed significant perinuclear fluorescence accumulation compared to healthy skin (p < 0.001). All imaging features improved significantly after 8 weeks of treatment (p < 0.001). PASI/TLS scores showed correlations with the epidermal thickness (r = 0.403/0.492, p < 0.001), nuclear diameter (r = 0.4/0.375, p < 0.001), and fluorescence intensity (r = -0.419/-0.492, p < 0.001).ConclusionsMPM is a novel and non-invasive imaging technique for psoriasis evaluation and treatment monitoring.Weiterlesen

No abstract supplied.Weiterlesen

Objective and designThis prospective multicenter cohort study was conducted to identify and compare clinical factors associated with the effectiveness of commonly used biologics in Chinese patients with moderate-to-severe psoriasis.SubjectsPatients from the SPEECH registry initiating treatment with ixekizumab, secukinumab, guselkumab, or ustekinumab were included.TreatmentGuideline-recommended dosing; 3-month follow-up.MethodsThe primary endpoint was PASI90 response at 3 months. Multivariable logistic regression estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for clinical predictors of treatment response.ResultsA total of 717 patients were included in the analysis. In guselkumab-treated patients, obesity (aOR 0.22, 95% CI 0.06-0.78) and prior biologic exposure (aOR 0.22, 95% CI 0.06-0.75) were independently associated with reduced PASI90 response. Psoriatic arthritis predicted poorer response to ustekinumab (aOR 0.16, 95% CI 0.03-0.78). For secukinumab, male sex reduced the likelihood of PASI90 (aOR 0.47, 95% CI 0.23-0.96), whereas family history of psoriasis improved outcomes (aOR 2.20, 95% CI 1.10-4.42). In ixekizumab-treated patients, obesity (aOR 0.38, 95% CI 0.18-0.80) was a negative predictor, while family history (aOR 2.79, 95% CI 1.22-6.38) enhanced treatment response.ConclusionsPredictors of biologic effectiveness differ by agent, supporting personalized treatment based on patient characteristics.Weiterlesen

Psoriasis and psoriatic arthritis (PsA) occasionally coexist with antinuclear antibody (ANA) positivity, cutaneous lupus erythematosus (CLE), or systemic lupus erythematosus (SLE), creating one of the most challenging therapeutic overlap scenarios in immunodermatology. Divergent immune pathways-IL-23/Th17-driven psoriatic inflammation versus type I interferon-mediated autoimmunity-generate unique vulnerabilities when systemic treatments are used. To synthesize treatment outcomes, lupus-related safety signals, and mechanistic insights across systemic therapies in patients with psoriasis or PsA who also exhibit ANA positivity, CLE, or SLE. A systematic review following PRISMA 2020 guidelines was conducted across PubMed/MEDLINE, Embase, the Cochrane Library, Scopus, and ClinicalTrials.gov from database inception through 31 October 2025. Thirty-three eligible reports (29 unique clinical studies; 1429 patients) were included and organized into six prespecified overlap subgroups. Mechanistic and translational studies-including ustekinumab and deucravacitinib SLE trial data and reports of IL-17 inhibitor-associated CLE-were reviewed separately to provide contextual interpretation. IL-23 inhibitors were consistently associated with a favorable cross-disease safety profile, with no clear signal for CLE worsening, SLE flares, or drug-induced autoimmunity. IL-17 inhibitors maintained strong psoriatic efficacy but were associated with an increased frequency of de novo or exacerbated CLE. TNF-α inhibitors showed the strongest association with ANA seroconversion, anti-dsDNA induction, drug-induced lupus, and lupus flares. Ustekinumab demonstrated a stable safety profile across lupus-spectrum disease despite variable efficacy in formal SLE trials. TYK2 inhibition provided dual modulation of IL-23 and type I interferon pathways and showed emerging utility in psoriasis or PsA coexisting with CLE or SLE. Apremilast, methotrexate, and mycophenolate mofetil remained reliable non-biologic systemic options. Phototherapy was associated with potential risk in ANA-positive or lupus-susceptible populations and therefore requires careful consideration. Interpretation is limited by the predominantly observational nature and heterogeneity of the available evidence. IL-23 inhibition and TYK2 inhibition appear to offer a balanced profile of efficacy and lupus-related safety in psoriatic disease complicated by lupus-spectrum autoimmunity. IL-17 inhibitors and TNF-α inhibitors may be associated with higher risk in CLE- or SLE-prone patients and therefore warrant particular caution. Personalized treatment strategies should integrate the relative dominance of psoriatic versus lupus disease, ANA/ENA profile, CLE subtype, and underlying mechanistic considerations. Prospective, biomarker-driven studies are needed to guide therapy in this increasingly recognized overlap population (PROSPERO registration: CRD420251241279).Weiterlesen

Psoriatic arthritis develops in up to one-third of individuals with psoriasis, typically following a prolonged subclinical phase. Diagnostic delays are common, often exceeding 2 years, and can result in irreversible joint damage. The growing recognition of this latent period has fuelled interest in earlier identification and interception. However, efforts are hampered by inconsistent definitions of early or subclinical psoriatic arthritis, insufficient prognostic tools, and an absence of consensus on the outcome for interception studies. This Review synthesises a rapidly evolving field, offering a framework organised around four crucial questions: first, what defines progression from psoriasis to psoriatic arthritis? Second, who is most at risk of transition? Third, how can progression be reliably measured using imaging, molecular biomarkers, or digital health technologies? Fourth, when should preventive intervention be considered? We critically examine new conceptual models, the limitations of existing classification criteria, advances in imaging and biomarker research, and the promise of digital phenotyping. Addressing the current challenges in definitions, risk stratification, measurement, and trial design is essential for the development of biologically grounded, ethically robust interception strategies.Weiterlesen

This study examined relationships between Early Maladaptive Schemas (EMS), emotion regulation, coping styles, and psoriasis outcomes in Istanbul, Turkey. Participants included 100 psoriasis patients (ages 25-45) and 107 healthy controls. Data were analyzed using structural equation modeling. Psoriasis patients scored significantly higher on six schemas: Emotional Deprivation, Approval Seeking, Pessimism, Self-Sacrifice, Punitiveness, and Unrelenting Standards (Cohen's d = 0.42-0.89). They also demonstrated greater emotion regulation difficulties and reduced adaptive coping. Mediation analyses revealed that maladaptive emotion-focused coping fully mediated relationships between EMS and quality of life deterioration (β = .11, 95% CI (.04, .19]) and psoriasis severity (β = .08, 95% CI [.02, .15]). Pessimism and Punitiveness schemas, impulse control difficulties, and maladaptive emotion-focused coping predicted general psychological symptom severity (measured by validated scales) (R2 = .46). Findings suggest maladaptive emotion-focused coping as a key mechanism linking schemas to psoriasis outcomes, supporting integrated dermatological and psychological interventions.Weiterlesen

Efficacious and well-tolerated systemic, oral treatments for psoriasis are needed. We report preclinical and phase 1c (NCT06808815) results for DC-806, a small molecule interleukin (IL)-17 inhibitor, for the treatment of mild-to-moderate psoriasis. Preclinical results demonstrated DC-806 targets IL-17AA and IL-17AF with secukinumab-like therapeutic efficacy. In the phase 1c trial, 32 patients consented to receive twice daily (BID) doses of placebo or DC-806 (200 mg or 800 mg) for 28 days. No serious adverse events (SAEs) or discontinuations due to treatment-related adverse events (TRAEs) occurred. In an exploratory analysis, adjusted mean percentage reductions from baseline in psoriasis area and severity indices (PASI) at Day 29 were 43.7%, 15.1%, and 13.3% for 800 mg BID, 200 mg BID, and placebo arms, respectively (800 mg BID vs placebo, P value = 0.0008). DC-806 was found to be well tolerated with an acceptable safety profile and preliminary signals of clinical efficacy in mild-to-moderate psoriasis. EudraCT Identifier: 2021-002888-21.Weiterlesen

Background and objectivesPsoriasis is a chronic inflammatory skin disease, and noninvasive diagnostic tools are essential for accurate diagnosis and treatment monitoring. Multiphoton microscopy (MPM) enables real-time, noninvasive skin imaging with submicron resolution. This study evaluated the diagnostic accuracy of MPM in psoriasis and its potential application in therapeutic monitoring.Patients and methodsThis prospective observational study enrolled 34 patients with psoriasis. It comprised three parts: (1) analysis of imaging features of lesional and nonlesional skin using multiphoton microscopy (MPM; Transcend Vivoscope); (2) evaluation of the diagnostic performance of MPM parameters compared with reflectance confocal microscopy (RCM); and (3) prospective monitoring of 24 patients treated with Benvitimod (Tapinarof) cream for 8 weeks (T0/T1/T2).ResultsMPM detected psoriasis characteristics (including hyperkeratosis, parakeratosis, an absent stratum granulosum, enlarged nucleus diameter, and absent bright rimming) with comparable diagnostic efficiency to RCM (AUC = 0.838, p < 0.001 vs. 0.824, p < 0.001). Psoriatic lesions showed significant perinuclear fluorescence accumulation compared to healthy skin (p < 0.001). All imaging features improved significantly after 8 weeks of treatment (p < 0.001). PASI/TLS scores showed correlations with the epidermal thickness (r = 0.403/0.492, p < 0.001), nuclear diameter (r = 0.4/0.375, p < 0.001), and fluorescence intensity (r = -0.419/-0.492, p < 0.001).ConclusionsMPM is a novel and non-invasive imaging technique for psoriasis evaluation and treatment monitoring.Weiterlesen

ObjectiveThis study aims to evaluate the clinical impacts of topical and/or oral administration of compounds rich in omega-3 fatty acids from various sources, such as oils and foods, on psoriatic lesions.DesignA systematic review was carried out.Data sourcesSearches were conducted in six databases (PubMed, Cochrane, VHL, Scopus, Embase, and Web of Science) using descriptors related to fatty acids and psoriasis.Study selectionInclusion criteria were studies published in the last 10 years (2013-2023) that involved patients with psoriasis and provided quantitative clinical outcome data, such as psoriasis severity scale.Data extractionTwo independent reviewers carried out the initial screening of the titles and abstracts identified in the search. The quality of studies was evaluated using the Newcastle-Ottawa Scale, the Risk of Bias in Randomized Studies of Interventions, and the Joanna Briggs Institute critical appraisal checklist.ResultsOut of 8570 articles identified, 9 met the inclusion criteria. The quality of randomized clinical trials and observational studies varied from low to high risk of bias, according to the respective parameters of each checklist.ConclusionsMost studies demonstrated that the topical and/or oral administration of omega-3 fatty acids from different sources significantly improved clinical parameters, as measured by severity scales and the Psoriasis Area and Severity Index (PASI).Weiterlesen

Abstract Background Psoriasis patients in China face significant challenges due to insufficient disease knowledge and limited access to medical resources, creating a need for reliable educational tools. Objectives This multicenter consensus study aimed to systematically evaluate the consultation quality of mainstream Chinese large language models (LLMs) for psoriasis patient education. Methods "365 Questions on Psoriasis" was jointly compiled by 109 Chinese psoriasis experts. Using an expert assessment methodology, nine dermatologists curated 40 high-frequency clinical questions from the book across five domains (etiology, triggers, treatment, management, psychosocial impact). Four Chinese LLMs (DeepSeek-R1, DeepSeek-V3, GLM-4, Qwen-3) were evaluated through double-blind scoring on a 10-point Likert scale assessing accuracy, completeness, clarity, and safety. Results Performance varied significantly, with mean scores ranging from 5.95 to 9.88 (SD: 0-3.05). Qwen-3 achieved the highest average score (9.12), while GLM-4 showed the greatest inconsistency. All responses avoided dangerous content, and 87.5% proactively emphasized the necessity of consulting a physician. However, 12.5% of responses deviated from evidence-based guidelines, particularly on complex topics like biologics and management. Conclusions Chinese LLMs show substantial potential for psoriasis education by providing generally safe information and appropriately directing users to doctors. However, current limitations exist, including performance inconsistency and occasional deviations from guidelines on specialized topics, indicating they are not yet replacements for professional medical. Weiterlesen

BackgroundDespite increased understanding of psoriasis pathogenesis, molecular classification of clinical phenotypes and disease severity is poorly defined. Knowledge gaps include whether molecular endotypes of psoriasis underlie distinct clinical phenotypes and the positive and negative molecular regulators of disease severity across tissue compartments.MethodsWe performed comprehensive RNA sequencing of skin and blood (n = 718) from prospectively-recruited, deeply-phenotyped discovery and replication cohorts of 146 subjects with moderate-to-severe chronic plaque psoriasis initiating TNF-inhibitor (adalimumab) or IL-12/23-inhibitor (ustekinumab) therapy.ResultsHere we show, using two complementary dimensionality reduction methods, that co-expressed gene modules and factors within skin and blood are significantly associated with psoriasis phenotypes and disease severity. We identify a 14-gene signature negatively associated with BMI in nonlesional skin and with disease severity in lesional skin. Genotype integration reveals that HLA-DQA1*01 and HLA-DRB1*15 genotypes are positively associated with baseline psoriasis severity. Using explainable machine learning models, we define two disease severity-associated gene modules in lesional skin - one positive, one negatively-associated - and a 9-gene signature in lesional skin predictive of disease severity. Disease severity signatures in blood are only seen following adalimumab exposure, suggesting greater systemic impact of adalimumab compared to ustekinumab, in line with its side effect profile. In contrast, a gene signature in blood linked to HLA-C*06:02 status is independent of disease severity or drug.ConclusionsThese findings delineate gene-environmental and genetic effects on the psoriasis transcriptome linked to disease severity.Weiterlesen

Originaltitel: Exploring clusters based on ultrasound-detected inflammation in patients with psoriatic arthritis: a post-hoc analysis from the ULTIMATE trial - BMC Musculoskeletal Disorders Link zur Quelle

Ich kann leider das spezifische JLE-Artikel nicht in den verfügbaren Suchergebnissen finden. Die Suchergebnisse enthalten andere hochwertige Quellen zu generalisierten pustulösen Psoriasis (GPP), aber nicht den exakten Artikel von JLE mit dem Fokus auf Mortalität, Prävalenz, Komorbiditäten und Schübe. Um den Artikel für Sie zusammenzufassen, benötige ich entweder: - Den vollständigen Text oder die Zusammenfassung des JLE-Artikels - Oder Zugriff auf die spezifische URL mit dem Artikel-Inhalt Falls Sie mir den Inhalt des Artikels zur Verfügung stellen, kann ich Ihnen sehr gerne eine verständliche Zusammenfassung im gewünschten Stil schreiben – locker, aber korrekt, und verständlich für Zehntklässler. Das wäre perfekt für ein Newsportal für Menschen mit Psoriasis oder Psoriasis arthritis. Originaltitel: JLE - European Journal of Dermatology - Mortality, prevalence, comorbidity, and flare patterns in generalised pustular psoriasis: a comprehensive literature review Link zur Quelle

# Neue Technologie zur Psoriasis-Diagnose Forscher haben eine neue Methode entwickelt, um Psoriasis früher und genauer zu erkennen[1]. Sie heißt Multiphoton-Mikroskopie und schaut sich die Haut von innen an, ohne dass man sie verletzten muss. Das Besondere daran ist, dass die Methode sehr genau arbeitet[1]. Sie zeigt nicht nur die oberflächliche Hautveränderung, sondern auch die winzigen Blutgefäße und tieferen Hautschichten. Bei Psoriasis-Patienten sind diese Gefäße deutlich dicker als bei gesunden Menschen – etwa doppelt so groß[1]. Das hilft nicht nur bei der Diagnose. Die Technologie kann auch kontrollieren, ob eine Behandlung funktioniert[2]. Man sieht direkt, ob die Blutgefäße wieder kleiner werden und die Entzündung nachlässt. Bisher musste man dafür eine Hautprobe nehmen – das ist schmerzhaft und hinterlässt eine Narbe[1]. Experten sehen darin großes Potenzial. Mit dieser Methode können Ärzte ihre Therapie besser abstimmen und Patienten schneller sehen, ob die Behandlung anschlägt[2]. Originaltitel: In vivo multiphoton microscopy of psoriasis: A new diagnosis and therapeutic monitoring technique Link zur Quelle

Psoriasis is a chronic inflammatory skin disease, and noninvasive diagnostic tools are essential for accurate diagnosis and treatment monitoring. Multiphoton microscopy (MPM) enables real-time, noninvasive skin imaging with submicron resolution. This study evaluated the diagnostic accuracy of MPM in psoriasis and its potential application in therapeutic monitoring. This prospective observational study enrolled 34 patients with psoriasis. It comprised three parts: (1) analysis of imaging features of lesional and nonlesional skin using multiphoton microscopy (MPM; Transcend Vivoscope); (2) evaluation of the diagnostic performance of MPM parameters compared with reflectance confocal microscopy (RCM); and (3) prospective monitoring of 24 patients treated with Benvitimod (Tapinarof) cream for 8 weeks (T0/T1/T2). MPM detected psoriasis characteristics (including hyperkeratosis, parakeratosis, an absent stratum granulosum, enlarged nucleus diameter, and absent bright rimming) with comparable diagnostic efficiency to RCM (AUC = 0.838, p < 0.001 vs. 0.824, p < 0.001). Psoriatic lesions showed significant perinuclear fluorescence accumulation compared to healthy skin (p < 0.001). All imaging features improved significantly after 8 weeks of treatment (p < 0.001). PASI/TLS scores showed correlations with the epidermal thickness (r = 0.403/0.492, p < 0.001), nuclear diameter (r = 0.4/0.375, p < 0.001), and fluorescence intensity (r = -0.419/-0.492, p < 0.001). MPM is a novel and non-invasive imaging technique for psoriasis evaluation and treatment monitoring.Weiterlesen

No abstract supplied.Weiterlesen

This first part of the updated German S3 guideline on the treatment of psoriasis vulgaris covers the sections on treatment recommendations, treatment goals, and monitoring of therapies. The recommendations are based on the current Cochrane network meta-analysis, the results of which are also summarized. When selecting systemic therapies for psoriasis vulgaris, the guideline emphasizes consideration of efficacy, safety, comorbidities, and individual patient factors. The decision framework is presented in the treatment options overview, and in this updated version, the possibility of first-line therapy with biologics or novel targeted small molecules is more prominently highlighted. Standardized instruments for assessing disease severity, as well as patient-centered treatment goals, are underscored. A Psoriasis Area and Severity Index (PASI) 75 response is defined as the minimum therapeutic target, while PASI 90 or an absolute PASI <2 are considered desirable goals. Since the last version, two newly approved agents, bimekizumab and deucravacitinib, have been incorporated, accompanied by specific usage recommendations. Among the established therapies, guidance on methotrexate has been extensively revised, particularly regarding administration, dosing, and monitoring. This guideline aims to provide clinicians with an evidence-based framework for therapy selection and monitoring, while strengthening shared decision-making with patients.Weiterlesen

Background and objectivesPeople with skin disease often experience stigmatization in health and body care settings, significantly impacting their quality of life. This parallel-group randomized controlled trial evaluated a face-to-face group seminar aimed at reducing stigma towards people with skin disease among health and body care professionals (HBCPs).Patients and methodsCosmetologists, hairdressers, nurses, and physical therapists were randomized into an intervention (IG; n = 64) or control group (CG; n = 65). The IG received a seminar consisting of self-awareness exercises, education and a patient encounter; the CG followed a seminar on "health at work". Stereotype agreement, disease-related misconceptions, desire for social distance, and behavioral intentions were assessed at baseline (t0), post-intervention (t1), and 3 months follow-up (t2).ResultsThe intervention group showed significant reductions over time in disease-related misconceptions (t0-t1: 0.398, p < 0.001; t0-t2: 0.225, p < 0.001; ηp2 = 0.12) and in stereotype endorsement (t0-t1: 0.392, p < 0.001; t0-t2: 0.299, p = 0.002; ηp2 = 0.12). In both groups, the desire for social distance decreased immediately after the seminar (t0-t1Intervention: 0.186, p < 0.001; t0-t1Control: 0.135, p = 0.012) but returned to baseline at follow-up (t0-t2Intervention: 0.097, p = 0.35; t0-t2Control: 0.016, p = 1.00).ConclusionsThe seminar improved skin disease-related stigmatizing beliefs and attitudes of HBCPs. Its integration into vocational training curricula or delivery in workshops to increase knowledge about skin diseases and to reduce prejudices in various professional groups is promising.Weiterlesen

Background and objectivesPalmoplantar pustulosis (PPP) is a chronic and refractory inflammatory skin disorder with unclear pathogenesis.Patients and methodsTen PPP patients treated with upadacitinib were monitored to assess efficacy and safety. Immunofluorescence and immunohistochemistry were employed to evaluate Th1, Th2, and Th17 cell expressions, along with their associated cytokines in lesions on palms or soles from 16 PPP patients, 10 chronic eczema (CE) patients, 10 psoriasis vulgaris (PV) patients, and 7 healthy controls (HC).ResultsIn PPP patients receiving upadacitinib, the shortest time to achieve PPPASI75 and PPPASI90 was 4 weeks and 8 weeks, respectively. The rates of patients achieving PPPASI90 at week 16, week 24, and week 52 was 70 %, 100 %, and100 %, respectively. Th1 cells and IFN-γ levels in PPP were comparable to CE and PV, and higher than HC. Th2 cells, IL-4, and IL-13 levels in PPP were similar to CE, and greater than HC and PV. Th17 cells, IL-17, and IL-36γ levels in PPP were comparable to PV, and more abundant than HC and CE.ConclusionsUpadacitinib is a safe and effective option for PPP patients, which may be attributed to the complex Th1, Th2, and Th17 inflammatory responses associated with PPP.Weiterlesen

No abstract supplied.Weiterlesen

No abstract supplied.Weiterlesen

Acne tarda is defined in the literature as adult acne, which according to most authors occurs in women aged 25 and older. However, the definitions and age groups vary depending on the study. Current guidelines rarely address adult acne. In this review, current studies and the literature on acne tarda are analyzed and evaluated by German experts. Recommendations regarding classification, clinical features, differentiation, and treatment of acne tarda were summarized in a consensus based on the discussion. The recommendations also include the treatment of post-inflammatory erythema/hyperpigmentation and acne scars, as well as the accompanying skin care. The goal is to improve the treatment of patients with acne tarda.Weiterlesen

BackgroundPsoriasis is a chronic autoimmune skin condition that significantly impacts an individual's quality of life, resulting in physical discomfort, psychological distress, and compromised social well-being. However, there is limited understanding regarding the challenges faced by patients in Malaysia. This study examines the lived experiences of patients with psoriasis in Malaysia, focusing on the emotional, social, financial, and treatment-related challenges they face, as well as the coping mechanisms they employ.MethodsA qualitative, phenomenological approach was employed among members of the Psoriasis Association Malaysia. Purposive sampling was used to recruit adult participants who were capable of participating in the online interview. Data collection involved the use of Google Forms, which included the Malay version of the Dermatology Life Quality Index questionnaire, supplementing the qualitative findings. This was followed by semi-structured online interviews conducted via video conferencing. Thematic analysis was conducted using NVivo version 14, and descriptive analysis was performed using SPSS version 28.ResultThis study involved 30 respondents with a mean age of 44 years diagnosed with psoriasis. The mean (SD) for the duration of illness is 21.3 (11.8) years. About 70% respondents reported that psoriasis had a moderate to very high impact on their quality of life. Thematic analysis has identified six major themes, including physical devastation, emotional burden, disruption in social functioning, treatment hurdles and advancements, financial barriers, and behavioral adaptation.ConclusionPsoriasis imposes complex challenges that extend beyond physical symptoms, affecting emotional well-being, social interactions, financial stability, and treatment struggles. In response to the various challenges that arose, respondents developed behavioral adaptations to achieve a better quality of life. Framed within the biopsychosocial model, the findings emphasize the need for a holistic, patient-centred approach to psoriasis care that integrates medical treatment with psychological support and social interventions to improve overall quality of life.Weiterlesen

BackgroundPsoriasis affects approximately 2% of the global population, with the IL-17A-STAT3 pathway mediating abnormal keratinocyte proliferation and inflammatory amplification. Solanum lyratum (Bai Ying) has long been used for skin disorders, and its steroidal alkaloids have anti-inflammatory potential, though the mechanisms remain unclear.ObjectiveTo elucidate the molecular basis and cytological efficacy of S. lyratum steroidal alkaloids in exerting anti-psoriatic effects via the IL-17A/STAT3 axis.MethodsHPLC-MS-QTOF, network pharmacology, molecular simulation, and a HaCaT cell model with STAT3-siRNA assays were employed.ResultsEighteen components were identified; steroidal alkaloids showed high affinity for STAT3 and IL17RA. S. lyratum (5-40 μg/mL) enhanced cell viability, inhibited p-STAT3 (IC50 = 14.30 μg/mL), and attenuated inflammatory responses and keratinocyte proliferation.ConclusionS. lyratum steroidal alkaloids exert dual-targeted blocking effects on the IL-17A/STAT3 axis, supporting it as a potential therapeutic candidate for psoriasis.Weiterlesen

IntroductionTreatment of moderate to severe psoriasis typically requires the use of multiple systemic therapies over a patient's lifetime. The efficacy and safety of systemic treatments are typically evaluated in clinical trials; however, patient registries are increasingly used to monitor long-term outcomes of systemic therapies for psoriasis in real-world settings. Psoriasis registries also generate important real-world evidence about psoriasis treatment that may facilitate a greater understanding of outcomes outside of a controlled clinical trial setting. This study thus characterises the design and measures used in real-world studies of psoriasis treatment from patient registries and assesses its use in informing clinical guidelines and reimbursement decisions.Methods and analysisA systematic literature review was conducted to identify real-world observational studies that used psoriasis registry data. PubMed and Embase were searched for English-language studies published between January 2018 and January 2023. To assess how real-world studies, clinical guidelines, and reimbursement and coverage reports have informed practice, treatment, and reimbursement guidelines, a narrative review of recommendations was conducted. All results were screened by two independent reviewers (LP and TAS) using prespecified inclusion and exclusion criteria. Outcomes of interest were extracted into Excel, with all conflicts resolved through discussion/consensus. Tables displayed outcomes and research topics first by year, then by registry.Prospero registration numberCRD42023402431.Weiterlesen